
Tracing Ebola’s Breakout to an African 2-Year-Old - denzil_correa
http://www.nytimes.com/2014/08/10/world/africa/tracing-ebolas-breakout-to-an-african-2-year-old.html
======
Zaheer
The last piece of the article is painful to read. Anyone know how we can
contribute to supplies, etc to fight Ebola?

"A Desperate Call for Help

By June and July, Sierra Leone was becoming the center of the outbreak. At the
government hospital in Kenema, Dr. Sheik Umar Khan was leading the efforts to
treat patients and control the epidemic.

But he was desperate for supplies: chlorine for disinfection, gloves, goggles,
protective suits, rudimentary sugar and salt solutions to fight dehydration
and give patients a chance to survive. Early in July, he emailed friends and
former medical school classmates in the United States, asking for their help
and sending a spreadsheet listing what he needed, and what he had. Many of the
lines in the “available” column were empty. One of his requests was for body
bags: 3,000 adult, 2,000 child.

Before his friends could send the supplies, Dr. Khan contracted Ebola himself.
He died on July 29."

~~~
cmrivers
Medecins Sans Frontiers (Doctors Without Borders) is an excellent choice. They
have been integral to controlling several past Ebola outbreaks, and have been
fighting this one since the beginning. They are almost entirely tapped out
right now. [http://www.msf.org](http://www.msf.org)

I can't vouch for them, but the Liberian Ministry of Health also has donation
instructions: [http://www.mohsw.gov.lr](http://www.mohsw.gov.lr)

~~~
ihodes
Not sure why you say MSF is "almost entirely tapped out"—from MSF's website
"Please note that Doctors Without Borders' response to the Ebola outbreak in
West Africa is fully funded." Nevertheless, they're a pretty excellent charity
to donate to (c.f. [http://www.givewell.org/international/charities/doctors-
with...](http://www.givewell.org/international/charities/doctors-without-
borders) and note they spend over 85% of funds on programs [~12% on
fundraising, and ~1% on management]).

~~~
cmrivers
You're right, I revisited the article that gave me that impression [0], and
it's very clear that staffing is the resource that is exhausted. Nonetheless,
it's an excellent organization and a worthy cause in my opinion.

[0] [http://www.msf.org.uk/article/ebola-official-msf-response-
wh...](http://www.msf.org.uk/article/ebola-official-msf-response-who-
declaring-epidemic-extraordinary-event)

~~~
timr
They're also one of the few charities to whom I donate that _doesn 't_ spam me
to death after the donation. Give money to the MSF, and you get a few letters
a year about what they're doing.

More charities should be like that.

~~~
jackweirdy
Not to mention they don't push any religious agenda while they're out there.
They do good work for its own sake.

------
jhonovich
"Unlike most previous outbreaks, which occurred in remote, localized spots,
this one began in a border region where roads have been improved and people
travel a lot. In this case, the disease was on the move before health
officials even knew it had struck."

What if someone in a major US city got infected? How bad could it get? Could
they even contain it at that point?

~~~
maxerickson
It's likely easier to control in the U.S. where there are a lot of resources
and people are less likely to engage in a lot of physical contact with the
infected, and where trust of doctors is a lot higher.

There is also a much more extensive public health system that is alert to the
risk of an infected person entering the country.

~~~
timr
People keep repeating this as if it were a definitive rebuttal of all fears,
but this story gives a few great examples of why the confidence might be
misplaced: when your primary diagnostic criterion is a fever (common; easily
suppressed with OTC medication) and affirmative answer to the question _" have
you been to West Africa?"_, it doesn't really matter how good your public
health system is -- it's a going to be a leaky early warning system.

If someone makes it through the airport screens and carries the virus into a
city, the epidemiology could become overwhelming before we know an outbreak
has begun. So yes, we have the advantage that we have real hospitals and good
infection control, but we have the _disadvantage_ that we have huge cities,
high population density and lots of personal mobility.

~~~
snowwrestler
The point of comfort for the U.S. is that ebola transmission currently
requires direct contact with bodily fluids--not that it's easy to diagnose.

If you had a fever and went to work, and it turned out you had ebola, it's
_still_ unlikely you would infect your coworkers, because it is rare for
American workers to directly contact each others' bodily fluids.

Think of ebola like AIDS that kills faster. That's the right mental model for
how it is transmitted. And, it's a good reminder that we have decades of
practice managing diseases transmitted that way.

~~~
jeffdavis
"The point of comfort for the U.S. is that ebola transmission currently
requires direct contact with bodily fluids"

Doctors who _knew_ they were working with Ebola still managed to get infected.
So it can't be that hard to get it.

We don't need to panic, but it would be unwise to be too complacent.

~~~
bsder
> Doctors who knew they were working with Ebola still managed to get infected.

Yes, but these doctors often don't even have the equipment to provide proper
antiseptic medical care let alone containment-type biosuits.

In addition, quarantines can be rolled out quickly and effectively in modern
countries with well-developed communication infrastructure.

This is not to say that we should be complacent. However, a bad flu epidemic
poses more direct hazard to the modern world.

------
alukima
Does the usage of African instead of Guinean bother anyone else? Africa is
widely not recognized as a continent of distinct countries and this isn't
helping. It's like referring to people from the U.S., Canada, and Mexico as
North Americans.

~~~
zachrose
Yeah, the mistake of referring to Africa as a single nation is unfortunately
common in the U.S., made by everyone from from leading Republican politicians
to, more sadly, Clayton Kershaw.

[1] [http://www.africaisacontinent.com/common-
mistake](http://www.africaisacontinent.com/common-mistake)

[2]
[http://mlb.mlb.com/news/article.jsp?ymd=20101220&content_id=...](http://mlb.mlb.com/news/article.jsp?ymd=20101220&content_id=16350030&vkey=news_la&c_id=la)

------
pinar747
How did the 2-year-old contract the virus in the first place?

~~~
Pxtl
The article makes it clear that this is the big question. Suspects are fruit
bat poop and bush meat.

~~~
iaw
Wouldn't fruit bat poop be more likely? I mean, if it were bush meat I'd
suspect it was prepared for the child in which case there would have been a
second patient-zero. Whereas fruit bat poop can easily get into a 2 year-olds
mouth without anyone noticing.

~~~
meepmorp
> I mean, if it were bush meat I'd suspect it was prepared for the child in
> which case there would have been a second patient-zero.

Just speculating, but maybe cooking the meat attenuated the virus, and it was
only able to take hold in a person with an underdeveloped immune system. Or,
maybe, the disease merely progressed faster in the child and so s/he only
looks like patient zero, despite the rest of the people eating having gotten
infected at the same time.

~~~
Pxtl
I'm sure the epidemiologists considered that possibility. If it was likely,
they would have mentioned it.

------
basicplus2
Nobody can be serious about containing this outbreak unless they stop the
planes flying and close all borders.

~~~
NkVczPkybiXICG
...or just move to Madagascar.

