Wednesday, October 15, 2014

A diagnostic problem


As I've mentioned before, I've traveled extensively in sub-Saharan Africa.  I'm familiar with viral hemorrhagic fevers such as Ebola, because there are many of them and they're frequently encountered there.  To name only two that are currently active:

  • Lassa fever is less lethal than Ebola, but its symptoms are similar and it's far more widespread.  There are a quarter to a half million cases each year in West and Central Africa, with up to 5,000 fatalities.
  • Marburg virus disease is much less common than Lassa fever, but much more dangerous.  There's currently a case in Uganda that's causing concern.

Wikipedia lists five families of viruses that lead to hemorrhagic fevers, and mentions several more of the diseases they cause.

The problem is that the symptoms of most of these diseases mirror those of Ebola.  For example, statistically speaking, we're far more likely to encounter someone suffering from Lassa fever than we are the Ebola virus;  but if the initial symptoms are similar, how will airport authorities and medical institutions be able to quickly differentiate between them?  Furthermore, if we start seeing a mass exodus of refugees from affected areas (something that's already rumored to be happening in the more remote districts of affected countries, where international borders are honored more in the breach than in the observance), how will refugee camps cope with multiple hemorrhagic virus outbreaks?

Fortunately, the spread of most of these viral hemorrhagic fevers can be controlled by the implementation of basic sanitation and quarantine measures;  but if those aren't available, or aren't observed, or are overwhelmed by more than one disease, things get difficult.  Just another complication to the whole Ebola situation . . .

Peter

4 comments:

Old NFO said...

Yep, problems all, but they ALL need advanced care! Quarantine first, THEN figure out which one they have...

Rolf said...

I think the best idea I've heard to date is to simple ban *air* travel to and from Africa, tell everyone to take the slow boat and enjoy the month-long trip. Automatic isolation and quarantine. If someone becomes symptomatic, you can drop off treatment equipment and radio/vid-link directions while they are isolated on the boat.
Make sure there is a good count of people aboard when they set sail so they don't just toss fevered people overboard and report "All good, boss!"

Stefan v said...

Good luck crewing a ship like that, Rolf! Another good reason for an exhaustive passenger manifest is when you arrive at destination and have to explain how Timmy sadly fell overboard during the first week because he sneezed. A sad, regrettable loss, poor Timmy. Achoo! Aww, shoot...

Anonymous said...

And now its mentioned in today's news that the 2nd CONFIRMED Ebola nurse was on a flight from Cleveland to Dallas (Flight 1143) Monday night, previous to the diagnosis found Tuesday. 132 passengers on board - and where did THEY travel ?

Its getting real - FAST !! Prayers for all affected.