Ebola Outbreak 2014

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Wendy S. Delmater's picture
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Ebola Outbreak 2014

Ebola Victim On The Run In West Africa Capital

http://www.breakingnews.com/topic/africa-ebola-outbreak-2014/ (twitter feed)

Someone who tested positive for Ebola was forcibly removed from the hospital by her family. No one knows where she is. This happened in the largest city in Africa, with an estimated 21 million inhabitants. And an airport.

Who knows how many people are already infected? The incubation period is 2 to 21 days.

Anyone familiar with Reston's work The Hot Zone has been expecting this sort of crisis for quite some time; an outbreak of a slightly less lethal strain that reaches a major population center.  Currently it looks fatal to around 60% of victims; while this is less than the 90% rate typically seen in previous outbreaks it's horrific.  If you look at the NIH blue ribbon panel scenario for a lab instigated outbreak of Ebola, they don't even provide values for R0, the basic reproduction number, which is a measure of expected secondary infections stemming from one infection in a susceptible population.  It is likely quite high even outside an aerosol context (less than pertussis, higher than polio).  The only people who may have formally simulated such a scenario are the classified elements of USAMRIID (Army) and NBACC (HomeSec). For what it's worth, Tom Clancy covers a potential Ebola outbreak in the USA in his novel, Executive Orders. It's instructive.

While everyone is wondering about the whereabouts of this woman, consider what was going on prior to and during her hospitalization.  An infectious vector wavefront has been propagating this entire time; it simply hasn't been detected/measured yet.  If you've watched this latest outbreak from the beginning you will have noticed the lackadaisical response with respect to regional isolation and complete shortage of qualified personnel to handle escalating ward requirements. 660 deaths as of this morning.

God help us all.

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Ebola: mode of transmission

Thanks for mentioning this Wendy. 

I've been doing a little reading these last couple of days and wondering if any of the "flu-like syndrome" (fever chills body aches) patients in the emergency department will turn out to have ebola.

From what I can gather, you can sit in the same room or ride the same bus with someone infected by ebola and not be at risk for infection.  (Not spread via aerosol -- the droplets released in a cough or sneeze.)  However bodily secretions contain the virus including sweat, blood, semen, saliva.  Those at risk:  health care workers, family member holding a dying person or giving a bed bath, or those preparing the body of the deceased for funeral.  [The virus can continue to live in secretions past the death of the patient.]

 

The cdc site summarizes

Transmission

Healthcare workers dressed in protective gear in a village in Africa

Because the natural reservoir of ebola viruses has not yet been proven, the manner in which the virus first appears in a human at the start of an outbreak is unknown. However, researchers have hypothesized that the first patient becomes infected through contact with an infected animal (Don't eat uncooked monkey meat....)

When an infection does occur in humans, there are several ways in which the virus can be transmitted to others. These include:

  • direct contact with the blood or secretions of an infected person
  • exposure to objects (such as needles) that have been contaminated with infected secretions

The viruses that cause Ebola HF are often spread through families and friends because they come in close contact with infectious secretions when caring for ill persons.

During outbreaks of Ebola HF, the disease can spread quickly within health care settings (such as a clinic or hospital). Exposure to ebola viruses can occur in health care settings where hospital staff are not wearing appropriate protective equipment, such as masks, gowns, and gloves.

Proper cleaning and disposal of instruments, such as needles and syringes, is also important. If instruments are not disposable, they must be sterilized before being used again. Without adequate sterilization of the instruments, virus transmission can continue and amplify an outbreak.

 

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Been keeping an eye on this....

...over at ZH.  They're not always on point with the fine-grained details, but I've been getting enough info to have this on my radar.  

Is this a new strain?  How many infected at this point?  NO, really -- how many infected (I don't think the govs in question will be totally forthcoming with that info -- nor am I convinced they're out ahead on this enough that they'd necessarily have a real handle on that number).  What are the options for containing a serious breakout?  Etc.

