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Reasonable precautions against Ebola

The Plague of Athens, an unknown disease thought to be similar to typhoid that swept through Greece and killed 75,000 to 100,000 people from 429 to 426 B.C., was one of the world's first recorded epidemics.

Over the subsequent millennia countless humans have perished from a variety of widespread, contagious afflictions, including smallpox, influenza, bubonic plague, malaria, tuberculosis, yellow fever, polio, measles, cholera, typhus and AIDS/HIV.

Though modern medicine has eradicated some of these maladies and developed treatments for others, the weak link in any public health program always has been persuading populations to heed warnings and change behavior.

The Ebola outbreak in West Africa that authorities fear will spread dramatically, and indeed has found its way to U.S. shores, represents a threat all of us must take seriously, which is why we are encouraged that hospitals here, including Lawrence + Memorial in New London and William W. Backus in Norwich, have begun making preparations for the (so far) unlikely event they have to care for a patient with the virus.

"We're ready with emergency kits and we're aware of the signs and symptoms," said Dr. Joseph Gadbaw, chief of infectious disease and department of medicine at L+M. "We're ready with travel questions."

Dr. Gadbaw said the focus with staff has been on reviewing symptoms and "thinking about (Ebola) as a possible diagnosis."

Patrick Turek, regional manager of emergency preparedness at Backus, said staff of the emergency department, environmental services, laboratory and other areas have received "refresher and specific training" about recognizing and responding to a patient with Ebola. Officials also conduct inventory reviews to ensure the hospital has a stockpile of protective equipment for health care workers, and staff have also been instructed to ask specific questions about patients' recent travel to Ebola-infected areas, Mr. Turek said.

Similar efforts are taking place in hospitals throughout the state and country - a reasonable approach that counters an apparent flawed response at the Dallas hospital where a 38-year-old Liberian man, Thomas E. Duncan, first showed up complaining of a fever and other Ebola-like symptoms four days after arriving in the United States on Sept. 20. The hospital sent him home with antibiotics and apparently never asked if had visited Liberia recently, even though news of the disease's spread had been reported widely around the world.

After Mr. Duncan's condition worsened he was taken back to the hospital by ambulance and only then did officials learn of his travels and make the Ebola diagnosis. They are investigating whether Mr. Duncan - at last report in critical condition, taking a turn for the worse - may have lied about his travels and failed to report he had been in contact with a woman in Liberia who subsequently died of Ebola.

In addition, the ambulance that took Mr. Duncan to the hospital also happened to be transporting a homeless man, who like the dozens of people Mr. Duncan came into contact with now must be monitored daily to make sure they haven't contracted the disease. The homeless man disappeared Saturday but was tracked down Sunday.

These incidents illustrate the challenges medical authorities confront in attempting to control Ebola's spread - much as public health officials did in the past when those suspected to carrying smallpox and other diseases fled rather than face quarantine or other official sanction.

The most infamous, an Irish immigrant named Mary Mallon - better known as Typhoid Mary - used aliases to continue working as a cook in New York and was believed to have infected 53 people, including three who died, before eventually being forcibly isolated twice for a total of nearly 30 years.

Meanwhile, on Monday another Ebola-stricken patient arrived in the United States, the fifth to date.

Ashoka Mukpo, 33, a video journalist from Providence who contracted Ebola while working in Liberia, arrived at a Nebraska hospital, where he will be treated. He had been hired by NBC as a freelance cameramen to help document the outbreak, which the World Health Organization estimates has killed more than 3,400 people.

Last month The Centers for Disease Control and Prevention warned that there could be 550,000 to 1.4 million cases by the end of January. The World Health Organization, which initially estimated a total of 20,000 cases, now fears that number will be reached in a few weeks.

Government officials appear to be doing their job in tracking and trying to control Ebola. Eventually they will be making specific recommendations about what the public should or shouldn't do.

We must prepare to abide by any forthcoming edicts as if our lives depended on it. They just may.

The Day editorial board meets regularly with political, business and community leaders and convenes weekly to formulate editorial viewpoints. It is composed of President and Publisher Tim Dwyer, Managing Editor Izaskun E. Larrañeta, staff writer Erica Moser and retired deputy managing editor Lisa McGinley. However, only the publisher and editorial page editor are responsible for developing the editorial opinions. The board operates independently from the Day newsroom.


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