Ebola outbreak - general thread #1

[newone]

They gave it to six people. Two died and four survived. Survival rate is said to be around 50 % without ZMAPP.
So it's not even clear whether it's actually works in people (they need a lot more patients to test it on to see if survival rate is acutely different).
Even if it does work, giving it to those six people exhausted the current supply and apparently it will take months to make more.
Also, I am sure it's going to be extremely expensive.

according the story at this link 1000 doses of the experimental drug are en route to the ebola affected region and if WHO deems it a reliable 'cure' more will become available

http://www.cbc.ca/news/canada/manit...-of-ebola-response-manitoba-mp-says-1.2735234

 

[jjenny]

according the story at this link 1000 doses of the experimental drug are en route to the ebola affected region and if WHO deems it a reliable 'cure' more will become available

http://www.cbc.ca/news/canada/manit...-of-ebola-response-manitoba-mp-says-1.2735234

That's completely different drug, not ZMAPP, but a vaccine. Vaccine is something you give to persons not yet infected, so they don't develop the disease if exposed. ZMAPP is a treatment for people who already have the disease.

 

[Soulmagent]

I think that the geography probably makes it unlikely that the Ugandan outbreak was a precursor to the identified first case in Guinea. I am not sure we can invariably expect to identify the way in which an index case contracted the disease - particularly several months after they died. It seems perfectly possible that he was outside and touched some dead creature which was a carrier. Youngsters are forever putting their fingers in their mouth etc. so picking up the virus wold be relatively easy. The article also mentions the possibility of the child being injected with a dirty needle - of course that would need another host to have infected the needle in the first place.

The recent outbreak in DR Congo has been connected to a pregnant woman butchering a carcass which her husband had killed and brought home to her. Tragically, she, her baby and several hospital workers have all died.


They have certainly tracked the spread from this index case in Guinea very well. Unfortunately a lot of the early spread can be traced to a local healer who claimed to be able to cure the mystery illness which was affecting people. I don't think the outbreak was actually identified as Ebola until March simply because they have never had Ebola in that part of Africa and did not recognise what they were dealing with.

Ebola has been document and studied in Guinea.

Here is just one quote that helps support the idea that Ebola has been an active virus for longer than the Dec death of the 2 yr old.

One of the problems with this particular outbreak is that scientists have not been able to fully trace the virus from 2004 in Guinea to the current outbreak. Being unable to predict where it will next appear makes it very difficult to contain. The World Health Organization said Thursday that it hopes to stop the spread by 2015.

http://www.ibtimes.com/origin-ebola-outbreak-may-be-bat-virus-has-rapid-mutation-rate-1673118

 

[newone]

That's completely different drug, not ZMAPP, but a vaccine. Vaccine is something you give to persons not yet infected, so they don't develop the disease if exposed. ZMAPP is a treatment for people who already have the disease.

my error I should have typed vaccine instead of drug....

 

[Lyra500]

Ebola has been document and studied in Guinea.

Here is just one quote that helps support the idea that Ebola has been an active virus for longer than the Dec death of the 2 yr old.



http://www.ibtimes.com/origin-ebola-outbreak-may-be-bat-virus-has-rapid-mutation-rate-1673118

I think there might be an error in the quote from the article about Ebola in Guinea in 2004.

This is the first Ebola outbreak in West Africa in history as far as I am aware - the only Ebola outbreak in 2004 was in Sudan and was the Sudan strain rather than the Zaire strain in this current outbreak.

This link is for a table listing the various outbreaks (not all are human -Reston Ebola has only ever been found in primates):

http://en.wikipedia.org/wiki/List_of_Ebola_outbreaks

This is from the WHO website:
http://www.who.int/mediacentre/factsheets/fs103/en/

I am afraid I was unable to retain the columns in the table.

