Bayou Renaissance Man

It had begun to look as if the authorities in the Congo, and the international medical teams, had started to get on top of the big Ebola outbreak there.  Sadly, their progress has just come to a grinding halt.

Three health workers were killed when Mai-Mai fighters attacked a center run by the United Nations health agency overnight in Biakato, a local official, Salambongo Selemani, told The Associated Press. One resident also was killed and Congolese forces killed one attacker and captured two others, Mr. Selemani said.

Warnings had been posted earlier demanding that the health workers leave or face “the worst,” he said.

Health workers trying to contain the second-worst Ebola outbreak in history have been targeted in the past, but the current outbreak has been described by some observers as more complicated than any other. Several rebel groups are active in the region, and local officials have said that some of the insurgents believe that the reports of Ebola are a political trick.

. . .

The Ebola response was put on lockdown in Beni, dismaying health experts who say every attack hurts crucial efforts to contain the deadly virus. Most recent new cases have been reported in the newly targeted communities of Biakato, Mangina and Beni.

The number of cases had been dropping in the yearlong outbreak, which has killed more than 2,100 people and was declared a global health emergency earlier this year. Several days this month, zero cases were reported, but cases have surged after attacks on health workers and facilities.

In one example of how any pause can sharply affect Ebola containment efforts, the World Health Organization has said that no one in Beni could be vaccinated against the virus on Monday. The health agency could previously trace more than 90 percent of contacts of infected people in the city, but that figure has dropped to 17 percent, a United Nations spokesman said on Tuesday.

There's more at the link.

The containment effort against Ebola has depended very heavily on "boots on the ground":  local workers, helped by foreign doctors and specialists, going from house to house, checking on the health of everybody in an area, taking the sick to treatment centers, and quarantining their contacts until it was certain they had not spread the disease.  If the price of doing that is a bullet, there isn't going to be much more of it, that's for sure!

My prayers go to those who were killed.  That won't comfort their loved ones, of course, and it won't help stop the resurgence of Ebola if the primitive, animist militia in the area can't be controlled or contained.  Prayer won't do that - it'll take more boots on the ground, these ones armed and trained military personnel.  Local troops won't do.  They're largely untrained, and most of them are so ill-educated they probably believe, as the militias do, that Ebola is actually a Western plot against the African population.  It'll take more effective, more efficient international intervention - but international troops, if they have any sense, will resign rather than allow themselves to be sent into a region where their chances of dying of the world's most loathsome disease are better than average.

Absent such intervention, this local and regional crisis could still spiral out of control, and become global.

Ebola isn't the only health crisis in Africa, either.  How about new cases of polio that appear to be caused by a mutation in the polio strain used in the oral vaccine widely distributed there?  If the vaccine itself is the problem, that's a very major issue indeed.

Peter

That's the title of a very interesting article in Popular Mechanics.  It's a long article with a lot of detail, far too much to include here;  but I'll post a series of short excerpts to give you an idea.

... two humanitarian medical workers helping out with the Ebola crisis in Liberia had come down with it. Their names were Kent Brantly and Nancy Writebol, and while everyone wanted to get them home, they had no idea how to do so safely. “The general dogma was, you don’t bring the zombie apocalypse to a city that doesn’t have zombies,” Walters says. But Walters had remembered what Dent had told him ... which was that as a joint consequence of ferrying Atlanta-based Centers for Disease Control luminaries around and being down for just about anything, Phoenix Air had developed a proprietary system for the transport of extremely sick people with extremely contagious diseases.

. . .

To build the Aeromedical Biological Containment System (ABCS), Phoenix Air had employed CDC and Department of Defense engineers who handled samples of the most threatening diseases and chemicals on earth.

The ABCS consists of a frame of metal tubing contoured to fit inside an airplane’s fuselage, supporting a disposable plastic cocoon—a giant zippered sock made out of what looks like a double-thick shower-​curtain liner. Everything inside the sock is disposable, including a stretcher, a bucket toilet, medical supplies, and leads for health monitors that can be operated by the medical crew from outside.

. . .

William Walters drew up a contract that made Phoenix Air an official provider for the U.S. Department of State, which would make all the life-and-death decisions itself. Walters wanted to do this anyway—Phoenix Air was the only company in the world equipped to transport extremely infectious patients. BP, ExxonMobil, and the Chinese government, all of which had extensive infrastructure in Africa, were circling in an effort to nail them down for themselves.

