Will Ebola become a big problem in the United States?

[Jeremie Boop]

Fatigue and exhaustion are symptoms for pretty much every condition under the sun from stress to cancer. Most MD's will say they never diagnose based on symptoms alone for anything because of this.

Sure, but if you are monitoring yourself for symptoms and you present some maybe you should not go out until you know you are ok? This isn't the same as someone just waking up being fatigued, we are talking about a person who was exposed to Ebola and was supposed to be monitoring himself for symptoms right?

[newtogolf]

That's 100% true, but given the person we're discussing was exposed to Ebola and treated Ebola infected patients, he should have known it was a symptom and stayed in quarantine.

Here is a list of other paranoid countries that have banned or restricted flights

Travel Briefing

Entry restrictions

Africa

• Cape Verde on 9 October announced that it would now deny entry to non-resident foreigners coming from countries with ‘intense Ebola transmission' – Sierra Leone, Guinea and Liberia - or who have been to those countries in the previous 30 days.
• Chad on 21 August closed its land border with Nigeria at Lake Chad. The country previously reportedly banned the entry of any travellers originating or transiting through Guinea, Liberia, Nigeria or Sierra Leone, with airlines serving the country reportedly rerouting flights.
• Côte d'Ivoire in early October reopened its borders with Guinea, Sierra Leone and Liberia, having closed the borders of 23 August.
• Equatorial Guinea is denying entry to travellers whose journeys originated in countries affected by Ebola.
• Gabon stated on 22 August that it is restricting the issuance of entry visas to travellers from Guinea, Liberia, Sierra Leone and Nigeria on a case-by-case basis.
• Gambia on 1 September suspended entry of persons who have visited Guinea, Liberia, Sierra Leone or Nigeria in the 21 days prior to travel. Those travelling indirectly from any of the aforementioned countries to Gambia via another country also come under this measure.
• Kenya on 10 October announced that it had closed the Suam border crossing (Trans-Nzoia county) with Uganda due to reports of an Ebola-related death in Bukwo district (Uganda). Earlier, the Kenyan authorities on 19 August suspended entry of passengers travelling from and through Guinea, Liberia and Sierra Leone, excluding health professionals supporting efforts to contain the outbreak and Kenyan citizens.
• Mauritania on 25 October closed its border with neighbouring Mali after an Ebola-related death in the border town of Kayes (Mali).
• Mauritius on 8 October banned entry to all travellers who have visited Nigeria, Sierra Leone, Guinea, Liberia, Senegal and Congo (DRC) in the last two months, rather than just citizens of those countries, as was the case previously. The authorities have announced that entry restrictions for travellers from Senegal and Nigeria will be lifted on 10 October and 17 October respectively, if no further cases of Ebola infection are reported.
• Namibia's foreign ministry on 11 September announced that foreigners travelling from countries affected by Ebola would be prohibited from entering the country.
• Rwanda, according to the US Department of State on 22 August, has banned entry to travellers who have visited Guinea, Liberia or Sierra Leone in the 22 days prior to travel.
• Senegal on 21 August closed its land border with Guinea, while the country's sea and air borders will also be closed to vessels and aircraft from Guinea, Liberia and Sierra Leone.
• Seychelles on 8 October suspended entry to travellers who have visited Sierra Leone, Liberia, Guinea-Bissau, Guinea, Nigeria or Congo (DRC) 28 days prior to their journey, with the exception of Seychellois citizens.
• Southern African Development Community (SADC) member states – Angola, Botswana, Democratic Republic of Congo (DRC), Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Seychelles, South Africa, Swaziland, Tanzania, Zambia and Zimbabwe – have stated that travellers coming from Ebola-affected countries (according to the World Health Organisation, WHO) would be monitored for 21 days and that travel to member countries for any gatherings would be discouraged. The SADC provided no details as to how member countries will carry out the associated screening and follow-up and it is likely that countries will have individual processes. There are also reports that some countries require health documentation for entry. Travellers are advised to contact the embassy or health ministry of their destination country to clarify their individual circumstances and prepare their trips accordingly.
• South Africa on 21 August restricted entry for all non-citizens travelling from Guinea, Liberia and Sierra Leone. The government subsequently clarified that this was not a blanket ban and could be waived for 'absolutely essential travel'.
• South Sudan has placed a ban on travellers coming from Guinea, Sierra Leone, Liberia or Congo (DRC), or those who have travelled to those countries in the preceding 21 days. According to the health ministry, entry of travellers from Nigeria depends on their travel history in that country and whether they have visited Ebola-affected areas.

