America has officially become the 7th country to be affected by the 2014 Ebola outbreak after confirming that a suspected case in Dallas, Texas has tested positive. The Center for Disease Control dispatched an Ebola team earlier today and has already begun contact tracing and surveillance. This is the first case of Ebola to occur in the United States. Previously the USA has treated patients who had returned from affected African countries but they had transported in full isolation. The announcement today marks the first serious risk of an outbreak in the USA.
Nigeria and Senegal have recently both successfully contained similar outbreaks in their countries after visitors to and from the so called “hot zone” which includes Liberia, Guinea and Sierra Leone entered and returned to their nations. The virus has claimed more than 3000 lives this year already with a terrifying mortality rate of 70%. Many Scientists and Doctors have repeatedly warned that the disease could spread beyond Africa and called for a global response to the growing epidemic.
The case has resulted from a Doctor who had recently returned from a high risk zone where they had been volunteering. The patient showed no symptoms of Ebola upon returning the USA and immediately sought medical attention when they later developed minimizing the risk for transmission to the general public. The Doctor’s family and close friends will be placed under strict surveillance and isolated at the first sign of possible symptoms.
The USA is one of the most developed countries in the world with a well funded medical system and sufficient resources to successfully contain a potential Ebola outbreak. The first Ebola case in America will put the system to the test with every possible precaution being taken to prevent a full blown epidemic.
UPDATE: Multiple sources have confirmed the case now including CNBC, CNN & Bloomberg
UPDATE: CDC to hold a press conference at 17:30 ET
The Center for Disease Control has dispatched a team to Dallas raising suspicions that the suspected Ebola case reported on Monday will be confirmed in the upcoming hours. Previous suspected cases have not resulted in the dispatch of a team. Dallas County Health officials have confirmed that a CDC team is en route from Atlanta in case the test results are positive. Samples for testing are sent to the CDC in Atlanta with a typical turn around time of 24-48 hours before results are confirmed. It has additionally been reported that a sample was sent to Austin for testing as well.
Contact tracing has already begun according to Health and Human Services officials with investigations under way to begin confirming the list of people that have had contact with the patient. The Doctor who has spent several days in the general public was admitted with “Typical Ebola Symptoms”. The official test results are expected later today but it is feared that there is a high probability of a positive result based on the history and symptoms of the patient.
This will be the first test of the capabilities of the American Health Care system as previous cases isolated in New York and Sacramento tested negative and did not attract sufficient interest from the CDC to warrant a response team deployment. If the case is confirmed as positive the announcement will likely come from the Executive Leadership of the USA in an official Press statement. The hospital involved has confirmed that maximum precautions are currently in place with all CDC recommendations being followed.
No details regarding the patient have been released as yet except where required as part of the contact tracing and surveillance process.
Sierra Leone released an official update yesterday showing a climb in the total number of Ebola cases to 2317 for the period between the 23rd of May 2014 and the 28th of September 2014 resulting in 570 reported deaths. The case fatality rate (CFR) has been reported as 25% by the Health Ministry. Port Loko, Kenema and Bombali remain particularly hard hit reporting several new cases in recent days.
The CFR report is questionable due to the fact that Ebola typically has a very high mortality rate with several strains exhibiting mortality rates of 90%. The under-reporting appears to be as a result of the counting method applied in the country which allegedly does not include deaths occurring outside of Government facilities in the official tally. The 2014 Ebola outbreak is reported to have killed 70% of its victims so far inferring that the death toll in Sierra Leone should be closer to 1622. The report also indicates that a total of 13687 contacts have been identified over the course of the outbreak.
The Ministry of Health and Sanitation in Sierra Leone issued a further press release yesterday after receiving information that residents of Bombali, Port Loko and Koinadugu had begun celebrating the end of Ebola. The Ministry reminded residents that Ebola remained a high threat and that no cure has yet been confirmed. The citizens were told that the state of emergency prevented them from gathering in public and basic Ebola prevention guidelines were reiterated.
Earlier today the Foreign Minister of Sierra Leone met with the United Nations Secretary-General Ban Ki-moon to discuss the Ebola outbreak. Joint efforts between the UN and Sierra Leone were discussed in addition to the current impact on West African Nation.
Sierra Leone Report 124 29 September 2014
A Doctor who had been exposed to the Ebola virus in Africa has been admitted to a hospital in Texas after exhibiting symptoms similar to those of the disease. The early symptoms of EVD are similar to several other diseases including Malaria and the Flu.
Texas Health Presbyterian Hospital has placed the Doctor, who volunteered in Sierra Leone, in isolation on Monday evening with test results expected during the course of Tuesday. The patients blood samples have been sent to the Center for Disease Control in Atlanta for PCR analysis. The cautionary stance taken by countries outside of the affected West African countries is in line with international recommendations designed to prevent further spread of the virus which could lead to a global outbreak.
The 2014 Ebola outbreak has seen 4 patients treated on American soil specifically in Nebraska and Georgia but if the case in Dallas tests positive it would be the first requiring full contact tracing and surveillance. Although initial results are expected on Tuesday the patient will likely be kept in isolation until a final confirmation is available. In the notable case of Dr. Kent Brantly initial testing for the virus was negative. Dr. Brantly was treated in Atlanta and went on to recover from Ebola.
Recent predictions have indicated as many as 20000 cases of Ebola by the end of October 2014. Only one model has been designed to predict which countries have a high risk for an outbreak. The model predicts that Ghana and the United Kingdom have the highest probability. The model also predicts that the USA could be exposed to the virus through immigration resulting in a small outbreak but further shows relatively low risk compared to several other countries including the aforementioned and Gambia.
UPDATE: This case is officially the first on American Soil
UPDATE: Although initially reported to be a HCW it was later confirmed that the patient was not a doctor
Ebola is a worldwide challenge and requires intervention and assistance from the global community. South Africa is arguably one of the most capable and geographically suitable countries when considering potential aid yet it has remained a small contributor to date.
The South African Department of Health sent a mobile testing laboratory to Freetown in August and contributed little over 3 million US dollars from public coffers calling on the public and private industry to provide an additional 20 million dollars. The Private sector has been slow to react and has, to date, collectively contributed less than 1 million dollars in more than a month after the Government called for assistance.
South Africa has committed to provide a 40 bed treatment facility in Freetown including qualified staff to run the unit. The Chief Director of communicable diseases at the Department of Health, Dr Frew Benson, has been quoted saying “speed is of the essence”. The South African Department of Health has already dealt with a suspected case of Ebola earlier this year when a traveler from Guinea was quarantined and tested negative for EVD.
Travel restrictions have remained in place with entry into South Africa from the affected countries severely limited. Strict monitoring occurs at the International Ports, most notably O.R Tambo International ,where fever scanners have been in use since the 2009 Flu Pandemic. To date no confirmed cases of Ebola have been reported within South African borders. The last reported case of Ebola in South Africa occurred in 1996 when a health care worker returned from Gabon carrying the disease.
Frans Viljoen, Director of the University of Pretoria’s Center for Human Rights has been critical towards the South African response to Ebola arguing that the country should be playing a major role in the efforts to stop the spread of the disease not only in West African countries but in the Democratic Republic of Congo as well.
The National Institute for Communicable Diseases (NICD) has noted that there is minimal risk of Ebola transmission in South Africa. The NICD considers Ebola to be a low transmission risk virus since it is not airborne and requires physical contact for transmission. Critically several global organizations have questioned the current understanding of Ebola transmission arguing evidence of short range aerosol transmissions.