Skip to content
  • About
  • Contact
  • Contribute
  • What Physicians Say
  • My Book
  • Careers
  • Podcast
  • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
  • About Kevin Pho, MD, Founder of KevinMD
  • Aging and dementia: what physicians say, in their own words
  • Artificial intelligence: what physicians say, in their own words
  • Be heard on social media’s leading physician voice
  • Board certification: what physicians say about the boards and MOC, in their own words
  • Cancer: what physicians say, in their own words
  • Children’s health: what pediatricians say, in their own words
  • Contact Kevin
  • COVID-19: what physicians wrote as it happened
  • Custom enhanced author page pricing
  • Diabetes and obesity: what physicians say, in their own words
  • Direct primary care: what physicians say, in their own words
  • DMCA Policy
  • End of life: what physicians say, in their own words
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words
  • Heart disease: what physicians say, in their own words
  • Immigration and medicine: what physicians say about immigrant doctors and immigrant patients, in their own words
  • KevinMD influencer opportunities
  • Medical errors: what physicians say, in their own words
  • Medical ethics: what physicians say, in their own words
  • Medical malpractice: what physicians say, in their own words
  • Medical school: what students and physicians say, in their own words
  • Mental health: what psychiatrists and physicians say, in their own words
  • Nursing: what nurses and physicians say, in their own words
  • Opinion and commentary by KevinMD
  • Opioids: what physicians and pain patients say, in their own words
  • Physician burnout speakers to keynote your conference
  • Physician burnout: what physicians say, in their own words
  • Physician careers: what physicians say about jobs, contracts, and leaving clinical practice, in their own words
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician personal finance: what physicians say about their own money, in their own words
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Physician suicide: what physicians say, in their own words
  • Physicians and administrators: what physicians say about who runs medicine, in their own words
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Primary care: what physicians say, in their own words
  • Prior authorization: what physicians say, in their own words
  • Privacy Policy
  • Private equity and corporate medicine: what physicians say, in their own words
  • Race and medicine: what physicians say, in their own words
  • Recommended services by KevinMD
  • Residency: what residents and attendings say, in their own words
  • Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words
  • Subscribe to the KevinMD enhanced author page
  • Subscribe to the newsletter
  • Surgeons and surgery: what surgeons say, in their own words
  • Take-home messages: what physicians say when asked to leave one
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The electronic health record: what physicians say, in their own words
  • Vaccines: what physicians say, in their own words
  • Violence against health care workers: what physicians and nurses say, in their own words
  • What physicians say: the KevinMD records
  • Women in medicine: what women physicians say, in their own words
  • Women’s health: what physicians say, in their own words

Ebola in Texas: Why you shouldn’t freak out

Albert Fuchs, MD
Conditions and Diseases
October 5, 2014
Share
Tweet
Share

The first Ebola patient has been diagnosed in the U.S. This news is likely making many of my regular readers wonder, “Should I freak out?” This is a reasonable question, and I will attempt to answer it. But first, let’s go over how this nasty microbe spreads.

Ebola is caused by a virus that is transmitted through contact with the bodily fluids of someone who is sick. It is not airborne; that is, it is not spread by respiratory droplets (coughing, sneezing). After being infected with the Ebola virus, a patient develops symptoms 2 to 21 days later. The patient is only contagious once symptoms appear, not before. Symptoms of Ebola include fever, headache, muscle aches, diarrhea and vomiting.

On September 15, Thomas Eric Duncan, a man living in Liberia, was helping a neighbor who had become ill. (The neighbor later died.) On September 19, while Mr. Duncan was feeling well, he boarded a plane and flew from Liberia through Brussels and Washington. He landed in Texas on September 20 and visited family in Dallas. As is now standard practice for all passengers leaving Liberia, his temperature was checked before boarding his flight and was normal.

On Wednesday, September 24, Mr. Duncan began feeling ill. On September 26 he presented to the emergency department at Texas Health Presbyterian Hospital. He told a nurse he had been in Liberia. The nurse used a checklist to screen for possible Ebola patients. Embarrassingly, that information didn’t get transmitted to the rest of the team caring for Mr. Duncan. He was evaluated and discharged with a prescription for antibiotics. Oops. Major, potentially consequential oops.

On September 28 Mr. Duncan became more ill and was taken by ambulance to the same hospital. At that point, things unfolded as they should. He was quickly identified as a potential Ebola patient and isolated. On September 30, tests confirmed that Thomas Eric Duncan is the first patient to be diagnosed with Ebola in the U.S. He remains hospitalized under isolation and is in serious condition.

Since then Centers for Disease Control (CDC) and state health officials have carefully tracked Mr. Duncan’s movements since he became ill. Remember, the disease is not transmissible until symptoms develop. So, as a CDC official said, there is “zero risk of transmission on the flight.” Four people at the Dallas apartment where he stayed are under quarantine and are being evaluated daily for symptoms. So far, all of them are still well. 12 to 18 people had direct contact with the patient and are also being followed by health officials but are not quarantined. A broader list of about 100 people who may have had very brief contact with Mr. Duncan was also interviewed by health officials to narrow the list to those who might have been exposed to Ebola and require monitoring.

So, dear reader, this is why you shouldn’t freak out. The conditions that have permitted Ebola to spread like wildfire in Africa simply don’t exist here.

