“I promise you this is not Ebola.”
On the one hand, I had figured I’d probably find myself saying those words sooner or later. With Ebola continuing to both spread unchecked in West Africa and dominate the headlines, it was only natural that sooner or later it would lead to paranoia within my own community. People are people, and scary things are scary. Part of my job as a pediatrician is to take the scary things in the news and make them the right size.
On the other hand, there was no reason to be concerned about Ebola in the first place for the child whose parent has raised concerns. For one thing, she was perfectly healthy and didn’t even really have a fever, just very mild cold symptoms. She had been nowhere near West Africa, nor had she been in contact with anyone who had been. As far as risk factors were concerned, hers were nil.
She didn’t have Ebola.
That patient encounter happened a few weeks ago. Since then, the first case of Ebola has been diagnosed within the United States, sadly with the patient dying several days later. A nurse who cared for him has become the first person to contract the illness within this country, through an as-yet-unspecified breach in protocol. A disease that once seemed distant has become, at least psychologically, more present to the American people.
As of the moment of this writing, no cases of Ebola have been confirmed in my area. A man who had traveled to Liberia was admitted to a nearby hospital with suspicious symptoms, but I was relieved to hear during my morning commute that the likelihood he actually has the illness is low. A different group of passengers were taken to yet another local hospital after displaying flu-like symptoms on a flight from Dubai, but it looks like they, too, were low-risk. Who knows what tomorrow’s news will confirm or refute?
But “flu-like” is a salient phrase to consider. These new cases, both real and merely suspected, are coming right as we approach the cusp of influenza season. Though at present flu activity is low in the United States, it’s only a matter of time before people start coming down with it in greater numbers. (This is as good at time as any to exhort you to get a flu shot if you haven’t done so already.) Thus far, the parents who have raised concern about Ebola have been relatively easy to reassure, as their children haven’t really had symptoms that looked like it. As more come down with the flu, I suspect the reassurance will become more challenging.
People have been getting pulled off of planes for concerns about Ebola for over a week now, and will likely to continue to be as the outbreak in West Africa continues to spread. Some have been genuinely ill in some way, others merely stupid. Patients remain in isolation in places as disparate as Kansas City and Belleville, Ontario, and nothing would surprise me less than additional locations being added to the list over time.
Even in that event, however, the risk to the general public will remain very low. As Dr. Aaron Carroll points out at The Incidental Economist, the people most at risk of contracting Ebola in this country are health-care workers taking care of those already known to have the disease, which is the case both for the second patient in the United States and a nurse in Spain. Even the deputy sheriff in Dallas who made news after he, unprotected, entered the apartment of the Liberian man who was first diagnosed with Ebola in this country and later spiked a fever ended up testing negative for the disease. For the overwhelming majority of people in this country, the likelihood of contracting it is fleetingly small.
As I am sure I’m going to be saying a lot in the coming weeks and months, there is no reason to panic about Ebola. Barring the extremely unlikely event that, against all advice to the contrary, someone has traveled to one of the countries experiencing the outbreak in Africa, there is no reason to be concerned about it. The only small adjustment I will be making to my own practice is asking more directly about travel history and sick contacts. But even if there is a case confirmed in my area, it won’t really change the reassurance I give my patients.
Flu-like symptoms are probably the flu or some other common virus. However near or far a real or suspected case of Ebola may be to anyone in this country, the actual risk of infection is negligible. Get a flu shot, wash your hands, and cover your mouth when you cough. Those are the best ways to keep yourself and others healthy, just like any other year.