Doctor in New York City Is Sick With Ebola

Dr. Craig Spencer (right) and fiancee Morgan Dixon    Photo: Instagram

 A doctor in New York City who recently returned from treating Ebola patients in Guinea became the first person in the city to test positive for the virus Thursday, setting off a search for anyone who might have come into contact with him.

The doctor, Craig Spencer, was rushed to Bellevue Hospital Center and placed in isolation at the same time as investigators sought to retrace every step he had taken over the past several days.

At least three people he had contact with in recent days have been placed in isolation. The federal Centers for Disease Control and Prevention, which dispatched a team to New York, is conducting its own test to confirm the positive test on Thursday, which was performed by a city lab.

Dr. Spencer, 33, had traveled on the A and L subway lines Wednesday night, visited a bowling alley in Williamsburg, and then took a taxi back to Manhattan. People infected with Ebola cannot spread the disease until they begin to display symptoms, and it cannot be spread through the air. As people become sicker, the viral load in the body builds, and they become increasingly contagious.

The driver of the taxi, arranged through the online service Uber, did not have direct contact with Dr. Spencer and was not considered to be at risk, officials said.

The Meatball Shop on Friday in Greenwich Village, where Dr. Craig Spencer had visited. Credit Todd Heisler/The New York Times        

Speaking at the news conference, city officials said that while they were still investigating, they did not believe Dr. Spencer was symptomatic while he traveled around the city on Wednesday and therefore had not posed a risk to the public.

“He did not have a stage of disease that creates a risk of contagiousness on the subway,” Dr. Mary Bassett, the city health commissioner, said. “We consider it extremely unlikely, the probability being close to nil, that there will be any problem related to his taking the subway system.”

Mayor Bill de Blasio, speaking at a news conference at Bellevue on Thursday night, sought to reassure New Yorkers that there was no reason to be alarmed.

“Being on the same subway car or living near a person with Ebola does not in itself put someone at risk,” he said.

Still, out of an abundance of caution, officials said, the bowling alley in Williamsburg that he visited, the Gutter, was closed on Thursday night, and a scheduled concert there, part of the CMJ music festival, was canceled. Health workers were scheduled to visit the alley on Friday.

At Dr. Spencer’s apartment building, his home was sealed off and workers distributed informational fliers about the disease.

Since returning, he had been taking his temperature twice a day, Dr. Bassett said.

He told the authorities that he did not believe the protective gear he wore while working with Ebola patients had been breached but had been monitoring his own health.

Doctors Without Borders, in a statement, said it provides guidelines for its staff members to follow when they return from Ebola assignments, but did not elaborate on the protocols.

Emergency medical workers, wearing full personal protective gear, rushed to Dr. Spencer’s apartment, on West 147th Street. He was transported to Bellevue and arrived shortly after 1 p.m.

He was placed in a special isolation unit and is being seen by the designated medical critical care team. Team members wear personal protective equipment with undergarment air ventilation systems.

Ebola is transmitted through bodily fluids and secretions, including blood, mucus, feces and vomit.

Because of its high mortality rate — Ebola kills more than half the people it infects — the disease spreads fear along with infection.

At least two Doctors Without Borders workers have contracted the disease so far this year.
Norwegian physician Silje Lehne Michalsen was infected in Sierra Leone and recovered this month, according to the Nordic Page website.
A French nurse was also diagnosed with Ebola on Sept. 16 while working in Monrovia, Liberia, and recovered in France.

N.Y. TIMES

Can You Get Ebola From a Bowling Ball?

Although the surface of a shared bowling ball is a likely place to find germs — and some people avoid bowling for this very reason — it is extremely unlikely that Ebola could be passed that way. There is no evidence that it has been passed, as colds or flu sometimes are, by touching surfaces that someone else touched after sneezing into their hand. Ebola is normally passed through contact with blood, vomit or diarrhea.

If someone left blood, vomit or feces on a bowling ball, and the next person to touch it did not even notice, and then put his fingers into his eyes, nose or mouth, it might be possible. But, the Ebola virus does not not normally build up to high levels in saliva or mucus until very late in the disease — several days after the initial fever sets in — and it is unlikely that someone that ill would have just gone bowling. Also, the Ebola virus is fragile and susceptible to drying out. It does not normally survive for more than a few hours on a hard, dry surface.

N.Y. TIMES

Can Pets Get Ebola?

Bentley, the one-year-old King Charles Spaniel belonging to Nina Pham, a nurse who contracted Ebola.Credit Courtesy of Sana Syed/PIO, City of Dallas, via Associated Press

Ebola is primarily an animal disease. Its natural reservoir is probably fruit bats, which can live with the virus without getting ill. Gorillas, chimpanzees and humans all die rapidly after getting infected.

Ebola is found in some hunted African animals, including forest antelopes and rodents. Pigs, guinea pigs, horses and goats have been infected experimentally and either had no symptoms or mild ones. Ebola has not been found in any African felines, such as lions, so cats may be immune.

Dogs living with humans apparently can get infected. Although the virus itself has not been found in dogs, antibodies have been detected in their blood, suggesting the dogs had survived infections.

Gabon has had several Ebola outbreaks, and in 2005 French scientists tested 337 dogs for antibodies. Many were village strays that lived on what they caught and scraps that hunters threw them.

Villages in which there were both human deaths and hunters returning with infected bush meat — which often started the outbreaks — had the most dogs testing positive.

The most likely explanation, the scientists said, was that the dogs were infected with the virus from meat scraps and from licking human vomit. They were not known to get ill.

