Ebola knocks on the doors of USA! What next?

Dr MK Raizada
Dr MK Raizada

Named after the river along which the virus is believed to have originated in 1976, Ebola virus disease (EVD) has resurfaced again with much more intensity. The numbers speak the story themselves – In comparison to the 1,716 cases of Ebola from 1976 to 2013, the recent Ebola outbreak in Liberia, Sierra Leone and Guinea has accounted for more than 10,000 cases, of which, close to 5,000 victims have succumbed to the virus.

At the time of writing, the Ebola disease is present in epidemic proportions in the above three west African countries, while five countries have been witness to travel-associated Ebola disease: Mali, Senegal, Nigeria, Spain and USA. In USA, as of October 24, four cases of laboratory-proven Ebola have been reported with one of them having died.

A flurry of statements every alternate day by the WHO highlights the gravity of the matter. While monetary and healthcare help from all corners of the world has been pouring into these three worst hit countries, the virus is slowly but surely spreading its reach to other parts of the world as well.
Recent cases of Ebola in the USA have sent shivers much beyond the country’s boundaries. For those who look up to the USA as the world leader, this news came as a shock. The first Ebola victim in the USA was reported from Dallas in Texas. Thomas Eric Duncan, a Liberian national who used to visit his family in Texas, died on 8th October.

The next two suspected cases to have been reported in the country were of the nurses who took care of Duncan, but both fortunately did not develop the disease. And just when it seemed like the disease won’t pick up any further, New York reported its first Ebola case. Craig Spencer, a physician, had just come back from Guinea after working with the humanitarian aid NGO, ‘Doctors Without Borders’.

As panic struck the city, Bill de Blasio, New York City’s mayor, came out to assure the locals that there is nothing to worry about. One of the other major reasons that have been worrying the city’s locals is that Spencer revealed that before being tested positive for Ebola virus, he did go to places within the city.
He traveled on different subway lines and went out with his fiancé to a number of public places. As of writing of this column, Dr Spencer seems to be having more symptoms of the disease. Four states – New York, New Jersey, Connecticut and Illinois – have enforced mandatory quarantine (of 21 days) on health workers arriving here from W African countries afflicted with the disease.

Though Ebola is not an air-borne disease, because of its contagious nature, if stricter measures are not taken, it can spread to many more countries. In modern era of air-travel, it is a real possibility! And it would be foolish to assume that it can’t possibly reach India.

India would rather be advised to take a closer look at its facilities and prepare for the deadly disease sooner rather than later. With a population like ours, India could easily turn into a happy breeding ground for Ebola. While steps such as thorough checking at airports have been termed as ‘adequate’ by the Government, cases such as Spencer’s, where his Ebola was tested a week after his US return, suggest that such measures could account for nothing. Preparing state of the art isolation centers is the least we must do to back up our claims.
I know this is being debated. But as a health professional, I have been espousing for restricting international travel to the affected countries. This seems to be one logical step to contain the disease along with providing the affected countries all the adequate technological and financial support.

The case fatality rates in current outbreaks have been high; varying from 50 to 70%, thus the scare it has generated is understandable. There is no specific therapy available and no vaccine is yet available. Under such circumstances, prevention and control of Ebola virus disease is important.
The author is a Chicago-based Board-certified practicing doctor (Neonatologist).

Dr. Munish Kumar Raizada