Ebola outbreak - general thread #8

[SteveS]

That's confusing. People have been stating as "fact" that he was vomiting and had diarrhea in his apartment at the same time as his first sign of fever. Those would certainly qualify as "gastrointestinal symptoms."

Quoting from CNN

"He arrived at John F. Kennedy International Airport on October 17, but he exhibited no symptoms of the virus until Thursday morning, said Dr. Mary Travis Bassett, New York City's health commissioner.

"The physician, who works at Columbia Presbyterian Hospital, was checking his temperature twice a day. He has not seen any patients since his return.

"The 33-year-old did not have any symptoms just after his return, but he developed a fever, nausea, pain and fatigue Thursday morning, authorities said."

 

[jjenny]

Couldn't agree more. It would be a huge leap forward if even the fear of this disease could be lessened. People around the world might seek treatment sooner and make it much easier to contain in future outbreaks.

In Africa, the health care system is overwhelmed. The lady who supposedly infected Mr. Duncan was not admitted into the hospital. There was no room.

 

[trigger]

New York Ebola patient Craig Spencer receives blood from survivor Nancy Writebol

nbcnews.to/1tpJLNw pic.twitter.com/I4NCEqFeTI

Oh thats great news! Lets pray it helps him!

Imo this should have been done years ago, it would have saved so many people.

 

[SteveS]

In Africa, the health care system is overwhelmed. The lady who supposedly infected Mr. Duncan was not admitted into the hospital. There was no room.

A bit of context is probably in order. By the time they were trying to get her to the hospital, she was already in the last stages of the disease (which helps explain how Duncan got it) and was (among other things) said to be bleeding out of the mouth and so sick she couldn't walk. She died the very next day.

With hospitals already saturated with patients, I can see why they'd turn away one who was clearly too late to be helped. But if she had gone there when first sick, who knows?

 

[IMO]

In Africa, the health care system is overwhelmed. The lady who supposedly infected Mr. Duncan was not admitted into the hospital. There was no room.

I am not sure of your point. Of course they are overwhelmed in the African countries that have a large number of cases. Nigeria, on the other hand, was able to stop it in its tracks due to early intervention and monitoring of contacts. My point is that one of the major barriers to stopping outbreaks during the critical early period is when people fear coming forward because they think there is no hope and/or they don't want to be separated from their families and/or they don't trust people in authority to help them, etc.

 

[jjenny]

A bit of context is probably in order. By the time they were trying to get her to the hospital, she was already in the last stages of the disease (which helps explain how Duncan got it) and was (among other things) said to be bleeding out of the mouth and so sick she couldn't walk. She died the very next day.

With hospitals already saturated with patients, I can see why they'd turn away one who was clearly too late to be helped. But if she had gone there when first sick, who knows?

The ones about to die are the most infectious. If hospitals are turning them away, the outbreak isn't going to stop.

 

[CarmelEyesD]

Parents Keep Kids From School Over Ebola Fears After Learning Student Has Relatives Visiting From Guinea

Dozens of parents kept their children home from the John Pearl Elementary School in Bohemia Friday because of fears about Ebola after a student's relatives came to visit from Guinea.

The second-grade student's aunt and cousin just flew in from Guinea, one of the three West African nations ravaged by the Ebola outbreak, according to school officials. The extended family is staying in the student's apartment, causing many parents to worry.

http://www.nbcnewyork.com/news/loca...-280382682.html?_osource=SocialFlowFB_NYBrand

 

[Inthedetails]

Cleanup Crews Disinfect Ebola Victim's Hamilton Heights Apartment

Workers will throw away bed linens, towels, toiletries, food in the fridge and garbage, a department spokeswoman said.

“We do not believe there are any body fluids in the apartment because the patient did not report any vomiting or diarrhea,” she added.

BBM

http://www.dnainfo.com/new-york/201...fect-ebola-victims-hamilton-heights-apartment

ETA: Hamilton Heights is a neighborhood of Manhattan.

