With free universal health care, Cuba has already racked up impressive medical achievements – why not take on the globe?
Back in June, I posted a map of the possible diffusion patterns for Ebola. At the time, a few other ecologists and disease ecologists soon posted notes on the internet expressing similar concerns.
The Jamaican Fruit Bat (Artibeus jamaicensis; white area on the map) is the ecological link between African Ebola and the potential for North and Central American neotropical Ebola or Ebola-prone ecological, environmental domains. Russian disease ecologists E.N. Pavlovsky (b. 1884, most important impact 1937, 47 – 1965), D. K. Zabolotny, and A.G. Voronov (1970 – ) perfected this macroecological interpretation of zoonotic related disease patterns. (see https://brianaltonenmph.com/gis/historical-disease-maps/zoonoses/ 😉
We can use the distribution of this species to define our first boundaries for a natural ecological diffusion pattern for Ebola, assuming this Artibeus is a sufficient animal host or carrrier.
If we superimpose on this map some of the newest data on cases that have escaped the African region (approximations given here, not exact lat-long), and we relate these to another historical map depicting travel routes abroad (light blue lines), we see expected and unexpected travel patterns behind the few cases that have erupted in Europe and the United States.
These are the essential human travel/migration/diffusion disease patterns.
The article on Cuban physicians active in the anti-Ebola campaign, even before the current eruption, brings up some important issues. Most certainly they must be thinking about this same series of observations on their own.
As noted in a number of my postings, there is this latitude effect that limits Ebola activities at the natural versus human ecological levels. In terms of natural ecology, Ebola prefers its native tropical settings; in the U.S., the Caribbean and per-Gulf of Mexico regions are prime neotropical vegetation and animal settings. Cuba is the center of where Artibeus prevails as well. Cuba is also close enough to the U.S. to interact with the Gulf of Mexico shoreline setting with their neotropical animal habitats.
Cuba is at the heart of the setting for where a nidus could most easily develop. Population density defines next how the disease might influence the environment. Most of the cases that penetrated the U.S. are well within the temperate zone borders, with the exception of the Houston events. But even the Houston area is well above the natural Artibeus domain.
Regarding westward versus eastward diffusion of Ebola along the Artibeus migration paths following both coastlines of Mexico, there is a Climate-Environmental Barrier (C-E Barrier) on my map that I defined in June, suggesting it would be hard for the disease to strike southern California, except through human transportation involvement. An Ebola specimen that did reach southern California still has some ecological requirements lacking, although other wildlife may serve as reservoirs as well (the "armadillo" effect for western Texas, as mentioned elsewhere by Lane Decamp, LinkedIn discussion).
The possibility of a northnortheastward migration from Mexico into the U.S. cannot be easily ruled out, in terms of environment. But other parts of the macroecology are also lacking (again, excluding "the armadillo").
So this leaves Cuba still a very good candidate for providing a route for Ebola migration into the U.S. and other parts of the Americas.
Other Caribbean Island routes are possible as well. But, due to its engagement in Ebola health care activities, any Cuban healthcare providers engaged in Ebola work in the field add a human ecological effect to this natural disease diffusion model.
Were Ebola to naturalize to the tropical Americas, the expectation is that it would behave much like other African-borne tropical zoonotic diseases with large animal resources, hosts and vectors.
It could also in theory impact the western shoreline countries of South America, tagging behind the cholera diffusion that ensued along the Peruvian shores following its naturalization off the coast of Lima (for US areas like this, see my El Tor video–https://www.youtube.com/watch?v=m5tccQopKFE ; also AA Franco et al., 1997. Cholera in Lima, Peru, Correlates with Prior Isolation of Vibrio cholerae from the Environment, article at — http://aje.oxfordjournals.org/content/146/12/1067.full.pdf ). This diffusion pattern also follows the distribution of the frugivore bat.
A naturalized Ebola is expected to demonstrate outbreaks in human population areas where sanitation practices are a concern, accompanied by eating practices that make use of certain wildlife-based foodways (how they prepare and keep the meat). The right ecological settings along the entire shoreline of South America, east and west, and through Middle America, are at risk.
In terms of latitudes–the 10, 15 and 20 degrees latitude line rules I discussed previously hold true for this region. On the western shore (including both sides of the Isthmus), I expect 12south-0-12north distribution; along the eastern shore, 12n-0-4s. The Brazilian population densities below 4s could bear some of the same risk as US temperate zone populations.