Ebola on the horizon?

[BigMatt]

She must not have followed protocol to get infected in the first place..... or something......

She isn't infected or showing symptoms at this point.

 

[printcraft]

She isn't infected or showing symptoms at this point.

Ah! Let's hope not.

 

[T.Lex]

Hey pudly - Belize is a country right? (Just checking.)

In other global ebola news...

Doctors Without Borders reports that 16 of its people have been infected, and 9 died.
Doctors Without Borders Loses 9 to Ebola

The deaths reveal that even at well-quipped and properly staffed treatment centers the risk of infection is high, according to the Associated Press.

And in Sierra Leone, every district now has registered ebola infections.

FREETOWN, Sierra Leone: Ebola comes to last safe district in Sierra Leone | Health | The Bellingham Herald

The deadly Ebola virus has infected two people in what was the last untouched district in Sierra Leone, the government said Thursday, a setback in efforts to stop the spread of the disease in one of the hardest-hit countries.

​

I expect updated WHO (or aggregate) numbers. Ought to be interesting. Sad, but interesting.

 

[pudly]

Anyone surprised the CDC is just another political wing?

CDC blames cuts for Ebola response, pays millions in bonuses - Washington Times

The CDCs recent problems haven't been due to a lack of resources, but instead to poor judgement. No amount of money can fix that problem. They took the two infected nurses to specialized facilities late, not because they didn't have such facilities. They didn't restrict movements of individuals who were closely involved in the treatment of Duncan late, not because they lacked resources.

Of course, all of this still brings up the contrast of restricting Americans who are even minimally involved with these Ebola infections, but not restricting people traveling from the countries where the bulk of Ebola cases are located.

Edit: Just saw this and had to add it-

Mark Steyn: It turns out [the CDC's] the DMV with test tubes

 

[T.Lex]

Ok.This is a Drudge link, with the corollary amount of alarmism. Which means I almost didn't read it.
Six Reasons to Panic | The Weekly Standard

It has some good info.

This sounds reassuring. Except that it might not be true. There are four strains of the Ebola virus that have caused outbreaks in human populations. According to the New England Journal of Medicine, the current outbreak (known as Guinean EBOV, because it originated in Meliandou, Guinea, in late November 2013) is a separate clade “in a sister relationship with other known EBOV strains.” Meaning that this Ebola is related to, but genetically distinct from, previous known strains, and thus may have distinct mechanisms of transmission.


Not everyone is convinced that this Ebola isn’t airborne. Last month, the University of Minnesota’s Center for Infectious Disease Research and Policy published an article arguing that the current Ebola has “unclear modes of transmission” and that “there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.”

I thought this strain was Zaire - the one they've known about for a long time. A bit more follow up on this note:
Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak

This West African variant likely diverged from central African lineages around 2004, crossed from Guinea to Sierra Leone in May 2014, and has exhibited sustained human-to-human transmission subsequently, with no evidence of additional zoonotic sources. Because many of the mutations alter protein sequences and other biologically meaningful targets, they should be monitored for impact on diagnostics, vaccines, and therapies critical to outbreak response.

Oh, and 5 members of the group that did that study died from ebola.

In memoriam: Tragically, five co-authors, who contributed greatly to public health and research efforts in Sierra Leone, contracted EVD and lost their battle with the disease before this manuscript could be published: Mohamed Fullah, Mbalu Fonnie, Alex Moigboi, Alice Kovoma, and S. Humarr Khan. We wish to honor their memory.

Yes. People who study ebola, know ebola, and are smart enough to take precautions became infected and died while researching this ebola. That's kinda staggering.

Just shaking my head.

All this 2-21 days stuff, only contagious if symptomatic, magic temperature of 100.4, is just BS. They really don't know.

 

[2ADMNLOVER]

Is it too much to ask that anyone who's had any amount of exposure to self quarantine ? To me that seems like a common sense move .

BUT NOOO , let's be selfish and take plane and boat rides and try our best to spread this crap world wide , YEAH that seems like a way better idea .

I'm not big on getting our legal system involved but in this case these idiots should be sued for any costs incurred for decontaminating the vessels and the time they were shut down or the stores were closed .

If you have any amount of exposure , keep your ass at your home !

 

[ArcadiaGP]

Doctor: Ebola Might Be Transmitted In Air Via ?Droplets? « CBS Dallas / Fort Worth

 

[T.Lex]

If you have any amount of exposure , keep your ass at your home !