In the end, Phoenix Air flew about 40 people who had, or who had been exposed to, Ebola from West Africa to treatment centers in the U.S. and Europe. Only two patients died, neither of them aboard the plane.

. . .

In 2014, Paul Allen, of Microsoft fame, decided he wanted to put some of his fortune to use combating Ebola. He asked the Department of State what he could do to help, which is how he, together with Phoenix Air and a research company called MRI Global, came to build the Containerized Biocontainment System (CBCS).

If the ABCS is a rubber raincoat, the CBCS is a submarine, down to 400-pound airtight doors that separate the clean, gray, and biohazard sections. The size of a semi-truck trailer, it has its own power and medical oxygen, and can be loaded onto a Boeing B-747/400 and shipped out of Atlanta’s Hartsfield-Jackson International Airport within 24 hours. The CBCS solves a major problem Phoenix Air faced during the 2014 epidemic, which was that they could only pick up one patient at a time, every three days, potentially dooming anyone left behind to wait for a later flight. The CBCS can transport four extremely sick, extremely contagious people, along with six medical staff, simultaneously.

There's more at the link, including photographs.  Recommended reading.

Considering the current status of the Ebola epidemic in Congo, and how it appears to be spreading, I presume Phoenix Air is dusting off its equipment and getting ready to do it all over again.  It must be a horribly expensive flight, though.  The ABCS is destroyed after use, so there's that write-off;  and then there's the hourly cost of an executive jet, plus its crew, plus the medical staff, and everyone else concerned.  I doubt whether regular medical insurance would cover the expense.  I guess it'll only be deployed if Uncle Sam is paying for it, with our tax dollars.  However, I'd much rather my taxes were spent on that than on some of the more wasteful and disgraceful pork barrels out there . . .

Peter

In a July article about the Ebola crisis in Congo, I wrote:

Officials in surrounding countries are terrified of admitting to Ebola cases on their territory, because they may bring with them restrictions on travel, trade, and all sorts of things that may affect their economies - and, consequently, the graft, bribery and corruption they rely on to fill their wallets. Can't have that interrupted, can we? This is Africa, after all!

I hate being right about something so serious - but it looks as if I was.

The World Health Organization issued an extraordinary statement Saturday raising concerns about possible unreported Ebola cases in Tanzania and urging the country to provide patient samples for testing at an outside laboratory.

The statement relates to a Tanzanian doctor who died Sept. 8 after returning to her country from Uganda; she reportedly had Ebola-like symptoms. Several contacts of the woman became sick, though Tanzanian authorities have insisted they tested negative for Ebola.

But the country has not shared the tests so they can be validated at an outside laboratory, as suggested under the International Health Regulations, a treaty designed to protect the world from spread of infectious diseases.

It is highly unusual for the WHO, which normally operates through more diplomatic means, to publicly reveal that a member country is stymying an important disease investigation.

“The presumption is that if all the tests really have been negative, then there is no reason for Tanzania not to submit those samples for secondary testing and verification,” Dr. Ashish Jha, director of the Harvard Global Health Institute, told STAT.

“It’s only upside for them to do that, to put any of these issues to rest. And the fact that they’re not doing that, I think both raises concern and … whatever they do next, people are going to have less confidence in it,” Jha said.

Further, Tanzanian authorities waited four days to respond to the WHO’s first urgent request for information — a wait that is well outside what is required of a country under these circumstances.

There's more at the link.

I'm willing to bet that the authorities in Tanzania, at least on a local and regional level, are desperately hoping against hope that the problem will go away.  It won't, of course.  If the initial reports are correct - and, knowing Africa in general and that part of the world in particular, my basic assumption is that they are - I'd say that Ebola has arrived in that country.  What's more, if there have been cases in Tanzania, the odds are very good indeed that there have also been more cases in nearby countries - Kenya, Uganda, Rwanda and Burundi.  As I discussed earlier, that's the logical route for the disease to spread, down the great lakes and rivers of Africa.

The fact that no such cases have been reported is no guarantee that they haven't occurred.  Official ass-covering is one factor;  another is the stigma and terror aroused by this disease, making families and entire communities afraid to acknowledge its very existence, let alone that it's in their midst.  "If we ignore the boogeyman, he'll go away!" is a tragically common reaction - and not just in the Third World.

Peter

Strategy Page brings us the latest on the Ebola epidemic in the Congo.  I've bolded and underlined a few key sentences that reinforce what I've been saying for months.

