Public Health and Ebola

The lethal Ebola virus was contained in one area in Africa before it began a geographical breakout to western Africa and beyond. What accounted for this migration of a historically, geographically static disease?

People and animals, such as monkeys, carry this disease and both migrate for various reasons. Monkeys have market value and may be captured in one area and transported to another, carrying diseases with them. People have become more mobile than ever and diseases can migrate at the speed of air travel. All countries should be prepared for an emerging viral attack by planning how they will handle an outbreak. This means modern equipment to quarantine patients and current training for health care workers to prevent them from contracting the disease.

The problem with any emerging disease in developing countries is their lack of capacity to manage both the medical care of the infected and the prevention of more infections. Fighting viruses takes technology, education and advanced protective equipment. Each are often in short supply in developing countries and can even be taxing on the existing resources.

The only method of controlling Ebola is containment in a quarantine environment where the patient is treated intensively and the health care workers are protected from accidental infection. Ebola will travel to new victims as people move. Anyone who is infected, and with the financial resources to receive treatment in a developed country, will spread the disease as they travel. Economic development does not make anyone immune from contact infection and the disease spreads to countries other than the point of origin.

A few countries, including the U.S. and other African countries, had Ebola patients in hospitals where they have never experienced the disease. Even with their vigilance, there was a risk that the virus would escape the quarantine to infect others, particularly health care workers and laboratory researchers. If Ebola is already present in a country, there is always a risk that the disease will begin its movement to other places. In other words, the Ebola outbreak has already broken out of its geographical containment hot zone, which is ground zero.

Is it wise to move Ebola patients to countries with modern medical facilities yet where the disease is not endemic? Conversely, should we move modern medical equipment and containment technology to the countries where the disease is considered ground zero?

In the U.S., government and public health are not integrated sufficiently to enable a rapid and effective response to mitigating another massive epidemic. The Ebola outbreak certainly demonstrated that the leadership of the U.S. Center for Disease Control and Prevention does not have the power to call for a localized or generalized quarantine. Our government officials, such as the president and state governors, also lacked the political will or understanding of risk to call for a quarantine of potentially infected people.

Submitted by Michael W. Popejoy


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