Ebola Virus Disease (EVD) in the United States


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Myself . By T.V. Antony Raj

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Great Seal of the United States

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Today, Ebola virus disease (EVD) represents a major public health issue, not only in sub-Saharan Africa, where it originated, but also to the whole world.

Researchers believe that the index case of the current EVD epidemic was the death of a 2-year-old boy in the village of Meliandou, Guéckédou Prefecture, in the West African nation of Guinea.

Guinea’s local health officials reported the first cases of fever in February 2014. They diagnosed the early cases as other diseases more common to the area and not as Ebola.

On March 19, 2014, Reuters reported an outbreak of an undetermined haemorrhagic fever in Guinea.

On March 22, 2014, Guinea confirmed that the viral hemorrhagic fever that killed more than 50 people is Ebola. On the same day, Liberia reported two EVD cases.

On March 30, 2014, Sierra Leone reported suspected cases.

On April 4, 2014, a mob attacked the Ebola treatment center in Guinea. In Sierra Leone and Liberia healthcare workers faced hostility from fearful, suspicious people.

On June 17, 2014, Liberia’s capital Monrovia reported the first case of Ebola.

On July 27, 2014, Liberia closed its borders with neighbouring countries. Three days later, Liberia shut down all schools. It quarantined worse-affected communities using troops.

On August 2, 2014, a U.S. missionary physician infected with Ebola in Liberia was flown to Atlanta in the United States for treatment.

On August 5, 2014, a second U.S. missionary infected with Ebola was flown from Liberia to Atlanta for treatment.

On August 8, 2014, World Health Organization (WHO) declared Ebola as “international public health emergency.”

On August 15, 2014, Médecins Sans Frontières (MSF) or Doctors Without Borders said it would take about six months to control the epidemic.

On August 19, 2014, one of the two U.S. missionaries treated in Atlanta declared free of the virus was released from the hospital.

On August 21, 2014, the second U.S. missionary treated in Atlanta declared free of the virus was released from the hospital.

By September the epidemic accelerated in sub-Saharan Africa.

On September 3, 2014, a third U.S. missionary doctor infected with Ebola was flown from Liberia for treatment in Omaha, Nebraska.

On September 7, 2014, President Barack Obama said the United States needs to do more to help prevent Ebola from becoming a global crisis.

On September 8, 2014, a fourth Ebola patient was flown to Atlanta.

On September 9, 2014, WHO said at least 2,296 died out of 4,293 cases recorded in five countries.

On September 13, 2014, Liberia appealed to Obama for help fight Ebola.

On September 16, 2014, President Obama promised to send 3,000 military engineers and medical personnel to West Africa to build clinics and train healthcare workers.

Thomas Eric Duncan (Source: abcnews.go.com)
Thomas Eric Duncan (Source: abcnews.go.com)

On September 20, 2014, Thomas Eric Duncan, a Liberian, flew to the United States after trying to help a woman with Ebola in his home county. He flew from Liberia to Dallas in the United States via Brussels and Washington.

On September 25, 2014, Duncan went to the Texas Health Presbyterian Hospital Dallas with fever and abdominal pain. Despite telling a nurse that he travelled from West Africa, the hospital sent him back to the apartment where he was staying with antibiotics.

On September 28, 2014, Duncan returned to Dallas hospital by ambulance.

On September 30, 2014, U.S. Centers for Disease Control and Prevention (CDC) confirmed Duncan afflicted with Ebola. This was the first case diagnosed in the United States.

On October 2, 2014, NBC News said that Ashoka Mukpo, the American freelance cameraman in its employ, afflicted with Ebola will be flown to the United States for treatment.

On October 8, 2014, Duncan, the first person diagnosed with Ebola in the United States, died in Texas Health Presbyterian Hospital Dallas.

The United States government ordered five major airports to screen passengers from West Africa for fever.

On October 9, 2014, WHO said there is no evidence of the epidemic being brought under control in West Africa. Some lawmakers in the United States called for the ban of travelers from the West African countries hit hardest by Ebola.

On October 10, 2014, WHO raised the death toll to 4,033 out of 8,399 cases in seven countries. Most fatalities were in Liberia, Sierra Leone and Guinea.

