Ebola outbreak - general thread #8

[jjenny]

Hickox developed a fever at the airport, but does she still have it? I wouldn't think so based on her activities. Have people with ebola developed a fever that then went away? I haven't heard of that, but perhaps I missed it. From what I've read, the symptoms develop rapidly once they appear, not that they appear and then disappear. And, didn't she already test negative?

As for Dr. Spencer, has anyone in the public contracted the disease from him? I haven't heard of that, but perhaps I missed it. I don't think he should've been in public places after he developed fatigue, but he did act responsibly as soon as he developed a fever.

There has not been enough time to determine if anyone contracted the disease from Dr. Spencer. Incubation period up to 21 days (and possibly even longer).

 

[Footwarrior]

The device used to measure Nurse Hickox's forehead temperature at the airport is designed to do a quick check that should be confirmed using a more accurate device like an oral thermometer. It's doubtful that she even had an elevated temperature at that time.

 

[faw720]

The fact that they knew she was coming is part of the protocol in place, regarding anyone who enters the US from WAfrica, especially HCWs. They are (supposedly) monitoring all of them for 21 days, and with HCWs there's probably a spotlight and ongoing interaction. In that context, it would be surprising if Texas officials DIDN'T know she was coming.

Oh, ok, thanks. I guess somewhere in all this hullabaloo I missed that.

 

[Inthedetails]

How many people have been infected someone at the "exact moment" they begin to run a fever? If this is a legitimate concern, why have we seen NO ONE in the US come up with ebola by simply "being around" someone who has just begun to spike a fever? Shouldn't SOMEONE around Mr. Duncan have become ill? He exposed 43 people after he spiked a fever. Shouldn't one or two or three have become sick if this fear is even remotely legit? None of the ER folks got sick-why not? They examined him when he was symptomatic-up close and personal, and not one of them is sick. SOMEBODY should have shown illness with that many people interacting with him in those first few days. Why haven't they? What about the people sharing the plane with Amber Vinson? If someone is contagious in the initial minutes or hours of experiencing symptoms, at least ONE of the hundreds of people sharing those planes should be sick by now. What about Nina Pham's fiance? Isn't tomorrow his 21st day? Why isn't he sick? Amber's family members-are they still okay?

I think it is a VERY dangerous thing to deny people their freedom when they are not sick when there has been zero evidence that the moment they begin to show their first symptom they are a public health threat. It's not been even remotely shown to be the case and "well, I'm just afraid it might happen" or "better safe than sorry" is a pretty poor rationale for locking people up imo in light of the fact that there is no science that backs up that claim and no practical evidence that it goes beyond the theoretical.

People keep saying we don't have a large enough sample size to conclude that people are not crazy infectious in early stages because so far we've only had 4 people exhibit early symptoms of ebola while in the US. But I think it's a great way to observe it. We have been "clean" and there are no confounding variables present. In other words, we don't have a lot of people sick with ebola here, so we can observe what happens with an early infected person without wondering if the presence of other sick people around them have muddied the waters. We have a solid waste management system, so if someone around a sick person in the earliest stage gets sick, we don't have to wonder if it was actually contamination from infected waste in the community. We don't have houses full of people sick with ebola to cause confusion as to what point Bob got sick because wife just began showing symptoms but Grandma is in the same house vomiting and having diarrhea. We have the perfect clean slate to observe if a person in their initial stages of ebola is in fact infecting others. And it just has not happened. The notion that the over 50 folks who were around Mr. Duncan after he began to experience symptoms and before he was admitted to the hospital (43 friends and family, as well as workers from ER visit #1 who were not wearing protective gear) have some kind of magical resistance to ebola just defies belief.

This nurse is causing no harm to anyone by going on a bike ride. The fact that the thought of the police shooting someone in this situation has even occurred to anyone should be really scary to all of us.

Bingo. Taking away someone's freedom out of fear is something we should be questioning very closely. I don't know why people are afraid of questioning this decision. Perhaps it's the right decision, but a huge decision like this should be questioned, and the decision should be changed if it doesn't make sense based on reality. Having a police tail a nurse who wants to take a bike ride is absurd, imo.

 

[wary]

What is a symptom? Dr. Spencer had fatigue for several days prior to getting a fever. Fatigue is listed as one of symptoms of Ebola. So was he then symptomatic for several days prior to getting a fever or not?

I believe that 12 percent of Ebola patients don't show a fever. I assume that they're symptomatic anyway. I'm wondering if this could have been the case with Amber Vinson. They kept saying that her symptoms weren't the usual ones--I forget the exact phrasing.

And, I assume that in medical talk, 'fever' means a temperature that reaches a given point, not just a temperature that is above 98.6.
Aha! I just checked http://www.webmd.com/first-aid/body-temperature. "In most adults, an oral temperature above 100.4 °F (38 °C) or a rectal or ear temperature above 101 °F (38.3 °C) is considered a fever."

OK, I, as an ordinary human, rather than a member of the medical profession, would have thought that I had a fever if my oral temperature reached 100. Evidently, I would have been wrong. (Just as I, as an ordinary human, would have thought that a disease was airborne if it could be transmitted through the air. I've learned my lesson on that.)

