Category A Bioterrorism Agent Lands in the U.S.

By Alena James

It has been one seriously scary and depressing summer with the multitude of cataclysmic events taking place all around the globe.  Much like the thousands of immigrant children whose futures are still being debated by the U.S. and Mexico, many of these crises have remained outside of U.S. soil. However, one potential crisis has been willingly brought to the U.S.

A few days ago a protocol was established to send medical evacuation planes to Liberia to bring back two missionary American health care workers suffering from the Ebola virus.  The decision to bring the patients back to the U.S. raised great alarm among many Americans that there is a chance of a major outbreak occurring with a disease that the U.S. is not prepared to fight

This past week, the Director of the CDC, Dr. Thomas Frieden, continually claimed that the necessary precautions were being taken to ensure the safety of the public from being exposed to the virus. According to Frieden, the chances of an outbreak taking place in the U.S. are minimal. Ebola is a virus that is not airborne and is not acquired through casual contact with an infected patient. For individuals to be infected they must have direct contact with bodily fluids septic (contaminated) with the virus.

During a CNN interview, Frieden explained that the decision to bring the Americans back to the U.S. was made by Samaritan’s Purse, the organization to which the two infected Americans, Dr. Kent Brantly and Nancy Writebol, belong. The role of the CDC will be to help assist in the transport and supportive care of the patients upon arrival at Emory University Hospital in Atlanta, Georgia.

The plane that transported Dr. Kent Brantly on Saturday was fitted with an Aeromedical Biological Containment System. In this system, a tent like structure was set up on board a modified Gulfstream III aircraft and used to isolate Brantly from the rest of the people onboard.

During an aeromedical evacuation, a patient undergoes medical assessment and evaluation before transport. This is to ensure the patient’s survival during the course of the trip. According to a study conducted by the U.S. Army Medical Research Institute of Infectious Diseases in Fort Detrick, Maryland, the physiologic effects of altitude, effect of confinement on patient-care delivery, and psychological effect of confinement within the containment system must be taken into consideration before transport.

Dr. Brantly arrived safely in the United States on Saturday at Dobbins Air Force Base in Marietta, Georgia. He was then transported to Emory University Hospital in Atlanta.

So, why exactly was the decision made to bring back to the Americans infected with a viral agent; which the CDC has classified as a Category A Bioterrorism Agent and to which there is no cure?

In his interview with CNN, Dr. Frieden, gave credit for the medical evacuation operation to Samaritan’s Purse. However, without the assistance of the State Department, the U.S. military, and the CDC it seems likely that the operation would not have come to fruition at all.

The reasoning for this evacuation, made by many advocates, seems to lie with the high level of confidence among those at the CDC and Emory University in their ability to control and contain the infected patients.  Despite the unprecedented nature of an Ebola patient returning to the U.S., infectious disease experts maintain the appropriate precautions are being made and the virus will remain contained.

The medical evacuation operations for Dr. Brantly and Nancy Writebol do not offer only an increased chance of recovery from Ebola and the chance to be reunited with their loved ones—if only through a glass partition. These operations also provide an opportunity for America’s best infectious disease experts and healthcare workers to gain firsthand experience with actual cases of a virus not available for study at clinical levels in the U.S. The medical evacuation operation is also beneficial to emergency response personnel who have been training on how to deal with these types of medical cases for years.

Over the summer, Americans watched intently as the creditability of the CDC took a hit when many of its laboratory staff failed to abide by proper laboratory safety techniques upon dealing with samples of Bacillus anthracis and H5N1.  The CDC and NIH’s credibility took another hit when the CDC discovered more than 200 vials of smallpox in a refrigerator in an NIH lab in Bethesda, Maryland.

Hopefully the fouls ups of the past have provided important lessons for all fields working with infectious diseases to take safety protocols very seriously…especially while working with patients suffering from a virus that has no cure.

Image Credit: Yahoo