 

[Inthedetails]

Fiancée of Ebola patient Craig Spencer returns to Manhattan home for quarantine

http://www.nydailynews.com/new-york...s-manhattan-home-quarantine-article-1.1987105

 

[jjenny]

Fiancée of Ebola patient Craig Spencer returns to Manhattan home for quarantine

http://www.nydailynews.com/new-york...s-manhattan-home-quarantine-article-1.1987105

That's going to be fun. Sounds like other residents are scared already as it is.

 

[DeDee]

In Africa, the health care system is overwhelmed. The lady who supposedly infected Mr. Duncan was not admitted into the hospital. There was no room.

Indeed, the small Monrovia hospitals became filled quickly. Ebola was first diagnosed in Liberia in March. <mod snip>

At this point in time, our military should have a few new hospitals built. Think: M.A.S.H. Units.

All of this waiting...

 

[Ray_of_hope]

Re-posting re: asymptomatic infections of ebola and ebola mutations. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61839-0/fulltext
http://www.npr.org/blogs/goatsandso...dly-mutating-as-it-spreads-across-west-africa

 

[Sonya610]

Again, there is an issue with risk perception here. For a direct comparison, at least 250,000 people will die from influenza worldwide in 2014. Fewer than 5000 have died from Ebola.

However Ebola is an equal opportunity killer and most strains of Influenza are NOT!

The vast majority of people that die from the "typical" yearly flu are elderly people or those with compromised immune systems and they almost always succumb to a secondary infection such as pneumonia. If a family member or co-worker gets the flu the whole lot of those close to them may get it BUT a 100% survival rate is expected.

Ebola is extremely deadly and ALSO comes with a big scary threat of government seizure, they take you physically into custody, they go through your home and all your stuff and destroy a lot of it, they can and will force your family/associates into mandatory quarantine, they confiscate your animals and you have NO say in the matter, etc....

They don't do any of the above when you have the flu. Honestly the thing that scares me about Ebola is NOT the actual disease or risk of dying from it but the ramifications of what will happen to you, your home, your loved ones etc.... IF you get it.

 

[Lyra500]

I found the article on phases of Ebola.
First three days are flu like symptoms and profound weakness.
Both Amber Vinson and Dr. Spencer appears to have experienced this weakness yet for whatever reason neither recognized it as first stage of Ebola.
So I am assuming Dr. Spencer is now entering the second stage.
I am amazed that we are being told that until fever the person is asymptomatic. Yet weakness is clearly a symptom and both of them had it for several days prior to onset of fever. So were they symptomatic or not?

http://www.huffingtonpost.com/2014/08/02/ebola-symptoms-infection-virus_n_5639456.html

If their only symptom was weakness, how would they be contagious?

Ebola is passed on through direct contact with bodily fluids which need to contain sufficient virus to be passed on.

Weakness does not result in release of bodily fluids and at that early stage there would not be sufficient virus in those fluids to be contagious anyway.

This is from the NHS Choices website in the UK quoting the WHO:

http://www.nhs.uk/Conditions/ebola-virus/Pages/how-it-spreads.aspx

The World Health Organization (WHO) says whole live virus has never been isolated from sweat

.

This is from a company producing protective equipment:

http://www.gvhealth.com/latest-news-100120/671-bodily-fluids-transfer-in-ebola.html

The Ebola virus is transmitted in the bodily fluids of people who have caught the disease, who are likely to be bleeding, vomiting or have diarrhoea. The most infectious fluids are blood, faeces and vomit. In the advanced stages of the disease even tiny amounts of any of these can carry high loads of virus.