That's kinda the rub. (Pardon the pun?) We have to do a better job of assessing what amount of exposure is "enough" to become infected. Think about how a hospital would run if every nurse/doctor/technician/janitor could only have 1 interaction with an ebola patient. They'd run out of staff PDQ.

Then, what if the people who've had contact with those medical workers had to stay home - kids/spouses. The quarantine lasts (at least) 3 weeks. It turns into a big chunk of people who are no longer working. That's bad for the economy.

Then, if medical care workers aren't available to treat people - with and without ebola - then more people get sick and stay sick. Which becomes another drain, and impacts overall health of the community.

Now, I'm certainly not defending the people who flew and went on the cruise (WTF?). But, it would be easy to go too far the other direction.

We just need to know more about how this virus is transmitted. That won't be easy, but it should be a focus.

 

[dusty88]

Perspective here. The infections in this country so far are those who were in close proximity with a dying patient, not casual contact nor early in the disease process.

There is not an epicenter here at this time.

The healthcare workers who flew or went on a cruise ship probably didn't consider themselves at risk when they left. I'm not clear on the "cruise ship" person. It's possible she went on a planned vacation before she even knew there was a concern about her, as a laboratory worker. She apparently left before "active" monitoring. Of course, I agree if she was told to "self monitor" then what she did was very wrong. Because you just what are you going to do if you start developing symptoms while on a cruise ship?

This highlights the reasoning for treating any Ebola cases in a few facilities. You can keep most of the gear in 1 place, and you can keep consistent training. You can't train the entire US healthcare system to treat Ebola while they are doing everything else they do. The problem for ERs may be figuring out what to do with every "suspect" that comes in.

It seems we have too many people on both extremes: some laughing at Ebola as if it's not going to cause global problems or as if we will never have enough cases here to cause problems for us. Others ready to declare it "airborne" with every rumor.

 

[T.Lex]

Perspective here. ...
It seems we have too many people on both extremes: some laughing at Ebola as if it's not going to cause global problems or as if we will never have enough cases here to cause problems for us. Others ready to declare it "airborne" with every rumor.

Too true. In fact, I vary between those extremes in any given day!

It just seems like "the authorities" communicate information as fact - to the public and medical workers - that is not "fact." Particularly when it comes to transmission. Sitting next to someone on a bus may not transmit sufficient amounts of the virus to lead to infection 9/10 times. That's great, unless you're the 10th person. They shouldn't have the President say "it can't happen." Instead, say, "It is very unlikely to happen." Then, let people make their own decisions.

I guess it comes down to comfort with the unknown. Some people are comfortable not knowing, others need to "know" something is true, even if it may not be.

 

[dusty88]

Doctor: Ebola Might Be Transmitted In Air Via ?Droplets? « CBS Dallas / Fort Worth

I think that everyone is not sure who to believe, and that's understandable.

Try to fetter out "what we know" from "what is possible" and "what we have seen before".

First of all, this guy is a director of a physicians organization. I don't know his background, but some of these organizational execs haven't practiced medicine for decades. They are basically more like lobbyists than doctors.

The "droplet" transmission has always existed and is known. What isn't known is how long it survives, partially because it's going to depend how much fluid the virus has in the droplet to keep the virus alive.

When Dr Orient says that "maybe they are contagious before they get symptoms" he is correct that there hasn't been experimental evidence to PROVE it. However, all the records and history of the disease spread show people aren't contagious until they are symptomatic. The fudge factor on symptomatic is probably whether that initial low-grade fever and lethargy is happening at the same time you are shedding virus. It appears unlikely that you would be shedding virus at that point, but I wouldn't want to be kissing someone or getting a direct contact with them to test that part of the theory. Stretching that to believe that the completely ASYMPTOMATIC person is contagious, isn't really rational based on the history of the disease, or even similar viruses.

 

[T.Lex]

First, I may have been remiss in saying this, but thank you very much for bringing your expertise to this.

The fudge factor on symptomatic is probably whether that initial low-grade fever and lethargy is happening at the same time you are shedding virus. It appears unlikely that you would be shedding virus at that point, but I wouldn't want to be kissing someone or getting a direct contact with them to test that part of the theory. Stretching that to believe that the completely ASYMPTOMATIC person is contagious, isn't really rational based on the history of the disease, or even similar viruses.

I follow your reasoning, but after reading the Science article (ok, mostly skimming it) (ok, reading the abstract and skimming the article) I don't think we know as much about this strain as we think we do.

