Ebola

[angeryamerican]

I've had a very interesting week, got to meet some real interesting folks too. I spoke with a high profile NYC doc about ebola, he knows his stuff about infectious disease, he treated the first case of SARS in the US. He said it will make it here, without a doubt. However, he is very optimistic that we can handle it as we have the technology and material to deal with it. He also said the situation on the ground over there is many folds worse than we are getting from the MSM, much worse. This was confirmed by a SF gent I got to know, he will soon be over there on the ground to work with local health folks. He said it's a damn nightmare. Just thought I'd pass this along to you guys, keep your eyes open.

I hope we can handle it, but the doc cautioned that with flu season about to kick off and the similarity in symptoms at the onset it could be a brushfire sort of thing initially.

[BePrepared533]

The current epidemic in Africa is the largest Ebola outbreak in history. Horrific and tragic as it is, we are getting a lot of information we did not have in the limited outbreaks of the past. Evidence of possible immunization/cure created from antibodies from survivors looks promising. And yet, we must be aware that viruses mutate and what works in this outbreak may not work in another outbreak. The conditions in the poorer countries and areas without high-end medical care allows the disease to spread more easily. While we are probably able to deal with these diseases better here in the US, we must avoid complacency. Be aware and beware. Knowledge is the cure for fear. We need to ask questions, as you did, of medical personnel and learn all we can. Keep the faith!

[wander]

Extremely scientific article, 5 authors died in the making.

http://www.sciencemag.org/content/early/2014/08/27/science.1259657.full

They stated 38 days infection doubling time. Extrapolating that into the future without slowing, that puts us at global infection in 2 years. Further, it has 99 separate genomes (read - individual strains) since the outbreak began, approximately 395 fixed mutations.

Not only is this virus spreading rapidly, there are so many strains out there that it seems unlikely that any information coming out of the area to be even remotely current. By the time it gets to the US, it'll be different than what is out there. Hopefully it'll mutate to be more annoying than lethal.

[Sacajawea]

uh... AA... how would you statistically support the fact that 70 some tests, just in the US just luckily turned out negative? Or the fact that it's now in 6 African countries... and then there are all the suspected cases in Europe, India, Myanmar, etc - all testing negative? Or this from Medicins sans Frontieres:

MSF team overwhelmedIn Monrovia, Liberia, for example, new Ebola management centres with adequate isolation facilities and qualified staff are urgently needed. The queue of patients continues to increase in front of MSF’s ever growing ELWA 3 centre, which now contains 160 beds. It is estimated that 800 additional beds are needed in Monrovia alone. The MSF team is overwhelmed and cannot offer more than palliative care.


“Every day we have to turn sick people away because we are too full”, said Stefan Liljegren, the MSF coordinator at ELWA 3. “I have had to tell ambulance drivers to call me before they arrive with patients, no matter how unwell they are, since we are often unable to admit them.”

http://www.msf.org/article/global-bio-disaster-response-urgently-needed-ebola-fight

But it seems the cavalry has other alligators snapping at it's ass... and not much money to mount it's usual rescue. Some projections say that the number of new cases won't even peak until the middle of next year. But the upside (so far) is that there is a confirmed case in Boko Haram's part of Nigeria... and perhaps they'll be less successful with Ebola, than the average.

[jimmyd]

70 tested? In the US? That seems kinda high... really high from what I've been reading...

But considering the number of people that become infected with the flu each year, Ebola of course has the same initial symptoms as the flu, and US medicine is incredibly proactive when chances of litigation or bad pr is possible and if the person has been flying to and from Africa they probably have insurance that will cover the cost of the blood test...

But Ebola is not that contagious - damned difficult to pass on in fact - so us having 0 cases (so far) out of the 5000+ cases Africa has had does make sense.

But as the disease spreads around Africa, and more than likely eventually spreading outside of Africa...

I need to get my flu shot.

[Sacajawea]

OH MAN... let me clear up a few things - we stopped counting (on a couple of threads I've been following closely for a month) after 70 suspected cases & test results. Since then, about 6000 international students from W. Africa have started fall semester. The universities are giving them thermometers, and asking to report to their clinics if they develop any symptoms. That first month or two of school is exactly when the usual bugs start going around. Because of the stigma associated with ebola - OMG zombies!! - people tend to keep to themselves and HOPE it's just the flu.

