How to Approach Concerns About Ebola

October 20, 2014

Mark L. Friedman, MD, FACEP, FACP

Have I gotten your attention?

Yesterday an administrator at my medical school pulled me into his office. “So what’s the story with the ebola virus?” he asked.

Ebola has been front-page media news EVERY DAY.

There is currently an epidemic of “ebola concern” in the US. The virus itself, not so much. Have no fear, the President has just appointed a politician / public relations (not public health) expert as the new “Ebola Czar.” The President has (correctly) identified this as a public relations problem, not a public health problem.

How can I be so sure?

There have been five major outbreaks of ebola since it was first discovered in 1976 (in central Africa along the Ebola River, hence the name). In the past it was dealt with / subsided locally and never became the sensation it is at the moment. This time is different due to a confluence of local factors. Political instability in West Africa coupled with a rapidly growing population has set the stage for an epidemic. The highly contagious agent has established itself in a densely populated region with poor medical resources. If you really want to scare yourself and your friends read Andromeda Strain by Michael Crighton, published in 1969 and based on an ebola-like virus.

But what are the odds the average American will contract ebola virus? At the time I am writing this article (9 PM EDT on October 17, 2014) exactly 1 in 159,548,840. This is not an estimate, but rather a precise statistic based on the US Census Bureau statistical page and the fact that to date there have been only two known cases of ebola transmission within the US, both nurses who were directly exposed to Eric Duncan, the patient from Liberia, in a Dallas Texas hospital. Now, I’m not saying other sporadic cases may not occur (in directly exposed healthcare workers and people leaving Africa), but the kind of epidemic spread we are seeing in West Africa is just not going to happen here. We are pretty good at public health in the US and have lots of medical resources and an intact social infrastructure.

For comparison purposes, what are the odds of contracting / dying from other causes in the US?

* Contracting ebola virus in the US: 1/159,548,840
* Death from a plane crash (domestic US flight): 1/10,000,000 (annual risk)
* Death from a lightning strike: 1/1,000,000
* Death from influenza (the “flu”): 1/345,000
* Death from a motor vehicle crash: 1/10,000
* Contracting the flu: 1/8
* Death from heart disease: 1/5 (lifetime risk)

So there are much more worrisome problems (statistically) than the ebola virus.

If you want to avoid getting ebola:

* Avoid visits to West Africa in the immediate future.
* Stay out of the hospital rooms of patients with diagnosed ebola infection.

If you want to do things more “statistically significant” in the pursuit of good health:

* Get a flu shot.
* Buckle your seatbelt and drive the safest possible car.
* Eliminate or reduce your cardiac risk factors.
* Do not stand under a tree during a thunderstorm.

If you are experiencing symptoms and would like to try our new “Symptom Checker” (courtesy of Isabel Health), go to:

If you would like more information about a medical problem, or to talk to a doctor NOW, go to:

Originally published Oct 20, 2014 1:42:00 PM.