In early August Congolese government health officials publicly stated what everyone suspected: many doctors and health care workers believe the medical relief effort is identifying only half of Congo’s Ebola virus (Ebola hemorrhagic fever) cases. That meant the current epidemic that began in August 2018, could continue another three years. During August 2019 the government and WHO (World Health Organization) confirmed the virus has spread from Ituri and North Kivu provinces to a third Congo province, South Kivu, where two cases were confirmed. WHO continues to worry about the spread of Ebola in the city of Goma (North Kivu province) and into Rwanda. Goma has over two million residents and many people cross the unguarded Rwanda border rather than an official border crossing site. Therefore they do not go through health screening.

On August 17 the government confirmed that a woman in the village 160 kilometers from Goma had contracted Ebola. This was well away from the epicenter of the epidemic. The Rwandan Hutu FDLR rebels still occasionally raid the area where this Ebola victim lived and local Security officials noted this was in a “very insecure area.”

The virus continues to take a steady toll within Congo. As of August 26 Congo had 2983 Ebola cases (2878 confirmed and 105 probable). So far 1994 have died from the virus, so it continues to have a 67 percent fatality rate. Reports have to be compiled and tend to be a few days behind the field count and, as health officials acknowledge, the figures likely understate the number of victims. On August 15 WHO reported a total of 2,842 Ebola cases and 1,905 deaths. Over an 11 day period 89 people died.

There's more at the link.

This crisis is far from over.  So far, international efforts have managed to slow its spread to a crawl, instead of a sprint.  That's actually a remarkable achievement, given the primitive state of that part of the world and its inhabitants.  Nevertheless, a breakout is more than possible, given the realities on the ground there;  and if that happens - if the disease gets beyond the "care boundaries" established in the Congo, and penetrates new countries before the boundaries can be expanded to include them - then it could flare up like wildfire.

Nobody should be taking this lightly.  Ebola really could pose a threat to every nation, if things get out of hand.  If you don't believe that, go back and read the death rate percentages referred to above.  That's with the latest treatments, vaccines, trained staff, etc. available in the area.  Without them?  The good Lord only knows . . .

Peter

I'm encouraged to hear that two new drugs to treat Ebola are showing promise, but the process of testing them has been fraught with difficulty - and bloodshed.  Nature reports:

The race to develop treatments for Ebola has accelerated since the largest epidemic in history devastated West Africa between 2014 and 2016. Scientists responding to the ongoing outbreak in the Democratic Republic of the Congo (DRC) have enrolled more than 500 participants in an unprecedented study of experimental drugs, vaccinated nearly 170,000 people, and sequenced the genomes of more than 270 Ebola samples collected from the sick.

. . .

Working in a conflict zone has forced researchers to adapt and persevere to an extraordinary degree. They have learnt how to conduct rigorous studies in areas where killings, abductions and arson are commonplace, and where Ebola responders have come under repeated attack.

. . .

Every aspect of the outbreak is affected by the area’s long history of conflict and trauma. Residents have endured more than two decades of terror from armed groups, along with resource exploitation, political instability and neglect from the world at large. That has bred distrust of authorities — including foreign health workers — and conspiracy theories about why Ebola is thriving. One popular rumour alleges that Ebola responders inject people with deadly substances at treatment centres and vaccination sites.

These false ideas have fostered nearly 200 attacks on Ebola responders and treatment centres so far this year, according to the WHO. Seven people have been killed and 58 injured.

To adapt to the conflict, clinical researchers at an Ebola centre in Beni operated by the French medical charity ALIMA give mobile phones to patients who check out of the clinic. This allows them to stay in touch about lingering symptoms, even if violence makes it impossible to keep follow-up appointments. Many people use the service as an emergency helpline, says Émilie Gaudin, a support officer at ALIMA. “Sometimes a patient calls us and says, ‘People want to kill me,’ or ‘I want to kill myself.’”

Despite this difficult environment, the drug trial is nearing completion. Researchers are 14 people shy of their goal of enrolling 545 participants, a threshold that should allow them to draw strong conclusions about the drugs’ efficacy. But there are already hints that the treatments are working. The mortality rate at Ebola treatment centres, where all patients receive one of the experimental drugs, is 35–40% — compared with 67% overall in this outbreak. The latter figure reflects the large number of people who have died at home or in facilities that aren’t equipped to treat Ebola.

Violence has also hampered vaccination efforts. A few months ago, Diallo Abdourahamane, the WHO’s Ebola vaccine coordinator, heard about a man in the town of Katwa who his team had immunized with an experimental Ebola vaccine made by the pharmaceutical company Merck. The man had told sceptical onlookers that the vaccine would protect against the disease. “But after the team left,” Abdourahamane says, “the neighbours came and surrounded him at night. They said ‘You are the one helping to bring Ebola to our area’ — and they killed him.”