The information that "it's really hard to catch" has officially been called into question. The Broad Institute study concluded that as many small mutations they've mapped, could possibly result in false negative or positive test results; that people infected could be contagious BEFORE they are symptomatic (so... you won't know if you had contact with someone who was "viral") and even the CDC/WHO recognize that if you are within 3 ft of a symptomatic victim, and they sneeze - the virus can become aerosolized (or "sneezeborne", if that's clearer - just like cold/flu).

The video on this page isn't too long. But it's worth watching for updated information.

Here's the head of CDC; just back from W. Africa:

http://www.kplctv.com/story/26427137/cdc-director-ebola-epidemic-spiraling-out-of-control

And here's an obstetrician who is positive; who wasn't working in the ebola ward (so, there are serious questions about how easy/hard it is to catch. Old study in Canada said the virus might stay alive on hard surfaces for up to 6 days.):

http://www.kplctv.com/story/26427572/another-charlotte-based-missionary-tests-positive-for-ebola

[wander]

Ebola is no longer hard to catch. According to the CDC, it appears to have mutated into an airborne or at least contact contagion. http://www.cdc.gov/vhf/ebola/hcp/case-definition.html

There appear to have been at least 2 known cases of ebola being transmitted solely through casual skin contact (though I cannot find the link right now)

My wife works as a lab tech in a local hospital, microbiology. They haven't even discussed (at least openly) the ebola outbreak reaching the US, but privately are concerned that once it does hit, the job abandonment rate at the hospitals will be high if any patients show up.

But they are starting stat flu tests (which is really early for the season).

[tk]

I don't know anything about the disease. But I still think it's a news diversion from the master's puppets . Or maybe it's been here all along and now they think its time. One thing for sure I don't want the PTB and their theory of the world being over populated to be the ones in charge of saving us.

[jimmyd]

I can only speak for the weekly reports we get from our State Board of Health/CDC keeping the hazmat team updated (only because we have a standard 'suspected communicable disease response' set up for the international airport in our response area).

The latest report was yesterday and as such the CDC hasn't changed the definition of transmission for Ebola (just like on the page linked above) - getting blood and body fluids on your skin or especially mucus membranes has ALWAYS been a transmission source even in a casual contact setting, and being within the three foot fall zone for aerosolized respiratory droplets has also always been a possible transmission source (as mentioned in the link above again). The CDC hasn't seen any evidence of mutations that have affected diagnostic testing/transmission/lethality as yet - but that is a concern with Africa being a great big petri dish, or with any contagious viral agent whether it be flu, SARS, MERS, etc. anywhere else in the world including the good ol' US of A.

Again according to yesterdays report the CDC has fielded many consultations from around the country with Physicians who were concerned about a patient with what they were worried was Ebola but after some simple questions/answers/guidance from the CDC (just as the page linked above does a great job of explaining when you should be concerned and actually do a blood test for Ebola - and when you shouldn't) there wasn't any need for blood tests in most of the cases and in the approx. 15 cases that did get blood tests they were all negative for Ebola.

The US has good healthcare systems in place... sure mistakes can happen anytime have you have the human element at the core... but it doesn't change the fact that we here in the US are light years above what Africa has! The MT/MLT's in the diagnostic labs of every hospital handle blood and body fluids every single day of their career that they don't if it contaminated - - - until they test it - - - but look at the stats for infectious disease for MT/MLT's ... very low, almost non-existent, because of the standard work practices of those medical professionals to use PPE and cleaning agents/procedures.

Our local trauma one centers (two) as well as the other large area hospitals and health systems have software linking them all with the State/County Health Dept. watching for stats on symptom complaints to observe for any type of epidemic and catch it as early as possible - and we're not special because I know a lot of your larger metropolitan areas do to - especially those with international airports who worry more about infectious outbreaks.

Will the US see an Ebola victim flown inside our borders before this outbreak is contained - almost definitely - but we DON"T need to panic right now and start believing everything we read/here/see on the internet? Panic is the enemy in every single situation. Now is the time to make sure you're prepared for any infectious disease - and to understand what you need to do to protect yourself from acquiring it (and others)... http://www.cdc.gov/vhf/ebola/outbreaks/guinea/qa.html

[angeryamerican]

I agree about not panicking Jimmy, however I do think it's prudent to keep an eye on this as it develops. Getting some 'official' details like you provide is great, thanks for doing so and please keep it up.