On October 11, 2014, Medical teams at New York’s John F. Kennedy International airport began screening travelers for Ebola symptoms from three West African countries.

Ebola survivor Nina Pham appears at a press conference after she was discharged from the hospital on ct. 24, 2014. (Source: abcnews.go.com)
Ebola survivor Nina Pham appears at a press conference after she was discharged from the hospital on October 24, 2014. (Source: abcnews.go.com)

On October 12, 2014, Nina Pham the nurse who took care of Liberian, Thomas Eric Duncan, at Texas Health Presbyterian Hospital Dallas tested positive for Ebola. She became the first person to contract the virus in the United States. U.S. National Institutes of Health said nurse Pham will be moved from Dallas to a National Institutes of Health (NIH) isolation unit in Bethesda, Maryland.

Nurse Amber Vinson (Source: nbcnews.com)
Nurse Amber Vinson (Source: nbcnews.com)

On October 15, 2014, officials said that Amber Vinson, a second Texas nurse who treated Duncan had contracted Ebola. She was treated at Emory University Hospital in Atlanta. Authorities said Vinson took a flight from Cleveland to Dallas/Fort Worth International Airport while running a slight fever.

On October 16, 2014, a U.S. congressional subcommittee sharply questioned health officials about the response to Ebola in the United States.

Dr. Craig Spencer (Source - nbcnews.com)
Dr. Craig Spencer (Source – nbcnews.com)

On October 17, 2014, The 33-year-old Dr. Craig Spencer, a New York doctor returned from Ebola-hit Guinea. Spencer, treated Ebola patients while working for MSF. After completing his work on October 12, 2014, he left Guinea two days later via Brussels, Belgium. He arrived at John F. Kennedy International Airport in New York City, on October 17, 2014. On his arrival, he did not exhibit any symptoms of the virus. The physician, who worked at Columbia Presbyterian Hospital, was checking his temperature twice a day. He had not seen any patients since his return.

On October 20, 2014, Emory University Hospital in Atlanta released an unidentified American who had contracted Ebola in Sierra Leone.

In Texas, 43 people were taken off Ebola watch lists. About 260 people were still being monitored in Texas and Ohio. United States issued stricter guidelines for health workers treating Ebola victims. Not to expose skin or hair.

On Tuesday, October 21, 2014, Dr. Spencer started feeling fatigued and sluggish though without a fever. That day, he visited a coffee stand and a meatball restaurant in Manhattan. The next day, he ran for three miles in his neighborhood, and took the subway to a bowling alley in Brooklyn. He was not symptomatic then.

On October 23, 2014, Spencer developed a fever, nausea, pain and fatigue in the morning. His fever spiked to 100.3 degrees Fahrenheit (about 38 Celsius). He tested positive for Ebola. He is the first case of the deadly virus in New York City and the fourth diagnosed in the United States.

Health officials cleared both the coffee stand and the bowling alley after assessing them. After closing the bowling alley on Thursday, they had the bar cleaned and sanitized as a precaution.

Spencer’s Manhattan apartment has been isolated and locked.

Spencer was in contact with a few people after he started exhibiting symptoms. Ebola is not contagious until someone has symptoms. Health officials said that three people – his fiancée and two friends – are on quarantine and monitored,

“They are all well at this time; none of them is sick,” said Dr. Mary Travis Bassett, New York City’s health commissioner.

Spencer also travelled on three subway lines. “At the time that the doctor was on the subway, he did not have fever… He was not symptomatic,” Bassett said. The chances of anyone contracting the virus from contact him are “close to nil,” she said.

Ebola spreads by direct contact with the body fluids of an infected person. The time between exposure to the virus and the development of symptoms of the disease is usually two to 21 days. Estimates based on mathematical models predict around 5% of cases might take greater than 21 days to develop the symptoms.

Dr. Craig Spencer is now lodged at New York’s Bellevue Hospital Center. He has been in isolation since emergency personnel took him there. It is one of the eight hospitals statewide designated by New York Governor Andrew Cuomo as part of an Ebola preparedness plan.

“We are as ready as one could be,” Cuomo said. New York state will be different from Texas he said.

“We had the advantage of learning from the Dallas experience,” he said, recalling the death of Liberian Thomas Eric Duncan on October 8, 2014, diagnosed with Ebola.

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