CDC plans to send ‘surge’ of staff to Africa as two Ebola-infected Americans return for treatment


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JUDY WOODRUFF: Now the latest on the Ebola outbreak in West Africa, which is moving faster than efforts to contain it.

The disease has struck hard in three countries, Guinea, Liberia and Sierra Leone, which is the epicenter. A Liberian government official who’d flown to Nigeria’s largest city, Lagos, died of the disease in a hospital there. Two American aid workers infected in Liberia, 33-year-old Kent Brantly and 59-year-old Nancy Writebol, will be sent home for care at Emory University Hospital in Atlanta.

It’s the first time any Ebola patient has been sent back to the U.S. for treatment.

This afternoon, Dr. Bruce Ribner of Emory said there was no cause for alarm among the public.

DR. BRUCE RIBNER, Emory University Hospital: From the time air ambulance arrives in the metropolitan Atlanta area, up to and including being hospitalized at Emory University Hospital, we have taken every precaution that we know and our colleagues at the CDC know to ensure that there is no spread of this virus pathogen.

JUDY WOODRUFF: Hari Sreenivasan in our New York studios picks up the story from there.

HARI SREENIVASAN: To date, 729 people have died out of more than 1,300 documented or suspected infections. The World Health Organization said it would launch a $100 million plan to deploy more health workers to the region.

It came one day after the Centers for Disease Control and Prevention warned Americans not to travel to the affected countries unless necessary.

Dr. Tom Frieden is the director of the CDC. And he joins me now.

So, first off, what can you tell people to assure them that this disease will not spread to Atlanta or other parts of the United States as we bring these patients back?

DR. THOMAS FRIEDEN, Director, Centers for Disease Control and Prevention: Well, first off, it’s really important to understand how Ebola spreads and how it’s spreading in Africa.

The outbreak there is the worst we have ever seen, but Ebola doesn’t spread from people who don’t have symptoms. So if you have contact with someone who is exposed, but not sick, you can’t get it. And, second, Ebola isn’t spread by casual contact. It’s not spread through the air. It’s spread through body fluids.

That’s why, in Africa, the two main reasons — the two main ways it’s spreading are by health care when there’s not good infection control and funerals, where there’s handling of bodies. And in this country, we have plenty of ways to make sure that if a patient with Ebola ends up here, we have isolation facilities in every major hospital in the country, and isolation procedures that will prevent health care workers from becoming exposed or infected.

And, of course, if anyone were to die, we have safe burial procedures. It’s hard to control in Africa. It’s easy to stop in the U.S.

HARI SREENIVASAN: So, if it is easy to stop, then, why the extraordinary measures, the private charted jet, the sort of isolation or unit that contains the patients?

DR. THOMAS FRIEDEN: The issue is that the stakes are so high.

So if you have a lapse in infection control in a hospital, as happens sometimes, you may get an infection or a health care worker may get infected or may spread it to another patient. That’s usually not fatal. In Ebola, the fatality rate ranges from 40 up to 80 or 90 percent.

So because the stakes are so high, it’s not that we do different procedures. It’s that we have to make sure that they’re absolutely secure, they’re absolutely well done.

HARI SREENIVASAN: Is the CDC giving guidelines to other government agencies who might be coming in contact, say, whether it’s Customs and Border Patrol or Homeland Security? We obviously have people and goods that are coming back and forth from Africa, the infected areas as well. I know we have a conference coming up next week where lots of African leaders are expected to come to D.C.

DR. THOMAS FRIEDEN: We work very closely across the U.S. government. There is a conference next week, as you mentioned.

But, of course, Africa is a very large continent. There are three small countries within that large continent with relatively small populations. And there are steps being taken to see about the delegations coming from those countries.

But the bottom line is that, to protect Americans, fundamentally, we’re doing three things, first, controlling the outbreak where it’s spreading. That’s the most effective and the best way to do it, because that’s the source.

Second, we’re helping each of these three countries do better exit screening, so they will reduce the likelihood that someone who is either sick or has been exposed leaves and becomes infectious in transit or when they arrive somewhere else. And, third, we’re alerting people throughout the U.S. health care systems of what to think about in case someone comes from Liberia, Guinea, or Sierra Leone within three weeks and has a fever.

What do you do? Well, usually, it will be a cold, or malaria, or flu or something else. But in case it could be Ebola, here’s how you test and here’s how you isolate. And that’s information we get out very widely through the health care system.

HARI SREENIVASAN: So, the World Health Organization said today that it’s spreading faster than their ability to contain it. Does that concern you?

DR. THOMAS FRIEDEN: Absolutely.

We are very concerned about the situation in Africa and West Africa in these three countries. This is the worst outbreak of Ebola we have seen. It’s the largest, it’s the most complex, it’s the most diverse outbreak, and it’s crossing borders. So when it’s controlled in one country, then it has flared up in another.

Controlling Ebola is possible. We know how to do it. Even though we don’t have medicines and we don’t have a vaccine against it, we know how to stop it. And we have been able to stop every outbreak that has occurred to date. And I am confident we will eventually be able to stop this one.

But the challenges are huge, because you have got to get the contact tracing right. You have got to get the case management right. And if you miss just one case, it’s like embers in a forest fire. It reignites. And then you have to start that process all over again.

HARI SREENIVASAN: Briefly, I know that you’re sending additional doctors to the region. Any concerns for their health?

DR. THOMAS FRIEDEN: We have safety as the first concern for our staff, so we will not send people to unsafe environments.

We plan to surge the CDC response, and we’re planning to send 50 more staff to the region in the next 30 days to help with the response, to help find patients, track contacts, make sure they’re effectively isolated, do the laboratory work to see where the infections are occurring and whether there are infections, and improve the response overall, including the communication, because there have been many misconceptions in the region.

This is a new disease to West Africa. It’s a big contrast with other places we have worked, where after many years of work, we have very productive and constructive relationships with everyone, ranging from traditional healers to ministries of health. Here, we have to kind of reinvent that system in a new place.

HARI SREENIVASAN: Director Tom Frieden of the CDC, thanks so much.

DR. THOMAS FRIEDEN: Thank you very much.

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