Ebola

[mmhmm]

There are cultural issues that effect the spread of Ebola in Africa that aren't in practice here. Our isolation procedures are excellent, if they're followed to the letter - and, they MUST be when dealing with a virus like Ebola. We don't commonly touch our dead, or carry them long distances with loved ones touching them along the way. Our procedures are very, very different than those in this area of Africa. As Mich says, if this virus was actually airborne there would be many, many more cases. It does, however, have a long life in bodily fluids once those fluids are out of the body, and/or the infected individual is dead.

[Tiny]

Jul 30, 2014 12:02:36 GMT -5 @sroo4 said:

Jul 30, 2014 11:51:11 GMT -5 Tiny said:

But, then, shouldn't there be more dead than the 700 or so?   The death count would seem to indicate that less than 2000 people have been diagnosed with Ebola.   Shouldn't there be more people dying/becoming ill?     Those with ebola have been in contact with alot of people AND there's been alot of travelling by those in contact with ebola (even if they haven't become ill themselves).  

Remember - this all started back 3 or 4 months ago... plenty of time for people to spread the virus around to tens of thousands of people.

I'm not tracking with you.  I posted the information in relation to the conversation about how it was spread.  Mostly to say that yes it is a that Dr Canada was irresponsible and an idiot.   I'm not saying that there is a super high possibility of spreading (as in TB for an example) but that it is possible.  

Ah! I misunderstood.        I have no problem with the Dr in Canada who's returned home and gone on 'self quarentine'.  Ebola seems to mostly spread when someone's already visibly sick.   It doesn't appear that there's much of a risk of him having spread ebola to the people he's been around before the self quarentine - if he eventually does become sick.   I think he might have a higher chance of survival if he does get sick (although it sounds like survival is a bit of a crap shoot ) because he will have access to better/quicker care.

Where he receives care may be an issue - but I suspect perhaps someone in some sort of power has given thought to how they will handle the need if/when the situation arises.     

[mmhmm]

Jul 30, 2014 13:08:49 GMT -5 @sroo4 said:

Jul 30, 2014 12:59:20 GMT -5 mmhmm said:

There are cultural issues that effect the spread of Ebola in Africa that aren't in practice here. Our isolation procedures are excellent, if they're followed to the letter - and, they MUST be when dealing with a virus like Ebola. We don't commonly touch our dead, or carry them long distances with loved ones touching them along the way. Our procedures are very, very different than those in this area of Africa. As Mich says, if this virus was actually airborne there would be many, many more cases. It does, however, have a long life in bodily fluids once those fluids are out of the body, and/or the infected individual is dead.

I never said it was airborne.  I highlighted the the bit (including the part) that said it hasn't been proven to be airborne.  However one of the doctors who was headed home was vomiting .  

Do viruses put themselves on hold when you get on a plane?  Is it reasonable to think that a person not yet showing symptoms when they get on a plane could start while en-route? Could it be reasonable that a person feels fine when they get on a plane and 20 hours later have a fever or any of the other symptoms. 

Our isolation procedures are excellent, if they're followed to the letter

Hmm,  like isolation and not getting on a plane with other people?

I haven't commented on the doctor,  Sroo. I haven't read much about that, so don't feel I should be commenting on the doctor. My comments have been general and in regard to the Ebola virus. You, and some others, may prefer to talk about the doctor.

[The Walk of the Penguin Mich]

Jul 30, 2014 12:59:29 GMT -5 @sroo4 said:

Jul 30, 2014 12:48:43 GMT -5 The Walk of the Penguin Mich said:

It sounds like the MSDS data sheet you copied s combining Reston Ebola with Ebola that is currently infecting the Africans now.  They are separate viruses, and hike Reton Ebola can bet aerosolized, it only infects monkeys.

If the virus WAS aerosolized, there would be waaay more cases than there are.

The Canadian doctor had no symptoms, nor had the virus been cultured from him when he got on the plane.  He was choosing to be prudent to quarantine himself.  I don't see how he was an idiot, because by your metric, no healthcare worker would be able to come back to their home.

Because I think there are just too many things that can be spread via travel, and a Dr should know better.  I also think if he was all set to go under quarantine he should have done it before he traveled.   

