UPDATE: the case is confirmed, making it the first imported Ebola Virus Disease case diagnosed in the U.S.
http://www.wfaa.com/...
It's important to keep in mind that, quite likely, the patient did NOT arrive by land, or come here illegally. He probably flew here legally, after visiting the affected region.
It's also very likely that healthcare workers have been tracking down the man's contacts since he started showing symptoms.
Quite likely, the first of many scares and/or actual imported cases of Ebola Virus Disease.
Dallas hospital isolates possible Ebola patient
DALLAS — A Dallas hospital is holding a patient in "strict isolation" as that person is evaluated for possible exposure to the deadly Ebola virus.
In a statement issued Tuesday night, Texas Health Presbyterian Hospital Dallas said the patient was admitted based on symptoms and "recent travel history."
The hospital, located at Greenville Avenue and Walnut Hill Lane in Northeast Dallas, said it is complying with all recommendations from the Centers for Disease Control and the Texas Department of Health to ensure the safety of other patients and medical staff.
Preliminary results of tests on the patient are expected from the CDC on Tuesday.
(more...)
It's important to remember, of course, that there are several illnesses with similar symptoms. However, if the best happens and this turns out to NOT be a case of EVD, given the still-accelerating epidemic it's probable imported cases will be found at some point.
Speaking of the accelerating epidemic, the ProMed mailing list has some accounts this evening of how sluggish the response has been thus far, and some of the daunting conditions that must be overcome to rectify that situation:
On Sat [27 Sep 2014], a handful of troops from the US Navy's 133rd Mobile Construction Battalion led a bulldozer through thigh-high grass outside Liberia's main airport, bottles of hand sanitizer dangling from their belt loops. They had been digging a parking lot in the East African nation of Djibouti this month [September 2014] when they received a call to build the 1st of a dozen or more tent hospitals the U.S. intends to construct in this region. The soldiers started by giving the land a downward slope for water runoff -- "to keep out any unwanted reptiles," said Petty Officer Second Class Justin Holsinger. While this team levels the earth, superiors hash out the still-uncertain details of the American intervention here...
"There is no argument the disease is out in front of the response," said Ken Isaacs, vice president of programs and government relations for Samaritan's Purse, who, as an expert in humanitarian assistance, is leading. In terms of response, he added, "where we are today is where we should have been 60 to 90 days ago." Now, some of that help has arrived, partly in the form of a rare -- if not unprecedented -- U.S. effort. So far, that assistance largely involves leveling swampy grassland, unloading supplies and setting up tents.
. . .
This month [September 2014], the U.S. Agency for International Development [USAID] helped Liberia's government convert an unused conference room in a telecommunications building into a war room. The U.S. aid agency had 12 wooden tables built and helped restore running water to the toilets and brought in filing cabinets from the U.S. Embassy, said people involved in that effort. Last Tuesday evening [23 Sep 2014], James Dorbah Jallah, the national coordinator of Liberia's Ebola Task Force, sat in the war room trying to get bottled water delivered to an Ebola clinic that had run out. "It's not possible," said the supervisor of the government's motor pool over speakerphone. "Everybody's gone home."
[There seems to be a lack of urgency in the response to Liberia's Ebola Task Force efforts, and a severe lack of heavy equipment at the airport. - Mod.JW]
(article excerpted from the Wall Street Journal story
U.S. Troops Battling Ebola Get Off to Slow Start in Africa
And this evening, Pulitzer-Prize-winning author and journalist Laurie Garrett, who has made a decades-long career out of covering disease epidemics, including Ebola, writes an article worth reading in its entirety. A few excerpts:
Hollow Words and an Exponential Horror
... The tap is turned, and water is starting to flow. But the questions in this newly announced war on Ebola are now are twofold: Will personnel and resources reach West Africa rapidly enough to dam the viral flow, and will the nations of the world learn from this disaster to build institutions and long-term targets that prevent pandemics in the future?
According to Médecins Sans Frontières (Doctors Without Borders, or MSF) international president Joanne Liu, few of the promised personnel and resources have yet reached Liberia, Sierra Leone, and Guinea. Following Obama's speech to the U.N., she, in graphic detail, told the American network NPR how her organization's Ebola clinics were so overwhelmed that each morning staff were removing the dead from their hospital beds, taking a count, and then admitting that number of ailing from the queues of Ebola-sufferers lying outside hospital doors. Far from getting ahead of the virus, she insisted, the world's response is still racing to simply catch up.
. . .
...there is growing evidence that Sierra Leone has grossly undercounted its epidemic and may actually have a larger crisis than neighboring Liberia. Quarantines now encompass the majority of Sierra Leone's villages and much of its capital, Freetown.
. . .
We have dueling narratives emerging in the Ebola fight. On one side, the forecast horrors and MSF's reports from the ground present a dire, nightmarish story. On the other, mobilizations around the world of finances and resources suggest a world prepared to fight the virus into retreat.
The first horrible narrative is accurate, assuming the second one fails to materialize in rapid, coordinated fashion.
. . .
The reality is as Obama put it at the U.N. last week: This is an all-hands-on-deck moment for mobilization of the basics. Sure, keep searching for drugs and vaccines. Keep struggling to build UHC and better health systems. But right now the Ebola world needs doctors, nurses, paved roads, electricity, oil, medical supplies, cots, protective gear, hydration kits, food, helicopters, airplanes, logistics expertise, mass communications education, soap, disinfectants, and, most of all, cause for hope.
And it needs all these things, yesterday.
Tue Sep 30, 2014 at 5:40 AM PT: EDIT: Since I think i wasn't very clear, I should point out that most experts believe Ebola Virus Disease is unlikely to spread far in uncontrolled fashion in the U.S. (see Laurie Garrett's article, linked above, for a discussion on the conditions under which Ebola can thrive as a contagious disease). Anything is possible, of course: prior to this epidemic, most experts seemed to feel EVD would not become an epidemic in the first place, since it's so lethal and kills so quickly. But conditions under which it's spreading now are quite a bit different than in most parts of the U.S.
The intent of the diary is not to fearmonger. However, if EVD is not brought under control in Africa, repeated incidents of people inadvertently importing the virus to the U.S. in uncontrolled fashion, along with attendant contact tracing and isolation, will likely occur. Whether we want it or not, we will probably be receiving occasional reminders of what is going on "over there". With luck, those reminders will involve very few fatalities.
The real point, however, is what is happening in Africa has been and is increasingly a catastrophe. Africa has been making great strides; EVD threatens that progress.
Addressing poverty doesn't just help the poor. Epidemics of contagious disease, such as EVD, remind us that what affects the poverty stricken can impact all of us.
Tue Sep 30, 2014 at 1:40 PM PT: CDC is confirming that the case in Dallas, Texas is Ebola. More as I get it.