Ebola

It seems to me that quarantine of west africa, ie nobody leaves other than returning medics etc (who in turn are quarantined for 28 days etc) is the best solution.

I agree, the WHO and other bodies seem to be underestimating it big-time.

The US government's response is detailed at:

http://www.whitehouse.gov/the-...epidemic-west-africa

Could more done? Of course. Other nations should also aid as they can, and in a similar manner, document their efforts.  China, for example, has received a lot of international praise for their contributions to fighting the epidemic. To date, according to Forbes, they have provided approximately 1/5 the amount of aid as the US. For a wealthy country that is so heavily invested in Africa's economic future, China (along with India) needs to do much more to help.

I have heard Obama say that there is no intention to stop flights into and from West Africa.  According to the people advising him, it would not necessarily help to stop the spread of the virus, and it would cripple the economies of countries that are already bordering on disaster. I understand and agree for the most part.

For now, I hope that what the CDC is telling us is true, and that the chance of a large scale outbreak in the western world is extremely small.  But the thought that we are relying on the questionnaires, with no way of validating the answers travelers from the region are giving, worries me. If this epidemic continues to spread, it may come down to quarantining outbound travelers at airports before they are allowed to leave West Africa. A frightening, but potentially necessary next step IMO.

Hook

Indeed, not a comfortable situation, but low risk. Ebola is spread through contact with body fluids, not via airborne means.

... from the WHO website:

"Ebola spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids."

Agreed, but the mere fact that the Spanish nurse wearing double layer Level 2 biohazard suit complete with taped gloves, goggles etc was able to contract the disease seems surprising:

This from the BBC website:

The Carlos III hospital was reported to have had extreme protective measures in place including two sets of overalls, gloves and goggles.

However, health workers told El Pais newspaper that the clothing did not have level-four biological security, which is fully waterproof and with independent breathing apparatus.

Instead it was level two, the paper says, as photographs provided by staff indicated that the overalls did not allow for ventilation and the gloves were made of latex and bound with adhesive tape.

So what the authorities are implying now is that somebody caring for a patient is not adequately protected by a double layer taped suit with taped gloves and goggles but it's fine for people to sit next to a passenger who may be sneezing/coughing/infectious etc on a flight and to have absolutely no barrier protection. 

I am not for one moment suggesting that the virus has become airborne or anything of that nature - but it does seem to be rather more infectious than the authorities implied.  When I hear the phrase 'spreads via bodily fluid' my mental picture is that you'd have to somehow injest blood, spit, semen or excrement - and none of these seem terribly likely unless you are having sexual relations with or performing surgery on a patient with Ebola.  Now though we seem to entering into a situation where somehow that bodily fluid got through surgical gloves, masks and goggles and I'm struggling to see how...  Is it enough that someone with Ebola sneezes on you or touches a fork you subsequently put in your mouth?  If that is the case then being on the tube or visiting a restaurant is about to become a whole lot less appealling!! 

In short I'm puzzled why the authorities are permitting mass transportation systems to function into and out of the affected areas when all this will do is make it harder to contain.  Given the exponential spread of this disease (cases doubling every 2-3 weeks approximately) I'm afraid that the reponses of various international authorities seems to be too little too late.  The airlines don't want to ground their planes, the immigration authorities don't want to put extra manpower and procedures into screening and yet International air travel will spread this disease globally within days/weeks and in my view should be very heavily restricted in the worst affected regions to slow this process down.

Somebody on another forum gave an interesting projection that the exponential growth in Ebola cases when projected forward shows the entire population of the world infected in around 12 months time.  Now I don't think that will happen of course and I'm pretty sure the NHS can cope with a few hundred cases across the entire nation but pretty soon if that number turns into a few thousand then I suspect the NHS and other modern first world healthcare systems will be overwhelmed quite easily.

This is going to have massive economic and social repercussions everywhere.  BA share price down 7% (£500m) yesterday - and it's not alone...

Jonathan

Nuke all affected areas. It's the only way to be sure.

Bet this is on soon..."It's airborne!"

http://www.youtube.com/watch?v=j1naQSJWwbk

Love the quote from Aliens!!  and I bet you're right - I've actually been tempted to watch Outbreak again myself - quite a decent blockbuster by modern standards.

J

The one thing you can count on is that the CDC & WHO will likely just flat get it wrong, as is their wont.

On our news site it was reported the nurse infected herself by contact of the glove with her face..

That's also what the BBC reported.

They also noted that its unclear for how long the virus can live when not in contact with the host body eg it can live on a rubber glove but can it survive 1 hour, 2 hours or what ?

This means that removing protective clothing and steralising it, needs to be very carefully controlled.

I had read it is rather hearty on surfaces as compared with other infectious agents.