He was tested for disease before he traveled.  He had no symptoms, nor did he have the virus cultured.  

I don't know what else you would want him to do.  Even if he was quarantined in the country, there is no guarantee that he could not have picked it up between quarantine and getting on the plane.

[The Captain]

Yea, @sroo4 - I read that also.

I gotta admit, this one scares me a lot.  Hell, if the lead expert in the virus in one of those countries couldn't practice proper quarantine procedures, why do we think our own doctors are some how superior?

Medical staff, whom I would presume know proper procedures, are getting infected and dying.  What's going on?

[mmhmm]

Aug 1, 2014 8:38:05 GMT -5 The Captain said:

Yea, @sroo4 - I read that also.

I gotta admit, this one scares me a lot.  Hell, if the lead expert in the virus in one of those countries couldn't practice proper quarantine procedures, why do we think our own doctors are some how superior?

Medical staff, whom I would presume know proper procedures, are getting infected and dying.  What's going on?

My guess is there was a breach in protocols, Captain. People get tired, and people get careless. Sometimes, protocols are broken because something happens that is unavoidable and/or accidental.  Needle sticks come to mind.

[mmhmm]

They're flying these people in special isolation pods that have been developed for that purpose, Sroo, and in charter planes that are prepared to do the job. There are no 100% guarantees of anything in this world. I'd rather see these people get the very best treatment available, and that the treatment be given under the auspices of the CDC so knowledge can be gained and disseminated throughout the process. That's my take as a healthcare professional. I'm sure others have different opinions.

[The Captain]

Sroo, again I agree with you 100% on flying in people with known cases.

This sucks.  No other way to put it.  And I mean the situation, not necessarily the choices that are being forced upon people.

Also, let's not forget the human side of this tragedy:


news.yahoo.com/ebola-stricken-doctors-gracious-gesture-171822279.html


On Wednesday, an experimental serum arrived in Monrovia, Liberia, but there was only enough dosage for one patient.

“Dr. Brantly asked that it be given to Nancy Writebol,” said Franklin Graham, president of Samaritan’s Purse, the Christian humanitarian organization Brantly is working for

[mmhmm]

In honesty, I have very little worry over the transport. The isolation pods give me confidence - or, as much confidence as one can have. If one of our citizens is seriously ill and in a country that cannot provide care with the very best technology and knowledge, I want them brought home. I want it done safely, and the plan is to do just that. These people went to Liberia to treat a horrible disease. Unfortunately, they have contracted that disease themselves. To my mind, we owe them the best possible treatment, and the best possible outcome we can offer and arrange. If I could, I'd be there to treat them!

[mmhmm]

Aug 1, 2014 9:15:47 GMT -5 @sroo4 said:

Aug 1, 2014 9:04:14 GMT -5 mmhmm said:

In honesty, I have very little worry over the transport. The isolation pods give me confidence - or, as much confidence as one can have. If one of our citizens is seriously ill and in a country that cannot provide care with the very best technology and knowledge, I want them brought home. I want it done safely, and the plan is to do just that. These people went to Liberia to treat a horrible disease. Unfortunately, they have contracted that disease themselves. To my mind, we owe them the best possible treatment, and the best possible outcome we can offer and arrange. If I could, I'd be there to treat them!

So why can't we go there and treat them?

Because we have better facilities and a higher level of technology here, Sroo. 

[Deleted]

Son-in-law just flew in from Africa last night. I suspect that DD still has him soaking in a tub of bleach. 

[mmhmm]

No, the isolation unit at Emory cannot be shipped to where the patient is, Sroo. "The slammer" (that's what it's called) at Emory is an on-site full isolation unit that is completely separate from other patient areas. I've seen it. It's quite the technological marvel, but it's not portable.

[mmhmm]

A mobile isolation tent isn't good enough, if any of the things you're worried about are true, Sroo. I don't believe they are, but if they are a mobile tent isn't going to do the job. 

[Deleted]

Aug 1, 2014 9:25:34 GMT -5 @wrongsideof30 said:

Aug 1, 2014 9:24:16 GMT -5 @lonewolf said:

Son-in-law just flew in from Africa last night. I suspect that DD still has him soaking in a tub of bleach. 

