NBC News Cameraman Comes Down with Ebola

A free-lance cameraman working for NBC News has come down with Ebola virus. Ashoka Mukpo was working with NBC News Chief Medical Editor Dr. Nancy Snyderman, covering the growing Ebola epidemic from Liberia.

The NBC News team had been taking a number of precautions to avoid the disease, including washing their hands and feet with bleach, avoiding hugs or handshakes, and taking their temperature at least twice a day. Mukpo had seemed well earlier in the day, Wednesday, at a border crossing, but “as the day went on, he was starting to feel tired and a little achy,” Dr. Snyderman said. “And in the field, we work long hours so thought maybe he just wasn’t taking care of himself, and we sent him home to rest. He signed off, went home [and] called me later that evening with an elevated temperature.”  The next morning he was taken to a Doctors without Borders clinic, where he tested positive for Ebola.

NBC News plans to fly Mukpo and the rest of the NBC News team back to the US. Mukpo will be treated here and the rest of the team will voluntarily be in isolation for 21 days. Snyderman says the risk to the American public will be “nearly zero”.

“We want to be respectful to our colleagues and the U.S. public. Because we know this is not a casually transmitted disease and because we don’t have any symptoms, we present zero to minimal risk. Our returning to the U.S. is a very, very minimal chance of getting anyone [else] sick.”

This news comes on the heels of the first case of Ebola being diagnosed in the US.  Thomas Eric Duncan was diagnosed with Ebola Sunday Sept. 28, about a week after returning to the US. Duncan had direct contact with a pregnant woman stricken with Ebola on September 15, days before he left for the United States. Duncan had been seen at Texas Health Presbyterian Hospital Dallas 3 days earlier with “low grade fever and abdominal pain” and was sent home. He returned when his symptoms became severe and he tested positive for Ebola.

Health officials, including the CDC (Centers for Disease Control) are trying to figure out (1) if Duncan did not reveal to Liberian airport officials that he was exposed to a sick individual and (2) why the history of his foreign travel was not shared with the entire healthcare team at the Texas hospital, allowing him to be sent home after the first visit.  They are also tracking down any  individuals who may have come in contact with Duncan while he was ill. CDC Director Dr. Tom Frieden, M.D., M.P.H. in an attempt to allay public concerns said in a statement:

“Ebola can be scary. But there’s all the difference in the world between the U.S. and parts of Africa where Ebola is spreading. The United States has a strong health care system and public health professionals who will make sure this case does not threaten our communities. While it is not impossible that there could be additional cases associated with this patient in the coming weeks, I have no doubt that we will contain this.”

The rest of Duncan’s family remains in isolation at their apartment and must remain there for the rest of the 21 day incubation period. Questions have been raised, however, about the delayed sanitization  of that apartment by the appropriate authorities.

Here are the current CDC recommendations on Ebola:

How do I protect myself against Ebola?

If you must travel to an area affected by the 2014 Ebola outbreak, protect yourself by doing the following:

  • Wash hands frequently or use an alcohol-based hand sanitizer.
  • Avoid contact with blood and body fluids of any person, particularly someone who is sick.
  • Do not handle items that may have come in contact with an infected person’s blood or body fluids.
  • Do not touch the body of someone who has died from Ebola.
  • Do not touch bats and nonhuman primates or their blood and fluids and do not touch or eat raw meat prepared from these animals.
  • Avoid hospitals where Ebola patients are being treated. The U.S. Embassy or consulate is often able to provide advice on medical facilities.
  • Seek medical care immediately if you develop fever (temperature of 101.5°F/ 38.6°C) and any of the other following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding.
    • Limit your contact with other people until and when you go to the doctor. Do not travel anywhere else besides a healthcare facility.

CDC has issued a Warning, Level 3 travel notice for three countries. U.S. citizens should avoid all nonessential travel to Guinea, Liberia, and Sierra Leone. CDC has issued an Alert, Level 2 travel notice for Nigeria. Travelers to Nigeria should take enhanced precautions to prevent Ebola. CDC has also issued an Alert, Level 2 travel notice for the Democratic Republic of the Congo (DRC). A small number of Ebola cases have been reported in the DRC, though current information indicates that this outbreak is not related to the ongoing Ebola outbreaks in Guinea, Liberia, Nigeria and Sierra Leone. For travel notices and other information for travelers, visit the Travelers’ Health Ebola web page.

