In September 2014, Teresa Romero, an assistant nurse in Madrid, Spain, was infected with the Ebola virus after caring for a Spanish missionary who had been sent home from Liberia with the disease. The missionary (and a second one) succumbed to the illness. Ms. Romero had apparently gone undiagnosed for days, despite that she had: 1) been treating two patients with Ebola, and 2) developed a fever.
Health officials suspect that she may have inadvertently touched her face with a gloved hand—a quick, thoughtless gesture that could have happened to anyone. It was that simple. Human error again plays a part.
The patient, Manuel García Viejo, who had been medical director of a Sierra Leone hospital for twelve years, passed away from Ebola on September 25, 2014. Another nurse who had aided in his care was tested several times and finally released from the hospital after all tests for Ebola came back negative. At the time of this writing, Ms. Romero is still hospitalized. Her dog was euthanized.
Madrid is not the Third World. How could this happen in a first-world hospital? An investigation by the European Center for Disease Prevention and Control determined that despite the advancements the hospital had to offer, it lacked the proper capacity to handle emergencies such as an Ebola outbreak. The Health Ministry’s coordinator of emergency alerts, Fernando Simón, reported, “The airlocks were set up to deal with highly infectious situations, but what hadn’t been foreseen was a need for bulky outfits to perform certain medical procedures in.”
We’ll look at how to find out if your hospital is equipped to deal with an Ebola outbreak later in this book, but as you can see, even in the best, most secure hospitals, human error will always be an issue.
There was an uproar when confirmed American Ebola victims Dr. Kent Brantley and Nancy Writebol were transported to Emory Hospital in Atlanta, Georgia, from Liberia in the late summer of 2014. Ebola had not touched America in this way before—it had always been something contained on a continent hundreds of miles from home.
Emory Hospital proved to be an effective container for the disease. Neither Brantley or Writebol contaminated any of the medical staff, and in a matter of weeks, both recovered and were sent home with no trace of it remaining. Indeed, patients who survive the virus receive, at least for ten years, immunity from the same Ebola strain.
TIP
Patients who survive the virus receive, at least for ten years, immunity from the same Ebola strain.
Texas Health Presbyterian Hospital in Dallas, however, did not have the same resources and capabilities. When Thomas Duncan first came to the hospital, he was sent home with antibiotics despite having a fever of 103 degrees and admitting to his recent arrival from the Ebola zone. At this point, he had already been incubating the disease for several days. Two days later, he returned to the hospital where he was diagnosed with Ebola on September 28, 2014, but by October 8 he was dead.
Thomas Duncan was a courier service driver in Liberia’s capital, Monrovia. He had traveled to the United States to visit his former girlfriend and their nineteen-year-old son. Shortly before he left West Africa, Mr. Duncan had taken Marthalene Williams, a young Ebola patient, to a hospital where she was turned away due to lack of space. He then helped carry her home. Ms. Williams died of Ebola several hours later in his presence. As an aside, her brother, who had also helped carry her to and from the hospital, died from Ebola several days later.
A statement from the hospital’s administration said, “We have made changes to our intake process as well as other procedures to better screen for all critical indicators of Ebola virus.” However, the failure of the hospital was multifold. It should have demanded an immediate transfer of Mr. Duncan to one of the four high-risk infectious disease centers in the United States instead of handling the case itself. It should have instituted a rigorous training program to educate the nurses and other staff. The first two days of Mr. Duncan’s admission, nurses wore wearing little protective gear while performing their duties. It is rumored that infected waste like bedding was piled to the ceiling of the hospital room.
What will be the fate of the people who cared for the medical staff stricken with the deadly virus? Ebola has been particularly cruel to health-care workers, with hundreds in West Africa contracting and dying from the disease.
You know that Ebola is a serious health threat, but it also poses economic threats beyond the cost of health-care and military expenses. The economies of some countries in West Africa have come to a standstill due to Ebola. A huge industry that affects the average American is also being hurt by restrictions tied to areas deeply affected by Ebola: The chocolate industry. According to a recent article on www.Politico.com:
The countries with the worst Ebola outbreaks neighbor three countries that produce almost 60 percent of the world’s chocolate production. “Prices on cocoa futures jumped from their normal trading range of $2,000 to $2,700 per ton, to as high as $3,400 over concerns about the spread of Ebola to Côte D’Ivoire (French for Ivory Coast),” noted Jack Scoville, an analyst and vice president at the Chicago-based Price Futures Group. “Since then, prices have yo-yoed down to $3,030 and then back to $3,155 in the past couple of weeks.”
The Ivory Coast, a small nation that borders both Liberia and Guinea, produces more than 33 percent of the world’s total cocoa beans. As a result of the epidemic, it has closed its borders. A large portion of the work force needed to harvest the cocoa beans (that eventually become chocolate) come from the neighboring countries. This will likely mean an increase in the cost of cocoa beans, and therefore, a spike in the cost of chocolate. From the same article, “The World Cocoa Foundation is working now to collect large donations from Nestlé, Mars, and 113 other members for its Cocoa Industry Response to Ebola Initiative.” The Ebola epidemic, even in far-away West Africa, affects us all in many ways.
NOW YOU KNOW…
So now you know the various ways that you can get Ebola, and how you can’t. It isn’t the easiest virus to get but that doesn’t mean it’s impossible either. All it takes is our continued failure to take the measures necessary to protect our health-care workers and our failure to restrict travel from the epidemic zone. Now, would you recognize an Ebola victim if you saw one? Keep reading to learn how.
3. Signs & Symptoms
In all that we’ve learned in the past decades about Ebola, one of the most effective ways to ensure survival is to treat the disease immediately. When symptoms arise, it’s important to keep in the back of one’s mind that what might seem like a simple bout of the flu could very well turn out to be Ebola. Once the later symptoms of the disease begin to present themselves, it is almost always too late.
In this chapter, we’ll break down the signs and symptoms that very well could indicate an Ebola infection. Don't be dismissive if you begin to show any of these symptoms. It is probably something else, maybe the flu, but those who seek help early for either the flu or Ebola will be in better shape than those who don’t.
Nancy Writebol was working with the missionary group Serving In Mission (SIM), an international organization with more than 1,600 active missionaries serving in more than sixty countries. Her job was to ensure that doctors working with Ebola patients were suited up properly in their personal protective gear. The tragic irony here is that she herself had not been properly protected. Ms. Writebol contracted Ebola and had to eventually be evacuated from Liberia. At first, however, it wasn’t clear that she had contracted Ebola, despite the nature of the service she was performing. Even people working deep in the trenches of the epicenter of the outbreak often believe that their symptoms are not caused by Ebola. In all fairness, malaria is much more common than Ebola, and kills many more people. It is common that most people with symptoms of Ebola just assumed it was an episode of the ubiquitous mosquito-borne illness.