Ebola outbreak: Lessons Learned

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By: Yekta Dowlati

As we followed the dramatic news of the Ebola outbreak in West Africa a few months ago and the hysteric fascination of the media with the few cases of Ebola that trickled into Western Europe and North America (mostly among health care workers who were in contact with Ebola patients), there may have been a small group within the scientific and healthcare community and many more in the public at large that considered this outbreak as a prelude to a “Viral Armageddon.” Of course there is no question that the epidemiologic characteristics and mortality rate of this disease are quite scary. That may explain why people throughout the world stared at their TV screens while the US Center for Disease Control issued regular updates. But if there is anything to be learned from this event, it is that the future focus of the healthcare community should not only be on a rapid and comprehensive response to the original cases identified, but also and more importantly on the prevention of such an outbreak in the first place. It is this concept of prevention that leads to the thought of many other potential disease outbreaks of infectious nature that are waiting to happen. And if this focus on prevention is correct, what should society think about diseases much more likely to result in outbreaks? Do they deserve less of the public’s attention?

Take for example the measles outbreak that began in December 2014 in the California Disneyland resort, which originally consisted of 147 cases of individuals who had visited Disneyland (of which 131 were California residents). Quickly the outbreak and spread of the disease was traced further north and across the US-Canadian border. This was possibly the direct result of two families from the Lanaudière region of Quebec that had visited California in the preceding weeks. Subsequently, the number of Canadian cases quickly escalated to 159 which surprisingly exceeded the original number of American cases. Although the past few decades have observed great strides in the prevention of measles worldwide through the use of appropriate vaccination techniques, there is no misconception that the disease continues to have a potentially dramatic spectrum of morbidity and even fetal-related mortality in pregnancies. The origin of this particular outbreak is still unclear, but the possible explanation points towards an “imported” cases of measles from beyond the borders or perhaps overseas. Is it possible a tourist from outside North American introduced the disease? Possibly yes. What makes it more concerning is that once measles enters our assumingly protected society, it can then rapidly spread through pockets of communities which do not believe or adhere to standard vaccination practices. Whatever the epidemiological course of this event, fortunately, it currently appears that the health authorities have launched an appropriate and sustained response in order to contain it. We are safe for now! Or, are we?

What I take from these events and from the world of infectious diseases is that we all need to be ever so vigilant for any case of an infectious agent, particularly those that have the potential to spread quickly in our modern world. Some may sound frightening while some may not be as bone chilling when we hear about them. Nevertheless, they all deserve a well thought and comprehensive response.