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The story of Thomas Eric Duncan’s experience with Ebola is one that has played out thousands of times in West Africa. The patient fell ill with a fever. Doctors misdiagnosed him. A vial of his blood was shipped to a high-tech laboratory to be tested. By the time virologists confirmed it was Ebola—in this case, four days later—isolation was long overdue.

It’s a sequence of events that captures one of the biggest, and often overlooked obstacles to curbing the spread of the disease in West Africa: inefficient testing.

There is only one approved, working test that can detect whether or not Ebola is present in the blood. One. The powerful technology required is slow, complicated, and requires both a laboratory and equipment. It is not that more-efficient tests do not exist; it’s that we don’t yet have the permission needed to use them.

As Ebola cases in West Africa surpassed 6,000 this week, Dr. Bob Garry, a scientist at Tulane University, is working harder than ever to get one possible solution—a rapid diagnostic test—approved. Until that happens do, testing will remain the epidemic’s secret ally.

The vial of blood taken from Duncan in Dallas was sent to the Centers for Disease Control and Prevention’s Atlanta lab, where a single test was performed. It’s the same one used by doctors in West Africa, or anywhere in the world. The test uses something called polymerase chain reaction (PCR) to amplify the DNA of the patient to a point where doctors can actually detect the virus. But the technology, while powerful, is cumbersome and takes anywhere from 12 hours to four days to get a result.

This isn’t the best test for this epidemic, but it’s the only one.

Garry says the biggest problem with this test is in its high-tech, time-consuming method.

For example, a vial of the patient’s blood is transported to one of the few laboratories in West Africa with the suitcase-size PCR equipment needed to test for the virus. These facilities, among other more sophisticated equipment, require central electricity. In many parts of West Africa, this is hard to find. The test can take anywhere from one day to four. Factoring in travel, an answer to a sick patient’s question could be as much as a week away.

At the outset of this process, the patient is told to remain at the treatment center until a diagnosis can be made. But by the time the test results come back, the vast majority are gone. Some have fled the hospital in fear. Some have gone into hiding. Some have gone home to die. All of those who are positive have now needlessly spread the virus to countless others.

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