Americas

• Antigua and Barbuda on 17 October imposed an entry ban on nationals of Guinea, Liberia and Sierra Leone. The ban will also apply on anyone who travels to the country within 21 days of visiting any of the aforementioned nations.
• Belize announced on 18 October that it will stop issuing visas for nationals of Guinea, Liberia and Nigeria. Sierra Leone nationals, who do not need visas to enter Belize, will also be banned. In addition, travellers who have visited any of the aforementioned countries in the past 30 days will be prohibited from entering the country.
• Colombia imposed an entry ban from 14 October on any traveller who has visited Guinea, Liberia, Nigeria, Senegal or Sierra Leone in the past four weeks. The restriction would also reportedly apply to Colombian nationals.
• The Dominican Republic has banned entry to travellers who have been in the following countries in the past 30 days: Sierra Leone, Senegal, Liberia, Guinea, and Nigeria, as well as any countries that the World Health Organization has deemed to be affected by the Ebola virus.
• Guyana announced on 16 October that visas will not be issued to nationals from Guinea, Liberia, Sierra Leone and Nigeria. Furthermore, health officials will screen travellers who have visited these countries in the six weeks prior to their arrival in Guyana.
• Haiti has banned ( PDF ) entry to travellers who have been to Guinea, Liberia or Sierra Leone in the past 28 days. Travellers who have been to these countries more than 28 days before travel to Haiti must present a government-certified health certificate and the results of a blood test for the Ebola virus upon arrival. It is uncertain at this time how these measures will be carried out or enforced. International SOS is monitoring the situation.
• Jamaica imposed an entry ban from 16 October for travellers arriving from Guinea, Liberia and Sierra Leone, as well as those who have visited these countries within the four weeks prior to their arrival. In addition, any Jamaican national who travels to the aforementioned countries will be quarantined for 28 days on return.
• Panama on 22 October banned the entry of travellers who have visited Guinea, Liberia and Sierra Leone in the past 21 days. The ban will remain in place until the three countries are declared Ebola-free.
• St Kitts and Nevis have restricted the entry of nationals from Guinea, Liberia and Sierra Leone. Similar measures will also be applied to travellers who have visited these countries in the 21 days prior to arrival.
• St Lucia has banned visitors from Guinea, Liberia and Sierra Leone. The government has also announced that, in addition to a visa, visitors from Nigeria will be required to present a recent medical certificate clearing them of the virus. No further details are available at this stage, though we are investigating further.
• St Maarten has said that visitors who have travelled to, from or through Democratic Republic of Congo, Guinea, Liberia and Sierra Leone in the past 21 days will be denied to enter or transit the country. Individuals returning from the above countries who live in St Maarten will be allowed to enter on condition that they agree to be quarantined for at least 21 days upon arrival.
• Suriname has banned entry to foreign travellers who have been to Guinea, Liberia and Sierra Leone in the past 21 days, unless they can present an ‘internationally recognised health certificate’ clearing them of the virus. No further details are available at this time.
• Trinidad and Tobago announced on 16 October that it would deny entry to nationals of Congo (DRC), Guinea, Liberia, Nigeria and Sierra Leone. In addition, travellers who have visited any of the aforementioned countries in the past six weeks will be quarantined for 21 days upon arrival.
• The United States announced that beginning 22 October, any passengers beginning their travels in Liberia, Sierra Leone or Guinea will only be able to enter the country through the following airports: JFK International Airport ( JFK , New York state), Newark International Airport ( EWR , New Jersey), Dulles International Airport ( IAD , Washington, DC), Hartsfield-Jackson International Airport ( ATL , Georgia) or Chicago O'Hare International Airport ( ORD , Illinois).

