WASHINGTON — Doctors and nurses are on the front lines of the war on Ebola. But an equally important role in the battle is played by men and women who combine detective work with medical science.
They are the public-health detectives who track down the contacts of Ebola patients and arrange for those at risk to be quarantined and monitored. It’s an especially important job in the fight against a mystery disease with no sure cure that kills at an alarming rate.
“We like to refer to it as shoe-leather epidemiology,” says Jesse Bump, an assistant professor in the Department of International Health at the Georgetown University School of Nursing and Health Studies.
He says the goal is to go out and find potential cases before they happen.
These detectives start by talking with the Ebola patients themselves, as well as their inner circle of family and friends. Bump says they move on to track people the victims may have met, places they may have gone, and things they might have done.
He notes this kind of work enabled two African countries — Nigeria and Senegal — to stop Ebola in its tracks. In both cases, when initial cases were discovered, the public health infrastructure swung into play.
In Nigeria, Bump says, “There were over 200 people involved in spreading over a web of contacts, conducting something like 26,000 interviews over the course of a month, just to try to identify anyone who had been connected to that possible case so they could be on the lookout for anyone who might have developed symptoms.”
It is a technique that has long been used to keep disease from spreading, and Bump says it is every bit as important as the work that goes into developing new treatments — perhaps even more so.
Heath professionals are involved with the process of tracking, isolating and monitoring those at risk, but so too are community volunteers and faith-based organizations.
That was the case in Nigeria and Senegal as well as in Dallas, where the first Ebola patient diagnosed in the United States died and two nurses were infected providing his care.
But, though it is looking to stop a relatively new disease, the notion of shoe-leather epidemiology has been around forever. Bump, who is also a health care historian, says the whole notion of quarantine dates back to Biblical times. He says it is in the Old Testament in the book of Leviticus.
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