Table: Chronology of previous Ebola virus disease outbreaks


Year Country Ebolavirus species Cases Deaths Case fatality

2012 Democratic Republic of Congo Bundibugyo 57 29 51%
2012 Uganda Sudan 7 4 57%
2012 Uganda Sudan 24 17 71%
2011 Uganda Sudan 1 1 100%
2008 Democratic Republic of Congo Zaire 32 14 44%
2007 Uganda Bundibugyo 149 37 25%
2007 Democratic Republic of Congo Zaire 264 187 71%
2005 Congo Zaire 12 10 83%
2004 Sudan Sudan 17 7 41%
2003 (Nov-Dec) Congo Zaire 35 29 83%

2003 (Jan-Apr) Congo Zaire 143 128 90%

2001-2002 Congo Zaire 59 44 75%
2001-2002 Gabon Zaire 65 53 82%
2000 Uganda Sudan 425 224 53%
1996 South Africa (ex-Gabon) Zaire 1 1 100%
1996 (Jul-Dec) Gabon Zaire 60 45 75%

1996 (Jan-Apr) Gabon Zaire 31 21 68%

1995 Democratic Republic of Congo Zaire 315 254 81%
1994 Cote d'Ivoire Taï Forest 1 0 0%
1994 Gabon Zaire 52 31 60%
1979 Sudan Sudan 34 22 65%
1977 Democratic Republic of Congo Zaire 1 1 100%
1976 Sudan Sudan 284 151 53%
1976 Democratic Republic of Congo Zaire 318 280 88%

So far, they have not been able to trace this outbreak further back than the two year old boy who is currently regarded as the index case from what I have seen.

The first mention of Ebola in Guinea on the WHO website was not until March 2014 and PH doctors then had to trace cases back to the 2 year old in Guekedou:

23 March 2014 - The Ministry of Health (MoH) of Guinea has notified WHO of a rapidly evolving outbreak of Ebola virus disease (EVD) in forested areas of south-eastern Guinea. As of 22 March 2014, a total of 49 cases including 29 deaths (case fatality ratio: 59%) had been reported.

 

[trigger]

UN: Ebola Could Eventually Infect 20,000 People.



GENEVA (AP) — The Ebola outbreak in West Africa is accelerating and could grow six times larger to infect as many as 20,000 people, the World Health Organization said Thursday. The U.N. health agency unveiled a new road map for containing the virus, and scientists are fast-tracking efforts to find a treatment or vaccine.

http://m.huffpost.com/us/entry/5728268

Graphic Video at link above. Shows people being shot. I read rubber pellets were used and I read they were shot with bullets. I just do not understand it, its horrible.

 

[Lyra500]

UN: Ebola Could Eventually Infect 20,000 People.



GENEVA (AP) — The Ebola outbreak in West Africa is accelerating and could grow six times larger to infect as many as 20,000 people, the World Health Organization said Thursday. The U.N. health agency unveiled a new road map for containing the virus, and scientists are fast-tracking efforts to find a treatment or vaccine.

http://m.huffpost.com/us/entry/5728268

Graphic Video at link above. Shows people being shot. I read rubber pellets were used and I read they were shot with bullets. I just do not understand it, its horrible.

That would mean over 10,000 horrific, terrifying, lonely deaths. Heart-breaking for all involved.

As for the shooting of rioters, it does seem extreme and horrible but imagine what would happen if Ebola reached the west and the virus continued to mutate until it became transmissible in the same was as 'flu.

I could see rioting, states of emergency being declared and shooting happening here just as easily - that level of fear will make people do crazy things and those in power would employ any means necessary to maintain control and prevent a total break down in the rule of law.

[I have faith that in its current form our level of equipment and facilities would enable richer 'western' countries to control an outbreak far more easily than the West African countries which have so few medics and not enough equipment or isolation facilities.]


JMOO

 

[trigger]

Thats what scares me Lyra500. It would be pandemonium here as well. But these poor people being shot, not fed, no water or electric. People cannot pay their electric bill bc its on the other side of the fence. Family members bringing food to their loved are not allowed near them. Their Gov't was not prepared. I hope we will be.

Im stocking up with food, water and bleach and masks and gloves, gasoline and having cash on hand, lol. And im afraid of Isil attacks as well.

 

[Lyra500]

It is a pretty scary time at the moment isn't it?

I can add concerns over where we are going with Russia to your list.

 

[Lyra500]

This article looks at how the outbreak in Sierra Leone is thought to have started:

http://www.dailymail.co.uk/news/art...ional-healer-s-funeral-14-women-infected.html

I think I read somewhere that this healer had been in Guinea which would explain how he contracted the infection. They think that 14 women picked up the virus at his funeral and that is how the outbreak started in Sierra Leone.

The article goes on to mention that the West African strain is genetically different to the Central African although it is still being referred to as the Zaire strain, so appears to have mutated from that strain over a number of years.

