Ebola’s volgende grens

NEW DELHI – Welke landen buiten West-Afrika zijn het meest ontvankelijk voor de Ebola-epidemie? De meeste epidemiologen zijn niet zo beducht voor een groot deel van de ontwikkelde wereld, met zijn effectieve quarantainemaatregelen en volgprocedures, en ook niet voor spaarzaam bevolkte ontwikkelingslanden. In beide groepen landen zou een uitbraak makkelijk kunnen worden ingedamd. Maar grote dichtbevolkte gebieden zonder fatsoenlijke indammingsmechanismen zijn zeer kwetsbaar.

India, met zijn omvangrijke emigrantenbevolking (de op één na grootste ter wereld), hoge urbanisatiedichtheid en ontoereikende infrastructuur voor de openbare gezondheidszorg, heeft mogelijk het meest te verliezen als het Ebola-virus zich verspreidt. De banden met West-Afrika zijn nauw en gaan een eeuw terug. Er leven bijna 50.000 Indiërs of mensen van Indiase herkomst in de regio.

Heel veel mensen vliegen op dagelijkse basis heen en weer tussen Accra, Lagos, Freetown, Monrovia of Abidjan en New Delhi, Mumbai, Calcutta of Chennai, waarbij ze het Midden-Oosten of Europa aandoen. Hoewel er op alle internationale luchthavens in de getroffen gebieden exitcontroles aanwezig zijn, betekent de incubatieperiode van het virus (die bij de huidige uitbraak gemiddeld acht dagen duurt, maar kan oplopen tot 21 dagen) dat iemand zonder symptomen van een recente infectie naar India kan reizen zonder de alarmbellen te laten rinkelen.

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