In: Nursing
With air travel as common as it is, borders don't mean all that much when it comes to disease. It's entirely possible — though by no means certain — that at some point, someone infected with Ebola could get on a plane and land in the United States.
Threats to the Unites States by Ebola Virus Outbreak
1) The first 24 hours:
identify the outbreak
The most likely way for Ebola to arrive in the United States would
be an infected person flying from West Africa who has Ebola but
doesn't even know it. Ebola can hide in a person's body from two
days to three weeks before symptoms emerge. And people don't
transmit Ebola during that incubation time — they're only
contagious once they show symptoms. Once an initial Ebola patient
starts feeling sick, the person will probably seem at first like he
or she has the flu or traveler's diarrhea. (Some of the more famous
symptoms of Ebola, like bleeding from orifices, don't tend to come
on until later. And bleeding doesn't even happen in about half of
cases.)
Although the patient would now be contagious, that doesn't mean that it's exceptionally easy to catch. Ebola doesn't spread through the air, and it's harder to catch than things like the flu. You can't get it just from being on the same plane or in the same public space. The only way to get Ebola is to touch a patient's bodily fluids, like vomit, diarrhea, sweat, saliva, or blood. Now would be when speed and public awareness plays a big role, no matter where in the world an Ebola patient is. The patient or someone around her will have to figure out:
If people realize that this might be Ebola early on, they should be able to avoid getting infected by keeping away from the patient's bodily fluids. But if that doesn't cross their minds for a while, people will be more likely to get the virus by accident. In that first day of symptoms, every hour counts.
2) The next step: isolate
the patient
In US hospitals, any suspected case of Ebola would be treated as a
potential risk until tests come back negative. This means that
standard procedures to protect other patients and health-care
workers from the patient's bodily fluids would be put into place.
Because Ebola doesn't spread through the air, hospital workers
wouldn't have to wear respirators or what you might think of as
full Outbreak gear. However, they would protect their body and face
from fluids that might splash on them, using things like gowns or
full body suits, masks, gloves, and goggles. Anything that touches
the patient would be sterilized or disposed of in a safe manner.
And if the patient dies, the body would be carefully handled so
that it won't be a danger to anyone, either.
Better adherence to these safety guidelines is one reason why the virus wouldn't spread as quickly in the United States as it has in West Africa. For example, over there, some health-care workers have gotten infected, most likely because the rules weren't followed as closely. And there's actually a reason for that — people who are supposed to wear protective suits in 100°F weather will get extremely hot and might cut corners, says Michael Osterholm, of the Center for Infectious Disease Research and Policy at the University of Minnesota. But US hospitals are more climate controlled, he says, and even that small difference makes a breach less likely.
3) Track down other
potential patients
Detective work is a major part of controlling a disease like Ebola.
Experts would interview the patient, her relatives, and other
potential close contacts to monitor them and make sure that they
don't spread the disease to others. Officials will then suggest
various options for these people, depending on the level of risk,
including watching and waiting, isolation at home, and testing for
infection.
Tracking down contacts has been especially problematic in West Africa in ways that unlikely to happen in the US. An editorial in the major medical journal The Lancet says "The geographical spread of cases and movement of people in and between the three countries presents a huge challenge in tracing those who might be infected." And the World Health Organization says that "low coverage of contact tracing" is one key problem it uncovered in a recent assessment the Ebola response in Liberia.
4) Keep patients in hospital
until they're not a threat
It's important to remember that about 40 percent of the patients in
this Ebola outbreak have survived. There's no specific pill or shot
that will make an Ebola infection go away, but doctors can try to
make the patient comfortable, give IV fluids, and treat symptoms.
To prevent Ebola from spreading, health authorities wouldn't
release a patient from the hospital until it's clear that the
person won't be a danger to others. This might seem intuitive, but
it hasn't always happened in West Africa. For example, the BBC
reports that there are several missing patients in Sierra Leone —
where some people don't trust that medical care will help them.
That, obviously, increases the odds that the outbreak will
spread.
The best case scenario and the worst case
scenario
To sum up, the best case scenario is that someone coming back from,
say, Guinea, realizes that he might possibly have Ebola as soon as
he starts feeling sick. Everyone makes sure not to touch her vomit
or diarrhea or other fluids. And the outbreak ends with just one
patient.
The worst case scenario is that this person is ill for days and in contact with a whole lot of people before anyone realizes that something unusual is going on and brings her to a hospital. But it's still unlikely that Ebola will get farther than a local problem in one city or town.