Others

• North Korea has banned foreign tourists since 24 October over fears of ebola; the ban applies to all entry points and border crossings.
• Australia has suspended the issuance of visas to travellers from Guinea, Liberia and Sierra Leone. Travellers from these countries who hold permanent visas can enter Australia if they have been quarantined for 21 days prior to arrival, while those who have received non-permanent visas and who have not departed for Australia will have their visas cancelled.

Flights and other transport

Countries that have implemented Ebola-related travel restrictions:

• Cameroon has banned flights to and from Nigeria. Chad has suspended all flights from Nigeria.
• Côte d'Ivoire has now lifted the ban on passenger flights from Guinea, Liberia and Sierra Leone.
• Gabon has banned the entry of flights and ships from countries affected by Ebola.
• Gambia has banned the entry of flights from Guinea, Liberia, Nigeria and Sierra Leone.
• Nigeria has suspended flights to the country operated by Gambian national carrier Gambia Bird.
• Senegal has banned flights from Guinea, Liberia and Sierra Leone.

Details of airlines that have restricted flights to Ebola-affected countries:

• Air France suspended flights to Sierra Leone from 28 August.
• The Togo-based carrier Asky Airlines has suspended flights to and from Guinea, Liberia and Sierra Leone.
• Arik Air (Nigeria), Gambia Bird and Kenya Airways have suspended services to Liberia and Sierra Leone.
• British Airways has extended their suspension of flights to Liberia and Sierra Leone until 31 December.
• Emirates Airlines has suspended flights to Guinea.
• Korean Air suspended flights to and from Kenya from 20 August.
• Senegal Airlines has suspended flights to and from Conakry (Guinea) until further notice.

[Dave2512]

Sure, but if you are monitoring yourself for symptoms and you present some maybe you should not go out until you know you are ok? This isn't the same as someone just waking up being fatigued, we are talking about a person who was exposed to Ebola and was supposed to be monitoring himself for symptoms right?

It would be a factor in my decision making but so would everything else I did in the past couple days. Example, using the NY doctor again, if he woke up feeling fatigued and just in general unwell after arrived home from treating ebola patients but had gone out the night before and drank a bottle of wine there's a greater chance what he is experiencing is simply a hangover. We are exposing ourselves to many things daily that can affect the way we feel.

[Dave2512]

Here are a list of "paranoid" countries that have banned or restricted flights

I don't see paranoid as much as a huge list of countries 2nd and 3rd world countries ill equipped to manage any kind of outbreak. I assume that is a big factor in why.

[newtogolf]

I'm curious why those of you that are against travel restrictions / bans have taken that position   What is the downside of being overly cautious until we're certain we can handle an epidemic if one hits here?

[Jeremie Boop]

I'm curious why those of you that are against travel restrictions / bans have taken that position   What is the downside of being overly cautious until we're certain we can handle an epidemic if one hits here?

Because it would potentially impede the progress in combating the outbreak by keeping people from going there to help.

[David in FL]

Because it would potentially impede the progress in combating the outbreak by keeping people from going there to help.

Not at all. As has been said many times, the relatively tiny number of healthcare workers could easily be handled as separate, exceptional cases.

[Dave2512]

Yeah in Africa I assume the bans are in place to prevent travel between African countries more than anything.

[newtogolf]

Because it would potentially impede the progress in combating the outbreak by keeping people from going there to help.

They can go to help, they just would need to fly back through government arranged flights and agree to 21 day quarantine

[Golfingdad]

From the CDC since you seem unwilling to read them yourself;

Symptoms of Ebola include

Fever

Severe headache

Muscle pain

Weakness

Diarrhea

Vomiting

Abdominal (stomach) pain

Unexplained hemorrhage (bleeding or bruising)

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days.

I highlighted weakness for you, so you can see that it is a symptom of Ebola and since the doctor claimed to be fatigued and exhausted before he went all over the city I'd say he was symptomatic given it's been confirmed he has Ebola.

But, are fatigue and exhaustion considered symptoms of ebola? If they are then what he said has merit, if they aren't then what he said has no merit.

Fatigue and exhaustion are symptoms for pretty much every condition under the sun from stress to cancer. Most MD's will say they never diagnose based on symptoms alone for anything because of this.