I also heard that it is not found in saliva, but that was just told to me so I am not sure of the veracity.

The Los Angeles Times reports today: (regarding the lack of air transmission of the disease)

Some scientists who have long studied Ebola say such assurances are premature — and they are concerned about what is not known about the strain now on the loose. 

***

Dr. C.J. Peters, who battled a 1989 outbreak of the virus among research monkeyshoused in Virginia and who later led the CDC’s most far-reaching study of Ebola’s transmissibility in humans, said he would not rule out the possibility that it spreads through the air in tight quarters. 

“We just don’t have the data to exclude it,” said Peters, who continues to research viral diseases at the University of Texas in Galveston.

Dr. Philip K. Russell, a virologist who oversaw Ebola research while heading the U.S. Army’s Medical Research and Development Command, and who later led the government’s massive stockpiling of smallpox vaccine after the Sept. 11 terrorist attacks, also said much was still to be learned. “Being dogmatic is, I think, ill-advised, because there are too many unknowns here.” 

***

“I see the reasons to dampen down public fears,” Russell said. “But scientifically, we’re in the middle of the first experiment of multiple, serial passages of Ebola virus in man…. God knows what this virus is going to look like. I don’t.”

Tom Skinner, a spokesman for the CDC in Atlanta, said health officials were basing their response to Ebola on what has been learned from battling the virus since its discovery in central Africa in 1976. The CDC remains confident, he said, that Ebola is transmitted principally by direct physical contact with an ill person or their bodily fluids.

Finally, some also question the official assertion that Ebola cannot be transmitted through the air. In late 1989, virus researcher Charles L. Bailey supervised the government’s response to an outbreak of Ebola among several dozen rhesus monkeys housed for research in Reston, Va., a suburb of Washington. 

What Bailey learned from the episode informs his suspicion that the current strain of Ebola afflicting humans might be spread through tiny liquid droplets propelled into the air by coughing or sneezing.

“We know for a fact that the virus occurs in sputum and no one has ever done a study [disproving that] coughing or sneezing is a viable means of transmitting,” he said. Unqualified assurances that Ebola is not spread through the air, Bailey said, are “misleading.”

Peters, whose CDC team studied cases from 27 households that emerged during a 1995 Ebola outbreak in Democratic Republic of Congo, said that while most could be attributed to contact with infected late-stage patients or their bodily fluids, “some” infections may have occurred via “aerosol transmission.”

Skinner of the CDC, who cited the Peters-led study as the most extensive of Ebola’s transmissibility, said that while the evidence “is really overwhelming” that people are most at risk when they touch either those who are sick or such a person’s vomit, blood or diarrhea, “we can never say never” about spread through close-range coughing or sneezing.

“I’m not going to sit here and say that if a person who is highly viremic … were to sneeze or cough right in the face of somebody who wasn’t protected, that we wouldn’t have a transmission,” Skinner said.

Peters, Russell, and Bailey, who in 1989 was deputy commander for research of the Army’s Medical Research Institute of Infectious Diseases, in Frederick, Md., said the primates in Reston had appeared to spread Ebola to other monkeys through their breath.

Thanks Mark. It's obviously not as clear cut as the WHO claims then...

http://mic.com/articles/100618...pubexchange_facebook

Calm down.  Despite best efforts to whip up panic, there is no evidence that the virus is spread through anything other than direct contact with the body fluids.

Need something to fret about?  Flu season is coming up and it is far more likely to kill more people than Ebola this year.  It killed over 200,000 people worldwide last year.

Rampant uninformed speculation will only serve to make containing the current outbreak more difficult. 

Get a grip.

Watch news from around the world; every country focuses on stories from their "neck of the woods" point of  view.  Stories that lead off one country's news don't even make the lineup in another.

But more than that most news here isn't news as much as it is getting the desired story line out, mind control, and infotainment.

digger - Nobody is not calm or needs to "get a grip" - I just posted a "respectable" (see my comment in the prior post) source quoting authorities who are not uninformed on the subject.  And correcting something I had written earlier that I had heard from a non-authoritative source.

Flu season is an overrated event designed to sell lots of vaccines for which there is not much quality data on their effectiveness.  I gave a bunch of flu shots 2 years ago and didn't get one myself. My then employer pushed them like crazy, and I am sure it was all about concern for the health of the public, and the 500% markup on the vaccine had nothing to do with it.

And my current employer (as a health care company) offers them for free, and I am passing on that as well.  I may get the flu, or not.  Frequent hand washing has been shown to be as effective as any flu vaccine.

And for the record, I am not anti-vaccine per se, but anti-worthless-vaccine.  Although I did see a story (needing followup) that Merck may have fudged some numbers on their most recent MMR vaccine trial data.

