Ebola threat puts spotlight on US epidemic readiness

The first Ebola case confirmed on American soil is driving debate on whether the US is prepared for future epidemics

When U.S. doctors diagnosed the country’s first case of Ebola last week, authorities had this message for the public: Keep calm. We have it covered.

The head of the Centers for Disease Control and Prevention, Dr. Tom Frieden, acknowledged that Ebola is a “scary disease” but pledged to contain it in the United States.

“We’re stopping it in its tracks in this country,” he said Tuesday, after the CDC confirmed that Thomas Eric Duncan, who traveled to Dallas after visiting Liberia, tested positive for Ebola.

Since March, the hemorrhagic fever has killed more than 3,400 people in West Africa, stretching hospitals there to their limits. U.S. health officials have stressed that America’s public health system is strong enough to keep Ebola in check. 

The handling of the case in Dallas, however, has raised questions over just how prepared U.S. hospitals are for a serious public health crisis.

When he first sought treatment last month, Duncan told a nurse that he had traveled to an Ebola-affected country, but this information was not properly communicated to doctors. He was sent home, only to land in the emergency room days later. Officials say 10 people had close contact with Duncan and a further 38 may have been around him when he was showing symptoms of the disease.

Although most hospitals in metropolitan areas like Dallas have infectious-disease specialists on staff, budget cuts are making it increasingly difficult for smaller areas to cope.

At the state and local levels, public health departments have more than 45,000 fewer staffers than they did before the 2008 financial crisis, according to CDC figures.

During Al Jazeera America’s regular Sunday night segment The Week Ahead, Dr. Amesh Adalja, a senior associate at the Center for Health Security at the University of Pittsburgh Medical Center, told Thomas Drayton about the challenges involved in tracking where infectious diseases are occurring.

“Lots of local health departments don’t have the capacity to process that data or even have individuals to go out and do what we’re talking about with Ebola, doing case findings and contact tracing,” Adalja said.

“Those are essential public health functions that are really at risk because of funding cuts.”

Since the 2001 anthrax attacks, the CDC reported that federal funding for public health emergency preparedness each year has decreased by about $1 billion.

Also appearing on The Week Ahead was Dr. Alexander Garza, a former assistant secretary for health affairs and chief medical officer for the Department of Homeland Security. He said lawmakers often have a “reactionary” approach when it comes to infectious diseases.  

“It’s very tough to get funding for things that haven’t happened yet,” he said.

Garza said Ebola’s high fatality rate has fed the public’s fear of the virus despite the fact that it is far less easily passed from person to person than other infectious diseases.

He argued that Americans should also be worried about enterovirus 68, a respiratory illness that has infected children in more than 40 states, not to mention the flu. 

“Every year, you have an opportunity to be vaccinated against one of the largest killers of infectious disease,” he said, “and that’s influenza.”

In recent years, different strains of the flu virus have resulted in about 200,000 hospitalizations annually, according to the CDC — with complications from the flu killing as many as 49,000 people in three decades.

Adalja said that despite major advances in treating and containing infectious diseases over the years, Americans should not become complacent or assume that the U.S. has “closed the book on infectious diseases.” 

“We’ve never closed it," he said. "And we won’t close it.”

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