Is Ebola in North America? | About That

Ebola is one of the deadliest diseases on the planet.Not because it's the most contagious, and not because it kills the most people.It's neither of those two things.But if you get infected with this particular strain of Ebola, there's no cure, no vaccine, and your odds of dying are quite high.Right now, the Democratic Republic of Congo is grappling with an outbreak.More than 600 suspected cases, more than 100 suspected deaths.

These numbers will keep going up, and the virus has spread to neighboring Uganda.

Early on Sunday, I declared a public emergency of international concern.over an epidemic of Ebola disease in the Democratic Republic of the Congo and Uganda.

The biggest question mark right now stems from the fact that the virus was spreading for possibly weeks before anyone even realized it was Ebola.

The challenge here is that this outbreak was identified quite late.

Meaning If one person got sick, infecting a dozen others before dying, and those dozen people went on to infect a dozen others each, and no one realizes this is happening?That's how epidemics start.

The late detection and quick spread of the virus are alarming health experts.

There's been weeks of the virus spreading and the true size of the outbreak is unknown.So let's talk about the potential for spread.Right now we know one American doctor was infected in a health care setting in the DRC.This person and six high -risk contacts were medically evacuated to Germany placed in a special isolation ward.What is unknown is whether Ebola could possibly have already arrived in North America.An Ontario resident is being tested after recent travel to East Africa.

Out of an abundance of caution is the language being used.And in another case, U .S.authorities are questioning whether a Congolese passenger on a flight from Paris to Detroitmight have been exposed.That passenger had also recently been to East Africa.

Once authorities realized the passenger had somehow been allowed to board the flight, it was diverted to Montreal.Now, this passenger was asymptomatic.No vomiting, no diarrhea, no bleeding.That's important, because that's what Ebola patients typically look like when they're most infectious, if this was an Ebola patient at all.So from Montreal, the plane full of people continued on to Detroit, while the Congolese passenger flew back to Paris.The World Health Organization does not currently believe this outbreak to be a global threat.

The situation is a public health emergency of international concern, but is not a pandemic emergency.

But they also freely admit the number of cases of deaths will certainly rise.And I can show you why.

We have now significant uncertainty about the numbers of infection and how far the virus has spread.I don't think that we have the patient zero for now.

The first known case of this Ebola outbreak dates back to April 24th.A woman reported symptoms including fever, hemorrhaging, vomiting, and intense malaise.According to the Congolese health minister, she died here in Bunia.That's a capital city of one of DRC's easternmost provinces.Then her body was repatriated here to Mongbalu.That's a gold mining town.

Lots of work, lots of people.Highly mobile, across borders.Now, around this point, there are two things happening, both incredibly unhelpful.In Bunia, another person gets sick on April 26th, two days afterthe first woman died.According to Africa's CDC, samples were sent to Kinshasa, the country's capital.

I should point out, it's well over a thousand kilometers away, in a country known for its poor infrastructure.But they were wondering, is this Ebola?Especially after the very first tests in Bunia focused solely on the more common Zaire strain of the disease.And those results had come back negative, not Zaire strain.This would have been reassuring.Meanwhile, hours away in Mongvalu, there's a problem with the original woman's coffin.

This series of moments, the woman's death, her repatriation to Mongvalu, the handling of her body, her funeral.

It's all believed to form a core piece of how this disease spread undetected.Because just imagine what all of that looks like.The washing and dressing of a body, sometimes by family members, at the service itself.kissing or touching the face, embracing the deceased, close intimate contact, while the virus is still highly contagious.

Even a drop of it can be quite contaminating to another individual.It's fairly easy to come into contact with as part of either routine care or being a part of a family member or in a burial practice.

It wasn't until 11 days after this woman's death, the World Health Organization would first learn Around 50 people had now died in Mongolia, and the fact that four of them were health workers is important, because Ebola is known as a disease of compassion, in that it doesn't spread by wafting from stranger to stranger.to stranger through the air.It spreads through close contact.And when a patient is incredibly sick, They're vomiting, they're having significant diarrhea, they may be bleeding.In these cases, Ebola spreads through close care.It is a disease that is, in a way, most dangerous to doctors and nurses.

The woman who died on April 24th, the first known case, she was a nurse, which also might be one reason experts don't think she's patient zero.She was caring for the sick.possibly treating people from more remote areas where Ebola more often originates, where there's more interaction with the wild animals who are the natural hosts of the virus, where people get sick, where surveillance systems may be weak, where transmission can continue quietly for weeks before anyone realizes what's happening.You might be wondering at this point, for a country that understands and has faced this disease many times in the past, Why didn't they catch it sooner?And for that matter, why did initial lab tests come back negative for Ebola, if this is Ebola?Further testing has since confirmed this was not Zaire Ebola.

It's Bundibugyo Ebola.That's a much rarer strain that Zaire testing does not catch.Zaire vaccines don't work.Zaire drugs don't help.

So we've seen only about, I believe, three outbreaks of this in history, which is challenging given that, you know, a lot of the work, the research and the tens of thousands of patients experience has been dedicated towards Zaire.

There aren't that many laboratories in the DRC that can even test for this rare strain of Ebola.

When you don't see a lot of those cases.you're not going to test for something that you're not seeing all the time.You're going to test for what it is you do expect to see.

So far as I can tell, they have the means all the way in the west, in Kinshasa.And while there are closer labs, like in Goma, for example, this is a part of the country that is also fractured by a war, contested and controlled by the Rwanda -backed M23 rebel group, which, at minimum, I point out to explain why experts point out again and again, the state presence where the outbreak has hit hardest is incredibly weak.and that people from Mangbalu have been allowed to move about freely when they should be restricted to prevent the spread of the virus.There are more than 100 militias active across just a small handful of eastern provinces.Sometimes they are violent against aid groups, which has forced many of them to leave.Logistics are difficult and, making matters worse, The world's foremost helper when it comes to urgent medical crises like these is nowhere near as helpful as it once was.

The United States has only very belatedly got involved, has mobilized only a really comparatively tiny amount of funding.

Countries like the DRC rely on countries like the United States to help it fulfill very basic needs.

They're not making anything like the funding or material support commitment that historically you've seen the U .S.

make.And when it comes to people, expertise, boots on the ground, Just think about those American organizations we're used to seeing mobilized in previous outbreaks.In 2018, during Trump's first term.In 2014, under Obama.But today, Trump administration cuts mean USAID no longer exists.The CDC's Global Health Center was slashed.

Hundreds of employees lost their jobs.One of Trump's first actionsin office was to withdraw the United States from the World Health Organization.

On every previous Ebola outbreak, on every other big health crisis like this, historically the United States has been the leader.They have convened an immediate sort of leadership task force that directed all of the people who were going to intervene.They had the surveillance network.Usually it was the United States, frankly, that picked up the first signs of an outbreak like this.And the United States has supply chain expertise like nobody else in the world.And historically, they have stood that up within days.

The head of the Africa CDC's emergency response group said to me yesterday, the Americans have shown themselves to be an unreliable partner and people now make their plans accordingly.

What this all adds up to is a truly dangerous situation on the ground in Africa.but also one that is frustratingly difficult to put in context when you live far, far away.Except it's never really that far away.

and low at the global level.

That being said, this virus has gone over at least one border and potentially many more.It is an unstable zone.As cases amplify, they may get closer to international borders.I wouldn't say that the risk is high to cause a global epidemic, but at the same time, there are always these one -off circumstances that could lead to someone showing up in another country.