What’s the worst that could (likely) happen? A few of the people under quarantine might get sick. That would be terrible. (Some of them are kids.) But the CDC would be on them like, well, health officials on an Ebola patient. They would be immediately hospitalized and isolated. It’s conceivable, but unlikely, that a couple of the 12 to 18 less-close contacts also become ill, but they would get the same treatment. The point is, if Mr. Duncan infected anyone, those patients won’t have a chance to infect anyone else. That’s good workaday epidemic control and it’s one of the many things that African health officials don’t have the resources for.

There are a few other important differences between the conditions here and in Africa that bear on this outbreak. The first is that a very large number of the victims in Africa are health care workers. That’s because of the lack of even the most basic equipment for personnel protection, like latex gloves and disposable gowns. Another difference is that in Africa there is deep mistrust of public health officials and many families hide sick relatives and don’t seek care. In the U.S. the response from the public is likely to be the opposite. If even three or four more patients are identified, the public is likely to overreact. Every fever, runny nose, or pessimistic thought in Dallas is likely to be reported to a physician. The problem will not be in quickly identifying all the Ebola cases. The problem will be that the health care system will be flooded with run of the mill flu symptoms. Don’t have a heart attack that day.

Traditional burial practices in Africa which involve direct contact with the deceased have also contributed to the spread of the disease, and obviously would not be allowed here.

So, spare a kind thought for Mr. Duncan. The Ebola case mortality in Africa is about 50 percent, but I hope with excellent care his chances are much better than that. I also hope that if any of his family fall ill they also recover.

West Africa will continue to require enormous resources to control the current outbreak. And infected people, despite the best screening methods, will continue to travel to the developed world and then learn that they are sick. But a few simple questions, some gloves and gowns, and meticulous tracking of contacts will always prevent a sustained outbreak here.

Albert Fuchs is an internal medicine physician who blogs at his self-titled site, Albert Fuchs, MD.

ADVERTISEMENT

Prev

Informed consent: Can patients ever truly be informed?

October 5, 2014 Kevin 0
…
Next

5 ways pharma can incorporate digital technologies

October 5, 2014 Kevin 0
…

Tagged as: Infectious Disease

< Previous Post
Informed consent: Can patients ever truly be informed?
Next Post >
5 ways pharma can incorporate digital technologies

 

ADVERTISEMENT

More by Albert Fuchs, MD

  • Processed meats and cancer: How much is too much?

    Albert Fuchs, MD
  • This is the best way to treat chronic insomnia

    Albert Fuchs, MD
  • Paying people to quit smoking. Does it work?

    Albert Fuchs, MD

More in Conditions and Diseases

  • Why is psychic pain treated as a symptom instead of pain?

    Michelle Wyrick, RN
  • Cancer care in Ghana: Poverty is the true malignancy

    Nana Akua Acquaye
  • Why choose sleep medicine as an intellectual frontier

    Bruce D. Forman, PhD
  • After 2 failed antidepressants, raise TMS and esketamine

    Ravi Singareddy, MD
  • Stop calling every form of physician distress burnout

    Devina Maya Wadhwa, MD
  • Physician burnout and autonomy are not just math

    Ashley Gay
  • Most Popular

  • Past Week

    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • What did the tirzepatide study actually test?

      Jeffrey Laman, MD | Medications
    • Private equity in medicine did not kill private practice

      Brian Hudes, MD | Health Policy
    • Setting boundaries as a physician doesn’t mean caring less

      Jerina Gani, MD, MPH | Physician
    • Medicare home care coverage pays for rehab, not an aide

      Raya E. Kheirbek, MD, MPH | Conditions and Diseases
    • Automation bias in health care can become paternalism

      John Wei, MD | Health Technology
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • What did the tirzepatide study actually test?

      Jeffrey Laman, MD | Medications
    • Why is psychic pain treated as a symptom instead of pain?

      Michelle Wyrick, RN | Conditions and Diseases
    • Diagnostic overshadowing and the war in her throat

      Diagnostic overshadowing and the war in her throat

      Franklyn R. Gergits, DO, MBA | Physician
    • Why do charity commercials leave clinicians uneasy?

      Why do charity commercials leave clinicians uneasy?

      Ronald L. Lindsay, MD | Physician
    • Revenue cycle management is more than medical billing

      Revenue cycle management is more than medical billing

      GetPracticeHelp | Physician Finance
    • Why AI fails in health care: Your data is the problem

      Michael Meucci | Health Technology

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 16 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • What did the tirzepatide study actually test?

      Jeffrey Laman, MD | Medications
    • Private equity in medicine did not kill private practice

      Brian Hudes, MD | Health Policy
    • Setting boundaries as a physician doesn’t mean caring less

      Jerina Gani, MD, MPH | Physician
    • Medicare home care coverage pays for rehab, not an aide

      Raya E. Kheirbek, MD, MPH | Conditions and Diseases
    • Automation bias in health care can become paternalism

      John Wei, MD | Health Technology
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • What did the tirzepatide study actually test?

      Jeffrey Laman, MD | Medications
    • Why is psychic pain treated as a symptom instead of pain?

      Michelle Wyrick, RN | Conditions and Diseases
    • Diagnostic overshadowing and the war in her throat

      Diagnostic overshadowing and the war in her throat

      Franklyn R. Gergits, DO, MBA | Physician
    • Why do charity commercials leave clinicians uneasy?

      Why do charity commercials leave clinicians uneasy?

      Ronald L. Lindsay, MD | Physician
    • Revenue cycle management is more than medical billing

      Revenue cycle management is more than medical billing

      GetPracticeHelp | Physician Finance
    • Why AI fails in health care: Your data is the problem

      Michael Meucci | Health Technology

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use Agreement
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Ebola in Texas: Why you shouldn’t freak out
16 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...