Mr. Duncan, a person known to have been exposed to Ebola, shouldn't have been allowed to travel.

[pnwmom]

He was exposed on September 15th to an Ebola patient who died the next day. Everyone she had come into contact with, including Duncan, should then have been observed for three weeks and not allowed to travel during the 2 - 21 day incubation period. Instead, he was allowed to get on a plane on September 19th.

Liberia needs to take stronger measures to contain the disease and so do we. At the very least, Liberia should be questioning people at the airports for possible Ebola exposure.

http://www.nytimes.com/2014/10/02/us/after-ebola-case-in-dallas-health-officials-seek-those-who-had-contact-with-patient.html?
smid=tw-share&_r=1

Mr. Duncan may have become infected after his landlord’s daughter fell gravely ill. On Sept 15, Mr. Duncan helped his landlord and his landlord’s son carry the stricken woman to the hospital, his neighbors and the woman’s parents said. She died the next day.

Soon, the landlord’s son also became ill, and he died on Wednesday in an ambulance on the way to the hospital. Two other residents in the neighborhood who may have had contact with the woman have also died. Their bodies were collected on Wednesday as well.

Health officials in Dallas said Wednesday that they believed Mr. Duncan came in contact with at least 12 to 18 people when he was experiencing symptoms. So far, none has been confirmed infected.

SNIP

Health officials on Wednesday continued to track down other people who might have been exposed to Mr. Duncan after he began showing symptoms, on Sept. 24, and will monitor them every day for 21 days — the full incubation period of the disease. Most people develop symptoms within eight to 10 days. As a patient becomes sicker and the virus replicates in the body, the likelihood of the disease spreading grows.

[badtoworse]

1. Fully agree.

The more important question is what are we doing to prevent a recurrence.

[Aerows]

3. Amen to that! n/t

[DustyJoe]

37. nothing

Pretty well the same thing when patient zero of the aids virus brought that virus from africa to the US, absolutely nothing.

No travel restrictions from the african epicenter
No quarantine of travelers from the epicenter

and then bingo, we have ebola vector zero in Dallas

Just same non action with a different virus. People in charge learn nothing from the past.

[Aerows]

2. Hopefully this slip-up

and making it widely known will prevent a recurrence. I hope those children are okay.

[LisaL]

8. They were exposed to an infectious person.

I would be surprised if none of them got it, not the other way around.

[LisaL]

29. And he was puking all over the place before being loaded into the ambulance for his second visit.

What about people living in his apartment complex? Are they being monitored?

[FLPanhandle]

4. I think you are assuming a level of monitoring and tracking that isn't available there.

Even if airlines asked passengers before boarding, there is no way to know if the person is telling the truth when they invariably answer "no".

The world is highly connected now.

[kestrel91316]

6. People love to lie to public health investigators. I know this firsthand.

[pnwmom]

9. No, you can't eliminate EVERY case. But it would reduce the numbers.

It is no harder to ask that question than the others they routinely ask passengers.

[FLPanhandle]

25. I doubt it.

You are assuming someone trying to travel somewhere will willingly say something that will stop their travels.

Extremely unlikely.

[SheilaT]

5. There's a lot we don't know about Mr. Duncan and exactly what transpired.

If you don’t understand how profoundly different the cultures in Africa are from ours, you just don’t understand at least some of the reasons Ebola is spreading as it is. Laurie Garrett was on the Diane Rehm show on July 31st, along with several other health care experts. Garrett made some very important points, which I’m summarizing here.

These people do not understand the germ theory of disease. For them, “. . .when a disease hits a given family, it's because your ancestors committed some sin against some other family and they have leveled evil spirits against you.” She goes on to point out that there were terrible civil wars in that part of the world where “evil deeds were done on almost every single family by somebody during the course of the 1985 to 2003 outbreak of violence.”

Add to that foreigners, mostly white people, show up dressed in space suits and don’t want the locals to bury their dead in the traditional way, which involves contact with bodily fluids.