There's more at the link.

Two new drugs have shown promise in the trials, provided they're administered as soon as possible after infection.  That, in itself, is a problem, as many Congolese are deathly afraid of being identified as Ebola carriers.  They'd rather wait at home, hoping against hope that they have flu or something simple, rather than the deadlier disease;  so by the time they're brought to a treatment center and diagnosed, it may be too late for the new drugs to have their desired effect.  Even so, the results hold out hope.

The survival rate for people who received either drug shortly after infection, when levels of the virus in their blood were low, was 90%.

. . .

One of the drugs, REGN-EB3, is a cocktail of three monoclonal antibodies against Ebola made by Regeneron Pharmaceuticals of Tarrytown, New York. The second, mAB114, is derived from a single antibody recovered from the blood of a person who survived Ebola in the DRC in 1995 , and was developed by the US National Institute of Allergy and Infectious Diseases (NIAID).

Both drugs outperformed two other experimental treatments in the unprecedented multi-drug clinical trial in the DRC, the World Health Organization, INRB and NIAID said in a joint statement on 12 August. Preliminary data from the first 499 people enrolled in the study show that 29% of people given REGN-EB3 died, compared with 34% of those who received mAb114.

Again, more at the link.

I'll be holding thumbs that further tests, and possibly further refinement of the two drugs, will lead to an even greater reduction in the death rate.  If an effective treatment for Ebola becomes available, it'll be a huge relief to countries like ours, that up until now have been faced with the possibility of an untreatable, almost invariably fatal disease showing up without warning in our major urban centers.  We've had no answer to that before now.  Here's hoping the new drugs will provide one.

Peter

The Ebola epidemic in West Africa in 2013-16 was declared a "Public Health Emergency of International Concern" by the World Health Organization, one of only five such events in history that have been officially given that title.  I don't know that the declaration did much in practical terms, apart from give warm fuzzies to the bureaucrats who issued it;  but it did underline the seriousness of the outbreak, and the potential threat it posed.  The world avoided a major international health crisis by the skin of its collective teeth in that outbreak, by shutting down as much travel as possible from the affected area unless passengers had been screened.  The screening wasn't very effective (a number got through despite it), but it at least kept the numbers to manageable proportions.

Now, for the sixth time in history, another such emergency has been declared - and, for the second time, it involves Ebola;  this time, the 2018-2019 outbreak in Congo.

The deadly Ebola outbreak in Congo is now an international health emergency, the World Health Organization announced Wednesday after a case was confirmed in a city of 2 million people ... More than 1,600 people have died since August in the second-deadliest Ebola outbreak in history, which is unfolding in a region described as a war zone.

A declaration of a global health emergency often brings greater international attention and aid, along with concerns that nervous governments might overreact with border closures.

The declaration comes days after a single case was confirmed in Goma, a major regional crossroads in northeastern Congo on the Rwandan border, with an international airport. Also, a sick Congolese fish trader traveled to Uganda and back while symptomatic — and later died of Ebola.

. . .

Dr. Joanne Liu, president of Doctors Without Borders, said she hoped the emergency designation would prompt a radical reset of Ebola response efforts.

“The reality check is that a year into the epidemic, it’s still not under control, and we are not where we should be,” she said. “We cannot keep doing the same thing and expect different results.”

Liu said vaccination strategies should be broadened and that more efforts should be made to build trust within communities.

There's more at the link.

I'm sorry that I'm not overwhelmed by medico-religious fervor at this news;  but the WHO has been dilly-dallying over this issue for far too long.  It's probably too late for this declaration to have the desired effect.  It should have been declared months ago, when a major push to screen for new cases and vaccinate those exposed to Ebola might have made a difference.  However, due to the dangers of operating in a war zone, that wasn't done.  It would have been too difficult, too dangerous.  As a result, the virus is now poised to break out into three or four new countries.  I'm taking bets that it will do so before long.  I know that area from personal experience.  Just look at this map (courtesy of the Daily Mail) of where the epidemic has spread, most recently to Goma, a city of at least one million people (according to informal estimates, double that).  Click the image for a larger view.