[Sacajawea]

Sorry, if I was getting a little defensive last night. There is enough evidence of changes in this version of Ebola -- that the "old info" isn't cutting it anymore. Add in, that news from the area is getting harder to come by - gov's insisting it's a "crime" to spread "rumors" in social media; there IS NO EBOLA in their country (even tho' those numbers are sorta being communicated to WHO); and desperate pleas from the MSF and other NGOs for help... and even the WHO will admit they can't begin to get numbers of cases or deaths in more rural areas... sigh. I just don't want anyone to walk around with a false sense of security about this and get blindsided.

Admittedly: we need a betting pool for what will happen first -

US gov default > followed not long after by gov collapse
dollar collapse > followed immediately by high inflation - then, hyperinflation
ISIS attack(s) > followed by military action here at home, and likely some limited martial law areas
Food shortages for any number of reasons
Grid issues (could be caused by lots of things - mortality rate of ebola for instance)

And none of these things will happen without threatening the others.

I'll take my doom and crawl back under my rock now. (Besides, I'm sure I forgot something on that list).

[Betty Buckshot]

http://www.cbsnews.com/news/report-armed-men-attack-liberia-ebola-clinic-freeing-patients/

Last Updated Aug 17, 2014 3:45 PM EDT

MONROVIA, Liberia - Liberian officials fear Ebola could soon spread through the capital's largest slum after residents raided a quarantine center for suspected patients and took items including bloody sheets and mattresses.
The violence in the West Point slum occurred late Saturday and was led by residents angry that patients were brought to the holding center from other parts of Monrovia, Tolbert Nyenswah, assistant health minister, said Sunday.
Local witnesses told Agence France Presse that there were armed men among the group that attacked the clinic.
"They broke down the doors and looted the place. The patients all fled," said Rebecca Wesseh, who witnessed the attack and whose report was confirmed by residents and the head of Health Workers Association of Liberian, George Williams.
Up to 30 patients were staying at the center and many of them fled at the time of the raid, said Nyenswah. Once they are located they will be transferred to the Ebola center at Monrovia's largest hospital, he said.
The attack comes just one day after a report of a crowd of several hundred local residents, chanting, 'No Ebola in West Point,' drove away a burial team and their police escort that had come to collect the bodies of suspected Ebola victims in the slum in the capital, Reuters reports.
West Point residents went on a "looting spree," stealing items from the clinic that were likely infected, said a senior police official, who insisted on anonymity because he was not authorized to brief the press. The residents took medical equipment and mattresses and sheets that had bloodstains, he said. Ebola is spread through bodily fluids including blood, vomit, feces and sweat.
"All between the houses you could see people fleeing with items looted from the patients," the official said, adding that he now feared "the whole of West Point will be infected.".....

(didn't copy the whole article...)

[wander]

My wife got a call asking what the hospital procedures were, and whether they could test, or state health could test. She had no idea, and refered them to state health, who basically gave a calm, reassuring speech about everything is fine, nothing can happen here in murica, we're way gooder than africa, etc.

Her co-workers daugher is an epidimiologist at state health. She says that privately they are terrified, there isn't anything they can do if it makes it into the US.

[jimmyd]

My wife got a call asking what the hospital procedures were, and whether they could test, or state health could test. She had no idea, and refered them to state health, who basically gave a calm, reassuring speech about everything is fine, nothing can happen here in murica, we're way gooder than africa, etc.

Her co-workers daugher is an epidimiologist at state health. She says that privately they are terrified, there isn't anything they can do if it makes it into the US.

Your wife works in the hospital lab but doesn't know what tests they can do in house? I've worked in ER's and ICU's and helicopters and I had a list of what labs could be done stat, in house, and were specialized...

And can you be more specific in regards to "there isn't anything they can do if it makes it into the US." . . . because it's just a virus. The plans for dealing with a viral outbreak are basically the same for Ebola as they are for any other virus...

[W.Lynn]

Wouldn't mind hearing from everyone here that's currently part of health care, if their system has specific testing, good isolation practices, and up-to-date plans and procedures for big emergencies.

In years past, when I had opportunities to look when the last time this or that place updated anything, I would see interesting things.