U.S. Unprepared for Ebola, According to Journal of American Physicians and Surgeons


TUCSON, Ariz., Dec. 15, 2014 (GLOBE NEWSWIRE) -- Despite spending billions on biological defense and pandemic preparedness, the U.S. is woefully unprepared, as recent experience with Ebola demonstrated, write Steven J. Hatfill, M.D., and coauthors in the winter issue of the Journal of American Physicians and Surgeons.

While U.S. troops are now deployed in an area of a raging epidemic, Hatfill points out that our ability to provide air transport of critically ill, highly contagious patients is seriously degraded compared with 1978. At that time, the U.S. Department of Defense created the Aeromedical Isolation and Special Medical Augmentation Response Team (AIT-SMART). The aircraft transit isolator was capable of biosafety level 4 (BSL-4) containment, and a special military unit was trained and practiced in its use.

In 2010, AIT-SMART was decommissioned, and the unified capability to admit a patient directly to a medical containment unit at U.S. Army Medical Research Institute for Infectious Diseases (USAMRIID), with a suite of specialized laboratories and a team of highly experienced physicians and researchers, was also lost, Hatfill states.

Current CDC guidelines, though rapidly revised after the events in Dallas, still call for a level of protection below BSL-4. We contained this threat in the U.S. for now, Hatfill notes, but it should be a wake-up call.

Ebola targets the body's immune system, causes a massive harmful inflammatory response and apoptosis (programmed cell death) of many cell types, and in fatal cases results in multiple organ failure. Hatfill explains disease manifestations in detail, along with the virus's family tree and cycle of transmission.

There are many unanswered questions about Ebola virus disease, including the timing of viral shedding, persistence of virus in the environment, possible reservoirs in domesticated animals, and the potential for aerosol transmission, Hatfill writes.

The Journal is the official, peer-reviewed publication of the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties, founded in 1943 to preserve private medicine and the patient-physician relationship.



            

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