Can hospitals in the United States care for an Ebola patient?

Any U.S. hospital that is following CDC’s infection control recommendations and can isolate a patient in their own room‎ with a private bathroom is capable of safely managing a patient with Ebola.

What is being done to prevent ill travelers in West Africa from getting on a plane?

In West Africa

CDC’s Division of Global Migration and Quarantine (DGMQ) is working with airlines, airports, and ministries of health to provide technical assistance for the development of exit screening and travel restrictions in the affected areas. This includes:

  • Assessing the ability of Ebola-affected countries and airports to conduct exit screening,
  • Assisting with development of exit screening protocols,
  • Training staff on exit screening protocols and appropriate PPE use, and
  • Training in-country staff to provide future trainings.
During Travel

CDC works with international public health organizations, other federal agencies, and the travel industry to identify sick travelers arriving in the United States and take public health actions to prevent the spread of communicable diseases. Airlines are required to report any deaths onboard or ill travelers meeting certain criteria to CDC before arriving into the United States, and CDC and its partners determine whether any public health action is needed. If a traveler is infectious or exhibiting symptoms during or after a flight, CDC will conduct an investigation of exposed travelers and work with the airline, federal partners, and state and local health departments to notify them and take any necessary public health action. When CDC receives a report of an ill traveler on a cruise or cargo ship, CDC officials work with the shipping line to make an assessment of public health risk and to coordinate any necessary response.

In the United States

CDC has staff working 24/7 at 20 Border Health field offices located in international airports and land borders. CDC staff are ready 24/7 to investigate cases of ill travelers on planes and ships entering the United States.

CDC works with partners at all ports of entry into the United States to help prevent infectious diseases from being introduced and spread in the United States. CDC works with Customs and Border Protection, U.S. Department of Agriculture, U.S. Coast Guard, U.S. Fish and Wildlife Services, state and local health departments, and local Emergency Medical Services staff.

Relatively few of the approximately 350 million travelers who enter the United States each year come from these countries. Secondly, most people who become infected with Ebola are those who live with or care for people who have already caught the disease and are showing symptoms. CDC and healthcare providers in the United States are prepared for the remote possibility that a traveler could get Ebola and return to the U.S. while sick.

What do I do if I’m returning to the U.S. from the area where the outbreak is occurring?

After you return, pay attention to your health.

  • Monitor your health for 21 days if you were in an area with an Ebola outbreak, especially if you were in contact with blood or body fluids, items that have come in contact with blood or body fluids, animals or raw meat, or hospitals where Ebola patients are being treated or participated in burial rituals.
  • Seek medical care immediately if you develop fever (temperature of 101.5°F/ 38.6°C) and any of the following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding.
  • Tell your doctor about your recent travel and your symptoms before you go to the office or emergency room. Advance notice will help your doctor care for you and protect other people who may be in the office.

What do I do if I am traveling to an area where the outbreak is occurring?

If you are traveling to an area where the Ebola outbreak is occurring, protect yourself by doing the following:

  • Wash your hands frequently or use an alcohol-based hand sanitizer.
  • Avoid contact with blood and body fluids of any person, particularly someone who is sick.
  • Do not handle items that may have come in contact with an infected person’s blood or body fluids.
  • Do not touch the body of someone who has died from Ebola.
  • Do not touch bats and nonhuman primates or their blood and fluids and do not touch or eat raw meat prepared from these animals.
  • Avoid hospitals where Ebola patients are being treated. The U.S. Embassy or consulate is often able to provide advice on facilities.
  • Seek medical care immediately if you develop fever (temperature of 101.5oF/ 38.6oC) and any of the other following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding.
    • Limit your contact with other people until and when you go to the doctor. Do not travel anywhere else besides a healthcare facility.