As the dark-humored folks in the comments section at ZH have been wondering:  can the Fed print a cure for a massive Ebola outbreak?  

Yet another developing story to keep an eye on.  Glad I have the means to hole up for a month if need be...

Viva anyway -- Sager

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ebola outbreak

Trader talk: "Gun to the head, what's the trade when the first case of Ebola is detected in the US?"

I don't think the answer is "buy equities."

Measures taken to stop the spread in first world countries would hopefully work, but the added stress on our already-stressed world economy would probably end up wreaking all sorts of havoc.

I'm left to wonder if the strong buy seen in COMEX gold near the close was due to the Ebola news.

Me, I'm more in the mood for a water & food purchase.

Chris?  Is this time for some research into the "US Government Response Plan for an Ebola Outbreak in the US?"  Or am I just fear-mongering?  The thing that got me taking this very seriously is the report of the known infected person running around loose in a major african city.

There's also the matter of the air traveler from Liberia that died in quarantine in Nigeria.  We await test results to see if it was Ebola.

My brief research on infectious disease responses: quarantines of suspected/actual infected people, closure of public gatherings (schools, ball games, churches, etc), closure of mass transit systems, travel restrictions, travel suspensions.

http://www.breakingnews.com/topic/africa-ebola-outbreak-2014/

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West Africa Ebola death toll reaches 660: WHO

http://news.yahoo.com/west-africa-ebola-death-toll-reaches-660-131032593.html

to top it off the man who flew from Sierra Leone to Lagos, Nigeria, who collapsed in the airport has since died of what was confirmed to be Ebola.

 

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quarantine

Given an incubation period of as long as 3 weeks, that 40% of cases present as vomiting and diarrhea without the hemorrhagic aspect, and that it's transmissible by sweat, perhaps on door knobs and elevator buttons, is containment possible or already too late?

John G

 

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Ebola questions

Sand_Puppy, 

Am I correct in that Ebola previously killed on a much shorter timeline? 
I seem to recall reading some medical publication that cited this as the reason that (at that time) no major outbreaks had sustained themselves. 

Essentially, it taking people through the progression of illness to death to quickly for it to "creep" its way into society. 

If that is the case, the longer incubation periods may indeed indicate that there is something different about the strain of Ebola making the rounds now, correct?

Cheers,

Aaron

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shut the barn door

Shut the barn door - the horse may be gone.

http://www.zerohedge.com/news/2014-07-26/following-first-ebola-death-nigeria-red-alert-deploys-specialists-airports-contaimen

One good thing is that I understand that the virus will probably mutate to a less violent form. It does not reproduce well, and makes errors that make it less virulent several generations down the line.

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Barn horse door gone bu-bye...
Wendy S. Delmater wrote:

Shut the barn door - the horse may be gone.

Either way, just add it to the long stack of dominoes.

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Social Unrest at Ebola Clinics

A side of this epidemic I had not heard of before:  The epidemic is happening in a population without any basic knowledge or understanding of biological science.  How would you explain viruses, bacteria, RNA, macrophages and inflammatory cytokines to someone who has never seen a microscope?  They would think you were BSing them.

From zerohedge this morning:

1.  [T]he female [Ebola] patient whose family broke her out of a hospital in Sierra Leone's capital Freetown, and who had been on the loose of several days, leading to a nationwide hunt. [P]olice found her in the house of a healer. Her family refused to hand her over and a struggle ensued with police, who finally retrieved her and sent her to hospital, he said. "She died in the ambulance on the way to another hospital," Sisi said.

2.  What is making things worse and is hindering the containment is that fear and mistrust of health workers in Sierra Leone, where many have more faith in traditional medicine. And over the past few days, this has culminated in crowds gathered outside clinics and hospitals to protest against what they see as a conspiracy, in some cases clashing with police as they threatened to burn down the buildings and remove the patients.

