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Under the microscope: Spread of Ebola epidemic from Africa to the United States unlikely

President Samuel L. Stanley Jr. said the best way to stop Ebola in the United States is to stop Ebola in Africa. (MANJU SHIVACHARAN / THE STATESMAN)
President Samuel L. Stanley Jr. said the best way to stop Ebola in the United States is to stop Ebola in Africa. (MANJU SHIVACHARAN / THE STATESMAN)

Every other week, Ruchi Shah, a junior biology major, will take a look at Stony Brook-related science and research news.

The first case of Ebola in the United States was diagnosed last week in Dallas, Texas, as the virus continues to spread in West Africa.

The patient, Thomas E. Duncan, went to the hospital with a fever after returning from a trip to Liberia, an African nation at the heart of the Ebola epidemic.

He was initially discharged by Texas Health Presbyterian Hospital, but as symptoms worsened, he went back to the hospital two days later and was admitted and isolated for treatment.

In the time that Duncan was discharged and symptomatic, he came into contact with a variety of people. Medical personnel are concerned that these people may have been exposed to the Ebola virus and are taking them into isolation.

The Ebola outbreak began in West Africa this summer and has continued to spread, taking thousands of lives in Guinea, Sierra Leone and Liberia.

According to the Centers for Disease Control and Prevention, the total number of Ebola cases could reach 1.4 million by January if further intervention or community changes are not made.

“Ebola starts out causing fever, and other symptoms can include severe headache, muscle pain, weakness, diarrhea, vomiting, abdominal pain, and eventually unexplained hemorrhage, bleeding or bruising,” Dr. Saul Hymes, an assistant professor in the Department of Pediatrics at Stony Brook Children’s Hospital who specializes in pediatric infectious disease, said. “Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days.”

The virus is transmitted through body fluids such as blood, stool, urine, vomit and semen. Ebola is not an airborne virus and cannot be transmitted in a way similar to the flu. However, Ebola can be transmitted through a cough or sneeze if it directly contacts the mucus membranes of another individual.

“The only populations more vulnerable are those who are at higher risk of coming into contact with the infectious materials—that would be lab workers, doctors, nurses—members of the science and healthcare apparatus,” Hymes said.

The virus continues to spread in African nations where burial rituals and a lack of resources expose health care workers and family members to Ebola.

According to the CDC, only 18 percent of Ebola patients in Liberia are cared for in medical facilities that have the capability to isolate patients.

“As the epidemic has continued to explode in Africa, the risk of this happening in the U.S. continues to increase,” said Stony Brook University President Dr. Samuel L. Stanley Jr. “The best way to prevent Ebola in the United States is to stop Ebola in Africa.”

Stanley and other infectious disease specialists, however, believe that the possibility of an outbreak in the United States is rare due to the availability of greater and more sophisticated resources.

“We have ample supplies, trained personnel, protective equipment, and active state and federal health departments and epidemiologists,” Hymes said. “Much of the apparatus to monitor and prevent an outbreak has been in place for years or decades, though the most recent stress test was the 2009 H1N1 Flu pandemic, and many of the same techniques used by hospitals and others to contain and track that outbreak will be useful if Ebola continues to crop up here.”

Additionally, the R0 value of Ebola is relatively low compared to other viruses, suggesting that a widespread outbreak in developed countries would be rare.

The R0 value is the number of people, on average, that one sick person could infect with a disease. For example, the R0 value of measles is 18, meaning that one person infected with measles spreads the virus to 18 other people, on average, if no one is vaccinated.

The R0 value of Ebola is about 1.5 to two. While still significant, the relatively low R0 value will prevent a large scale outbreak in countries like the United States that have a good public health infrastructure.

Research institutions around the world are working to develop vaccines and more effective treatment options in hopes of helping to combat Ebola’s spread.

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