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Patient Zero: Thomas Eric Duncan and the Ebola Crisis in West Africa and the United States

In the following article Dr. Clarence Spigner, Professor of Public Health at the University of Washington, Seattle, describes the life of the first patient to die of Ebola on U.S. soil and the larger crisis of Ebola in West Africa.  He views it as a consequence of a long history of disease, poverty, and underfunded health care systems in the West African nations of Guinea, Sierra Leone, and Liberia which are at the center of the 2014 epidemic. 

On September 20, 2014, a forty-two year-old Liberian native, Thomas Eric Duncan, arrived in Dallas, Texas from a plane flight that originated in Monrovia, Liberia.  Duncan came to the United States ostensibly to reunite with his estranged teenaged son and the boy’s mother, Louise Troh, who had at one time been his girlfriend in Liberia.  Troh and her son lived in Dallas.

Unknown before that point, Duncan entered the international public consciousness because he had flown from the hot zone of the Ebola virus outbreak then occurring in West Africa. On March 30, 2014, Liberia reported two cases of people with the Ebola disease.  Six months later on September 30, over 3,000 people had died from Ebola in West Africa including more than 1,000 in Liberia alone.  Duncan, who would be the first reported case of Ebola in the United States and as of this writing, the only fatality, was symptom-free and not contagious when he left Liberia by way of Brussels, Belgium and Washington, D.C.

The deadly Ebola disease has symptoms similar to the mosquito-borne infectious malaria.  Both malaria and Ebola are endemic to Africa, though malaria is now far more widespread and dangerous.  So is West Nile Disease which like malaria is mosquito-borne and was first identified in 1937 in the East African nation of Uganda. 

Unlike those diseases, Ebola is spread by physical contact with an infected person or animal.  The virus is not airborne.  The rapid spread of Ebola and the even more rapid spread of fear of a worldwide distribution of the Ebola virus comes from the knowledge that diseases like