Thousands had gathered outside the [the country's main Ebola hospital in Kenema] the day before, threatening to burn it down and remove the patients. Residents said police fired tear gas to disperse the crowds and that a 9-year-old boy was shot in the leg by a police bullet. ...A former nurse who had told a crowd at a nearby fish market that "Ebola was unreal and a gimmick aimed at carrying out cannibalistic rituals".....  He said calm had been restored to Kenema on Saturday, adding that a strong armed police presence was in place around the clinic and the local police station.

3.  A 33-year-old US doctor working for relief organization ... in Liberia was the latest to test positive for the disease on Saturday.  (Dr. Kent Brantly, on the right)

I'll bet this brings Ebola into American households.

Is everyone prepared to stay home for a month??

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google trends ebola

I'm a big fan of google trends to chart a story's "penetration" into the mainstream population's attention zone.  I did that with bitcoin, and it seemed to align pretty closely with price movements.

Here's a link to "google trends ebola" - I was fascinated to see particularly the "regional focus" section only had hits for the African countries directly affected by the virus.  The US didn't even appear on the list!

http://www.google.com/trends/explore#q=ebola

At least according to google, ebola is not on the radar screen of anyone outside Africa.  At least, as of last week.

At some point after the first case in America appears, the coverage will flip from "totally asleep" to "24/7 Ebola" coverage.  CNN will go nuts.  "OUTBREAK AMERICA".  There just doesn't seem to be any middle ground.

I like sand_puppy's question.  Are you prepared to stay home for a month?  That's what I concluded too.

Here's an article with a more positive note to it entitled: "I caught Ebola in Guinea and survived."  Its not all roses though - once people realize you've had ebola, they tend to get nervous about physical contact.

http://www.bbc.com/news/world-africa-27112397

 

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all hail the goog,,,,,

In a related outbreak highly qualified Australian Chairperson suspects MERS is a bioweapon:

http://theconversation.com/mers-coronavirus-animal-source-or-deliberate-...

When I google Mers bioweapon I get articles from 2003 and from conspiracy sites.

Look at this woman's credentials and you will understand why she is so well qualified to make this interpretation (she has devoted her career to being able to answer this question)

"She has won numerous awards for her research including the Sir Henry Wellcome Medal from the US Association of Military Surgeons for her work on risk analysis of bioterrorism;"

http://theconversation.com/profiles/raina-macintyre-101935

 

If this really breaks out please get lots of sources for your info.....

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Ebola: "No risk to US population"

An obligatory phase of all disasters seems to be when representatives of the status quo try to keep the game going without interruptions by issuing authoritative statements that "there is nothing to worry about."  Too bad that these statements cannot be relied on to offer realistic risk assessments.  Alas,  we are forced to think for ourselves.  (Or to wait for Chris' report!)

This morning Zerohedge reports:

 

The Panic Containment Team Speaks: Ebola Poses "Little Risk" To The US, CDC Claims: Is It Wrong?

Limitation of my summary:  I am not an expert in tropical diseases, travel medicine and have never seen anyone with Ebola, so my summary here is entirely "book knowledge," gathered from articles and studies that are a couple of years old, and is the perspective of a non-specialist.  

GeoSentinal (and here) is a network that tries to keep track of international movement of infectious diseases. UpToDate Online is a subscription text service with a chapter on evaluating sick travelers returning from sub-Saharan Africa.  I'll hit the high points of my understanding of Ebola risk at this point in time.  [PM me if you'd like me to send you the pdf of this UpToDate chapter--SP]   And I'd love to hear from others. 

1.  Ebola is a viral infection that presents with a "flu-like illness" very much like hundreds of other viral and bacterial infections.  Fever, chills, headache, body aches, weakness (and sometimes vomiting, diarrhea and sore throat).  But, those infected quickly become too weak to get out of bed (prostration, sepsis).  They LOOK SICK.

