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Title: Blog by Novelist William S. Frankl, MD

First Ebola Case Diagnosed in the USA

As expected,  despite the previous nonsense from the Administration, an Ebola case has come to the United States. And there will be more. The diagnosis was missed in a local hospital. Apparently no one asked the patient where he came from and when! The following is the best we know about the case:

SCIENTIFIC AMERICAN
First Ebola Case Diagnosed in the U.S.
Dallas hospital is treating traveler from Liberia
Sep 30, 2014
By Dina Fine Maron

Federal officials today announced the first case of Ebola diagnosed in the U.S. The male patient was admitted to Texas Health Presbyterian Hospital Dallas and placed in strict isolation on
September 28 after flying from Liberia to visit family in north Texas. The patient left Liberia on September 19, arrived in the U.S. on September 20 and started showing signs of illness on Sept. 24. Because Ebola can be transmitted only after a person becomes sick, health authorities said, the man could not have infected nearby passengers.  The individual did not appear to have been in west Africa providing Ebola care.

“He undoubtedly had close contact with someone who was sick with Ebola or died from it,” Tom Frieden, the director of the Centers for Disease Control and Prevention said in a press conference this evening. The patient is being cared for in intensive care and any individuals who had potential exposure to him after he began showing symptoms will be contacted and monitored for 21 days. The disease typically has an incubation period of 8 to 10 days.

The case comes six months after the World Health Organization first formally published notification of the outbreak in Guinea.  The disease, spread solely by contact with the bodily fluids of symptomatic Ebola patients, has already caused more than 3,000 Ebola deaths in west Africa and rippled from Guinea to Liberia, Nigeria, Senegal and Sierra Leone. Nigeria and Senegal are no longer reporting any new cases, however, suggesting the countries have controlled the outbreak there. Despite some speculation published in the media, the disease is not spread by air and is unlikely to do so as Scientific American reported on September 16.

For months, the U.S. Centers for Disease Control and Prevention has maintained that unlike the health systems in west Africa, the robust health infrastructure in the U.S. would prevent Ebola from readily spreading if the virus was detected in the country. Healthcare workers who became ill with Ebola while caring for patients in west Africa and transferred to U.S. hospitals recovered without infecting other individuals.

Frieden again today reiterated that isolation capabilities at U.S. hospitals, healthcare workers ability to track people who may have been exposed to the ill patient and strong health communication which can alert people about how best to protect themselves, will keep this case from blossoming into a large-scale outbreak. Indeed, the CDC director reminded reporters that a woman who had contracted a similar disease, caused by the Marburg virus, was successfully treated in Colorado in 2008 after she became ill and had even undergone surgery without transmitting the virus to anyone else.

There are no other suspected Ebola cases in Texas at this time.

No therapy or vaccine has yet cleared scientific testing for Ebola although several candidates are currently in clinical trials. To date, the WHO has said that blood transfusions from Ebola survivors  should be the immediate priority treatment. Such blood, hopefully chock-full of antibodies against the virus, could help the newly infected to respond to the disease more quickly. Although the WHO has said the disease kills 70 percent of patients, individuals are more likely to survive when they have access to care that would be offered in the U.S. including electrolyte replacement for lost fluids.

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