
Could The Ebola Outbreak Spread To Europe Or The U.S.? - timr
http://www.npr.org/blogs/health/2014/06/25/324941229/could-the-ebola-outbreak-spread-to-europe-or-the-u-s
======
giarc
The largest driver of this outbreak (and many ebola outbreaks) is the fear of
healthcare and the way many cultures treat the deceased. These two issues are
what would make transmission to NA or Europe very unlikely.

Many people in African nations will stay away from hospitals because they
believe they will get Ebola from the hospital. Therefore often people that are
sick die of Ebola in the community and therefore spread the disease (symptoms
of ebola are very similar to malaria in the first stages, and therefore does
not always draw attention to people familiar with malaria)

Secondly, when people die in many of these cultures, there is much more
physical connection with the body, potentially spreading the disease more.

In NA and Europe, people are much more likely to seek care and we also don't
have as much contact with deceased person (and also have guidelines for
handling of infectious bodies).

~~~
sliverstorm
_Secondly, when people die in many of these cultures, there is much more
physical connection with the body, potentially spreading the disease more._

You would think this would have been selected against ages ago.

~~~
emiliobumachar
Human culture changes _way_ too fast for evolution to act.

~~~
nhaehnle
I have no idea why you were down-voted. It's true: even if, somehow, evolution
had managed to at some point kill off all cultures with a certain trait, the
same trait is likely to develop again in at most a few centuries.

If somebody has solid arguments against emiliobumachar's point, I'd be
interested to hear them.

~~~
marcosdumay
Maybe the downvote was because it isn't completely true. Nothing can be too
fast, or too slow for evolution.

It's only that culture evolves by different means than genotipes, and by those
means fitting the norm more than compensates any unfitness caused by health
problems. At least at the short term.

------
Asparagirl
Last month, an American doctor who is working with Doctors Without Borders
(Médecins Sans Frontières/MSF) wrote these really harrowing and sad letters
home from the heart of the Ebola outbreak:

[http://news.unchealthcare.org/news/2014/june/dispatch-
from-g...](http://news.unchealthcare.org/news/2014/june/dispatch-from-guinea-
containing-ebola)

~~~
Ocerge
That was an absolutely terrifying read. What seems to make Ebola worse is the
manner in which you die...bleeding out on the floor, alone. Doctors Without
Borders is an incredible organization, and one that I gladly donate to yearly.

~~~
frozenport
They are not without criticism, in Rawanda they might have supported the wrong
side, supporting a group of refuges that would be the imperious for an
invasion of Zaire, the destabilization of which has lead to continuous
conflict in the Congo.

 _As Alain Destexhe, the secretary-general of Doctors Without Borders, put it:
"How can physicians continue to assist Rwandan refugees when by doing so they
are also supporting killers?"_[1]

[1]Dancing in the Glory of Monsters: The Collapse of the Congo and the Great
War of Africa Paperback – March 27, 2012

------
KhalilK
_So should Europe and the U.S. begin worrying about the virus?_

As a North African inhabitant (Tunisia), I can't help but consider this
egocentric. Are other African countries somehow doomed?

~~~
privong
Well, NPR is an American organization, so it's not really surprising that
they're writing it with an eye towards their primary demographic (Americans,
and to a lesser extent, Europeans) .

> Are other African countries somehow doomed?

It would certainly be interesting to look at the likelihood of propagation in
Africa, and hopefully someone does that. But I'd be surprised to see that from
a news organization with a primarily American audience. Also, I didn't see
anything in the article implying anything about further spread in Africa.

~~~
KhalilK
That last question was merely sarcastic and based on my understanding of the
article; discussing potential spread to the US/Europe suggests that the virus
has already spread in Africa, at least that's how I saw it.

~~~
privong
I figured you were being sarcastic. But I do think it would actually be
interesting for someone to look into propagation within Africa.

------
bayesianhorse
Ebola is a third-world disease. First world countries are not at risk, due to
a combination of health-care, hygiene and "lucky" cultural differences. SARS
is much more of a first-world disease because it spreads faster, more easily
and has less visible symptoms.

Europe and US should still try everything possible to stop Ebola. And Malaria,
and Tuberculosis and all the various parasites that are affecting mostly the
poor people of the world....

------
nickthemagicman
The burn rate is too fast for Ebola plus Ebola isn't transmitted via air(yet)
so even if it did contaminate America or Europe it could be contained rather
easily.

~~~
Fomite
The notion that "the burn rate" is too fast is both on epidemiologically shaky
ground, and something I'd be disinclined to rely on given "the burn rate is
too fast" was supposed to be why we hadn't seen Ebola in places now
experiencing outbreaks.

~~~
kordless
Aparently, so is the air part:
[http://healthmap.org/site/diseasedaily/article/pigs-
monkeys-...](http://healthmap.org/site/diseasedaily/article/pigs-monkeys-
ebola-goes-airborne-112112). I was fascinated by its structure - a filament -
and it's small size of code - only about 20K base pairs. Also, it's mutation
rate is pretty high. That sucks.

~~~
nickthemagicman
Notice I put yet in parenthesis. Google: Reston ebola virus, or just read the
hot zone.

You want stuff to be afraid of look up: drug resistant tuberculosis, or the
scientist Yoshihiro Kawaoka.

------
quattrofan
What is the likelihood ebola could mutate into something that could be spread
by aerosol?

------
KaiserPro
Yes.

But there are a few caveats. First, does ebola have environmental factors?
What are the vectors for transmission?

Are parts of the rest of the world immune/partially immune already?

THe problem is that remote africa is very hard to look after, however
fortunately for the surrounding areas movement of people is slow and fairly
easy to trace.

If it were to hit a town in say nigeria, then its pretty much game over.
Country wide quarantines. Stopping of shipping and all movements across
borders.

------
joe_the_user
I usually hate mentioning it, but this seems a perfect example of Betteridge's
law.

[http://en.wikipedia.org/wiki/Betteridge%27s_law_of_headlines](http://en.wikipedia.org/wiki/Betteridge%27s_law_of_headlines)

~~~
rjsw
Maybe.

One danger that isn't mentioned in the article is that Ebola is suspected of
being carried by animals, fruit bats in particular.

Lots of bushmeat gets smuggled into Europe.

~~~
pyre
> Lots of bushmeat gets smuggled into Europe.

As a delicacy (i.e. people looking for Chimpanzee meat)? Or to serve African
immigrant populations (looking to bring home to a foreign land)?

~~~
DanBC
It used to be for personal consumption but now there is a "luxury market" and
illegal meat is being traded.

[http://www.theguardian.com/environment/2010/jun/18/illegal-b...](http://www.theguardian.com/environment/2010/jun/18/illegal-
bushmeat-smuggled-europe)

------
batmansbelt
Probably not. You'd need a vector. I saw a documentary about an outbreak in
the 90s and it was a monkey that a man let loose in the forest.

~~~
Fomite
An infected human is a perfectly functional vector, and this is already a
sustained epidemic.