The CDC web site is very clear on how the disease spreads...

Can Ebola spread by coughing? By sneezing?

Unlike respiratory illnesses like measles or chickenpox, which can be transmitted by virus particles that remain suspended in the air after an infected person coughs or sneezes, Ebola is transmitted by direct contact with body fluids of a person who has symptoms of Ebola disease. Although coughing and sneezing are not common symptoms of Ebola, if a symptomatic patient with Ebola coughs or sneezes on someone, and saliva or mucus come into contact with that person’s eyes, nose or mouth, these fluids may transmit the disease.

What does “direct contact” mean?

Direct contact means that body fluids (blood, saliva, mucus, vomit, urine, or feces) from an infected person (alive or dead) have touched someone’s eyes, nose, or mouth or an open cut, wound, or abrasion.

And I maintain they may not be telling the whole story, as outlined by reputable experts from the LA Times article. 

The CDC is hardly the last word on things - they haven't even been able to keep their own s**t together recently with all the lab mishaps involving infectious agents.

"It is ironic that the institution that sets US standards for safety and security of work with human pathogens fails to meet its own standards. It is clear that the CDC cannot be relied upon to police its own select-agent labs." - Rutgers University Chemistry & Chemical Biology Professor Richard Ebright

Further, the second statement cited from the CDC somewhat contradicts the first - if in fact it is in saliva or mucus, and the infected person coughs/sneezes (perhaps repeatedly) that saliva or mucus is propelled into the air, which gives someone else the possibility of inhaling those droplets, which would satisfy the "nose" component of the second half of that statement.

Ask yourself would you feel comfortable with your most loved close person (wife, child, mother, etc) spending 24 hours in a small room with an Ebola infected person who might be coughing and/or sneezing.  Based on the current info available, I certainly would not be.

As someone who is currently in Ghana, I don't really support that idea.

No reported cases here. Lots of publicity and discussion. Some basic precautions being taken. 

Nova aired a report on ebola yesterday. Online video link below (if available in your region):

http://www.pbs.org/wgbh/nova/b...surviving-ebola.html 

The British citizen in Macedonia is indeed a puzzling case if he ends up being confirmed as Ebola because it seems he never visited any infected areas in Africa.

His friend appears to be under observation according to the Independent and is reported to be ill.

I think my big concern with all this is that the first world has effectively stood on the sidelines for six months now while the situation in parts of Africa got out of control.  It would have been relatively cheap/easy to contain things if it was still at the level of 500-1000 cases in Africa if the USA, UK, France, Germany, China etc had mobilised significant personnel, resources and equipment and got them airlifted over there 2-3 months ago.

When (not if) this reaches those 'civilised' countries and if it spreads as easily as it seems to be doing (people in close proximity and family members catching it) then the impact on business and society could be enormous.  I really can see a situation where people are afraid to go out, to catch a tube, bus or plane and to go shopping and where people are afraid to send children to school.  I'm not normally one to jump into panic mode over anything really but I must admit this has me rattled and I really hope I am wrong.

Do I want to use shared bathrooms/toilets/catering facilities that may have just been used by someone with as yet undiagnosed Ebola? - no I do not!  Do I want to send my child to school if a case there is confirmed? - no I do not, do I want to go to work on a train full of other people who may have Ebola? - no I do not.  I can see a situation where millions of people stop travelling, shopping, eating out or sending kids to school and society and industry will grind to a halt as a result.  It's already happening in the USA:

http://www.theguardian.com/wor...at-laguardia-airport

This may not have killed as many people this year as malaria or flu yet but if the wealthy nations don't get their act together and fast it has the makings of a second plague.

I know there are a few Doctors on this forum and it would certainly be very interesting to hear their views on this and also what briefings and communications they have been sent regarding the threat.

The Washington Post had an interesting article by a US doctor a few days ago:

http://www.wnd.com/2014/10/ebo...sibility-downplayed/

I do get the feeling the USA has finally woken up to the risk it faces and is now mobilising an airbridge and 3000 troops, Britain has offered 1500 beds but I'm unclear on whether this includes the biohazard tents and other equipment needed to isolate patients.  Given this thing is doubling every 3 weeks perhaps the West needs to increase these provisions by a factor of ten anyway. 

The Guardian reported that there's lots of verbal assurance being provided but not much action on the ground yet.  http://www.theguardian.com/wor...-us-man-flew-liberia

In my view the West/First world nations need to establish a co-ordinated task force with a multi-billion dollar budget - in short put the kind of resources into this that they normally reserve solely for wars!  Then we might just stop it. 

Here's what's been pledged so far:

http://www.theguardian.com/glo...-key-funding-pledges

Jonathan