Ebola Travels From West Africa To America: How The World Dropped The Ball On Deadly Disease

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Eric Duncan -- Texas hospital sent him home with 103 degrees fever

[Commentary]

If you had any doubt in your mind that the world we live in today is anything but a global village where what happens to inhabitants of rural Guekedou must be of concern to urban Americans in Dallas, you might want to think again.

The first confirmed case of Ebola was reported in Guekedou, Guinea on March 24, this year. About six months later on September 30, Thomas Eric Duncan tested positive for Ebola in Dallas, Texas. In six months, Ebola had traveled from Guinea, to Liberia, Sierra Leone, Nigeria, Senegal, Spain, and the United States of America.

According to a report in The New England Journal of Medicine which traces the spread of the deadly Ebola outbreak, the first suspected case of Ebola in West Africa has been mysteriously traced to a two-year old boy who died on December 6, 2013. The boy died just a few days after falling ill in the village of Guekedou.

Within a week, the boy’s mother, his three-year old sister, and his grandmother all died one after the other.

All of them showed symptoms of fever, diarrhea, and vomiting, but no one knew what had befallen them.  Two mourners who had attended the grandmother’s funeral took the virus home to their respective villages infecting relatives and health workers. On March 24, three months later, the strange sickness was confirmed to be Ebola. By that time, dozens of people had died in and around Guekedou, and suspected cases were beginning to emerge in neighboring countries. Next door to the south-east in Liberia, several suspected cases had already been reported around the same time.

To the south across the border in Sokoma village, Sierra Leone lived a well-known traditional healer. Her famous healing powers were known across border towns in Guinea and Sierra Leone. As the outbreak continued to spread in Guinea, desperate patients struggling for their lives reached out to her for cure.  The healer reportedly traveled across the border to Guinean villages where she treated patients.

In the event, she became ill and died. Upon her death, hundreds of mourners reportedly came to her burial from nearby towns. Unknown to them that she had died of Ebola; many participated in the traditional burial rituals including touching of the corpse. Although the virus had been spreading in neighboring Guinea for two months, many died in Sierra Leone before the first case was confirmed on May 25, 2014. A young woman who had been admitted following a miscarriage tested positive for Ebola. A week ago, infection rates rose to as many as five cases per hour in Sierra Leone.

On July 20, 2014, Patrick Sawyer, an American working in Liberia arrived in Nigeria sick with Ebola. He died five days later leaving several people including health workers infected. In his wake, eight Nigerians have died of the virus. In Senegal, the only confirmed case of Ebola was registered in August after a returning student from Guinea fell sick with the virus. He survived and returned to Guinea. Both Nigeria and Senegal have reportedly been able to contain the virus since no new cases have been confirmed in both countries in more than a month. This is evidence that with the right response, Ebola can be contained.

Elsewhere in Spain, the virus continues to spread ever since a Spanish priest who had contracted the virus in Liberia, died under treatment in Spain. A nurse who claimed to have used all precautions while caring for the priest is now struggling for her life.

A couple of weeks ago, the U.S mainstream media had reported that Ebola was only a plane ride away from the United States. Indeed they were right. Thomas Eric Duncan arrived in Dallas Texas, a week after he had contracted the virus while helping a pregnant woman in Liberia. Despite showing up at a Dallas emergency room with 103 degree temperature and displaying symptoms consistent with Ebola, he was sent home with antibiotics after a few diagnoses. While at home he is believed to have come in contact with several people who in turn were in contact with others --up to 80 people may now be under observation.

What started in a remote forest in West Africa has become a global threat in about six months. From Guekedou to Dallas, over 8,000 thousand have been infected with the deadly virus and about 4,000 of them have died.

The death toll as of October 10, 2014 according to the World Health Organization (WHO) includes 2,316 in Liberia, 930 in Sierra Leone, 778 in Guinea, eight in Nigeria, and one in the United States. The disease has taken toll on many. Survivors have been left stigmatized while the children of the dead are left orphans.

Although limited in nature, the international community has come to the aid of West Africa. WHO, Doctors Without Borders, United States, China, United Kingdom, Cuba, and many more have provided funding, logistics, and manpower to help in the containment effort. But without adequately funded and comprehensive risk-based national plans; effective Ebola crisis management processes with adequately designed, implemented, and strictly monitored controls; and an “all hands on deck attitude” that significantly changes people’s way of life, defeating Ebola is going to be difficult.

Going by what experts have concluded, we may have missed the window of opportunity to contain Ebola before it got out of hand.  What we’ve come to learn is that the best way to contain Ebola is to stop it at its source. And according to experts, the first case of Ebola should have triggered aggressive awareness campaigns as well as quarantine and isolation of entire communities that were home to the initial outbreaks. Some countries in West Africa missed this opportunity as quarantines only started several months into the outbreak after hundreds had become infected across several communities. Regional governments’ Ebola containment efforts have been for the most part untimely, ineffective and weak.

On July 30, this year, I predicted in an article a possible doomsday scenario hoping it would never happen and still hoping it never does.

Under that scenario, entire communities would be left devastated as hospitals and Ebola treatment centers would be abandoned while medical practitioners flee for their lives; scores of Ebola corpses left to rot in the streets of towns and cities in West Africa; entire households and families wiped out; flights to and from the countries grounded; foreign countries would stop issuing visas, they would evacuate their citizens and shutdown their embassies; public utilities such as power and running water facilities would be abandoned leaving the countries dark and without water; and businesses and food markets will shut their doors.

Some of my observations have come to pass and it may get even worse. And right here in the United States, a scenario in which several Ebola cases will emerge and spread across the country is probable as long as Ebola continues to spread in West Africa.

It's imperative that it be contained in West Africa.

On September 24, 2014, the U.S. Center for Disease Control and Prevention (CDC) released a report predicting as many as 1.4 million cases of the Ebola virus in Liberia and Sierra Leone alone, by the end of January 2015 if the progression trend is not halted. If drastic measures are not taken, it will be catastrophic.

Evidence suggests that American hospitals are not as prepared although we are made to believe otherwise. On October 2, 2014, a nurse who had cared for Duncan, apparently using state-of-the art facility with full protective gears contracted the virus.

A survey of 1,700 registered nurses conducted by the National Nurses United in more than 35 states about Ebola emergency preparedness disclosed the following: 

    •    “76 percent still say their hospital has not communicated to them any policy regarding potential admission of patients infected by Ebola;

    •    85 percent say their hospital has not provided education on Ebola with the ability for the nurses to interact and ask questions;

    •    35 percent say their hospital has insufficient current supplies of eye protection (face shields or side shields with goggles) for daily use on their unit;

    •    39 percent say their hospital does not have plans to equip isolation rooms with plastic covered mattresses and pillows and discard all linens after use; only 8 percent said they were aware their hospital does have such a plan in place”.

These findings are consistent with some of the shortcomings that have led to the spread of Ebola in West Africa. A week ago, more than 1,000 health workers from around the world held a die-in in the streets of Las Vegas, Neveda to register their discomfort over inadequate preparedness in American hospitals, while calling for a significant escalation in the global Ebola containment effort in West Africa.

So, while we may live in the United States, we remain vulnerable until Ebola outbreak in West Africa is brought under control.

And Ebola still remains a flight away from the United States, if not already here to stay. From Guekedou to Dallas, and in-between, each and every one of us has a role to play. 

 

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