 

[Elley Mae]

No mandatory Ebola quarantine for health workers coming to Washington area

http://www.washingtonpost.com/natio...a9a8c8-5c68-11e4-bd61-346aee66ba29_story.html

 

[Elley Mae]

This Ebola corps is a collection of doctors, nurses, scientists, soldiers, aviators, technicians, mechanics and engineers. Many are volunteers with nonprofit organizations or the government, including uniformed doctors and nurses from the little-known U.S. Public Health Service. Most are military personnel, snapping a salute when are assigned to their mission &#8212; &#8220;Operation United Assistance.&#8221; It does not qualify for combat pay, only hardship-duty incentive pay, which is about $5 a day &#8212; before taxes.

http://www.washingtonpost.com/natio...eba6a8-5b99-11e4-8264-deed989ae9a2_story.html

The outbreak on Saturday officially topped 10,000 cases &#8212; 10,141 confirmed or suspected cases and 4,922 deaths, according to the World Health Organization.

 

[Lyra500]

A bit of context is probably in order. By the time they were trying to get her to the hospital, she was already in the last stages of the disease (which helps explain how Duncan got it) and was (among other things) said to be bleeding out of the mouth and so sick she couldn't walk. She died the very next day.

With hospitals already saturated with patients, I can see why they'd turn away one who was clearly too late to be helped. But if she had gone there when first sick, who knows?

I think that is rather unfair to be honest. It probably isn't meant that way but seems to imply that her death was almost self inflicted for not going to the hospital sooner.

I believe that her particular suburb had not had any cases of Ebola before Marthalene. She was seven months pregnant in a country with high levels of pregnancy related problems. There are also many other illnesses which have similar symptoms in the early stages.

She attended a clinic locally who then told her to go to the hospital. They gave her an interim diagnosis of malaria.

I read that she was convulsing - this can quite easily lead to tongue biting and bleeding from the mouth. So I honestly do not think this was the obvious open and shut Ebola case which so many insist that it was.

http://www.latimes.com/world/africa/la-fg-ebola-liberia-20141003-story.html

But the Blessing Home Clinic, which examined Marthalene on Sept. 15, had diagnosed malaria, according to staffers. When she started convulsing, they told the family to take her to a hospital.

I am also not convinced that she would have found a place at the treatment centre or hospital even if she had turned up earlier in the course of her illness - I think when the centres are full, that is it - you don't get in whatever your condition.

My personal view is that the urge to place blame was first manifest in the case of Mr Duncan and Marthalene's family in Liberia and it is continuing with the current urge to heap blame on Dr Spencer and insinuate he had overt symptoms and ignored them to go bowling.

I think he came back, felt a little jaded but probably thought this quite natural given a long flight and the stresses of what he had been doing. He was still well enough to go jogging and bowling - anyone who has had influenza will know that he therefore was not experiencing anything like the 'fatigue' one would expect from a serious viral illness. As soon as his temperature crept up, even though it had not reached the required threshold, he contacted the medical authorities.

I really think people should give Dr Spencer a break.

 

[sonjay]

What I mean is infected is a scary word for the public vs exposed. It's true ebola (enough of the virus) is very, very likely to cause infection, ok be infected, and for the person to then develop the active disease.
Compare this to MRSA where most exposed just become carriers. Are MRSA carriers infected? They have the bacteria in their body, in their blood. So I guess they are. But they don't have an infection, a localized lesion, sore on their skin or manifestations such as sepsis.

I was just thinking about exposure vs an active infection but this depends on which virus or bacteria we're talking about. Does anybody understand what I'm trying to say?

Yes, I do understand (I think) what you're trying to say.

As a non-doctor (nor nurse, nor any other medical professional), I have only a surface understanding of these concepts. It seems to me there must be a difference, medically, between someone who is a carrier and someone who has a virus and is on their way to becoming symptomatic but is not yet symptomatic.

MRSA carriers can still infect other people, right? So the same care must be taken with a MRSA carrier as with someone with an active MRSA infection.