The observed substitution rate is roughly twice as high within the 2014 outbreak as between outbreaks (Fig. 4F). Mutations are also more frequently nonsynonymous during the outbreak (Fig. 4G). Similar findings have been seen previously (15) and are consistent with expectations from incomplete purifying selection (16–18). Determining whether individual mutations are deleterious, or even adaptive, would require functional analysis; however, the rate of nonsynonymous mutations suggests that continued progression of this epidemic could afford an opportunity for viral adaptation (Fig. 4H), underscoring the need for rapid containment.

Now, I'm not a big "OMG the viruz might mutatify" person, but I dated a molecular biology major in college. (Drosophila have some whacked out mutations!) The thought that this strain has such a significantly higher substitution rate, and already shows significant mutations, leads me to the conclusion that the old school assumptions must be challenged. I think there is evidence that they are no longer valid in the greater number of health care workers who've been infected.

 

[T.Lex]

Dupe.

 

[2ADMNLOVER]

That's kinda the rub. (Pardon the pun?) We have to do a better job of assessing what amount of exposure is "enough" to become infected. Think about how a hospital would run if every nurse/doctor/technician/janitor could only have 1 interaction with an ebola patient. They'd run out of staff PDQ..

I get that from a scientific aspect this whole affair is a " teachable moment " and there's probably a lot of folks wanting to learn what they can from it .

I just think that with a group of folks who've been trained and go through constant skills upkeep courses / lectures on the most basic things like "universal precautions " they as " Professional " health care workers should know better than to take what could be cavalier risks involuntarily , involving those around them .

I don't care if a person wants to kill themselves , just don't take everybody around you , with you .

 

[dusty88]

I don't think we know as much about this strain as we think we do.

I agree and I think that falls under the "what we know" vs "what we don't know"

There is a whooooole lot of geography between "direct contact, primarily bloodborne" virus (like HIV) and an "airborne" virus.

It does seem this Ebola outbreak/strain is different, based on the reality it's not contained, and that trained healthcare workers such as Doctors Without Borders, are getting infected.

That could simply mean it is becoming more virulent and surviving longer on fomites.

If you watch the explanation of Doctors Without Borders protective wear and removal, you can see that while it's thorough, it's not going to be perfect. If the survival time and strength of the virus increases, perhaps a few remaining particles are more likely to become infectious than previously seen.

 

[ArcadiaGP]

This is who Obama just appointed as Ebola Czar.

Notice anything missing? Such as a medical background?

 

[ghuns]

...but I dated a molecular biology major in college...

Is that like staying at a Holiday Inn Express last night?

I neither stayed at a Holiday Inn Express last night, or dated a biology major and my translation of all that scientific mumbo-jumbo is, Oh She-it!

 

[dusty88]

This is who Obama just appointed as Ebola Czar.

Notice anything missing? Such as a medical background?

Well that's just stupid.

As highlighted by all of these conversations and quotes and questions, we DO need someone who has the PR savvy to answer the media's questions without getting pigeonholed into absolutes.

Such as when asked "COULD someone who isn't showing symptoms be contagious" they just need to keep repeating that all information and history of Ebola shows it to only be contagious after the person is visibly ill. That minimizes the misinformation quotes. The problem with someone who is "only" PR or political is they can't really answer any of those questions without making mistakes or being completely useless. Things get messed up in translation.

I also worry about a person being given an executive position and no knowledge, not knowing who to believe. Like when Jimmy Carter supposedly told the military how many helicopters they could take into Iran.

 

[2ADMNLOVER]

This is who Obama just appointed as Ebola Czar.

Notice anything missing? Such as a medical background?

Right now , while I'm looking for a sharp pencil to plunge repeatedly in my eyeballs , Lewis Black is having a $h!t fit in my head screaming " NO ! LET'S NOT GET THE EINSTEIN OR HAWKING OF EBOLA , NO ! WE NEED A ****ING LAWYER TO HEAD THIS UP ! WAY TO GO CHAMP !!!!!!

Is there any doubt left that the guy in the white house is a jackass ?

 

[smokingman]

[h=1]BREAKING: Ebola Scare at the Pentagon[/h]Arlington County’s hazmat team is on the scene at the Pentagon due to an Ebola scare. Medics responded to the Pentagon this morning for a report of a woman on a tour bus who was sick and vomiting. When they learned that she had recently arrived from Africa
BREAKING: Ebola Scare at the Pentagon | ARLnow.com