How much danger is there for the general population? Basically there is no danger except for the few people (~10) who had direct contact with the individual when he became sick i.e. family members and medical personnel. Vox.com has a nice quiz on whether or not you have (or in danger of ever contracting) EVD that crystalizes this point:
Figure 1. Do you have (or will you ever have) Ebola Virus Disease (Vox.com).
At this point, public health professionals are retracing the steps of Mr. Duncan, and then checking whether anyone may have had direct contact with him and his bodily fluids. The following timeline from The New York Times outlines his journey:
1. Contracting EVD in Liberia:
"On Sept. 15, he helped his landlord's daughter, who was stricken by Ebola, get to the hospital, but they were turned away for lack of space. Mr. Duncan then helped carry the woman back to the family home, where she died hours later."It is pretty clear how Mr. Duncan contracted Ebola virus disease.
2. Plane flight to America:
"Mr. Duncan showed no signs of fever or other symptoms of Ebola when he was screened on Sept. 19 before boarding a flight from Monrovia to Brussels. He flew from Brussels to Washington Dulles and then on to Dallas-Forth Worth."An Ebola patient is only contagious if he or she is showing symptoms. Mr. Duncan's temperature was taken before he boarded the plane from Monrovia, and he was not sick. Thus, everyone who shared the plane with him will be fine.
3. Stay in Dallas:
"Mr. Duncan arrived in Dallas on Sept. 20 and appeared to be staying with relatives who lived in Ivy Apartments. He started showing symptoms on Sept. 24 and sought medical care at Texas Health Presbyterian Hospital on Sept. 26 but was sent home. His condition worsened, so he was taken back to the hospital by ambulance on Sept. 28. Health officials believe he came into contact with 12 to 18 people when he was experiencing symptoms. Among the possible contacts are relatives he was visiting, five schoolchildren, and at least three medical technicians who were in the ambulance with him."Public health officials have identified approximately 50 individuals who may have been in (direct or indirect) contact with Mr. Duncan, and they will be followed closely (i.e. checked daily for symptoms). Another 10 people were in close quarters with him (i.e. direct contact) who are being monitored closely by medical personnel with restricted access. These include the paramedics who took him to the hospital, and Mr. Duncan's fiancee and her family (who shared an apartment with him); the latter have been quarantined at a private residence.
Vigilance and painstaking precautions are extremely important. However, after the observation period of 21 days (typically the incubation period before symptoms are seen is 8-10 days after exposure but 21 days is considered the maximum), we will know whether any of the people who had contact with Mr. Duncan have been infected by EV. With good fortune, none of the 10 people who had direct contact will become ill. At that point (around mid October), the quarantine can be lifted on his family and the EMTs can rest easier after their brave actions. I am hopeful that no one else falls ill; however, if they do, their contact radius will be extremely limited, and so the impact will be contained.
One final remark is that the key to resolving this issue is once and for all is to eradicate EV at its source. The head of the CDC, Dr. Tom Friedan, made this point quite forcefully in a CNN opinion piece:
"And there is one final thing to remember, even as the first case here grabs the headlines: We must be relentless in stopping its spread in West Africa. After all, after all is said and done here, that is the only way to truly and completely protect the health security of America -- and the world."
Figure 2. Please stay calm.
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