American medical history was made on Tuesday, September 30, when it was announced that the first case of Ebola has now been diagnosed in the United States. Until then, a handful of Ebola patients had been treated in the U.S. only after first being diagnosed in Africa.
Ebola is a mere microscopic virus, not even a full-fledged living organism – but it is deadlier and more dreaded than vampires.
It was perhaps inevitable that this terrifying scourge should arrive on our own shores, given its exponential growth in West Africa, its long incubation period, the ease of international air travel, and the sheer number of both returning Americans and foreigners (tens of millions of travelers and migrants annually) entering the United States from abroad. The infected person is a man who boarded a flight from Liberia on September 19 and arrived in Dallas, Texas on September 20.
The Atlanta-based Centers for Disease Control and Prevention (CDC) and the sophisticated American public health apparatus and epidemiological establishment will now have to step up to the plate in order to nip this horrific menace in the bud before it spreads any further here. Dr. Thomas Frieden, director of the CDC, vowed at a September 30 news conference: “We’re stopping [Ebola] in its tracks.” Let’s hope this isn’t hubris.
Dallas hospital where the Ebola patient is being treated
As of this writing, the unidentified patient is reported to be in critical condition, and all people who were exposed to him since he became symptomatic on Wednesday, September 24, will themselves have to undergo isolation – confinement in their homes for three weeks of observation – before they can be deemed out of danger.
These are extraordinary measures and one can appreciate how they are feasible only in a wealthy, organized and educated society, one in which the medical establishment is generally trusted and where well-endowed facilities and specialized treatment are available. This is not the case in impoverished West Africa, where the disease is ravaging Liberia, Guinea and Sierra Leone in particular.
As of September 30, the World Health Organization estimated that Ebola had infected more than 6,550 people and has killed more than 3,000 since the outbreak began. This is widely regarded as an underestimate. The number of cases has been growing exponentially – doubling every three weeks – and the CDC projects that the epidemic may afflict up to 1.4 million people by January 2015 if it is not brought swiftly under control. That’s a tall order.
Prior to this outbreak of the Ebola virus, which is killing 60-70 percent of those who become infected, all outbreaks had been confined to isolated villages. Ebola was first discovered and described by scientists only in 1976. The ongoing outbreak in West Africa is by far the largest and most complex in the virus’ documented history. Already, there are more cases and deaths than in all previous outbreaks combined.
Agony in Africa from Ebola
In an arresting article at Wired, “The Mathematics of Ebola Trigger Stark Warnings: Act Now or Regret It,” Maryn McKenna writes: “This now truly is a type of epidemic that the world has never seen before.” That may be hyperbole, as the Spanish flu pandemic of 1918 infected an estimated 500 million people worldwide – from isolated Pacific Islands to the Arctic – claiming the lives of 50-100 million victims before it fizzled out, 3-5 percent of the world’s population. A similar percentage of today’s much larger global population would entail up to 360 million deaths.
Nevertheless, the sheer lethality of Ebola is stunning and frightening.
Epidemiologist Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, claims that: “The Ebola epidemic in West Africa has the potential to alter history as much as any plague has ever done.” Osterholm draws attention to the following possibility:
… that the Ebola virus spreads from West Africa to megacities in other regions of the developing world. This outbreak is very different from the 19 that have occurred in Africa over the past 40 years. It is much easier to control Ebola infections in isolated villages. But there has been a 300 percent increase in Africa’s population over the last four decades, much of it in large city slums. What happens when an infected person yet to become ill travels by plane to Lagos, Nairobi, Kinshasa or Mogadishu – or even Karachi, Jakarta, Mexico City or Dhaka?
Osterholm emphasizes that Africa’s population has exploded in recent decades, much of it concentrated in poverty-stricken urban slums. Such overcrowded settings are breeding grounds for infectious, contagious pathogens like Ebola and other viruses, bacteria and protozoans.
Paul and Anne Ehrlich wrote of the nexus between overpopulation, poverty and disease nearly half a century ago in The Population Bomb. High birthrates and rapid population growth can exacerbate poverty and keep large numbers of people in poverty, malnutrition and overall suboptimal health, thus making them more susceptible to contagions. Overcrowding in unhygienic slums and shantytowns then facilitates the rapid spread of contagious disease.
Recent demographic projections showing that Africa’s population could quadruple or quintuple to as many as 5.7 billion by 2100 will only create more of the conditions that have resulted in the current Ebola epidemic. Overcrowding and poor environmental hygiene aggravate human vulnerability to our ancient microbial adversaries.
If we humans prove unable to limit our numbers humanely, sooner or later nature will do so cruelly and with much needless human suffering and loss. Infectious, contagious diseases are one of nature’s main culling mechanisms.
Humankind needs to be decisively proactive and not reactive in facing this threat. So far, the record is mixed at best.