2.  In a GeoSentinal 2006 report of some 4,000+ sick travelers, someone returning to the US from Sub-Saharan Africa with a fever,  62% have malaria, 6% Dengue, and 28% could not be identified. In those returning with diarrhea, the parasites giardia and ameba were tops, and bacteria camphylobacter, shigella and salmonella, next, and unidentified viruses about 30%.

3.  At this moment, a febrile, sick person who just came in from Africa probably has one of these common infections, not Ebola.  (Like 6-8 orders of magnitude more likely!)  

4.  Despite its scariness, the transmissibility of Ebola seems pretty low. The best information I find is that you can sit in the same room with an infected person and not catch it.  Latex gloves, a mask that covers nose and mouth and an eye shield would protect against minor splashes of bodily fluids in a social proximity contact type of situation like sitting on the same bus or in the same doctors waiting room.  However, a healthcare worker who was starting an IV, giving a bed bath or cleaning up diarrheal stool would need a full suit and face shield--like right out of a movie.   Routes of infection:  One vet who did an autopsy on an infected monkey, people eating poorly cooked monkey meat, eating fruit that fruit bats had salivated on.   Mostly though, Ebola is passed to the family members of the sick person who have intimate contact with bodily secretions as they care for their loved one.  [Much sadness here.]

5.  The hemorrhage part.  Very scary imagery, but only about 50% of Ebola cases have hemorrhages and most of those are not terribly dramatic.  Bleeding from an IV site, easy bruising of the skin and conjunctival hemorrhages were most common manifestations of "hemorrhage."  And the hemorrhages were late stage developments in people already feverish and profoundly weak.  Very few actually vomit blood or pass lots of bloody diarrhea.

Some of the infectious diseases mess with the clotting system so that oozing capillaries keep oozing. (Technically, DIC).  With conjunctival hemorrhage, pictured above, a few drops of blood collect on the outside of the sclera (the white rubbery part of the eyeball), and under the conjunctival membrane (the thin transparent membrane covering the sclera.) This gives a very visible bloody eye.  Under ordinary conditions in the US, conjunctival hemorrhages are common and are considered entirely benign and simply result from a forceful sneeze, or rubbing an itchy eye.  They go away in 7 days.  In a healthy person, conjunctival hemorrhages have no medical significance at all.   But, in the setting of a high fever and prostration (too weak to get out of bed) in someone just back from Sierra Leone, a hemorrhagic fever like Ebola would be considered.

6.  Hemorrhage during an Ebola infection was not predictive of mortality.  Some died without hemorrhage and some that hemorrhaged recovered.  However, the rare, massive bleeding from the rectum case would be fatal.

My impression here is to not overrate the "hemorrhage" aspect of Ebola infection.  It shows up late, is only seen in 50%, and doesn't predict outcome.  Major hemorrhage though, is a rare pre-terminal event.

7.  A post exposure vaccine is "promising" (and here) as is post exposure monoclonal antibody administration, but neither of these is clinically available yet.

8.  Medical treatment is supportive:  IV fluids if dehydrated, oxygen if low on oxygen.  Much less often: blood transfusion and clotting factors if hemorrhaging, heparin if clotting.  Mostly though, quarantine.

Viruses change and adapt.  As Aaron mentioned in an earlier post, Ebola has historically killed its hosts quickly limiting the extent of epidemics.  A virus becomes more evolutionarily successful as it gets "less ferocious," incubates longer and gives a milder illness so that the host can travel and spread it farther.   A model for "evolutionary success" in the viral world might be the chicken pox virus, VZV.  It kills almost no-one and has spread to nearly every member of the host population.

What to look for in the news:  most important will be the transmissibility issue.  Can you catch the virus by being in a crowded social gathering with an unknown infected person.  Right now the best answer available is "no."