Soulmagent - they mention that the divergence of the Ebola strains probably happened as far back as 2004, which corresponds with the article you quoted, but I think whilst they mention the possibility of the virus circulating in humans in Guinea they also say that it was present in fruit bats and/or monkeys during that time. The virus causes such devastation in humans that it seems pretty unlikely that there has been an ongoing outbreak in humans for the last ten years in Guinea.

I think the current theory remains that the 2-year old in Gueckedou was the index case for this outbreak with the virus somehow passed from an animal host.

Historically, outbreaks in humans have been pretty short-lived because the death rate is so high and they were usually confined to remote communities, so there would be a short deadly outbreak in humans and then the virus just carried on in its' normal animal hosts.

That is what makes the current situation so unprecedented - it is continuing and spreading from human to human far more than ever before because of the involvement of urban areas and the advent of greater mobility allowing carriers to take the virus to new areas. Also, though it is still horrific, the relatively 'low' death rate around 50% rather than the 75-90% seen in earlier outbreaks facilitates more effective spreading of the infection.

 

[Ausgirl]

I think this "stepping up" is a load of BS... they've had 38 years to step it up, since the first serious outbreak in 1976. Nearly 40 years of this deadly disease breaking out periodically, potentially threatening the entire human population of the world -- one would think the CDC would have been 'stepping up' their efforts for several decades now....

I recall reading a very interesting book about ebola and other rampantly deadly diseases back in the 90's:

http://www.amazon.com/The-Hot-Zone-Terrifying-Origins/dp/0385479565

http://en.wikipedia.org/wiki/The_Hot_Zone

This is not only extremely informative (though 20 years old now) but also very well-written. It's the scariest book you will ever read, I will guarantee you that right now. And once you have read it, I have no doubt the sloppy attitude toward ebola demonstrated during this present outbreak will outrage you to the core.

Since reading this book, my opinion of outbreak protocol has included shutting down all international and regional traffic to affected areas immediately. Total quarantine, of whole countries if necessary, and get the army in there to enforce it. I do not think the use of all necessary force to contain the virus' spread is wrong at all.

 

[Ausgirl]

Here's a Q&A on reddit, with author of the Hot Zone, Richard Preston, and a link to his article on the latest outbreak, which details some of the struggles medical staff are facing:

eta: WHY can we not post reddit links? Sigh. No link for that interesting discussion, sorry. But google 'I am Richard Preston' and it'll pop up. Well worth reading!!!

article: http://www.newyorker.com/magazine/2014/08/11/outbreak

 

[Yoda]

There have been a handful of suspected cases outside of Africa. The most recent found in MSM (within last 48 hours) was a young girl in Canada and a man in Brussels- these two both tested negative. Within the last several hours there is a suspected case in Sweden and in Spain. Neither are confirmed. This post is an FYI

http://www.cbc.ca/news/videos/ebola-outbreak-swedish-hospital-investigates-possible-case-1.2752090
http://lainfo.es/en/2014/09/01/activate-protocol-action-against-ebola-in-spain/

 

[Lyra500]

I think this "stepping up" is a load of BS... they've had 38 years to step it up, since the first serious outbreak in 1976. Nearly 40 years of this deadly disease breaking out periodically, potentially threatening the entire human population of the world -- one would think the CDC would have been 'stepping up' their efforts for several decades now....

I recall reading a very interesting book about ebola and other rampantly deadly diseases back in the 90's:

http://www.amazon.com/The-Hot-Zone-Terrifying-Origins/dp/0385479565


http://en.wikipedia.org/wiki/The_Hot_Zone

This is not only extremely informative (though 20 years old now) but also very well-written. It's the scariest book you will ever read, I will guarantee you that right now. And once you have read it, I have no doubt the sloppy attitude toward ebola demonstrated during this present outbreak will outrage you to the core.

Since reading this book, my opinion of outbreak protocol has included shutting down all international and regional traffic to affected areas immediately. Total quarantine, of whole countries if necessary, and get the army in there to enforce it. I do not think the use of all necessary force to contain the virus' spread is wrong at all.

I read The Hot Zone just recently having seen it recommended elsewhere. I would endorse your view 100%. It is a fascinating and terrifying read. I could not put it down until I had finished it. It is why I am so concerned about what we are (or possibly more accurately are not) doing in response to this outbreak.

