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Ebola: This outbreak is different

15038945315_7613c40e54_zMisinformation about Ebola blankets the web. To clarify priorities, and spur action, Stanford global health specialist Michele Barry, MD, penned a strongly worded essay published today in Boston Review:

In the United States, the few cases imported have incited irrational fear which is not only unwarranted but actually undermines an appropriate response to the outbreak. By focusing on quarantine, we are ignoring the need for centralized public health systems and training to deal with inevitable cases of Ebola.

Ebola is not spread through air, water or food, but end-stage sick patients can have over a billion viral particles in a cubic centimeter — or about a fifth of a teaspoon — of blood making contact with bodily fluids highly contagious.

This Ebola outbreak is different, she says. Previously, the virus stayed close to its forest reservoir in Central Africa. Now, it's in large cities, spreading through heavily populated areas that have been decimated by poverty and conflict.

As the virus spread, the World Health Organization was slow to respond, Barry writes. "The WHO was alerted to the cluster of cases in Guinea by March, but did not sound the alarm until August. Why did this happen?"

And what, now, can be done?

In actuality, the solution to this Ebola crisis is not drugs, mass quarantine, vaccines or even airdrops of personal protective gear. The real reasons this outbreak has turned into an epidemic are weak health systems and lack of workforce; any real solution needs to address these structural issues.

We have the tools to spot emerging outbreaks and to stop them. We know how to prevent transmission of Ebola. Orchestrating an international response, however, one that considers the welfare of patients and healthcare workers, the resilience of healthcare systems and the triumph of reason — that needs some work.

Previously: Stanford physician shares his story of treating Ebola patients in Liberia, How to keep safe while operating on Ebola patients and Ebola: A look at what happened and what can be done
Photo from the European Commission DG ECHO

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