 

 

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Additional Concerns

Sand_Puppy,

I have been reading the platitudes from the health officials and while I see their point, I am coming across some faulty logic or unanswered questions. It doesn't make them wrong - I'm not credentialed to question the experts on the matter, and have no special knowledge, but I do have some thoughts I'd like your opinion on.

"It's not easy to catch Ebola"

Well, sure, not in a rural African village which doesn't have a door, sits in the open air and sunlight and lacks business centers, public transportation and cell phones. But how about in an environment in which people are sneezing and coughing and then touching door handles on buildings and cars, sweating in seats and sharing utensils and glasses at diners (that may or may not be properly washed/sterilized)? 

Doesn't this change the nature of how we should map the disease?
In short - why are we using the "what we know" template from a situation that is entirely dissimilar?

People live in much closer proximity in the city. 
This is unprecedented in Ebola's saga and shouldn't be dismissed...

"The doctor who was in Sierra Leone..."

Was young and healthy.

He used all the proper protocols to avoid it, and was described as "meticulous" and very detail oriented.  

So how did he get it - alongside the top doc (now deceased) and another American Aid worker?

Furthermore, he self-quarantined and send his family, who was living with him in Sierra Leone, back to Abilene, Texas about 5 days ago. His family is said to be 'self-monitoring' for symptoms, but "very unlikely to be infected". I do believe that if they are infected, local powers will quickly and easily quarantine the disease. But I'm interested in hearing about the epidemiology involved...

"It's unlikely it'll make it to the U.S."

I'm as Amerocentric as the next guy, but this is like watching a fire in a town upwind and the firefighters saying "we've got it covered", while picking at their fingernails leaning up against the light post. My hope, and I'm sure a lot of others as well, is that the 'keep calm' attitude is prevailing, and there are actually people working on keeping this as quarantined as possible. It might have a few houses to burn down before it reaches the U.S., but that is still a possibility. 

What's the bottom line, Sand_Puppy? 
Do you think these elements make it worth keeping a close eye on, or is it another SARS/H1N1 type disease, that lacks communicability and will die out organically within a couple months?

Cheers,

Aaron

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a couple thoughts

The fact that this seems to have only 60% mortality rate seems to me to make it more likely to spread.

The previous outbreaks seem to have been jumped all over and contained very quickly.  This one has not.

I read several of the Ebola/pandemic books a few years ago, but that is the extent of my knowledge on the subject.

An e-book I was reading last week by some doctor regarding scavenging medical supplies mentioned that latex gloves do not block viruses, only bacteria.  The ZH article above mentioned using latex gloves.  The e-book said that when protecting against viruses you need nitrile gloves.

I agree with what AM said regarding the difference between containing in a small rural village and in large cities possibly connected by air travel.

 

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Lots of uncertainty still

There is still lots not known about how ebola is transmitted.  It seems reasonable to stay at least moderately worried while hard numbers on transmissibility come in.

And the BIG question is aerosol transmission.

1.  In some non-human primates, it IS possible to infect an animal with an aerosolized spray delivered into the trachea.  

http://www.ncbi.nlm.nih.gov/pubmed/21651988

http://www.ncbi.nlm.nih.gov/pubmed/15588056

2.  But it was NOT possible to infect mice with aerosolized EBOV unless the mice were first bred to have a genetic defect in immunity.  http://www.ncbi.nlm.nih.gov/pubmed/21852521

3.  And epidemiological evidence (that I read but can't locate quickly) says that aerosol transmission is not the normal mode of spread.

So there is lots just not known.

Let me know what you are hearing, Aaron.

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fascinating account of makeshift ebola ward

I thought this was a fascinating account of the trials of trying to care for suspected Ebola patients in a third world country with minimal resources--a makeshift Ebola ward.  The staff is afraid to approach the patients or even enter the ward, the patients are afraid of each other (and rightfully so, it turns out some of those put in the Ebola ward did not have Ebola), and no one has the resources to do anything creative.  Minimal food and water were available so the patients are hungry and dehydrated. Some were too sick to clean up their diarrhea and vomit and no one would approach them to help.  It took days to weeks for a blood sample to be tested and the diagnosis to be clarified one way or the other.  But until cleared, they were told if they left the ward they would be shot.

