Okay, the Ebola virus is here, and yes, that really matters – but probably not for the reason you’re thinking.
It landed in Dallas, Texas, on a flight from Africa on Friday, September 20th. The person in whose body Ebola hitched a ride began showing symptoms on September 24; on September 28 he was hospitalized and is reported to be in critical condition.
The crucial medical fact about Ebola is this: it can only be transmitted when the patient is sick and showing symptoms and even then only though direct contact with that person’s body fluids, notably blood, vomit, or excrement. Healthcare workers, therefore, need to be very careful, as the African experience shows. But the rest of us will be okay: “I have no doubt that we’ll stop this in its tracks in the U.S.,” says Tom Frieden, Director of the Centers for Disease Control and Prevention. So a local, internal spread of the virus isn’t really the issue.
There is, however, a deeper concern: Is the fact that Ebola made its way here a one-off, or does it portend a future where all bugs, especially those resistant to to antibiotics, although once geographically limited, now have a global reach?
The evidence overwhelmingly supports the latter view. Disease, like us, and because of us, is on the move everywhere; thus: “A disease outbreak anywhere is a disease risk everywhere,” says Dr. Frieden. That is because international travel has grown dramatically and it’s estimated that one billion people are travelling every year, most of them by air. In fact, worldwide tourist travel alone is expected to almost double over the next 15 years:
Since flights take people half way around the world in less than a day, that is well within the incubation period of many infectious diseases. That is why long-distance travel of persons and materials has long been recognized as a factor that drives the emergence of infectious disease; and now, increasingly so, as population levels rise.
The other thing is that germs don’t just attach themselves to people. Like you and me they hitch rides on airplanes too. For example, MRSA, the flu virus, E Coli, and diarrheal bugs are found throughout a plan, as this CNN report tells us. Moreover, the bugs will hang out in the plane for days: MRSA, which kills more than 11,000 Americans every year, was found to last 7 days on the seat pocket, 6 days on the armrest and seat, 5 days on the window shade and tray table, and 4 days on the toilet handle of planes.
The upshot of all this is well put by Dr. Cesar Arias, professor of medicine at the University of Texas: “Bugs don’t have passports. They don’t respect borders. They can travel very easily. And, in fact, this has been shown for MRSA.”
Notice that it’s not just MRSA that’s a frequent flyer. All the bugs on the graphic below – and many more – are joining the club every day. Welcome to the Global Village of infectious disease.