Whether dogs can pass the virus to humans or to other dogs is unknown. Many diseases — including polio and typhoid — have silent human carriers who never get sick but pass fatal infections to others.

Ebola is not known to exist in any North American animal species, including bats. But many species clearly could become carriers.

Since dogs interact intermittently with humans and with animals in city parks and rural forests, they could be a vector for transmitting Ebola from humans into wildlife, where it could, in theory, establish a permanent American reservoir.

While an infected dog could be quarantined, it would have to be caged indefinitely, since it is unknown how long it might remain infectious.

OBAMA: THE CENTER RULES

 

 MICHIKU KAKITANI, NY TIMES

THE CENTER HOLDS
Obama and His Enemies
By Jonathan Alter
Illustrated. 428 pages. Simon & Schuster. $30.

 

------------. 

....This book... provides a close analysis of what Mr. Alter sees as the administration’s missteps, focused around the author’s conviction that the president’s “detached and self-contained nature had hampered his presidency.” Mr. Alter contends that what he calls Mr. Obama’s lack of “the schmooze gene” (“standard equipment for people in politics”) and his reticence in cultivating relationships with members of Congress and other politicians left him with “one less way to leverage his authority.”

Many of Mr. Alter’s observations echo complaints frequently heard within the Beltway. He argues that the Obama White House has been too insular, that it has often done a poor job of selling its agenda (say, on health care) and that the president has frequently been slow to go on offense: he “developed a habit of letting the dialogue deteriorate until he rode to the rescue like a one-man cavalry, solving all the problems with a big speech, large chunks of which he wrote himself at the last minute.” ....

In Mr. Alter’s view, the president’s lack of experience in negotiations hobbled his efforts to cut deals with Republicans, much the way his paucity of earlier political experience “hampered him on management questions.” “Relations with Cabinet-level departments were so tangled that it was often hard to get decisions made,” Mr. Alter writes. “While centralizing the national security apparatus at the White House worked well enough (unless you happened to work at the State Department), domestic agencies had to deal with several competing power sources inside the White House that each got to say, ‘It’s the White House calling.’ ”

Mr. Alter’s thesis is that the 2012 election was possibly “the most consequential” in recent times and “a hinge of history” — “a titanic ideological struggle” that put the “social contract established during the New Deal era” on the line. He readily acknowledges that he thinks the United States “dodged a bullet in 2012,” and that in re-electing Barack Obama and rejecting the Republicans’ “extremist” views, America reaffirmed its identity as an essentially “centrist nation.”

 

Toward the end of this volume, Mr. Alter quotes Mr. Obama telling an aide that if he lost, his presidency would be “a footnote” and that “all of the progress we made in the first four years would be reversed”; if he won, his first-term achievements would be cemented for a generation and he could move ahead on promises sidetracked by the recession.

 

....Mr. Alter says, President Obama was “pretty much the same calm and self-contained guy inside the bubble as he was in public.” With one exception, Mr. Alter adds: “the intense racial consciousness that he had nurtured in his own mind since childhood was more apparent in private. He knew that if he crossed a certain line in reacting to criticism, he would hand his enemies a weapon: “ ‘See, he’s like all the rest of them.’ It was better for him to be perceived as ‘different,’ with all the challenges that brought.” This “stifling of himself,” this “inability to swing at certain pitches,” made him, according to one aide, about “5 percent more aloof than he had been before coming to the presidency.”

A similar sort of dynamic, in Mr. Alter’s opinion, helps explain the president’s dismal first debate, which jeopardized his re-election: “Obama didn’t trust himself to tangle with Romney. He thought Romney was a liar and an empty suit and would reverse everything worthy he had done as president,” and he had “long worried that his attitude would spill out. Suppressing that was part of what threw him off his game” in that Denver debate.

------

....[Alter] provides some interesting observations on Republican-backed efforts to implement election “reform” around the country (like requiring state-issued photo ID’s and cutting back on early in-person voting) that would hold down “turnout among young people and minorities, who tended to vote Democratic.” Those efforts failed, says Mr. Alter, instead creating a backlash against Republicans as a wave of black voters headed to the polls in Pennsylvania, Ohio, Virginia and Florida, angry at attempts to suppress their votes.

--------

....Over all, however, the long passages in this book recounting the 2012 presidential campaign feel like tired television reruns of a not-too-popular show. The only sections that substantially add to our understanding of the campaign are those chronicling, in minute detail, the Obama team’s creation of a sophisticated operation for reaching out to potential supporters and getting out the vote — an operation that combined impressive ground troops with the digital analysis of huge amounts of data.

This big data helped the campaign figure out what worked and what didn’t (for a while, e-mails with yellow backgrounds “generated 10 to 20 percent” more responses than those with white backgrounds) and assess the ever-shifting metrics of the contest. Some 4,000 to 9,000 phone calls a night were placed to voters in battleground states, Mr. Alter says, providing “the campaign high command” with “a 360-degree view of the state of the race.” Facebook was used for “supporter mobilization” and cable television data was employed to help micro-target ad buys. A mobile app, “Quick Donate,” Mr. Alter reports, “raised an extra $75 million by letting supporters give money with one click instead of filling out a form.”

This state-of-the-art campaign machine would help insure that Mr. Obama won a second term. After the election, Mr. Alter says, the Obama for America campaign was reincarnated as a group called Organizing for Action. With more than 20 million e-mail addresses in its database, Organizing for Action “would try to make the 2012 Chicago machine a permanent force in American politics, applying money, analytics, door-knocking, and the rest of the magic formula to advancing the president’s agenda.”