05 August 2014 (Primary Source) Concerned about Ebola? You’re worrying about the wrong disease

A deadly disease is set to hit the shores of the US, UK and much of the rest of the northern hemisphere in the coming months. It will swamp our hospitals, lay millions low and by this time next year between 250,000 and 500,000 worldwide will be dead, thousands of them in the US and Britain.

Despite the best efforts of the medical profession, there’s no reliable cure, and no available vaccine offers effective protection for longer than a few months at a time.

If you’ve been paying attention to recent, terrifying headlines, you may assume the illness is the Ebola virus. Instead, the above description refers to seasonal flu – not swine or bird flu, but regular garden variety influenza.

Our fears about illness often bear little relation to our chances of falling victim to it, a phenomenon not helped by media coverage, which tends towards the novel and lurid rather than the particularly dangerous.

Ebola has become the stuff of hypochondriacs’ nightmares across the world. In the UK, the Daily Mirror had “Ebola terror as passenger dies at Gatwick” (the patient didn’t have Ebola), while New York’s news outlets (and prominent tweeters) experienced their own Ebola scare.

Even intellectual powerhouses such as Donald Trump have fallen into panic, with the mogul calling for the US to shut off all travel to west Africa and revoke citizens’ right to return to the country – who cares about fundamental rights during an outbreak? Not to be outdone, the endlessly asinine “explanatory journalism” site Vox informed us that “If the supercontinent Pangaea spontaneously reunited, the US would border the Ebola epidemic”.

Ebola is a horrific disease that kills more than half of people infected by it, though with specialist western treatment that death rate would likely fall a little. It’s unsurprising that the prospect of catching it is a scary one. The relief is that it’s not all that infectious: direct contact with bodily fluids of a visibly infected person is required, meaning that, compared with many illnesses, it’s easily contained.

Even in the midst of the current outbreak – the worst ever – the spread of the disease has not been rapid in west Africa: around 400 new cases were reported in June, and a further 500 or so in July. This is a linear spread, meaning each person at present is infecting on average around (actually just over) one additional person.

Far more worrying are diseases that spread exponentially: if one infected person spreads the disease to two or more on average, the illness spreads far quicker and is a much more worrying prospect, even if mortality is considerably lower.

The 800-plus deaths from Ebola in Africa so far this year are indisputably tragic, but it is important to keep a sense of proportion – other infectious diseases are far, far deadlier.

Since the Ebola outbreak began in February, around 300,000 people have died from malaria, while tuberculosis has likely claimed over 600,000 lives. Ebola might have our attention, but it’s not even close to being the biggest problem in Africa right now. Even Lassa fever, which shares many of the terrifying symptoms of Ebola (including bleeding from the eyelids), kills many more than Ebola – and frequently finds its way to the US.

The most real effect for millions of people reading about Ebola will be fear and stigma. During the Sars outbreak of 2003, Asian-Americans became the targets of just that, with public health hotlines inundated with calls from Americans worried about “buying Asian merchandise”, “living near Asians”, “going to school with Asians”, and more.

Similarly, during the H1N1 “swine flu” outbreak, which had almost identical spread and mortality to seasonal flu, patients reported extreme fear, prompted largely by the hysterical coverage.

In the coming months, almost none of us will catch the Ebola virus. Many of us, though, will get fevers, headaches, shivers and more.

As planes get grounded, communities are stigmatised, and mildly sick people fear for their lives, it’s worth reflecting what the biggest threat to our collective wellbeing is: rare tropical diseases, or our terrible coverage of them.

04 August 2014 (Primary Source) "Patient at Mount Sinai Has Ebola-Like Symptoms, Hospital Says"

Heightened concern about the Ebola virus has led to alarms being raised at three hospitals in New York City. But so far, no Ebola cases have turned up.

The latest episode involved a man who had recently been to West Africa, and who went to the emergency room at Mount Sinai Hospital in Manhattan late Sunday with a high fever and gastrointestinal problems, the hospital reported on Monday. He is being kept in isolation at the hospital while tests are being done for Ebola, a deadly disease, but also for other illnesses that could have caused his symptoms.