Ebola: Anticipating challenges and improving patient health and safety measures on makeshift filovirus wards

http://www.odihpn.org/the-humanitarian-space/news/announcements/blog-articles/ebola-anticipating-challenges-and-improving-patient-health-and-safety-measures-on-makeshift-filovirus-wards

The WHO offers this document recommending procedures for healthcare workers caring for suspected Ebola patients. So far, I am not finding any discussion of the latex vs nitrile protective gloves issue Joe mentioned.

http://www.who.int/csr/bioriskreduction/interim_recommendations_filovirus.pdf

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Ebola: The Acid Test Has Begun

The question of the transmissibility of Ebola will be clarified most decisively in the next 7 to 14 days.

Patrick Sawyer, an American businessman of Liberian descent, flew to Africa as a part of his work promoting trade.  While there, he cared for is sick sister who subsequently died.  It turns out, she had Ebola, something not known at the time.  Mr Sawyer was apparently infected while caring for her (or preparing her for burial?).  

He then flew on 2 flights through 3 airports (Monrovia in Liberia, Lome in Togo, and Lagos in Nigeria) while he was developing worsening symptoms and collapsed in the Lagos airport.  He was taken to a hospital where he later died.

Fellow passengers were reportedly given warning about the symptoms of Ebola, but allowed to continue their travels.  The names of the exposed passengers (and their destinations) were not released.

So here it is guys:  If Ebola is transmissible through casual contact or aerosol we will know this without a doubt in the next 7 to 14 days.  If not, we will know that, too.  This is the acid test. 

I think that I'll top of my rice and beans supply and freshen the water jugs while we wait for resolution of this question.

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Not dissinvitted

Obama is continuing on with a summit of African leaders--including leaders from infected countries. Meanwhile, a US senator is calling for us to close the borders to countries where it has already landed.

Me,? I just finished my habitual Summer restocking of our pantry and medicine cabinet. Yes, Sand_puppy, I am (as usual) prepared to shelter in place for a month. But this time, it's with masks, gloves, and antivirals.

We are getting a bunch of XXL (our hand size) nitrile gloves from Grainger. I have to wash the dishes anyhow.

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gloves

I felt bad for not at least attempting to do the level of background research that most of you do before I made my glove comment.  I did a quick search and found three articles that did not rule out latex gloves for stopping viruses.  The test for virus blocking is quite elaborate and usually not performed by the manufacturers.

It might be that the quality of the glove rather than the material is the determining factor.  They also are concerned with the strength of the glove against ripping or puncture.  They seem to advise wearing two gloves in sensitive situations.

It seems to me that the main reason for choosing latex over nitrile is cost, which at the quantities we are talking about should not be an issue.

Here are some of the links.

http://www.hse.gov.uk/biosafety/blood-borne-viruses/use-of-gloves.htm
 
http://en.haiwatch.com/data/upload/Program/HC213_00_UK.pdf
 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC120672/
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Audience

Thanks for the info and updates, Doc, I'd be curious to know how big your audience among health care workers out here in the pucker brush is.  No pressure.  wink

Thoughts:

What if Mr. Sawer hadn't become symptomatic for another week and had presented at an ER in Minnesota?  How long would it have take before some asked if he'd been traveling in Africa recently?  How long would it have taken if he had been white and not spoken with an African accent?  What if Dr. Brantley had returned to Texas with his family?  What if the reason he became infected was that he was exposed some were out side of the hospital?  How many asymptomatic people are wandering all over the planet right now?

