Fact v. Fiction: How likely is an Ebola outbreak in the U.S.?

Scott Gottlieb ---- Forbes (commentary) 

Given the scope of the Ebola outbreak unfolding in Western Africa, it seems possible that a case will eventually emerge in the U.S. We could even see an isolated cluster of infections in an American city.

Ebola response signage indicates the presence of the World Health Organization (WHO) on site in West Africa, offering aid during the efforts made to control the outbreak’s spread. --- Center for Disease Control and Prevention 

Ebola response signage indicates the presence of the World Health Organization (WHO) on site in West Africa, offering aid during the efforts made to control the outbreak’s spread. --- Center for Disease Control and Prevention 

Considering the nature of the Ebola virus, and the medical infrastructure we have to combat its spread, the diagnosis of some cases on American soil shouldn’t be reason to panic. We have a plethora of tools and public health practices to readily combat its spread. Yet because the virus is so dangerous, and feared, its arrival in America would likely to trigger a robust response from our public health establishment.

For most Americans, it may be the first time they glimpse the tools that our government has staked out over the last decade, as preparation for public health emergencies like a pandemic flu, or even bioterrorism. Some of these authorities are wholly necessary. Others will prove controversial and worthy of closer scrutiny.

Chief among them are authority maintained by the Centers for Disease Control to quarantine Americans suspected of having a dangerous, communicable disease. In some cases, this includes the power to isolate people, and hold a healthy person against his will. The CDC’s quarantine authority has been strengthened in recent years. But we haven’t had sufficient debate about how to balance individual rights against public health in these circumstances. And when quarantine is even effective. We should revisit these issues before we find ourselves invoking these tools.

What will happen if Ebola arrives in America?

First, there will be a lot of misplaced panic. But there’s no reason for most Americans to fear of Ebola’s wider spread. While Ebola is highly infectious, it is not very contagious.

It’s highly infectious because someone stricken with Ebola is very likely to get sick (and harbors a lot of virus particles that they can readily transmit to another person, given the right conditions). But the virus itself is fragile, and does not easily spread. So it’s not very contagious. In short, Ebola is harder to contract than many other viruses.

The Ebola virus can only be spread by direct contact (through broken skin or mucous membranes) with the blood, or other bodily fluids or secretions (stool, urine, saliva) of infected people. Infection can also occur if the broken skin of a healthy person comes into contact with environments that have become contaminated with an Ebola patient’s infectious fluids (such as soiled clothing).

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