If You Get Ebola, Be a Mukpo, Not a Duncan

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You probably won't get Ebola, but if you do, please be like Ashoka Mukpo, who self-quarantined, and not Thomas Eric Duncan, who traveled after exposure. (Ebola image: © Stocktrek Images/Corbis/hospital image: © RICHARD RODRIGUEZ/epa/Corbis)
You probably won’t get Ebola, but if you do, please be like Ashoka Mukpo, who self-quarantined, and not Thomas Eric Duncan, who traveled after exposure to the virus. (Ebola image: © Stocktrek Images/Corbis/hospital image: © RICHARD RODRIGUEZ/epa/Corbis)

Now that we have the first case of Ebola turning up in the U.S., it’s time to seriously think about two things. First, consider just how damned unlikely it is you will ever be within 100 miles of anyone with the disease, let alone contract it. Second, let’s review what YOU should do if you are infected with Ebola.

Ebola is indigenous to Africa and is found nowhere else in the world. So unless you go to Africa or spend time with someone who has, YOU CANNOT GET EBOLA.

If you do spend time there or have visitors who have, if they have been exposed to the virus, and if you do not exchange body fluids, YOU CANNOT GET EBOLA.

If you do exchange body fluids with someone who has been exposed to Ebola yet that person is not showing symptoms yet, or if their symptoms have passed, YOU CANNOT GET EBOLA.

The truth about Ebola is that it just isn’t all that contagious. Epidemiologists have a measurement for how contagious a disease is. The basic reproduction number, written R0, pronounced R Nought, is the average number of people that the average infected person is likely to infect. (Biology geeks, I know this is simplified, but I am a simple person). The R0 for measles is 18, very contagious. That one person will infect 18, and that 18 will probably infect another 18, and pretty soon, the whole population is sick. That’s why we vaccinate everybody for measles (except for stupid-ass parents who believe medical science doesn’t know anything).

For a disease like small pox, the figure is around 5-7 depending on the outbreak. HIV and SARS come in at 2-4. This figure has nothing to do with the deadliness of the disease (I’d rather have measles than small pox or HIV/AIDS), merely the rate of contagion.

For Ebola, the R0 is 1.5-2. That’s right, it spreads more slowly than HIV, and we know how hard it is for people in a monogamous relationship who don’t share hypodermic needles or get blood transfusions to get HIV. Almost impossible.

The whole point of vaccination and quarantine and everything else we do to halt outbreaks is to bring the RO to below 1. If that figure is met, the disease will burn out on its own.

OK, so let’s look at what to do if, out of the goodness of your heart, you have been treating Ebola sufferers in Africa, and the law of big numbers catches up with you. What should you do?

What you don’t do is what Thomas Eric Duncan did. He got on an airplane and flew to Texas to be with his family. Whether he knew he had Ebola or not when he got on the plane is a matter of debate, but if you are sick, don’t travel. Thanks to him, we now have to quarantine his family, decontaminate the apartment they shared and deal with public worry.

Instead, you do what the freelance cameraman NBC had hired did. Ashoka Mukpo was covering the Ebola outbreak with an NBC crew, and he came down with it. He immediately self-quarantined, and he let the doctor in the group, Dr. Nancy Snyderman, the network’s chief medical correspondent, know he was ill. She and the rest of the team also quarantined themselves. Mukpo came home Oct. 5 and is being treated at the Nebraska Medical Center biocontainment unit. In my books, Mukpo is a hero. He kept his cool and did what he had to in order to protect others.

Both men will be treated, but the only cure is for your immune system to fight the virus and win. All medical science can do to help is to give IV fluids, and balancing electrolytes. They will get oxygen and will have their blood pressure watched closely. And if there are any infections other than that, the doctors will treat those.

Ebola has a mortality rate of 60-90 percent depending on the outbreak. That 90 percent figure came from one of the earliest cases in which no real medical support occurred. The 60 percent is still pretty scary, but I think we are looking at a much better prognosis for Messrs. Duncan and Mukpo because they will get the very best science can offer.

The difference is others may need the best that science can offer in the Duncan case. Mukpo is likely not to infect anyone at all. Be a Mukpo, not a Duncan.

Jeff Myhre is a contributing journalist for TheBlot Magazine

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