How will the US public health care system respond?  I remember vividly a hysterical woman I treated in the early stages of the SARS outbreak.  She had been in our waiting room for 30 minutes and had been walked right through our department without a mask.  She was so upset that it took me ten minutes to figure out (her English was good, but not fluent) that she had just come from Hong Kong.  Even years later the memory of that gut punch moment of standing at her bedside and realizing that I might have been exposed, that I might not be allowed to leave the hospital, that I might not get to see my family again, that I might die, packs an emotional charge.  I self quarantined with my patient for several hours as charge reassigned the rest of my rooms and the doctor and radiology came and went in full PPE.  Eventually, as she was afebrile, had a clear chest X-ray, and the incubation period was too long, the diagnosis was just a bad cold and we were cleared, but so many things could have gone wrong and being on the wrong side of a quarantine line is scary as hell.

Watching this thing play out is going to be fascinating,

John G.

 

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Transmission

Sand_Puppy,

"So here it is guys:  If Ebola is transmissible through casual contact or aerosol we will know this without a doubt in the next 7 to 14 days.  If not, we will know that, too.  This is the acid test. "

Most of what I'm reading, specifically from the CDC, is saying that the transmission characteristics are not understood. They're believed to be zoonotic, but the exact method is up for speculation. 

I assume everyone has heard by now that the Aid Worker who stole the Ebola victim's cell phone caught the disease and died; This calls into question the notion that it's not easy to contract, doesn't it?

As well, here is a CDC Ebola Timeline Sheet with some specifics about the disease's history:
http://www.cdc.gov/vhf/ebola/resources/outbreak-table.html

With regards to the information presented here,one thing that stands out to me immediately is that this outbreak is - at minimum - nearly twice as expansive as the most prominent outbreak in the past (The Uganda outbreak which infected 425).

WHO projections have this as almost 3x as expansive, and it's an international concern, which is likewise unprecedented. 

As jgritter says, it's going to be fascinating. 
Off to check the storage room. 

Cheers,

Aaron

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ebola: Liberia's Action Plan

Here is Liberia's action to combat Ebola, as presented by VOA: http://www.voanews.com/content/liberia-announces-additional-ebola-containment-measures/1968611.html

* Closure of all schools

* Non-essential government workers placed on mandatory 30 day leave

* Closure of all markets in border areas

* Friday declared a "non-working day" to be used to disinfect and chlorinate all public facilities

* Several communities where the infection rate is high are being considered for complete quarantine

A taste of what we might see if it ever comes to North America.

Having traveled through Hong Kong a few months after SARS, walking through those IR screening cameras in HKG airport definitely made me nervous.  Was I a little overheated from walking too fast?  Just how high a temp was too high?  The thought of getting stuck in a box for a day while they tested me for whatever - not a pretty thought at all.

Moral: if you want to travel by air, better do it prior to any arrival of You Know What in the US.  Otherwise, if you have a fever and those scanners are in place, best not to travel at all!

I have a friend who works international flights for a US carrier.  Tough job to have right now, especially if you encounter a sick passenger on the flight...

Wendy S. Delmater's picture
Wendy S. Delmater
Status: Diamond Member (Offline)
Joined: Dec 13 2009
Posts: 1982
This just in

http://www.zerohedge.com/news/2014-07-31/what-going-happen-if-ebola-comes-america

If the worst Ebola outbreak in recorded history reaches the United States, federal law permits "the apprehension and examination of any individual reasonably believed to be infected with a communicable disease".  These individuals can be "detained for such time and in such manner as may be reasonably necessary".  In other words, the federal government already has the authority to round people up against their will, take them to detention facilities and hold them there for as long as they feel it is "reasonably necessary".

In addition, as you will read about below, the federal government has the authority "to separate and restrict the movement of well persons who may have been exposed to a communicable disease to see if they become ill".

 

VeganDB12's picture
VeganDB12
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Posts: 731
A recent example. Remember Andrew Speaker?

  http://en.wikipedia.org/wiki/2007_tuberculosis_scare

There is  a recent precedent for detaining people with such lethal communicable diseases in the US. 