Should people traveling to Africa be worried about the outbreak?

Ebola has only been reported in multiple countries in West Africa (see Affected Countries). A small number of cases in Nigeria have been associated with a man from Liberia who traveled to Lagos and died from Ebola, but the virus does not appear to have been widely spread. CDC has issued a Warning, Level 3 travel notice for United States citizens to avoid all nonessential travel to Guinea, Liberia, and Sierra Leone. CDC has issued an Alert, Level 2 travel notice for travelers to Nigeria urging them to protect themselves by avoiding contact with the blood and body fluids of people who are sick with Ebola. CDC has also issued an Alert, Level 2 travel notice for the Democratic Republic of the Congo (DRC). A small number of Ebola cases have been reported in the DRC, though current information indicates that this outbreak is not related to the ongoing Ebola outbreaks in Guinea, Liberia, Nigeria, and Sierra Leone. You can find more information on these travel notices at http://wwwnc.cdc.gov/travel/notices.

CDC currently does not recommend that travelers avoid visiting other African countries. Although spread to other countries is possible, CDC is working with the governments of affected countries to control the outbreak. Ebola is a very low risk for most travelers – it is spread through direct contact with the blood or other body fluids of a sick person, so travelers can protect themselves by avoiding sick people and hospitals where patients with Ebola are being treated.

Why were the ill Americans with Ebola brought to the U.S. for treatment? How is CDC protecting the American public?

A U.S. citizen has the right to return to the United States. Although CDC can use several measures to prevent disease from being introduced in the United States, CDC must balance the public health risk to others with the rights of the individual. In this situation, the patients who came back to the United States for care were transported with appropriate infection control procedures in place to prevent the disease from being transmitted to others.

Ebola poses no substantial risk to the U.S. general population. CDC recognizes that Ebola causes a lot of public worry and concern, but CDC’s mission is to protect the health of all Americans, including those who may become ill while overseas. Ebola patients can be transported and managed safely when appropriate precautions are used.

What does CDC’s Travel Alert Level 3 mean to U.S. travelers?

CDC recommends that U.S. residents avoid nonessential travel to Guinea, Liberia, and Sierra Leone. If you must travel (for example, to do for humanitarian aid work in response to the outbreak) protect yourself by following CDC’s advice for avoiding contact with the blood and body fluids of people who are ill with Ebola. For more information about the travel alerts, see Travelers’ Health Ebola web page.

Travel notices are designed to inform travelers and clinicians about current health issues related to specific destinations. These issues may arise from disease outbreaks, special events or gatherings, natural disasters, or other conditions that may affect travelers’ health. A level 3 alert means that there is a high risk to travelers and that CDC advises that travelers avoid nonessential travel.

In the United States

Are there any cases of people contracting Ebola in the U.S.?

CDC confirmed on September 30, 2014, the first travel-associated case of Ebola to be diagnosed in the United States. The person traveled from West Africa to Dallas, Texas, and later sought medical care at Texas Health Presbyterian Hospital of Dallas after developing symptoms consistent with Ebola. The medical facility has isolated the patient. Based on the person’s travel history and symptoms, CDC recommended testing for Ebola.

CDC recognizes that even a single case of Ebola diagnosed in the United States raises concerns. Knowing the possibility exists, medical and public health professionals across the country have been preparing to respond. CDC and public health officials in Texas are taking precautions to identify people who have had close personal contact with the ill person and health care professionals have been reminded to use meticulous infection control at all times.

Is there a danger of Ebola spreading in the U.S.?

Ebola is not spread through casual contact; therefore, the risk of an outbreak in the U.S. is very low. We know how to stop Ebola’s further spread: thorough case finding, isolation of ill people, contacting people exposed to the ill person, and further isolation of contacts if they develop symptoms. The U.S. public health and medical systems have had prior experience with sporadic cases of diseases such as Ebola. In the past decade, the United States had 5 imported cases of Viral Hemorrhagic Fever (VHF) diseases similar to Ebola (1 Marburg, 4 Lassa). None resulted in any transmission in the United States.

Are people who were on the plane with this patient at risk?