And maybe that is why, although @newtogolf is correct that it's listed as a symptom, it's conspicuously the one that is left off this infographic highlighting how it can be transmitted:

I'm curious why those of you that are against travel restrictions / bans have taken that position   What is the downside of being overly cautious until we're certain we can handle an epidemic if one hits here?

Come on.  Seriously?  You've been here the whole time and this is exactly the conversation that I exhausted with David over about 8 million posts, like 9000 pages ago.  Go read them again if you forgot.

Oh, and I'll also remind you that in the time since this thread started, zero people have acquired Ebola due to the fact that we haven't instituted a travel ban.  ZERO.  Remember that if/when you respond.

Again, I really don't have any personal opinions on this subject.  I remember that I don't know much and defer to the people that do.  In this case, the people that do are the CDC and WHO, not the media or politicians.  If the scientists tell me to be worried, then I'll be worried.  Until then, I won't be.

The stats would be based on worse case scenario, that's the way the CDC publishes info.

[Dave2512]

And maybe that is why, although @newtogolf is correct that it's listed as a symptom, it's conspicuously the one that is left off this infographic highlighting how it can be transmitted:

Hard to say but the symptoms that are listed, other than unexplained bleeding, are also generic. When the panic was at it's highest the similarity of ebola symptoms to flu symptoms was being discussed.

[Golfingdad]

Hard to say but the symptoms that are listed, other than unexplained bleeding, are also generic. When the panic was at it's highest the similarity of ebola symptoms to flu symptoms was being discussed.

True ... but they are all at least a sign that something is actually wrong.  "Weakness" occurs for some (me!) on a daily basis.  When I get out of bed in the morning and when I get out of my chair at work after having not moved for a period of time, as two examples.

[Jeremie Boop]

Not at all. As has been said many times, the relatively tiny number of healthcare workers could easily be handled as separate, exceptional cases.

They can go to help, they just would need to fly back through government arranged flights and agree to 21 day quarantine

I was simply repeating what others have said. I don't have any opinion on travel restrictions myself.

[newtogolf]

True ... but they are all at least a sign that something is actually wrong.  "Weakness" occurs for some (me!) on a daily basis.  When I get out of bed in the morning and when I get out of my chair at work after having not moved for a period of time, as two examples.

But if you weren't exposed to Ebola then weakness couldn't matter as much as if you were.

[Dave2512]

Yes they should emphasize with diseases like ebola is the symptoms are a group of symptoms not just one. Weakness on it's own is common.

[trickyputt]

Off to play golf, so I'm out of here. but you all stay afraid.

Two rain suit layers will do it.

[phan52]

Well in the case of Dr. Craig Spencer, he stated that the day he went out that he was feeling "fatigue and exhaustion" but no fever.  In my opinion, given the circumstances, fatigue and exhaustion are early symptoms of Ebola.

You have never felt fatigue or exhaustion? Especially after just travelling thousands of miles from another country and about 4-5 time zones? I walked 18 holes yesterday afternoon and I was beat afterward (probably had more to do with playing poorly).

If he didn't have an elevated fever, he was not symptomatic.

[newtogolf]

You have never felt fatigue or exhaustion? Especially after just travelling thousands of miles from another country and about 4-5 time zones? I walked 18 holes yesterday afternoon and I was beat afterward (probably had more to do with playing poorly).

If he didn't have an elevated fever, he was not symptomatic.

Of course I have and had I not been exposed to any deadly diseases I'd not have thought twice about it.

Sometimes my stomach doesn't feel right after I eat something and I blow it off as indigestion but If I am exposed to someone with a stomach virus and the next day I feel nauseas I consider that I've caught the same bug and try to isolate myself from the rest of the house until I'm sure.

It's about common sense.  The doctor was exposed to Ebola.  Exhaustion / fatigue are known symptoms of Ebola.  Common sense would dictate given the circumstances that he'd quarantine himself for the day and re-evaluate.    Had he done that he'd have been right to do so since he exhibited fever the very next day.

So how many symptoms does one have to exhibit before you would consider him symptomatic?  If exhaustion / fatigue is one symptom of Ebola and it's been confirmed he has Ebola why do you not consider he was symptomatic?