Ebola Risk

Ebola: The Natural and Human History of a Deadly VirusI feel to a certain extent that I got ripped off by David Quammen whose non-fiction books I have enjoyed.  I received his latest – Ebola – in the mail yesterday only to find out that the book is

excerpted and extracted from my 2012 book Spillover [which I read], with some additional material, . . . to place the 2014 West Africa outbreak . . . within a broader context that makes sense of those mysteries and their partial solutions.

The book Ebola has updates that encompass the current outbreak in west Africa so it is probably the most up-to-date description of the Ebola virus in the popular press.  I am reading it and refreshing what I know about Ebola.  My reading confirms my belief that there is little need to worry about an epidemic in the United States.  The outbreak in Africa has reached epidemic proportions because of the poor public health and medical practices in the regions affected and superstition and burial practices that involve a lot of people handling the dead.  In the US, with our public health system and given that Ebola is not highly contagious, there will be no epidemic.  One might occur if Ebola mutated into a form that could spread through the air.  Then I would start worrying.

Efforts to contain the outbreak in West Africa

were hampered by a number of factors:  the weakness of governance in Liberia, Guinea, and Sierra Leone after decades of coups, juntas, and civil wars; the bitterness and suspicion among their peoples as a legacy of those conflicts; the inadequacy of health-care infrastructure and basic health-care services in the three countries, as reflected in extremely low annual per capita expenditures on health; the immediate shortage of money and outbreak-response supplies necessary for stopping Ebola, such as examination gloves, masks, gowns, rubber boots, bleach, and plastic buckets in which to put bleach solution so that hands could be washed; the shortage of treatment centers and beds within them; the porosity of the national borders between Guinea, Liberia, and Sierra Leone; the reluctance of people in affected villages and towns to see their loved ones confined to isolations facilities, within which treatment was often marginal and case fatality rate was running about 50 percent; the reluctance of people to suspend their traditional burial practices, which often involved washing or otherwise touching the body; the relatively short distances between rural areas where the outbreak started and the capital cities of the three counties allowing people to travel from affected area to Monrovia, Freetown, and Conakry by such relatively inexpensive modes of transport as shared taxi and bus; and the shortage of timely international aid.

None of these factors exist in the United States.  Fatality rates for Ebola run around from a bit over fifty to around seventy percent in the regions of Africa where the factors do exist.  The fatality rate in the United States would be much lower and there would be many more and much more effective barriers to the spread of Ebola.  There is little to worry about, but every time I turn on CNN, all I see is hour after hour of experts repeating themselves about Ebola.  The voices saying that given due diligence there is very little to worry about are being drowned out.

Was I ripped off in my book purchase?  I think there should have been some sort of disclaimer on the cover of the book that Ebola is excerpted from Spillover.  If I had known, I might not have purchased it.

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