A person must have symptoms to spread Ebola to others. The ill person did not exhibit symptoms of Ebola during the flights from West Africa and CDC does not recommend that people on the same commercial airline flights undergo monitoring. The person reported developing symptoms five days after the return flight. CDC and public health officials in Texas are taking precautions to identify people who have had close personal contact with the ill person and health care professionals have been reminded to use meticulous infection control at all times.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

3 Comments

  1. Hannah Willey

    October 6, 2014 at 7:02 pm

    I have been fascinated with the disease Ebola ever since reading Richard Preston’s non-fiction book The Hot Zone. When written on 1994 Ebola was a far away thought, with occasional small outbreaks in parts of Africa but nothing on the level of the current outbreak occurring in West Africa. This is the largest Ebola outbreak with more than 7,000 cases so far and the first outbreak to occur in the West Africa region, which makes this outbreak a very rare occurrence. Another reason this outbreak has become such a large story in the United States news is the infection of several American aid workers, doctors, and NBC’s news cameraman. With this increased coverage of the Ebola outbreak comes increased stigma and fear of the disease due to lack of education. Over the past week I have seen tons of posts on social media of Americans expressing their fear of contracting Ebola, an irrational fear with America’s well-developed healthcare system and the fact that Ebola is a disease that is only transmitted with direct contact. Even in West Africa at the heart of the outbreak, there is a lack of education regarding Ebola transmission, and there is often a stigma against patients who have survived and recovered from the disease due to the incorrect fear they might still transmit the disease. We need more articles such as this article on celebrity diagnosis that educate the public on the spread of Ebola and what needs to be done to prevent it.
    In our Medicine and Media course we have discussed the importance of media forms, such as television dramas, in portraying accurate medical information to the public to reduce stigmas against disease. In 2006 the Grey’s Anatomy episode included a plot line regarding the ability of an HIV-positive woman’s ability to give birth to an HIV-free child. They found that viewers retained this knowledge and held a reduced stigma against HIV, even though the information was relayed through a fictional story line. This leads me to believe that people could retain medical information regarding Ebola from a news source known to be factual even better than a fictional source. With Ebola making the news headlines so frequently now there are many opportunities to educate the American public about the actual dangers of Ebola and precautions necessary to take to avoid contracting the disease. However, many new sources focus only on the numbers of people coming down with the disease and dying. These headlines convey the urgency and danger of the Ebola outbreak leading the reader to think they too may be at risk. These news stories could provide a valuable educational experience to help reduce the stigma regarding Ebola similar to the way Grey’s Anatomy writers used their influence to reduce the stigma of HIV. It is important for more articles to explain the risk factors for exposure to Ebola and how to prevent contracting the infection if you do come in contact with the disease, as done in this article.

  2. Monica Bodd

    October 7, 2014 at 6:18 pm

    The Ebola outbreak has made headline news on every form of media – iPhone news apps, Twitter, Facebook, and beyond. What interested me about the Ebola case was the delayed diagnosis of the patient. Why didn’t the doctors catch the disease during his first visit? What are the potential repercussions of sending a patient with Ebola back into the public? In an article by Patel in the Journal of Biomedical Informatics, the interesting paradox between illness and disease is presented; the utilization of EMR technology has limited the story-like aspects of a patient’s narrative, and instead emphasized the medical symptoms of the disease. This has created a tunneled vision for doctors, who focus mainly on quickly treating the disease rather than considering the events surrounding the patient’s sickness. In this Ebola case, if doctors had considered the timeline of the patient’s sickness – his visit to Liberia, his work with Ebola patients – could the disease have been identified upon his first visit? The limited space available on EMRs nationwide has forced doctors to summarize the patients visit in a couple of sentences, filtering out all nonmedical narratives and only including details most ostensibly related to the patient’s case. It will be interesting to see the modifications done to EMRs across the nation to include Ebola monitors to immediately detect and treat signs of Ebola.

    Another often-overlooked aspect to the Ebola outbreak in America is the related social media scene. As this article mentioned, a second patient, a NBC News Reporter, has been brought back to be treated. Gradually the number of Ebola patients is growing in America and, in parallel, the severity and urgent need for a treatment.