Should this virus mutate in a way which makes it even more transmissible than it already is, then I do not think it is scare-mongering to suggest that it could threaten the human race - or at least our current way of life. Imagine the statistics for how many people catch influenza out of a population - then factor in the 50%+ death rate and think how your society could possibly survive an outbreak of those proportions. Even if 'only' 20% of the population died, how would your schools, hospitals, utilities, police, fire service etc continue to run effectively?

This is why I think we should stop all air travel to the affected areas (apart from humanitarian flights of medical personnel and equipment) until we have this outbreak under control.

 

[HMSHood]

Disease modelers project a rapidly rising toll from Ebola
http://news.sciencemag.org/health/2014/08/disease-modelers-project-rapidly-rising-toll-ebola

Alessandro Vespignani hopes that his latest work will turn out to be wrong. In July, the physicist from Northeastern University in Boston started modeling how the deadly Ebola virus may spread in West Africa. Extrapolating existing trends, the number of the sick and dying mounts rapidly from the current toll—more than 3000 cases and 1500 deaths—to around 10,000 cases by September 24, and hundreds of thousands in the months after that. “The numbers are really scary,” he says—although he stresses that the model assumes control efforts aren't stepped up. "We all hope to see this NOT happening," Vespigani writes in an e-mail.

Vespignani is not the only one trying to predict how the unprecedented outbreak will progress. Last week, the World Health Organization (WHO) estimated that the number of cases could ultimately exceed 20,000. And scientists across the world are scrambling to create computer models that accurately describe the spread of the deadly virus. Not all of them look quite as bleak as Vespignani's. But the modelers all agree that current efforts to control the epidemic are not enough to stop the deadly pathogen in its tracks.

Not a good prognosis.

 

[jjenny]

There is some hope. A vaccine is being tested in US. Unlike ZMAPP, it appears that company can rapidly produce a lot of doses (assuming vaccine works). Other countries also have been working on the vaccines.

"The NIH is developing the vaccine with pharmaceutical giant GlaxoSmithKline. Although Fauci said the vaccine has “performed extremely well” in primate studies, it has not yet been tested in humans."

http://abcnews.go.com/Health/human-trial-ebola-vaccine-begin-week/story?id=25204379

 

[Yoda]

This is good news, if they can be implemented quickly. Japan creates ebola test that gives results in 30 minutes.

http://www.marketwatch.com/story/ja...st-report-2014-09-01?link=MW_home_latest_news

 

[atthelake]

Another diary type article in a New England Journal of Medicine (prestigous publication IMHO) , published August 27th 2014

http://www.nejm.org/doi/full/10.1056/nejmp1410179

Perspective
Face to Face with Ebola — An Emergency Care Center in Sierra Leone

Anja Wolz, R.N...............The Ebola outbreak has been out of control for months, but the global health community has taken a long time to react. All organizations have limits, and here in Kailahun, MSF's limit is in case management. The current international Ebola response remains dangerously inadequate. Last week, 250 contacts of infected persons were identified for contact tracing, but given the number of confirmed cases, there should have been more than 1500. The alert system — whereby an investigation team (and, if needed, an ambulance) is sent to a village when a suspected case or death is reported — is not functioning properly, and the Ministry of Health has only four ambulances in a district with about 470,000 people. Our health promotion teams are still visiting villages where no other health care provider has been. Every day sees deaths in the community that are surely caused by Ebola, but they are not counted by the Ministry of Health because the cause has not been confirmed by laboratory testing. The epidemiologic surveillance system is nonfunctional. We need to define the chains of Ebola transmission to interrupt them, but we lack key data...............

 

[BlueberryBird]

The Hot Zone is pretty sensationalized and not all that accurate. It is a good read, but i think does more scaremongering than necessary, plus the descriptions of the actual disease aren't very reliable.

I recommend Spillover, by David Quammen. It covers a variety of zoonotic viruses, but has a sizable section on Ebola. Spillover is beautifully written and wonderfully researched--it might be one of the best books I've read in the past few years (I read a lot of science books).

 

[zwiebel]

Japanese researchers have developed a 30 minute test for ebola, it was announced today, that costs less than the current one too.

http://news.yahoo.com/japanese-rese...-061658028.html;_ylt=AwrTWVVlZwVU8GYASTfQtDMD