On Friday, Gov. Paul LePage addressed his concerns about Fort Kent nurse Kaci Hickox, who treated Ebola patients in Sierra Leone and has resisted efforts by Maine and New Jersey to force her into a 21-day quarantine. Hickox has not tested positive for the disease. LePage also spoke about an incident in which a Cumberland County restaurant worker may have exposed customers to hepatitis A. LePage made several factual assertions about Ebola and other infectious diseases, and he appeared to link the hepatitis A exposure to immigrants living here illegally.
Governor’s statement: “Do you know that 13 percent show no symptoms. Thirteen percent of people who have Ebola and died of Ebola show no symptoms, until a few hours before they died.”
Facts: LePage was most likely referring to a figure in a study of Ebola cases in West Africa that was done by the World Health Organization and recently published in the New England Journal of Medicine. Researchers found that nearly 13 percent of suspected and confirmed Ebola patients did not show a fever when they were evaluated by medical personnel.
Fever is the single most common early indicator of the illness. Fever was present in 88 percent of fatal cases and 84 percent of nonfatal cases, the study found. The assertion that 13 percent of people who died of Ebola showed no symptoms at all “until a few hours before they died” is false. Ebola does not sneak up on its victims like a heart attack, but builds over time until the patient is overcome with the virus. Once inside the body, the virus travels through the bloodstream until it attaches to a cell. The virus replicates itself to the point that it disrupts cell function and kills the cell. The process repeats in countless cells, with the virus attacking many types of tissue at once. After fever, the next most common symptoms are fatigue and vomiting. Patients who die of the disease often suffer uncontrollable diarrhea, and in the final stages, massive organ failure.
Statement: “I have been trying to get the president to pay attention to the illegals who are in our country. Because there is a spike in hepatitis C, tuberculosis, HIV, and it’s going on deaf ears.”
Facts: Rates of hepatitis A and hepatitis B have been falling in the United States consistently, according to the U.S. Centers for Disease Control and Prevention. The governor was right to characterize a spike in hepatitis C, but studies indicate that the greatest increases in hepatitis C are among young white people in suburban neighborhoods east of the Mississippi River who had abused prescription opioids in the past and had a recent history of intravenous drug use. The number of tuberculosis cases in 2013 nationwide, at 9,582, was the lowest in 50 years of record-keeping, according to the Center for Disease Control and Prevention. And the rate of HIV contraction in Maine is roughly a third of the national rate, with about 34 people contracting the disease per 100,000, compared to about 107 cases per 100,000 nationally.
Statement: “To cure hepatits C is about $90,000. To cure tuberculosis is somewhere between $80,000 and $100,000. To treat (an) HIV patient is $90,000 a year.”
Facts: LePage was on target about the cost to cure hepatitis C. In 2013, the Food and Drug Administration approved Sovaldi, an oral pill for hepatitis C that in clinical trials cured nearly all of the patients who took it. The cost of the drug is about $1,000 per pill in the United States, and for a 12-week course, that can run up to about $84,000. But the governor was far off on the cost of the other treatments. Curing a case of traditional tuberculosis costs between $2,000 and $17,000 in the United States, but if the strain of tuberculosis is resistant to drug therapies, that cost can skyrocket and range from $250,000 to $430,000, according to the World Health Organization and the U.S. CDC. Only 95 cases of drug-resistant tuberculosis were reported in the U.S. in 2013. In the same year, there were 9,582 cases of non-resistant tuberculosis, 65 percent of them originating in foreign-born people.
The cost of treating HIV is also only a fraction of what the governor said it was. According to the federal CDC, one year of HIV treatment in the United States costs about $25,000 on average.