Ebola in the U.S.: Reason to Fear, to Hope, to Prepare

Cheryl Clark, September 25, 2014

At some point an Ebola case will probably show up at a U.S. hospital, most likely in a big-city ED. Here's what hospitals should be doing to prepare.

The rapidly evolving Ebola epidemic, with 4,507 probable and confirmed cases in West Africa by September 14—more than double those from the 33 preceding outbreaks combined—should make U.S. hospital providers wary, if not nervous, about what to expect next.


Ebola: 7 Questions About U.S. Providers' Response


Consider these evolving facts:

  • The new case count model for 2014 released Tuesday estimates that 21,000 people in Liberia and Sierra Leone will have become sick with Ebola viral disease in the next five days, and as many as 1.4 million by Jan. 20, 2015. That's up from 49 cases just six months ago, according to the Centers for Disease Control and Prevention.
  • The agency's projections factor the knowledge that cases are "significantly underreported by a factor of 2.5." In some parts of West Africa, case counts are doubling every 15-20 days, with fatality rates between 50% and 70%, the CDC says. "Fresh Graves Point to Undercount of Ebola Toll" read the New York Times page one headline Tuesday.
  • CDC director Tom Frieden, MD, in a warning published today in an Ebola-themed issue of the New England Journal of Medicine, writes, "If a single case is missed, a single contact becomes ill and isn't isolated, or a single lapse in infection control or funeral-practice safety occurs, another chain of transmission can start."

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