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Is Ebola heading to a city near you?

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Public Health England issued a warning on July 4 that medical practitioners in the United Kingdom should be prepared for the possibility of a patient with Ebola. The warning states that doctors should be "vigilant for unexplained illness in those who have visited the affected areas." The Agency states "The risk to a traveler going to West Africa of contracting Ebola is very low without direct contact with the blood or body fluids of an infected person."

Ebola is a viral illness with no treatment and no cure. No vaccine exists. There are several strains of the virus. The first outbreak of Ebola was discovered in 1976 in what was then Zaire, the Democratic Republic of the Congo.

The West African outbreak began in late March 2014. It has spread to three countries, Guinea, Liberia and Sierra Leone. For the first time, it has become an illness seen in urban areas.

As of July 2, the World Health Organization reported 779 suspected, probable and confirmed Ebola cases in the three countries. There have been 481 Ebola-related deaths for a mortality rate of 62 percent.

Ebola hemorrhagic fever is spread by contact with fluids from an infected patient. In West Africa, local customs for the care of the sick and for burial of the dead are contributing to the spread of the illness. These customs call for frequent touching of the sick and bathing the corpse prior to burial or cremation. Both are extremely dangerous to participants since they expose them to the virus.

Health care workers are at risk if they are unable or unwilling to use masks, gowns and gloves as protective gear. In the poverty-stricken nations where Ebola appears, these protective items are in very short supply and the result is that doctors and nurses often become infected themselves.

The two Ebola cases ever seen outside of Africa were due to laboratory accidents. Accidental needle sticks by contaminated needles or other exposures to contaminated medical and research instruments can result in an infection. The exposures occurred in different labs in different countries.

It is possible for a patient with Ebola to take an airplane flight from West Africa to just about anywhere in the world. The Centers for Disease Control believe that the symptoms of an infection appear anywhere from two to 21 days after exposure. They feel the average incubation time for Ebola is eight to ten days.

Could a case or several cases of Ebola be found in the United States or a European country? Perhaps. The continue importation of chikungunya illnesses and the two imported MERS cases earlier in 2014 show that the potential is there. Some media outlets are citing the immigration crisis on the Mexican border as a risk to the U.S. for Ebola. That is a false claim since Ebola has not appeared anywhere but on the continent of Africa.

The risk for the spread of the virus if it should arrive is minimal. Health care workers in the West use protective equipment as a matter of course. Isolation and restriction of visitors are common for contagious illnesses. The corpses of patients who die with such infections are not routinely surrendered to the patients' families but are cremated or buried safely.

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