The Ebola Threat: Why Not an Outbreak Here?

Separation of continents no longer provides a secure buffer against the spread of communicable diseases.
Separation of continents no longer provides a secure buffer against the spread of communicable diseases.

Thanks to air travel, the separation of continents by thousands of miles of ocean no longer provides a secure buffer against the spread of communicable diseases from far-flung places.

Passengers from Africa, Asia, or South America who are infected with highly virulent bacteria or viruses can arrive in the heart of a bustling American city in less than a day. Given the numbers of people traveling between countries, the international dispersal of potentially lethal pathogens seems inevitable. One of those pathogens could be Ebola virus, which kills up to 90% of people infected with it. 

The World Health Organization (WHO) recently declared the Ebola outbreak in West Africa (namely Guinea, Liberia, Sierra Leone, and Nigeria) a global emergency. According to WHO, confirmed, probable, or suspected Ebola disease has been documented in 2,240 individuals as of August 16, and 1,229 have died from it. The U.S. has no guaranteed immunity from an Ebola outbreak, even though we may have an edge in containing the virus compared with the nations now beset by a severe Ebola outbreak. 

Complacency here could set the stage for an outbreak. A patient sickened with the virus could seek care in an emergency department, where medical staff might not immediately suspect Ebola infection and the usual precautions taken to prevent pathogen transmission may not be enough. 

Paramedics could respond to a 911 call for somebody who collapsed, bleeding, on a city street and never give a thought to the possibility of Ebola. Complacency is understandable. Many exotic diseases are endemic to distant countries afflicted by poverty and squalid living conditions. 

Additionally, we trust that our modern medical and public health infrastructure would rapidly contain the spread of a contagious disease before a major outbreak results. 

Travel-related dispersal of potentially deadly infectious diseases across great distances is not new. Europeans traveling by ship brought smallpox to the New World in the late 1400s and early 1500s, and it decimated the susceptible Native American populations. In those days, a ship's journey from Europe to the New World took a few months. 

Now, millions of people traverse oceans in travel times measured in hours, crisscrossing the globe relatively quickly by jet as they make countless visits to various destinations. Under the right set of circumstances, it would take just one of these individuals to be infectious with Ebola or something just as bad—or worse—to start an outbreak. 

Medical personnel, especially those on the front lines, must be vigilant.

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