Andrew Speaker had XDR (extremely drug resistant) Tuberculosis.  "the CDC placed him under involuntary isolation (similar to quarantine) using a provision of the Public Health Service Act.[3] With this action, Speaker became the first individual subjected to a CDC isolation order since 1963.[4]"

He was subjected to state and federal regulations and detained, underwent surgery for his TB out west and seemed to fall off the map after that. Overall I believe he was evaluated in hospitals in at least 4 different states In the US. Coincidentally his father in law was  a TB researcher at the CDC. 

I imagine hospital workers and family members will be expected to isolate themselves  "voluntarily". IF the virus becomes prevalent here I doubt law enforcement and military will be enthusiastic to restrain people who are sick and so contagious. The isolation of potentially ill people could end up meaning sheltering in place at home.

No one will want to be near those who might be infected.  

 

jasonw's picture
jasonw
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Posts: 1018
Hospital in Georgia is expected to receive Ebola virus patient

It didn't take long for vectors to reach our shores: 

Emory University Hospital in Georgia is expected to receive Ebola virus patient 

Time2help's picture
Time2help
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Posts: 2766
WHO: Ebola moving faster than control efforts

WHO: Ebola moving faster than control efforts

Bringing them to Atlanta, really???  What happened to "containment" and "isolation"?

Wendy S. Delmater's picture
Wendy S. Delmater
Status: Diamond Member (Offline)
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Posts: 1982
moving faster than the efforts to control the disease

http://www.zerohedge.com/news/2014-08-01/who-warns-ebola-outbreak-out-control-high-risk-spread-other-countries

Things just went to 11 on the Spinal-Tap amplifier of massive infectious disease outbreaks. As AP reports, the Ebola outbreak that has killed more than 700 people in West Africa is moving faster than the efforts to control the disease, the head of the World Health Organization warned. Dr. Margaret Chan pulled no punches in her direct statement, "If the situation continues to deteriorate, the consequences can be catastrophic in terms of lost lives but also severe socio-economic disruption and a high risk of spread to other countries." Time to panic?

Wendy S. Delmater's picture
Wendy S. Delmater
Status: Diamond Member (Offline)
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Posts: 1982
practical preventon ideas - now

If an epidemic hits your country? Most of what you'd need to do we at this site are already doing.

As stated above, be prepared to shelter in place for a month: food, medicine, water, energy.  To this I'd add::

  •  nitrile gloves
  • Zicam - it's an antiviral
  • dust masks
  • ways to sanitize things: bleach, rubbing alcohol

And I would top off the fuel in my vehicle.

davefairtex's picture
davefairtex
Status: Diamond Member (Offline)
Joined: Sep 3 2008
Posts: 5069
known cases in the US don't worry me

The two sick people being flown into Atlanta don't worry me at all.  We fly in two people, clean the plane, be careful, most likely nothing will go wrong.  One of those high odds of success outcomes.  Plus, we can try various things out on them - no doubt with their consent, I'd sure consent if I were in their place - that might help both them and future victims.

Its the infected travelers we don't know about that worry me - the asymptomatic traveler who returns from an African Safari with a little something extra they didn't plan on bringing back, that makes its appearance a week after landing.

That is what I worry about.

VeganDB12's picture
VeganDB12
Status: Platinum Member (Offline)
Joined: Jul 18 2008
Posts: 731
Prevention measure

Those are good guidelines.  I am topping off my water supplies as a priority. 

The Wiki on Ebola suggests that those who have succumbed have less of an immune response and presumably anything to enhance your immunity will be a good thing. 

I personally have decided to limit hand shakes since the virus (as of now) is thought to be transmitted by physical contact or possibly droplets.  Aerosolized spread by droplets requires that you be in close physical proximity to come in contact with it.

Living near a major population center and immigration hub, I have decided as of now I will greet people with a friendly smile with my hands at my side. 

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