But the city’s health department issued a statement on Monday saying that after consulting with Mount Sinai and the Centers for Disease Control and Prevention in Atlanta, “the health department has concluded that the patient is unlikely to have Ebola. Specimens are being tested for common causes of illness and to definitively exclude Ebola. Testing results will be made available by C.D.C. as soon as they are available.”

At NYU Langone Medical Center last week, a patient who went to the emergency room with a fever and who mentioned a recent visit to West Africa was given a mask and moved to a secluded area, said Dr. Michael Phillips, the hospital’s director of Infection Prevention and Control. But further questioning revealed that the patient had not visited any of the affected countries, “so we stopped right there,” Dr. Phillips said.

At Bellevue Hospital Center last week, a patient was placed in isolation, but it quickly became clear that he did not have Ebola.

An Ebola outbreak centered mainly in three West African countries — Sierra Leone, Guinea and Liberia — has infected more than 1,300 people and killed more than 700 of them. American health officials have advised against nonessential travel to the three countries, and have urged doctors to be on high alert for people who return from the region with symptoms like fever, diarrhea and vomiting.

A Mount Sinai spokeswoman, Dorie Klissas, said that to protect the patient’s privacy, the hospital was not making public his occupation, which country he had been in, whether he had been exposed to a patient with Ebola there, or whether he had close contacts like family members, friends or co-workers who were also at risk. Officials said they expected the results of the tests for Ebola in 24 to 48 hours.

In a statement to employees, hospital officials said that Ebola was spread only by direct contact with bodily fluids, and that infection control measures were being employed to protect patients and staff members.

In the Bellevue Hospital Center case, Dr. Ross Wilson, the chief medical officer at the New York City Health and Hospitals Corporation, said that the man had symptoms also found in Ebola patients. He had arrived at Kennedy International Airport from West Africa and was being detained by security personnel at the airport for an unrelated matter when he fell ill.

“He developed a headache and fever,” Dr. Wilson said. He was transported to Bellevue, but the people who brought him there did not suspect Ebola.

“We immediately put the dots together,” Dr. Wilson said.

Following the guidance of the Centers for Disease Control and Prevention, every patient entering one of the city’s hospitals who has fever, headache and other symptoms associated with Ebola (as well as countless other ailments), is asked two new questions.

“Have you traveled to or from West African countries in the last 10 days? Have you been in contact with an Ebola patient or with anyone who has been in contact with an Ebola patient?”

03 August 2014 (Primary Source) U.S. doctor quarantines himself at home after treating Ebola patients in Liberia

Patients are only contagious when they show symptoms, not during the incubation period, according to the World Health Organization.

“I was not concerned that I was contagious when I left Africa, and not concerned at this time because I have no symptoms of the disease,” Jamison said.

The retired pediatrician said he was volunteering with Medical Teams International.

“It was very stressful and emotional to see these things in Liberia,” Jamison said.

Liberia is one of three nations battling an outbreak of Ebola. The World Health Organization says Ebola has been confirmed or suspected to have infected more than 1,300 people, with more than 700 deaths in West Africa this year.

So far, the disease has been confined to Liberia, Sierra Leone and Guinea. One man died in quarantine in Nigeria after leaving Liberia.

Two American medical workers infected in West Africa will receive treatment in Atlanta.

Dr. Kent Brantly arrived in Georgia on Saturday aboard a specially equipped plane and was taken to Emory University Hospital.

The plane is headed to Liberia to retrieve the other American, fellow missionary Nancy Writebol.

The treatment of the patients will be conducted under strict safety protocols, U.S. officials said.
There’s no cure for Ebola. The most common approach is to support organ functions and keep up bodily fluids such as blood and water long enough for the body to fight off the infection.
Despite the risks, Jamison said he’d return to West Africa to help combat Ebola.