Here’s a link to the transcript of the show:
http://thedianerehmshow.org/shows/2014-07-31/understanding-deadly-ebola-virus/transcript I urge everyone to listen to the show or read the transcript.

I happened to listen to it on that day, and I've also read Garret's book The Coming Plague which came out in 1994 and is still completely relevant, as well as Betrayal of Trust subtitled The Collapse of Global Public Health. It came out in 2000, and again is totally relevant today. The second one details not only the breakdown of public health systems everywhere, especially in the United States, but points out how political instability makes things worse. These two books are now old enough that a lot of people have forgotten them, forgotten what they were saying which is 1, New disease arise and spread, and 2, If we don't properly fund public health, a lot of people will get sick and die.

[pnwmom]

12. Whatever their culture, modern airplanes land and take off in Liberia.

Andthe people who check passengers in are capable of asking the passengers if they've been close to anyone in the last 21 days who might have had Ebola. This man KNEW he had been , and he knew she had died, so if he had been asked, they would probably have discovered the information.

Yes he might have lied -- but this is all about REDUCING odds of transmission, not eliminating any chance. And a simple question like that could reduce the chance that a man like Duncan would fly.

[SheilaT]

34. But if you do not understand

that the close contact with someone who had that disease has put you at risk, then asking the question may not elicit the "correct" answer.

Read back what I posted from Laurie Garrett. And look at the link to the transcript, because she goes into more detail. We here are thinking with our 21st century knowledge, and a lot of other people out there simply don't have that knowledge.

Look at the otherwise well-educated people who should clearly understand the germ theory of disease and choose to ignore it. So if you think you get sick because your ancestors committed a sin and now evil spirits are after you, a question about whether or not you've been in contact with someone who has Ebola isn't going to register the same way.

[pnwmom]

36. No, but if he had told them he had been with an Ebola patient who died the next day,

then they probably would have asked him the obvious follow up questions, and would have figured out that he was probably exposed when he carried her to the hospital.

This wouldn't depend on him understanding science; it would depend on his veracity. And, yes, he could lie. But we shouldn't presume he would lie.

[uppityperson]

27. Thank you.

I am about ready to take a DU break. So many assumptions, so many fearful inaccuracies. I appreciate your posting this.

[LisaL]

7. Clearly we can't count on Liberia or Liberians to do the right thing.

But unfortunately we can't count on ourselves either.
Why not restrict travel from affected countries?
Nobody obviously is even tracking people that come in from these countries.
The hospital didn't even keep him in the first time despite being told he came from Liberia.

[MohRokTah]

11. you would have had to restrict travel from Belgium in this case.

Duncan's flight to the US originated in Belgium.

So now if we restrict all passport holders from affecteed countries, we don't cover those who were there, but hold a passport from a different country.

None of the countries in Africa affected by the Ebola outbreak have direct flights to the US.

[Barack_America]

10. Shit. If I were him, I would have lied about my exposure and been on the next plane.

To the US. I will likely die in Liberia and survive in the US. How are you going to prevent me from doing so?

[LisaL]

13. And whoever you would come in contact with doesn't matter?

He was exposed, and apparently he knew he was exposed. But he got on the plane and traveled here anyway.
Apparently you wouldn't care about who you would infect.

[Barack_America]

14. So, the infected and symptomatic missionaries shouldn't have been brought here?

They were actually contagious when they arrived on American soil, unlike this man.

Unlike this man, I would have self-quarantined and alerted the CDC upon my arrival, but yes, I would have traveled when I was asymptomatic and non-contagious (just as many physicians and missionaries returning from West Africa have done).

[LisaL]

15. The infected missionaries were brought in special isolation pods.

This guy came in on a commercial flight.
Now 20 people are being monitored for being in contact with him.
How many of his relatives will get it?