 

[SStarr33]

The device used to measure Nurse Hickox's forehead temperature at the airport is designed to do a quick check that should be confirmed using a more accurate device like an oral thermometer. It's doubtful that she even had an elevated temperature at that time.

Is this the same thermometer used in all airport screenings? If it is so inaccurate then WTH are they using it? It is used by the CDC, right?

 

[jjenny]

Is this the same thermometer used in all airport screenings? If it is so inaccurate then WTH are they using it? It is used by the CDC, right?

They obviously can not use oral thermometers for screening. That would be extremely un-hygienic. So they are using a no contact thermometers.

 

[SStarr33]

They obviously can not use oral thermometers for screening. That would be extremely un-hygienic. So they are using a no contact thermometers.

My question stands.

 

[faw720]

Bingo. Taking away someone's freedom out of fear is something we should be questioning very closely. I don't know why people are afraid of questioning this decision. Perhaps it's the right decision, but a huge decision like this should be questioned, and the decision should be changed if it doesn't make sense based on reality. Having a police tail a nurse who wants to take a bike ride is absurd, imo.

The police were probably trying to scare her but I don't think she's going to scare easily.

 

[jjenny]

My question stands.

It's considered less accurate than oral thermometer.

 

[Inthedetails]

It's considered less accurate than oral thermometer.

And that measurement is what put her in a tent against her will. Scary.

 

[SStarr33]

And that measurement is what put her in a tent against her will. Scary.

Or let someone on a plane.

 

[SStarr33]

It's considered less accurate than oral thermometer.

Then why are we using it to protect ourselves?

 

[SteveS]

Riding a bike in a wilderness area is most likely harmless. My problem is, what if somebody wants to ride the bike, go running, go out to eat, use public transportation, in highly populated areas? How are they going to know the exact moment they get a fever? They don't have a thermometer attached to their forehead.
Dr. Spencer was out and about the night before he got a fever. In highly populated areas. Amber Vinson flew while already with a low grade fever. That's cutting it close. Very close.

And if she's bicycling along with a fever, so what? She's suddenly going to emit death rays to the whole world the instant she gets a fever (if she ever gets one), and zap the whole town dead from ebola? LOL

I'm sure that's what the Maine officials believe, and the irrational panic is funny.

 

[ButForFortune]

I don't see what the big deal is about if you are asked to self-quarantine in your home for 21 days. It's not like she was thrown into prison. She claims her "civil rights were violated". She been "imprisoned". Buzzwords. I've said it before and I will say it again. IMO this is about the money. Watch for it. A big lawsuit is coming.

 

[SteveS]

Many of the comments seem to imply that Hickox is part of some dark and evil plot to bring Ebola to America. But such a plot would need to involve the CDC, Doctors Without Borders and other groups actively fighting the disease in Africa and the physicians that wrote the JAMA editorial that I linked earlier. The sheer numbers that would have to be involved involved should cause any rational person to dismiss such a theory. But when people are afraid, they often don't act rationally.

CDC already changed their guidelines.

Wow, what a dastardly deed, to work to improve things, and to learn from mistakes. That's a sure sign that they must be up to no good!

 

[SStarr33]

http://www.nbcnews.com/storyline/eb...rs-have-come-back-safe-ebola-hot-zone-n237001

A look at the numbers from groups such as Doctors Without Borders and the International Medical Corps shows just about 150 people have gone to help fight the epidemic in Liberia, Sierra Leone and Guinea. Of them, 47 have returned symptom-free.

That's a lot fewer than I would have thought would have gone over there.

 

[ellemo]

CDC already changed their guidelines. I think it's obvious there is a lot we don't know about Ebola. It's a new disease for us.
In Africa, current outbreak is killing 70 % of its victims. Yes, we had much better survival rates for a few patients that we had. But that's because we threw unlimited resources at treating those patients. Now imagine if we were to get more patients.

We do not need to throw unlimited resources at the disease. Nigeria and Senegal did not do that and health care workers stopped the spread of the disease in those countries.

Ebola may be new here, but it is not an unknown disease. Doctors, epidemiologists, scientists have studied the disease and treated people with the disease for decades. We know how it is transmitted. It is worth noting that several people in the US have been treated for the disease and the only two people who contracted Ebola in this country were health care workers at a hospital that did not follow established guidelines. The man in Dallas who died of Ebola was home and with symptoms and no one from his family contracted the disease.

 

[ellemo]

It's considered less accurate than oral thermometer.

But it will record a very high fever. So it can be useful

 

[SStarr33]

We do not need to throw unlimited resources at the disease. Nigeria and Senegal did not do that and health care workers stopped the spread of the disease in those countries.

Ebola may be new here, but it is not an unknown disease. Doctors, epidemiologists, scientists have studied the disease and treated people with the disease for decades. We know how it is transmitted. It is worth noting that several people in the US have been treated for the disease and the only two people who contracted Ebola in this country were health care workers at a hospital that did not follow established guidelines. The man in Dallas who died of Ebola was home and with symptoms and no one from his family contracted the disease.

Um, you might want to watch this video from the Johns Hopkins Ebola Crisis Dean's Symposium

https://www.youtube.com/watch?v=NAKBtPWGO10