Between 2,000 and 5,000 travelers arrive monthly in the New
York City metropolitan area from the West African Countries currently
struggling to contain the Ebola Virus outbreak. It is highly unlikely though
that an individual infected with the virus will arrive here without the medical
community knowing about him or her.
Any passenger found to be sick on the flight would be reported to the
CDC Quarantine Station by the flight crew and whisked into isolation with full
infection control precautions in place. If the illness starts after arrival all
emergency departments are prepared to isolate the sick traveler and determine
the etiology of the febrile illness. Typhoid fever, cholera and malaria are
infinitely more likely than Ebola.
Of the fifty or so people who have arrived in NYC from West
Africa sick none have even had an illness worrisome for Ebola let alone the
disease. This includes the well-known patient at Mt. Sinai. Should a patient with
Ebola arrive in NYC there would still be little reason for the general public
to be concerned. The primary transmission risk for Ebola is to health care
workers who do not have adequate personal protective equipment and persons
handling infected bodies during burial rites. The health care systems in the
affected countries are both understaffed and under resourced, a problem not
present in NYC (or anywhere in the US for that matter). NYC has the ability to rapidly test
suspect patients, something that isn’t easily done in West Africa. Additionally,
Ebola, unlike say measles, isn’t contagious until after symptoms begin, so
there is time to implement control measures. Ebola isn’t airborne so to be
infected one needs to come in contact with body fluids. The risk of Ebola transmission
is low during the beginning of the illness, therefore hospital infection
control precautions can be put in place in time and reduce the risk to health
care workers. Ebola just isn’t the type of disease to pose a risk to the
general US population. It’s not the Andromeda strain.
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