Ebola Confirmed in Texas!

Since my last blog, Ebola has not only worsened in West Africa, but the virus has finally hit the U.S. This is the first time Ebola has been diagnosed on U.S. soil, a scary reality to say the least! You may remember two Ebola patients being admitted to Atlanta’s Emory hospital in early August. These cases were different, however, in that they were diagnosed in Africa and consequently isolated prior to entering the United States. In the present case, the infected person arrived to Texas from Liberia on September 20th, but was not admitted to a hospital and isolated from the public for entire week! This is after the patient had already visited Texas Health Presbyterian Hospital on September 26th complaining of Ebola-like symptoms. The medical staff was informed of the patient’s recent arrival from West Africa and still sent the patient home, albeit with pain killers and antibiotics. A major failure of the screening system perhaps? 

The most pressing question right now is, do we have cause to panic? I don’t personally believe so, and it appears many experts don’t either. Though I was admittedly alarmed to here this news yesterday, the reality is that this virus remains difficult to contract from person to person. The explosiveness of the West African epidemic is a result of variables other than the simple virulence and communicability of the disease, but rather to issues such as preparedness, infrastructural capacity, and availability of resources, as noted in my earlier blogs. These factors do not pose the same obstacles in the U.S.
About a month ago, I predicted future Ebola case and fatality rates through the weeks of September based on the virus’s rate of spread throughout the preceding five months. Now a month down the road it is time to reflect on those predictions and see where things stand. Frighteningly, the predictions were an underestimate and not an overestimate of the true chaos continuing to unfold. Under predicting by about 14%, the true death toll by Sept. 18th (the most recent data) stands at 2,833. Rising even more sharply, the number of cases by this date stands at 5,883. Since disease statistics are usually delayed, and because WHO has been releasing Ebola data less frequently in recent weeks, there is no way to compare my Oct. 1st predictions at the moment. Although they are certain to represent even greater underestimates if the rate of Ebola’s spread has continued uninterrupted. I will keep you up to date as new information is released by WHO and CDC. In the meantime, let’s cross our fingers that diligence and precaution prevent any further spread of Ebola to or throughout the United States and that the situation in West Africa gets under control! 

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                                                                                    -Shahir Masri, MS


  1. Wow! What an interesting blog post. One thing I did not know before reading this was the increasing rates of Ebola. I thought ever since Ebola was diagnosed in West Africa, the statistics were decreasing because health officials had it under control. It is to my surprise to hear the rates actually increased. Regarding the screening system that failed to take initiative of the patient with Ebola, has the U.S system improved since that case? Have any new regulations, standards, or laws been put in place to better control situations like this in the future?

  2. Hello,
    Great post on the Ebola issue. This particular issue is an interesting one to consider. Ebola is labeled as a West African epidemic. Given the migration patterns of disease carrying insects as the world warms, it would be naive to think that the US doesn't have major reason for concern. I learned from this article that the death toll from Ebola was underestimated by 14%. This number went from 2,833 deaths on September 18th to 5,883 on October 1st. The increase in deaths is alarming. What is even more alarming is the unpreparedness of the US health care system to even treat and isolate a deadly condition such as Ebola. When the Texas Health Presbyterian Hospital in Dallas reported failure to adequately handle an Ebola case, hospitals everywhere secretly would of experienced the same thing. I was working at a well established hospital in MI around this time, and Ebola protocols weren't implemented until Spring 2015. Given the warming of our globe and the possibility of new diseases that we don't have any current means of treating, how can we boost national protocols to ensure preparedness? Fast forward to 2016 and we have governments telling their women not to get pregnant for the next two years due to the Zika virus. If the climate crisis isn't addressed at every level we can expect more deadly and aggressive diseases to deal with in the future.

  3. I remember following this story when I started working at my hospital, and initially when it was still restricted to the African continent I was convinced that Ebola would not become a global epidemic. Even after it had spread to the continental United States, I was still convinced that the Ebola virus would not become an epidemic like it had in Africa. As you had pointed out, several variables not related to the biology of the virus allowed Ebola to become epidemic in Africa, and nonepidemic in the United States. From what I observed in the media, government reports, and academic journals, it appears that the cases seen in Texas are due to an individual traveling from an epidemic region of Africa (at the moment the individual was asymptomatic). After gaining experience in my hospital laboratory, I feel that it is likely that it is likely that Ebola in Africa spread because of the lack of sufficient facilities or services equipped to handle Ebola. In the United States, healthcare facilities and staff are generally better equipped to handle Ebola, and thus better able to prevent any sort of widespread epidemic. What I did not know about Ebola, or perhaps not really considered, is that even with infrastructure and greater available resources, widespread implementation of precautions against Ebola were not put into place until the it is proven that the disease could come into the United States. It is frustrating that we see this with the Zika virus, as it was not until there were dozens of cases in the Continental United States that research into specific tests for Zika were developed. Why is it that the United States healthcare system waits until there is clear and present danger before implementing precautions that should have been implemented earlier?

  4. Jorrel,
    You bring up a great questions and one I too was pondering upon when I returned from the global experience trip in Cuba last month. Simple answer is: culture.
    When I was in Cuba their primary and first tier in health care is Primary and Preventative care. Hospitalization and specialists are secondary. When a person gets sick they have access to free health care. Pregnant women are required by law to visit their OB at least 16 times unless the physician is requiring more. Children get their immunization shots, no exceptions!
    In contrast, the U.S. culture is very individualistic. We are focused on OUR rights, OUR property, OUR right to liberty and to choose. As a result, the government cannot force a person to see their physician when they get sick nor would a person necessarily seek medical attention until they become symptomatic. That is our right as U.S. citizens. As a result, the government cannot quarantine a person without due process as we have a constitutional right to life and liberty. Also, since U.S. citizens most likely not see a primary care physician until they become symptomatic, by the time a disease is caught it may be too late. If a person does not see their physician, no incidence of any disease occurring will be documented. Chances are by the time a virus like Ebola is documented, that virus may have infected many people who are probably asymptomatic.
    When I studied healthcare processes in Cuba, it was apparent that their model of focusing on primary care fit in to their Socialistic Communist government. In a Capitalistic society like the U.S., people, not the government or healthcare providers, focus on treatment. We want to do what we want and when we get sick, give us a pill!

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