And on the topic of being infectious, my understanding (again, as a non-medical professional) is that early on, before symptoms begin, there is such a low concentration of the virus in the person's system that infection is near-impossible. I'm not sure I accept that it's impossible, but I'll accept near-impossible. And as the quantity of virus increases, infection becomes more likely. (And especially at the end stages when the person is emitting huge concentrations of virus from every orifice.)

But to my knowledge, the docs/researchers don't know at exactly what stage of virus concentration contagion becomes "likely" vs. "not likely." And IMO, there wouldn't necessarily be a clear dividing line, but a continuum going from "near impossible" to "very likely." How certain are we -- how certain can we be -- that before symptoms manifest, the risk of contagion remains at the "near impossible" end of the spectrum?

 

[WideOpen]

However Ebola is an equal opportunity killer and most strains of Influenza are NOT!

The vast majority of people that die from the "typical" yearly flu are elderly people or those with compromised immune systems and they almost always succumb to a secondary infection such as pneumonia. If a family member or co-worker gets the flu the whole lot of those close to them may get it BUT a 100% survival rate is expected.

Ebola is extremely deadly and ALSO comes with a big scary threat of government seizure, they take you physically into custody, they go through your home and all your stuff and destroy a lot of it, they can and will force your family/associates into mandatory quarantine, they confiscate your animals and you have NO say in the matter, etc....

They don't do any of the above when you have the flu. Honestly the thing that scares me about Ebola is NOT the actual disease or risk of dying from it but the ramifications of what will happen to you, your home, your loved ones etc.... IF you get it.

I am appreciating your perspective and opinions regarding ebola and find myself agreeing with your basic logic.
I want to add to the above that what bothers me is the way the system dropped the ball and seem to not be prepared to handle this within the communities.
I do not like feeling like we are a bunch of lab rats.
Also, what is the cost?
I am barely able to pay my bills, how could I ever cover the cost of this in my family?

I am a person who doesn't immunize. I made that choice after my own research and family experiences. My daughters who have children are being rejected & turned away by pediatricians for not immunizing now.
I want the facts and the truth. I want to be able to understand and trust the source of that information.
I do not follow the crowd when it comes to my life choices.
I take responsibility for those choices. It makes me really upset to know that our leaders are "failing" our country and my rights as a United States citizen are being taken away and diluted to a point where we are watching the literal invasion of a deadly virus let loose and possibly waiting to run rampant amongst us. I do not trust WHO, the CDC, the prez, or local government to protect me and my family and when it comes to life and death-that takes serious thought and consideration.

I am not a prepper or conspiracy nut, just a single mom who has struggled to raise 6 kids on less than 20,000 (last year I made 13.5) every year for 28 years. I never received child support, food stamps, medical assistance or even free food pantry community help. I tried a few times but the red tape and complicated and time consuming, drawn out effort made it easier for me to scrape up the money somewhere else. I mean gee, if my family was to get ebola-no one would come rushing to help us.

JMO

 

[WideOpen]

respectfully sniped

And on the topic of being infectious, my understanding (again, as a non-medical professional) is that early on, before symptoms begin, there is such a low concentration of the virus in the person's system that infection is near-impossible. I'm not sure I accept that it's impossible, but I'll accept near-impossible. And as the quantity of virus increases, infection becomes more likely. (And especially at the end stages when the person is emitting huge concentrations of virus from every orifice.)

But to my knowledge, the docs/researchers don't know at exactly what stage of virus concentration contagion becomes "likely" vs. "not likely." And IMO, there wouldn't necessarily be a clear dividing line, but a continuum going from "near impossible" to "very likely." How certain are we -- how certain can we be -- that before symptoms manifest, the risk of contagion remains at the "near impossible" end of the spectrum?

I have a question, for anyone.
In the early stages, before the symptoms begin how vulnerable is a person who already has a weak immune system? The elderly, cancer patients, infants and children? I mean for already sick individuals it seems quite possible if they came in contact with the virus of any count it could wreak havoc. IDK.

JMO