Last estimates I read was that this is expected to infect around 20,000 people before its all over - which is unquestionably serious as one would expect, based on mortality rates for this outbreak to lose 10,000+ people. That is definitely serious and you’re right, the press has not played that up.
That’s still vastly different than the notion this will go global and kill off half the human race.
A study was published today in PLOS Currents: Outbreaks on the chances of ebola’s spread.
Chance of Ebola reaching US by 22 September now sits at up to 18%. UK at up to 25%.
The chances of Ebola spreading to the US is 100%.
The question that matters is not “could someone with Ebola end up on US shores?” That is without question true-- they already have. The question that matters is “Could Ebola spread among the general population in an uncontrolled way?” That is highly unlikely.
The top cause of Ebola right now is contact with bodies. When was the last time you touched a body? When was the last time someone you know touched a body? What are the chances that a hospital is going to release an Ebola-infected body to whoever to dispose of? There are three things we do that don’t happen in most of West Africa- we go to the hospital when we are very sick, we report deaths to local authorities who track and investigate them, and we don’t do DIY funerals.
Dallas has one.
Be afraid.
Texas has problems with controlling health care workers with tuberculosis. I wonder if they would be any better with ebola?
So what level of contact with the patient in Dallas over the past few days could potentially have spread the virus? Could a passenger sitting next to him on the bus have gotten it from casual physical contact? How about the worker who cleaned the public restroom he used? The snot rag tossed in the wastebasket and then handled by the cleaning lady? Cash handled by the clerk at Walgreens when the patient bought Nyquil during the early symptoms and fever?
I don’t feel as if there is a clear cut “no problem” for these scenarios. We don’t want needless panic, but I’d hate to find out concerns were being dismissed solely to avoid that panic.
First Ebola case diagnosed in the US
Quick, what is the difference between TB and Ebola?
Bus passenger: back when I rode mass transit I seldom if ever had even “casual physical contact” with my fellow commuters. If the ill person was spewing body fluids onto surfaces later touched by others there is a small risk, but presumably he was normally clothed, not incontinent, not throwing up or bleeding (if he had been 911 and an ambulance would likely have been called). That pretty much leaves “snot”. If, like most people he used a tissue, hanky, or shirt sleeve to sop that up and took it with him probably not transmitting ebola but yes, some risk of doing so.
That’s why the authorities mentioned it, so if someone gets sick they’ll go to a doctor and hopefully not be spreading it around to others.
People who clean public restrooms wear rubber gloves in my experience. Assuming the skin on their hands is intact, they use gloves, the gloves remain intact, they dispose of the gloves after they’re done cleaning/before doing something else like eating and also wash their hands… they’re probably OK. They do all that so they don’t catch every other disease germ living in public toilets. Ditto for most office/store cleaners for whom can emptying is a major part of their duties. Now, at the end of an evening shift where I work I do empty one trash can in my part of the store, but usually entails bunching up a long “tail” of plastic that hangs over the can. If it’s really sloppy I can pull another plastic bag over the offending can so I don’t have to touch anything icky. And the workplace provides plastic gloves for anyone who needs/wants them.
The biggest problem at public washrooms are people who can’t seem to hit a toilet bowl that’s wider than their ass. See various threads on this board about prehensile rectums and women who hover. Let’s assume until proven otherwise that this gent had sufficient bodily control to get all waste into the proper receptacles, because most people do. That should cut the risk to anyone else using the toilet to a minimum.
Cash at Walgreen’s? Again - snot/mucus is the most likely offender here, and even then, most people don’t hand over dripping bills and coins. If he paid with plastic likely no risk at all to the clerk if he swipes his own card through the machine.
Keep in mind, this guy voluntarily went to medical professions when he started to show symptoms. He knew he was at risk and he wasn’t wandering around town in a delirium spewing body fluids on passers-by. His contacts since his return have been tracked and will be monitored, and I’m guessing that he probably didn’t infect anyone casually - like Walgreen clerks. But maybe he did. The chances are higher than zero.
That’s why the public is informed and told to see a doctor if they have symptoms. Of course, this is going to overburden the ER’s with people coming in with mundane problems thinking they’re plague victims but that’s the trade-off here.
Most likely this will be limited to just one case. Maybe one or two close contacts. Could it spread farther? Yes, the chances of that are non-zero. We could also have an epidemic of superflu, too, but I’m not up nights worrying about it. It is highly unlikely, given that Dallas has modern sanitation and medical infrastructure, and given very different death and burial customs than, say, rural Africa, that this would be anything more than a localized outbreak
The US still has a half dozen to a dozen cases of the Black Plague, Yersinia pestis, every year, you know, the plague that at one point killed 1/3 of Europe? But we don’t have an epidemic of it, even when someone turns up with the pneumonic form of it, because of modern sanitation (we don’t tolerate flea-bearing rodents the way past peoples did) and because we do have a means of treating it. We understand its causes, how it is spread, and how to isolate the contagious.
For ebola, we understand its causes, how it spreads, and how to isolate the contagious. What we lack is a specific treatment but researchers are working on that, and just having something as basic as IV’s to keep an ill person hydrated and “supportive care” for symptoms can be life-saving.
Bottom line: it’s nasty, serious disease and it’s killing a lot of people in Africa, but it’s unlikely to become an epidemic in a First World country.