Why was he there?

His mother just died and he was taking a get away 5 star vacation with his step dad, so pretty sure they weren't living in a hut somewhere on the West side.  

[djAdvocate]

what would America be without being scared shitless over something on an almost weekly basis?

edit: and with that, i leave you on an 8 day camping trip to the lovely California coast.  adieu.

[mmhmm]

You're going on vacation and leaving me behind again, dj!  Ahhh, well. Have a good time, anyway! 

[Deleted]

Aug 1, 2014 9:46:03 GMT -5 djAdvocate said:

what would America be without being scared shitless over something on an almost weekly basis?

edit: and with that, i leave you on an 8 day camping trip to the lovely California coast.  adieu.

You mean to the same California coast where all the polluted waste is finally washing up from Japan!!!?

[mmhmm]

Aug 1, 2014 9:43:16 GMT -5 @sroo4 said:

So let me get this straight... we can't isolate them in the country they are currently in, the one they got infected in, and we apparently can't ship medical supplies and drugs to them for treatment.  

So the next logical step is to bring them to a country where there is currently no exposure,  but a really good isolation room?  

. He said that people often do more harm than good when trying to "help".

This I agree with.  I read somewhere (long before this outbreak) that the disease was kept in relative check,  because the outbreaks were occurring in remote areas.  These areas were organically quarantined due to location.   Because of this the virus outbreaks would burn out fairly quickly on their own.  

No we are seeing much larger outbreaks in more populated areas.  I can't help but think part of it is down to all the humanitarian aid workers going into those isolated areas and bringing to the more urban ones. 

You don't quite have it straight, Sroo. These patients can be isolated on-site; however, we have better facilities here for that purpose than are available in Liberia. We can, and do, send medications and supplies. The job can simply be better done with more likelihood of a positive outcome here than it can be done there.

There are those who will fear. I'm not one of them so I'll bow out.

[The Walk of the Penguin Mich]

Aug 1, 2014 9:25:45 GMT -5 @sroo4 said:

Aug 1, 2014 9:19:51 GMT -5 mmhmm said:

Because we have better facilities and a higher level of technology here, Sroo. 

Surely that can be shipped to where the patient is?   Especially since I believe it was the head of the CDC said that the plane ride could do more harm to the patients than good. 

No, they can't.  There is a tremendous amount of corruption in these African governments and getting supplies over there is damn near impossible without them being scavenged.  

There is one book I read where they had shipped some blood analyzers over from the US, and when the scientists finally got the machines out of customs, the guts of the machines had been removed, rendering them useless.  This is the norm.

The scientists working over there have no where near the facilities that are here.  Electricity and clean water are in very short supply, and both of these can be critical.

Finally, by bringing cases here, it gives more scientists more exposure to treating the disease and symptoms.  More scientists=more ideas as to better thoughts as to treating the disease process.  Having more scientists observe the disease process is a very good thing.

[mmhmm]

Aug 1, 2014 10:10:16 GMT -5 @sroo4 said:

mmhmm, 

Hope you're right.  But I still see it as an unnecessary and reckless risk,  no matter how remote.  

I don't see it that way, at all, Sroo. I see it as the right thing to do under the circumstances, for a number of reasons. We can better study this virus and learn by having these patients here. The more we learn, the faster we'll be able to address the problem and develop better treatment and, possibly, a vaccine. To me, there is no reason to leave our stricken citizens in a country with inferior technology and equipment when we can safely transport them here BECAUSE we have the technology to do so. We've transmitted patients with Lassa Hemorrhagic Fever to this country from Africa more than once without a single case of transmission.

[djAdvocate]

Aug 1, 2014 9:53:05 GMT -5 @lonewolf said:

Aug 1, 2014 9:46:03 GMT -5 djAdvocate said:

what would America be without being scared shitless over something on an almost weekly basis?

edit: and with that, i leave you on an 8 day camping trip to the lovely California coast.  adieu.

You mean to the same California coast where all the polluted waste is finally washing up from Japan!!!?

no.  the pristine coast that is at it's healthiest levels in decades.    sorry, no more time, lone.  gone for 8 days.  ciao!