Notice how the centers of the epidemic are roughly aligned with the lakes that run from north to south along the spine of Africa.  There's a reason for that.  In the old days, commerce ran along those lakes, because water transport (by canoe, or raft, or colonial steamboat) was a lot easier than hacking one's way through equatorial forest.  Nowadays there are roads, but some are awarded that title only by courtesy.  The population is still concentrated along the old trade routes, and absent some major upheaval, it'll stay that way.  What's more, traffic is still concentrated along those routes.  That's why Ebola has spread north-south in that part of the world;  it's following the traffic.

Unless we're very lucky, look for Ebola to reach Burundi next, and from there, slowly but surely, all the way down the central African lakes and their connecting rivers to Zambia and Malawi.  Look at the blue areas on the map below.  That's how informal, local trade travels, and (like many others, such as the Black Death in Europe in the 14th century) this disease follows trade.  It will not be possible to screen all travelers using such routes.  It's physically impossible to intercept them all - and given their mistrust of graft-seeking officialdom (of which more below), they'll have every incentive to avoid checkpoints.  They'll simply take to the bush and walk around them, or sail past them.




After the Rwanda massacres in 1994, hundreds of thousands of refugees fled to Goma, and still live there in camps.  Traffic across the border is almost completely uncontrolled (or was when I was last there).  People cross wherever they feel like it, to visit relatives, or shop for food, or whatever.  It's a nightmare for those trying to stop Ebola spreading any further.  That's probably going to be flatly impossible in such a location.

"Isolated cases" of Ebola have now been reported from Uganda and Kenya, with the latter subject to official denials.  (If you believe them, I have a bridge in Brooklyn, NYC, to sell you.  Cash only, please, and in small bills.)  Officials in surrounding countries are terrified of admitting to Ebola cases on their territory, because they may bring with them restrictions on travel, trade, and all sorts of things that may affect their economies - and, consequently, the graft, bribery and corruption they rely on to fill their wallets.  Can't have that interrupted, can we?  This is Africa, after all!  (That's how wealthier refugees from Ebola will evade travel restrictions, even though they may be carrying the disease.  A suitable bribe, and they'll be waved through.  How do I know this?  Because I've done it myself to evade travel restrictions, in more than one country in Africa.)  That being the case, distrust any and all official statistics coming out of the affected areas.  They may or may not be correct.  I'll trust Doctors Without Borders' figures before I trust those from any health ministry (or the World Health Organization).

I've been warning about the risks of this latest outbreak for almost a year.  Aesop, over at Raconteur Report, has been doing likewise, in rather stronger terms.  I can only draw your attention to those earlier posts, and urge you to do what you can in terms of personal preparedness.  That isn't much.  If this breaks loose over here, it's not going to be good.  (That's known in the trade as an "understatement".)

Peter

I've warned often enough about the dangers of the Ebola outbreak in the Congo.  Aesop, over at Raconteur Report, has done the same.  I don't see any point in doing so again - if people haven't listened before, they won't listen now.  Instead, I'll just point out that events are proceeding almost exactly as Aesop and I have predicted they would.  Click each headline below for more information.


1.  Ebola reaches Uganda

Uganda announced two more cases of Ebola on Wednesday - a grandmother and a three-year-old boy, confirming that a deadly outbreak has spread for the first time beyond the Democratic Republic of Congo.

. . .

"This epidemic is in a truly frightening phase and shows no sign of stopping," said Jeremy Farrar, an infectious disease specialist and director of the Wellcome Trust global health charity, which is involved in fighting Ebola.

"We can expect and should plan for more cases in DRC and neighboring countries," he said, adding: "There are now more deaths than any other Ebola outbreak in history, bar the West Africa epidemic of 2013-16, and there can be no doubt that the situation could escalate towards those terrible levels."

2.  One in four DR Congo Ebola cases could be going undetected

Michael Ryan, executive director of WHO's Health Emergencies Programme, said on Thursday the epidemic was "not out of control, but it is certainly not under control", with insecurity and community mistrust hampering emergency responders' efforts.

"We believe we are probably detecting in excess of 75 percent of cases. We may be missing up to a quarter of cases," Ryan said at a press conference in the Swiss city of Geneva.

. . .

The outbreak - the second-worst on record - reached 1,000 cases in March. It then took less than three more months to surpass 2,000, signalling a tripling in the rate of infection.

. . .

Health teams have been unable to reach some areas because of violence by rebel groups, with scores of rival armed factions active in the region. More than 100 attacks on treatment centres and health workers have been recorded since the beginning of the year, according to WHO.

. . .

According to a recent study by the Lancet Infectious Diseases journal, large segments of the local population believe the virus is a fabrication invented for the financial gain of business-owning local elites or to further destabilise the area.