[Barack_America]

16. He wasn't contagious on the flight.

What about all the other asymptomatic Americans who have returned home?

[pnwmom]

19. Anyone who has been in close contact with an Ebola patient should be under close observation

for the 21 day incubation period, including any asymptomatic Americans who have returned home.

[SheilaT]

18. Most people, when faced with the question of their

own survival, even if it means infecting others, are going to opt for their own survival. It's nice to know that you would be a good humanitarian and stay put, but lots of others wouldn't.

[LisaL]

31. And that is how the deadly disease spreads far and wide.

Because people do things that infect others, even if they know they were exposed.

[SheilaT]

35. And many people in Africa do not

understand exposure the way you and I do. They don't have any concept of the invisible world of viruses, and -- especially since not every single person exposed gets sick -- they just aren't buying into our way of thinking.

Don't get me wrong. I'm not saying we shouldn't do our best to keep Ebola out and to help every single person who comes down with it not matter where they are or how they got it, but we are up against such a fundamentally different understanding of how disease works, that it's going to be very, very difficult.

[LostInAnomie]

17. No way it will ever happen unless you quarantine the area.

Those countries don't have the resources, and you will always have some no good sack of shit willing to expose others to death so that they have a better chance.

Unless we start refusing admittance to people that have been in the area, there's nothing to stop peoole from getting in.

[pnwmom]

20. They are already asking screening questions about their health,

their travel history, and taking their temperature before boarding.

Why can't they add a question asking if the traveler has been in close contact with an Ebola patient during the last 21 days? And anyone in that situation shouldn't be flying unless cleared by a doctor.

[LostInAnomie]

22. They could, but if you thought you might be infected...

... why would you tell the truth?

Lying gives you a chance to get to the US where you'll get better treatment. Telling the truth means you habe to stay in Liberia. There is no downside to lying.

[pnwmom]

23. I don't think we should PRESUME they'd all lie. And every infected individual who is prevented from

traveling helps reduce the number of future cases.

Besides, Liberians who have been exposed wouldn't necessarily know that the treatment outcomes are so much better here, since I'm being told over and over again that they don't even understand the germ theory of disease.

[LostInAnomie]

26. They wouldn't all lie, but a good number would...

... especially those with the means to leave and the education to know how germs work.

Leaving the border open only sets us up for more infections. Even if peoole were 100% truthful about their knowledge of their exposure risks, it wouldn't mean that they haven't been unknowingly exposed.

[Aerows]

21. It has been all over the news that 4 people in the US

survived Ebola. If I knew I was exposed to it and would probably die from it, I'd probably be hauling ass to the US, too, if I had the means.

People want to survive. Refusing to allow people in from the affected areas is the only way to prevent it from spreading everywhere, but I suspect the genie is out of the bottle at this point.

The bad part is that the more people it infects, the more opportunity it has to mutate.

[ecstatic]

30. "the experimental vaccine that was used on two Americans who contracted Ebola in Liberia this

summer is no longer available."

http://www.star-telegram.com/2014/09/30/6162320/cdc-team-mobilizing-to-come-to.html

It looks like the "experimental vaccine" will only be used on elites.

[LisaL]

33. They are calling it a vaccine incorrectly. It's a drug, not a vaccine.

Production takes a very long time since they have to grow special plants to produce it.
They only had a few doses and they were used up.

[Aerows]

38. They don't have any more of it n/t

[LisaL]

32. There is no more ZMapp.

[Aerows]

39. Exactly.

It will take several weeks to replicate more.

[dembotoz]

24. this past month as i visited my dying mom at the hospital

she had c-diff which is a nasty intestinal thing that is spread in a way like
ebola
i might have been exposed to it
the staff would have gowns and gloves
i did not
getting it would not have been with flashing lights
getting it would be shown by bad smelly poop

no magic moment with music
i did not get infected
i could have
but i did not
cut the man some slack

[uppityperson]

28. condolences on your mom.