[The Walk of the Penguin Mich]

Aug 1, 2014 9:43:16 GMT -5 @sroo4 said:

. He said that people often do more harm than good when trying to "help".

This I agree with.  I read somewhere (long before this outbreak) that the disease was kept in relative check,  because the outbreaks were occurring in remote areas.  These areas were organically quarantined due to location.   Because of this the virus outbreaks would burn out fairly quickly on their own.  

No we are seeing much larger outbreaks in more populated areas.  I can't help but think part of it is down to all the humanitarian aid workers going into those isolated areas and bringing to the more urban ones. 

Actually, the very nature of the virus contains it.  When a virus makes a host sick very fast and kills the host at a very high rate, this is what largely keeps the virus contained.  It is the diseases where you are not as sick and still ambulatory where an epidemic becomes a pandemic.  A good example is the flu.  It quickly becomes pandemic because it has a lower mortality rate, is aerosolized and the host is ambulatory for the first stages of the disease.

Larger outbreaks are due to the fact that it is now so publicized.  While this may be one of the larger ones, most of these outbreaks have gone largely unknown by the general public.  This outbreak has been way more publicized than usual, likely due to the infection of the healthcare workers.

[djAdvocate]

Aug 1, 2014 9:51:29 GMT -5 mmhmm said:

You're going on vacation and leaving me behind again, dj!  Ahhh, well. Have a good time, anyway! 

yep.  two weeks out of three!!!    i am stoked!

[mmhmm]

I'll bet! I really hope you have a wonderful time! You work hard, you should play hard.

[djAdvocate]

Aug 1, 2014 10:22:08 GMT -5 mmhmm said:

Aug 1, 2014 10:10:16 GMT -5 @sroo4 said:

mmhmm, 

Hope you're right.  But I still see it as an unnecessary and reckless risk,  no matter how remote.  

I don't see it that way, at all, Sroo. I see it as the right thing to do under the circumstances, for a number of reasons. We can better study this virus and learn by having these patients here. The more we learn, the faster we'll be able to address the problem and develop better treatment and, possibly, a vaccine. To me, there is no reason to leave our stricken citizens in a country with inferior technology and equipment when we can safely transport them here BECAUSE we have the technology to do so. We've transmitted patients with Lassa Hemorrhagic Fever to this country from Africa more than once without a single case of transmission.

hard to imagine what would have happened if Salk had suggested quarantine rather than researching treatments.

[mmhmm]

Aug 1, 2014 10:27:07 GMT -5 djAdvocate said:

Aug 1, 2014 10:22:08 GMT -5 mmhmm said:

I don't see it that way, at all, Sroo. I see it as the right thing to do under the circumstances, for a number of reasons. We can better study this virus and learn by having these patients here. The more we learn, the faster we'll be able to address the problem and develop better treatment and, possibly, a vaccine. To me, there is no reason to leave our stricken citizens in a country with inferior technology and equipment when we can safely transport them here BECAUSE we have the technology to do so. We've transmitted patients with Lassa Hemorrhagic Fever to this country from Africa more than once without a single case of transmission.

hard to imagine what would have happened if Salk had suggested quarantine rather than researching treatments.

No kidding! This virus isn't all that easy to contract. With the precautions that are being taken, I see the risk to the general public as all but non-existent. I'll just be glad to know these folks are here and being treated with the best we have to offer. They're going to Emory and that's the best place for them to be. I understand there's a new facility in Nebraska that's supposed to be fantastic, as well, but I haven't looked into it.

[Tennesseer]

One must keep in mind the hospitals in west Africa are not up to the medical and cleanliness/sterile standards of American hospitals.  Some of these west African hospitals are overwhelmed with Ebola patients and have very limited facilitates to treat numerous Ebola patients, including keeping them isolated from others.

Many of those affected by the Ebola virus are also being treated in the remote areas of the affected countries.  Patients in these remote facilities are being treated for the virus in primitive medical facilities.

[The Walk of the Penguin Mich]

Aug 1, 2014 9:11:02 GMT -5 @wrongsideof30 said:

Finally finished The Hot Zone.

