State has defense in place to combat threat of Ebola

Patients are beginning to share their increasing concerns about the recent spread of Ebola in West Africa. While it is prudent for the people of Hawaii and the Department of Health to remain vigilant about global trends of any infectious disease, there is no imminent cause for alarm.

As of Tuesday, 1,229 people have succumbed to Ebola with another 1,011 cases now identified, primarily in Guinea, Sierra Leone and Liberia, according to the World Health Organization. The two Americans affected by the disease and evacuated to an isolation ward in Atlanta were recently released after tests showed the virus was no longer present. The two had used an experimental treatment, ZMapp.

Unlike chicken pox, for example, that can be spread through the air, Ebola requires actual contact with body fluids. Its mode of transmission is similar to HIV and hepatitis B and C. While the illness is limited essentially to West Africa at present, it has been difficult to contain because this region has extremely limited healthcare resources. In developed countries with solid healthcare infrastructure, illnesses like Ebola are easier to contain.

It is also important to appreciate that the number of people infected by Ebola to date is dwarfed by those who succumb to malaria, tuberculosis, AIDS, yellow fever and diarrhea every day.

Nevertheless, because Ebola is associated with high mortality and does not have a well-established, readily available cure, governments across the globe are beginning to form contingency plans should the disease continue to spread.

While Hawaii couldn’t be much farther from West Africa and there is not a robust number of visitors to and from the region, there were 8.24 million total visitors to the islands in 2013, a huge ongoing opportunity to bring not only dollars but also fresh germs to our 1.36 million residents.

It is not only the health of Hawaii residents that must be considered. Any scare, real or imagined, that impacts the perceived safety of the islands as a visitor destination stands to impact the economy. The Sept. 11, 2001, terrorist attacks, for example, caused a transient drop in tourism by some 30 percent. In 2013, visitor revenues were $14.5 billion, which comprised 17 percent of the gross state product. Any sustained drop in visitor arrivals, by say a third, would wreak havoc on the state economy.

Hawaii is fortunate to have a highly effective health director in Linda Rosen, and, under her, a strong department of epidemiology working hard to track and address public health risks as they arise. The state also benefits from Dr. Josh Green, a practicing physician, serving as chairman of the Senate Health Committee. Both leaders have the training and judgment to address potential risks in a measured manner.

While Ebola has hit the headlines in recent weeks there are other illnesses that warrant vigilance for the people of Hawaii. Through much of the South Pacific there is an ongoing epidemic of dengue fever, Zika fever and Chikungunya. All three of these viral diseases are mosquito-borne and cannot be directly transmitted from one person to another. Nevertheless, someone who is bitten by a mosquito carrying dengue in Tahiti can return to Hawaii and get bitten by a mosquito in the islands that can then spread the illness to others here.

The Centers for Disease Control and Prevention, part of the National Institute of Health under the Department of Health and Human Services is an excellent resource to remain up to date with global health risks by country. Advisories for travelers and recommendations for vaccinations prior to travel and other precautions can be found at: wwwnc.cdc.gov/travel.

While the Information Age offers tremendous benefit in getting important communications to go "viral," there is also potential for the media to whip up undue public concern. Just as we used the National Oceanic and Atmospheric Administration to track hurricanes, the CDC is an excellent and reliable source for public health information. However, it could take even more steps to identify upticks of illnesses such as Ebola even earlier.

Although many grave illnesses may begin with mild fever, headache, weakness and nausea, when they occur, the overwhelming odds are that these symptoms represent a common cold, not a rare, life-threatening illness. Certainly, more severe, deteriorating or prolonged symptoms warrant a visit to a healthcare provider.

In the meantime, the single best way to prevent infectious disease is to wash hands thoroughly both before and after eating, or when touching one’s nose, mouth or eyes.

As of now there is no cause for alarm from Ebola but vigilance is always in order to prevent the spread of infectious disease and to protect the health and the economy for the people of Hawaii.

Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.