Texas Health officials now say that as many as 80 people came into contact with the first case of travel-related Ebola to come to the United States, according to the Associated Press.
Meanwhile, 'patient zero,' who is now in isolation in a Texas hospital, is 'critically ill,' said Thomas Frieden, director for the Centers for Disease Control and Prevention.
Arizona health officials agree that, similar to what's happened in Texas, the possibility of an Ebola-infected traveler coming to Arizona has existed since the largest-ever Ebola outbreak began back in August.
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'The probability that we could observe one case is pretty low but it's not zero. It's possible we could have an importation in the next few weeks or months,' said Gerardo Chowell-Puente, an associate professor of mathematical epidemiology at Arizona State University's School of Human Evolution and Social Change.
'I wouldn't be surprised if it happens, particularly in the context of the growing epidemic in West Africa as the number of cases increase, as the epidemic continues to spiral out of control, then the probability that other countries are affected is increased.'
The probability that we could observe one case is pretty low but it's not zero. It's possible we could have an importation in the next few weeks or months.
Gerardo Chowell-Puente, associate professor of mathematical epidemiology at Arizona State University's School of Human Evolution and Social Change
As of Sept. 29, the CDC reports 6,574 total cases of Ebola and 3,091 deaths in West African countries including Guinea, Liberia, Nigeria, Senegal and Sierra Leone. The virus, known as a hemorrhagic fever, is transmitted through touching the blood or bodily fluids of a person who is sick or has died from Ebola, from touching contaminated objects like needles, or from touching the bodily fluids of, or eating, infected animals, according to the CDC.
Although Phoenix Sky Harbor International Airport does not have any direct flights from West Africa, Phoenix metro has a higher possibility of importing a case of Ebola than other U.S. cities because of its population size, Chowell-Puente said.
However, the speed and volume of the outbreak in West Africa cannot be translated to the U.S. because of the higher quality of health care, he said. U.S. health-care providers can more easily isolate individuals and contact anyone who might be exposed to the virus, Chowell-Puente said.
In contrast, the West African countries most heavily affected by the outbreak, Liberia, Sierra Leone and Guinea, lack treatment centers, equipment and supportive care that would slow the rate of transmission and increase chances for survival, he said.
There is precedent that the spread of this Ebola outbreak can be stopped. Both Senegal and Nigeria have contained the spread of the virus after identifying infected individuals, isolating them, contacting those who may have been exposed and monitoring them for up to 21 days, which is the maximum incubation period for Ebola, Chowell-Puente said.
In Nigeria, they identified an individual within three days, had an outbreak of about 20 individuals, and now, after implementing the CDC guidelines, seem to have contained the outbreak, he said.
'I think that we need to be aware as a community about the issue in West Africa and the importance that we as global community implement and put the resources that are needed to quell the epidemic in these regions because we all are at risk,' Chowell-Puente said.
In Arizona, the Arizona Department of Health services is working closely with Maricopa County Health Services, Sky Harbor Airport, law enforcement and doctors and nurses throughout the state as part of a health-alert network to provide authorities with the information they need to identify possible cases of Ebola, said Jessica Rigler, chief for the Bureau of Epidemiology and Disease Control at Arizona Department of Health Services.
Part of the alert-network's outreach includes teaching doctors and health-care practitioners to ask about a patient's travel history and to identify the signs and symptoms of Ebola, which can include fever, muscle pain, weakness, diarrhea and vomiting, Rigler said.
If there is any suspicion the patient may have Ebola, doctors are supposed to contact their local public-health department so that the patient can be placed into isolation for testing, she said.
Public-health epidemiologists would then conduct an investigation to find anyone who may have come into contact with the virus and monitor them for 21 days.
'This is core public-health work, this is what epidemiologists do every day for a number of diseases including pertussis and tuberculosis.' Rigler said.
In the case that a communicable disease, such as Ebola, is detected on a flight coming to Sky Harbor Airport, Maricopa County Public Health works directly with the airport to ensure that the individual is evaluated, isolated and receives appropriate treatment immediately upon landing, said Rebecca Sunenshine, medical director for disease control at Maricopa County Public Health.
'That is a plan that has just been updated within the last 6 to 12 months, which is a joint effort of public health, airport, law enforcement, EMS, customs and border, TSA and numerous other stakeholders,' Sunenshine said.
Although all passengers leaving West Africa receive screening in their country of departure, Arizona health officials are nonetheless working closely with the airport to monitor travelers coming from Liberia, Nigeria, Sierra Leone and Guinea since the outbreak began in August, she said.
'We have had several incidents with ill travelers on planes where there was a concern for a health issue, but we have never had an actual ill passenger with suspected Ebola illness,' Sunenshine said.
Julie Rodriguez, public-information manager for Sky Harbor Airport, said the Phoenix Fire Department would provide initial response and would be in contact with public health officials, if an individual suspected of having Ebola landed in Phoenix.
'We do not have direct flights from West Africa. Passengers who arrive from areas at high risk for Ebola would connect through another airport before coming to Phoenix Sky Harbor. It would be at those airports that potential cases would be addressed,' she said.
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