Given the media freak out every time there is even a suspected case of ebola on US soil, it's not too difficult for people with a susceptible imagination to develop visions of a vast epidemic sweeping the country. Epidemiologists are attempting to come up with some educated projections for the next few months. They all agree that there will be more cases. The question is how many.
Top medical experts studying the spread of Ebola say the public should expect more cases to emerge in the United States by year's end as infected people arrive here from West Africa, including American doctors and nurses returning from the hot zone and people fleeing from the deadly disease.
But how many cases?
No one knows for sure how many infections will emerge in the U.S. or anywhere else, but scientists have made educated guesses based on data models that weigh hundreds of variables, including daily new infections in West Africa, airline traffic worldwide and transmission possibilities.
This week, several top infectious disease experts ran simulations for The Associated Press that predicted as few as one or two additional infections by the end of 2014 to a worst-case scenario of 130.
"I don't think there's going to be a huge outbreak here, no," said Dr. David Relman, a professor of infectious disease, microbiology and immunology at Stanford University's medical school. "However, as best we can tell right now, it is quite possible that every major city will see at least a handful of cases."
The 130 number is a far outlier among the different projections that were developed. The general range is about 2 - 20. It is anticipated that these cases will occur in health care workers returning from West Africa and possibly other travelers. If US health care workers caring for them stick closely to established infection control protocols they are not at a high risk of contracting the disease. There is a very low risk of other members of the public who come into casual contact with the people in the early stages of an infection becoming infected. So far that has never happened in the US.
If these numbers turn out to be accurate projections the vast majority of the American public will never get any where near a person who has ebola. The really important concern is what happens in West Africa and whether the epidemic could spread form there.
The foreseeable future extends only for the next few months. After that, projections depend entirely on what happens in West Africa. One scenario is that the surge in assistance to the region brings the epidemic under control and cases peter out in the U.S. A second scenario involves Ebola spreading unchecked across international borders.
"My worry is that the epidemic might spill into other countries in Africa or the Middle East, and then India or China. That could be a totally different story for everybody," Vespignani said.
Dr. Ashish Jha, a Harvard University professor and director of the Harvard Global Health Institute, said he's not worried about a handful of new cases in the U.S. His greatest worry is if the disease goes from West Africa to India.
There is reason for the world to worry about ebola. I think the biggest thing that Americans should be worried about is anything that would impede the flow of assistance to West Africa in order to bring things under control.