On July 11, I shared an article about the Ebola outbreak that was reaching historic levels. At that point in time, the outbreak was contained to the West African countries of Sierra Leone, Liberia and Guinea with 888 confirmed cases.

That number has doubled to 1,711 cases in a little under a month, according to the World Health Organization's reporting Aug. 4. Clearly, the disease is moving at an unprecedented rate, recently spreading into Nigeria.

As the world watches this unfold, history was made when the Ebola virus recently entered the United States voluntarily. With this new turn of events, the Centers for Disease Control has been under extreme scrutiny regarding its role in protecting the public at large by allow this virus to enter the United States.

There was much debate in the medical community regarding the ethics of bringing a highly contagious person into a population that was not infected, nor likely to be exposed. The risk seemed too great in most people’s opinions.

In fact, one of the tenets of infection control is to isolate the infected to prevent exposure. Therefore, bringing the infected person here was certainly deemed counterintuitive. More disturbing, CDC Director Dr. Thomas Frieden recently stated on CNN that a formal risk benefit analysis was not performed in bringing them to the U.S.

He stated that CDC’s roll was only to support the decision of the private parties and to assist Americans in returning to the U.S. With every decision in healthcare, a risk benefit analysis is undertaken.

In light of the high stakes of a potential infection, the risk to the public at large certainly seems great. Considering the infected people will be cared for two nurses and one doctor at all times, these people are at substantial risk that was not present previously in their daily lives.

On Aug. 6, the same time the infected Americans were in the process of arriving, the CDC finally issued guidelines for healthcare workers for hospitalized patients with known or suspected Ebola hemorrhagic fever. In reading the guidelines, it is clear that every precaution should be taken, including double gloving, wearing gown, mask and goggles and possibly shoe and leg covers – just as has been displayed in most pictures.

Ebola, although exceptionally deadly, is transmitted only via direct contact with blood or body fluids, just like HIV or Hepatitis B. However, Frieden has said numerous times that “fancy isolation” procedures are not needed because it is known how the virus is spread. Again, in lies the confusion and why many healthcare professionals feel that the virus is much more contagious than originally reported.

Although it is highly unlikely that Ebola will become a public health concern in the United States, new ethical discussions are currently underway regarding the use of untested treatments. Prior to the transport of the infected Americans, they received an experimental medication called zMapp. It had never been tested on humans and had minimal clinical trials in animal studies.

Although the two American’s who received the medication have shown positive results, new questions have arisen. On Aug. 6, the WHO announced that they will be convening a medical ethical review of the use of experimental treatment to aid in the current outbreak.

The question has been raised about whether medications currently under development, that have never been shown to be effective in humans, should be used in the outbreak. Also, considering the limited supplies, how will it be decided who receives the medications.

If the medications were used, it would be a large, uncontrolled human experiment that will test the boundaries of all current ethical practices.

Although the likelihood of an American outbreak is low, it is important to be informed, especially healthcare providers at all levels. As with any new disease, new lessons are learned and unfortunately, uncharted ethical territories are also encountered.

Overall, it will be interesting to see the world’s response to this humanitarian crisis, with the hopes of a quick resolution.