Untreated tuberculosis has a fatality rate north of 80%, which makes it deadlier than the current ebola strain which is “only” 60-70% fatal.
Of course, we can treat (most) TB, and it doesn’t kill you as quickly or make you leak blood out of every orifice.
Broomstick, that was a very helpful analysis. Thank you.
The central question for me is where do we go from here? I think the current scenario would have been considered fairly unlikely last April, yet here we are. It is unlikely that the Dallas case will spread, nor the one after that in the US when it certainly occurs.
But what about the rest of the world? With Africa looking at tens of thousands of cases there are sure to be other outbreaks outside that continent. How do we stop this from becoming so widespread that eventually the low probability events start occurring more frequently simply due to the sheer number of cases? How many countries currently not experiencing ebola can handle it effectively when their “Dallas Patient” occurs?
Seems like we have to solve the problem NOW, in Africa. Perhaps the Dallas incident will help the world understand that this is not something to let petty politics prevent us from all working together to stop.
This ebola outbreak is about 10 months old. Where will we be ten months from now?
Hospitals have surveillance programs for employees for TB and not for Ebola. Am I close?
On second thought, I’ll admit that I have no expertise in this area, and I didn’t intend to threadshit here. Sorry.
TB takes a long time to kill you, is asymptotic for a lot of that, is common in the US among drug addicts and other generally non compliment folks, and has a long obnoxious treatment regime that said people don’t want to go through (often because you can’t drink for months to years).
Ebola kills quickly, and patients aren’t going to be able to stay on the lam for long. And I don’t think anyone is going to decide Ebola treatment takes to long to bother with.
TB is spread through the air (coughing, sneezing, speaking).
Ebola is transfer of body fluids which is very close contact with a person or what that persons came in contact with.
(Sorry! My compulsion 
here just won’t let me get past this… Don’t take it personally.)
Should be “asymptomatic”.
J.
You’re welcome.
Unlikely by who?
The likelihood of an air travel bringing an exotic disease from aboard has been known about for decades. In this instance, I think the authorities (CDC, WHO, various other agencies and governments) were in fact expecting at some point someone from the affected region would show up elsewhere just because air travel is so ubiquitous at this point. We went through something like this a few years ago with SARS. The particular risk has been considered, though about, discussed, and planned for. That’s why airports have people who look at travelers, body temperature scanners, and the like. It’s also why hospitals in major urban areas like New York, London, and yes, Dallas have meetings and make plans to handle exotic diseases, have isolation units, and so forth.
It’s always been a matter of when, not if.
Well, of course such cases will occur elsewhere. People travel, it’s a feature of the modern world.
First world nations should be able to contain any outbreaks provided no one does anything stupid (yes, stupidity does happen). Anyone with even basic modern medical infrastructure - disposable gloves, hot water, reliable power, etc. - should be able to contain any infections, and that covers substantial parts of the developing world as well.
Keep in mind not all African nations affected are suffering equally. Nigeria has been affected but you’re not hearing much about it because the outbreak is being contained and not spreading rapidly. That’s because Nigeria has better medical infrastructure and less cultural ignorance than Liberia.
The places to fear this getting loose are where there is little or no effective government and poor medical care.
I predict we’ll have some more scattered instances of world travelers going home then turning up sick. Probably one or two instances where other people close to said person get infected, maybe a few medical people who care for the patients. We’ll have a much better understanding of how to provide care for those infected even if we don’t have a definitive cure. No epidemics outside of Africa or, if we’re unlucky, some other location with weak governance and poor medical care.
There will still be an outbreak on-going in Africa, with people dying, although if we’re lucky the world will be paying enough attention and providing enough resources that the case numbers will be falling instead of rising.
You mean, other than the hysteria?
It should be no surprise to anyone that someone with ebola showed up in the US, although I figured it’d be New York if anywhere. Haven’t they already had at least one in Europe? It’s virtually certain there’ll be several more in various places before this is over.
I’m actually surprised it hasn’t done more spreading to more African countries. Yes, they’ve had some in Nigeria and Senegal (both contained) but I figure there should be more.
Something positive about it
There are the three countries specifically that are subject to this, the Liberia, the Sierre Leone and the Guinea Conakary, not Africa. It is a specific small geography in the West African region, not Africa. If there is an earthquake in the Japan do you write “Asia is hit by earthquakes”? I hope not.
Already the Nigeria is said by the WHO to have completely contained the outbreak which came from a sick Liberian man. All exposed persons passed the known incubation time period, and the fatality rate of those who became sick was below 50%.
The Senegal has also demonstrated control.
Yes as the Nigerian case shows.
And in fact there is no connection with all of the African continent.
What is going on in both the Liberia and the Sierre Leone cases is as much the demonstration of how badly damaged these societies were by the long and the nasty civil wars they experienced. Both are more fragile than any of their neighbours - very very much more fragile. The Senegal, the Cote d’Ivoire are much stronger societies and governments. If the Liberia and the Sierre Leone had more functioning societies and governments, their cases would look like the Guinea Conakry, which is serious but not the apocalypse of the Liberia.
Well, let’s hope they’re more careful with any dead ones than they were with the live one. 
It’s not like a hospital is going to keep a deceased ebola patient indefinitely, sooner or later the body will be released - the question is whether such a release will be done safely or not.