Fewer than two-thirds of the nearly 1,000 respondents said they would take a vaccine for Ebola.

3.  Wave of undocumented Africans arrive in Mexico

A wave of 11,900 African migrants, mostly from the Congo, fleeing wars and poverty and heading to the United States in search of political asylum, has entered Mexico ... According to the INM, migrants come mainly from the Republic of the Congo, in Africa ... They start a journey of three to four months from Africa to the southern border of Mexico. They cross the Atlantic Ocean by sea or air to reach Sao Paulo, Brazil.

From there, they move through the jungle to continue through Peru; in buses, vans, and stretches on foot or by boat, they travel through Ecuador, Colombia, Panama, Costa Rica, Nicaragua, Honduras, and Guatemala, until they reach Chiapas.

“So far we have no refugee applications, they tell us that they intend to arrive in the United States and only using Mexican territory as transit,” said Jordán Alegría.

Aaaaaand . . .


4.  350 Congolese Migrants Arrive in San Antonio

“We didn’t get a heads up,” Interim Assistant City Manager Dr. Collen Bridger told KEN 5 after a group of 350 Congolese migrants arrived in the city unexpectedly. “When we called Border Patrol to confirm, they said, ‘yea another 200 to 300 from the Congo and Angola will be coming to San Antonio.'”

. . .

South and central African migrants began illegally crossing the South Texas border on May 30 when 117 migrants from the Republic of the Congo, the Democratic Republic of the Congo, and Angola crossed in the Del Rio Sector. By June 5, more than 500 African migrants had crossed illegally in this single Border Patrol sector...

The new arrivals in the USA from Congo are probably not carriers of Ebola, and probably did not flee because of that virus - they've been on the road for several months to get here.  The next wave of Congo refugees?  You can bet your bottom dollar many of them will be fleeing Ebola.  Where do you think those Uganda cases came from?  They were from a single extended family fleeing Ebola in north-eastern Congo, that's where.  That family undoubtedly had contact with border officials, hospital workers, and others in Uganda before the nature of their disease became apparent.  Every one of those people should now be under observation, in quarantine, along with everyone else with whom they had contact.  If they aren't . . . the virus will spread through them.  Guaran-damn-teed.

There are undoubtedly hundreds more people and families like that, probably thousands more, already in Uganda, Rwanda and Burundi.  They haven't passed through official checkpoints to get there, either, because of the risks of being turned back (particularly if they show any symptoms of any illness whatsoever).  They're sneaking across borders through thick bush, along forest trails, keeping out of sight.  By the time Ebola symptoms become apparent, they may have had contact with dozens, scores, even hundreds of locals.

So far, the figures for this Ebola infestation appear to show a doubling of the number of cases approximately every month.  I predict that's about to change for the worse, at least locally.  I also predict that the disease will make its appearance in Rwanda and Burundi soon, to go along with Uganda, and will spread from there to Kenya, Tanzania, and probably South Sudan and Chad as well.

So far, the saving grace for the USA is that such refugees have taken several months to get here.  Since Ebola's incubation period is plus-or-minus 21 days (with some outliers taking up to 40 days to show symptoms), that means most of those infected will die before they get close to our borders.  That does not, repeat, does NOT apply to those who can afford to travel faster.  If a refugee family has passports and funds at its disposal (and some do), it can hire smugglers to get it to an airport (e.g. Kampala in Uganda, or the big international airport at Nairobi in Kenya).  From there, it's an overnight flight to any one of a dozen cities in Europe.  From those cities, it's another eight- to twelve-hour flight to the USA.  They can do the whole journey, start to finish, in less than a week . . . leaving them two to three weeks to wander around the USA, spreading Ebola to everyone they meet.

Nightmare?  No.  It's a clear and present danger.  If you don't understand that, you haven't been following the situation for the past year.

It's even worse because the Democratic Party-controlled Congress absolutely refuses to fund a border wall and other effective exclusionary measures.  That's the only thing that can stop such refugees from crossing our borders almost at will . . . yet, for their own political reasons, the Democrats refuse to countenance it.  Right now, that borders on criminal negligence.  If Ebola crosses our southern border with its carriers, it will become actual criminal negligence at least, and possibly manslaughter.  I can only hope and trust that those blocking effective border security measures will be held accountable for the results of their actions, if worse comes to worst.  In that case, I can't think of a penalty that would be too severe.

Go read Aesop's latest take on the situation, and the comments from his readers.  He's not exaggerating.

Peter