    As the fear of Ebola has exponentiated, I have noticed more and more tweets about Ebola. Pages like Dr. Bryan Vartabedian’s and BBC tweet scientific and respectful information.

    However, as appalling as it is, I have seen the number of lighthearted, joking tweets about getting Ebola also directly rise as the disease has been brought to America. Most of these tweets are by pages directed towards teenagers. This unforeseen lightheartedness of teenagers’ view of Ebola, which is dominating the Twitter sphere, can be due to many causes. One possibility may be an overly optimistic mindset that they will never catch the disease themselves. Perhaps this speaks to their immense faith in the American medical care system or their view that less healthy and older patients would become infected before they do.

    This is not to generalize all teenagers. Students and adults who have any exposure to the medical field or the concept of Ebola will and do recognize that the disease is a legitimate threat to mankind and it not a lighthearted topic. The small percentage of teenagers that is the retweet catalyst for Ebola jokes on Twitter, however, is in a way “sheltered” from the virulent truth out there – a slightly depressing thought. Even though social media has raised awareness of the Ebola outbreak across the world, it has it also diminished the fear of the disease to the point where portions of the general public are able to joke about it; to what penetrative extent will this disease have to reach for every age group to realize that Ebola is a serious problem infecting our country?

  3. Monica Bodd

    October 8, 2014 at 7:37 pm

    The Ebola outbreak has made headline news on every form of media – iPhone news apps, Twitter, Facebook, and beyond. What interested me about the Ebola case was the delayed diagnosis of the patient. Why didn’t the doctors catch the disease during his first visit? What are the potential repercussions of sending a patient with Ebola back into the public? In an article by Patel in the Journal of Biomedical Informatics, the interesting paradox between illness and disease is presented; the utilization of EMR technology has limited the story-like aspects of a patient’s narrative, and instead emphasized the medical symptoms of the disease. This has created a tunneled vision for doctors, who focus mainly on quickly treating the disease rather than considering the events surrounding the patient’s sickness. In this Ebola case, if doctors had considered the timeline of the patient’s sickness – his visit to Liberia, his work with Ebola patients – could the disease have been identified upon his first visit? The limited space available on EMRs nationwide has forced doctors to summarize the patients visit in a couple of sentences, filtering out all nonmedical narratives and only including details most ostensibly related to the patient’s case. It will be interesting to see the modifications done to EMRs across the nation to include Ebola monitors to immediately detect and treat signs of Ebola.

    Another often-overlooked aspect to the Ebola outbreak in America is the related social media scene. As this article mentioned, a second patient, a NBC News Reporter, has been brought back to be treated. Gradually the number of Ebola patients is growing in America and, in parallel, the severity and urgent need for a treatment.

    As the fear of Ebola has exponentiated, I have noticed more and more tweets about Ebola. Pages like Dr. Bryan Vartabedian’s and BBC tweet scientific and respectful information.

    However, as appalling as it is, I have seen the number of lighthearted, joking tweets about getting Ebola also directly rise as the disease has been brought to America. Most of these tweets are by pages directed towards teenagers. This unforeseen lightheartedness of teenagers’ view of Ebola, which is dominating the Twitter sphere, can be due to many causes. One possibility may be an overly optimistic mindset that they will never catch the disease themselves. Perhaps this speaks to their immense faith in the American medical care system or their view that less healthy and older patients would become infected before they do.

    This is not to generalize all teenagers. Students and adults who have any exposure to the medical field or the concept of Ebola will and do recognize that the disease is a legitimate threat to mankind and it not a lighthearted topic. The small percentage of teenagers that is the retweet catalyst for Ebola jokes on Twitter, however, is in a way “sheltered” from the virulent truth out there – a slightly depressing thought. Even though social media has raised awareness of the Ebola outbreak across the world, it has it also diminished the fear of the disease to the point where portions of the general public are able to joke about it; to what penetrative extent will this disease have to reach for every age group to realize that Ebola is a serious problem infecting our country?

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