Yes, Ebola Reston is absolutely transmittable to humans. The four men who worked as caretakers in the monkey house (a business/warehouse in the U.S. where monkeys infected with Ebola Reston had been shipped to in 1989) all eventually tested positive for Ebola Reston. The virus had entered their bloodstream (most likely through their lungs, just from breathing the air near the infected monkeys) and multiplied in their cells, but it did not make them sick.

The book says that Zaire and Reston are so much alike that it's hard to say how they are different. Each filovirus (Marburg, Ebola Sudan, Ebola Zaire, and Ebola Reston) strain contains seven proteins, four of which are completely unknown. This book was written in 1995, so hopefully more is known. The book also speculated that while the Reston virus supposedly comes from Asia, it's possible that it originated in Africa and flew to the Philippines on an airplane. "Experts do not doubt that a virus can hop around the world in a matter of days".


Sorry to talk about the book so much! I don't know anybody else that has read it.

Many viruses/bug have their preferred host.  Monkeys are exquisitly sensitive to TB, waaay more than humans.  When I worked with monkeys, I had to be tested every 3 months, to make sure I wasn't carrying the bug into the monkeys.

OTOH, monkeys carry a virus called Herpes B, that is much like regular herpes is in humans.  However, if a human picks it up it has about an 85% mortality rate.  Not only that, the virus can be spread from human to human.  It starts out as a rash and an animal worker at one of the facilities I worked with scratched himself on a cage from an infected monkey.  He got a rash, and his wife rubbed cortisone cream on it.  By the time they realized what it was, both were infected, both died.  I believe if you get on acyclovir, you can stop the disease but you wind up on it for life.  It has been awhile sixe I worked with the monks, but it was a really stressful situation.  You had to be incredibly careful, and even with the repercussions, you DO get complacent and let your guard down.  Being vigilant 100% of the time is very difficult.  I only had to be doing it fr 4 hour stretches, I can't imagine needing to be 'on' for 18 hours at a time.  4 hours is exhausting.

[Tiny]

Aug 1, 2014 8:41:06 GMT -5 mmhmm said:

Aug 1, 2014 8:38:05 GMT -5 The Captain said:

Yea, @sroo4 - I read that also.

I gotta admit, this one scares me a lot.  Hell, if the lead expert in the virus in one of those countries couldn't practice proper quarantine procedures, why do we think our own doctors are some how superior?

Medical staff, whom I would presume know proper procedures, are getting infected and dying.  What's going on?

My guess is there was a breach in protocols, Captain. People get tired, and people get careless. Sometimes, protocols are broken because something happens that is unavoidable and/or accidental.  Needle sticks come to mind.

Yeah this... it's hot there too. No A/C in the hospitals.  One article said they've got about 30 to 40 minutes at a time in a 'hazmat suit'.    I'm sure they aren't leaving patients alone for hours on end.        I think they also don't have enough of whatever it is they need so they can't just 'dispose of something' and pull out a new sterile one.    I think they also have a shortage of people trained to do the disinfecting/whatever.  A shortage of trained 'support people'. 

         
 

[The Walk of the Penguin Mich]

Aug 1, 2014 10:34:50 GMT -5 @wrongsideof30 said:

One of the most unsettling parts of the book is where it's mentioned that half of the entire operation regarding the infected monkeys was making sure the news was contained and that nobody found out what was happening. This decision was made before they knew that the Reston strain wouldn't cause death like it did in the monkeys. The building was filled with an airborn ebola virus AND the army found used, hypodermic syringes with needles attached to them in a wooded area behind the building. Throughout the book, there is mention of a daycare facility nearby with children playing outside. It was difficult to read.

I'm getting ready to go camping too. I'll try and bring some uplifting books!

(I'm lying. I'm totally going to bring The Stand, lol)

I really doubt that the hypodermic needles were from the facility.  Probably from addicts in the area.  Disposables from labs are not discarded that way as OSHA would have our ass, and things have been like this since about 1980....and have gotten more onerous since then.

I hate to tell you this, but it was publicized.  I remember hearing about it and reading about it and it was discussed in scientific circles.  But quite frankly, the popular press has such an abysmal knowledge of science, that they didn't understand the implications.  But it was on the news and in the papers.