Ebola outbreak - general thread #1

[Yoda]

Two Dutch doctors exposed in Sierra Leone. Being evacuated.

Two Dutch tropical doctors may be infected with the Ebola virus. The doctors, coming from Reeuwijk and Apeldoorn, working in the Lion Heart Medical Center in Yele in Sierra Leone. That hospital is built mainly with Dutch money. Both doctors are currently no symptoms detected, but it can sometimes take up to three weeks before the virus manifests itself.

The Dutch have last week been in contact with three patients who later turned out to have. Ebola The doctors did not wear protective clothing because at that time it appeared that the patients had the virus among the members. Meanwhile, patients are deceased.

http://translate.google.com/transla...97290-mogelijk-2-nederlanders-met-ebola.html

 

[redheadedgal]

a bit OT, sorry--

WINDSOR, Ontario -

ahhh, home sweet home. see you soon, i hope MUAH!!!

 

[Yoda]

4784 cases, 2400 deaths

http://www.ibtimes.com/ebola-outbre...says-death-toll-hits-2400-west-africa-1686806

 

[Yoda]

The Winnipeg Regional Health Authority has confirmed two patients who arrived at a Winnipeg emergency room Thursday with symptoms of Ebola have tested negative for the disease.The patients told officials at the Health Sciences Centre they had been in contact with relatives from West Africa.

Read more: http://winnipeg.ctvnews.ca/2-winnip...-tested-negative-wrha-1.2003775#ixzz3D6aAKR00

 

[Yoda]

Cuba sending 165 health workers. They will arrive in October and stay for six months.

Orjeda said that the health brigade would consist of 62 doctors and 103 nurses, all of whom have 15 years of experience.

http://www.oregontelegraph.com/index.php/sid/225650167

 

[Linda7NJ]

Cuba sending 165 health workers. They will arrive in October and stay for six months.



http://www.oregontelegraph.com/index.php/sid/225650167

Cuba IMO has amazing medical schools!


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[TexanMom]

Airborne Ebola!

http://www.nytimes.com/2014/09/12/o...dit_tnt_20140911&nlid=745484&tntemail0=y&_r=2

 

[atthelake]

Airborne Ebola!

http://www.nytimes.com/2014/09/12/o...dit_tnt_20140911&nlid=745484&tntemail0=y&_r=2

Just so folks are not misled by the title given by the OP above - the author states "You can now get Ebola only through direct contact with bodily fluids" and merely theorizes (as many have in the past) how devastating it would be if it were airborne.

 

[Herding Cats]

I can't help but cry for sierra leone and any/every country under the gun from this disease. and while apparently this particular strain is less fatal, still, a fatality rate of 60 percent is devastating.



Best
Hc

 

[jjenny]

I can't help but cry for sierra leone and any/every country under the gun from this disease. and while apparently this particular strain is less fatal, still, a fatality rate of 60 percent is devastating.



Best
Hc

Being less fatal actually makes it worse in terms of spreading as it can spread to more people. So it will end up killing more people in the end.

 

[Yoda]

The World Health Organization said Saturday it could not meet a request from Sierra Leone to evacuate a doctor who contracted the deadly Ebola disease. Sierra Leone requested funds from the World Health Organization to evacuate the doctor to Germany on Friday, and said a Hamburg hospital was ready to receive her. But a WHO spokesman said Saturday it could not comply with the request and instead would work to give Buck "the best care possible" in Sierra Leone, including access to experimental drugs.

I'm not sure this was a wise decision. I think they are going to find it very difficult to get medical personnel to come to help if the the health of those working now is not a top priority. I understand the doctor is from the affected country, but it will help no one, now, or in the future, if 60% of the country's healthcare workers die. JMO

http://www.nbcnews.com/storyline/eb...ve-ebola-sickened-doctor-sierra-leone-n202811

 

[Soulmagent]

As Ebola cases accelerate, Liberia’s sick must fend for themselves.




http://www.washingtonpost.com/world/africa/as-ebola-cases-accelerate-liberias-sick-must-fend-for-themselves/2014/09/13/6ee71468-3b61-11e4-9c9f-ebb47272e40e_story.html

 

[Linda7NJ]

What is the course of treatment ?


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[Soulmagent]

Ebola Virus Outbreak: Liberia's Largest Newspaper Has A Conspiracy Theory About Fast-Moving Disease, ‘It Was Manufactured By US’

http://www.franchiseherald.com/articles/6587/20140912/ebola-virus-outbreak.htm


I dont know what to think about the news paper printing this ,in middle of the outbreak, It seems it might hinder the resolution (if there is to be one) in a less then positive way. In almost every photo you can see anger in the faces of people there . The are already running away from hospital blaming them for spreading ebola. Which in a way is true to some degree.

Then watch officials ship sick doctors out for better care as their loved ones die by the thousands now. I have also noticed in pictures that there is a lack of education to the population ,such as how risky it is to hang your laundry out on the busy sidewalk. To walk behind a sick person while not wearing shoes. I dont know why a person would leave an deceased person ,feet from their home for days. I wondered why the neighbors just didnt light fire to the body to reduce to risk of infection to themselves?

Cold hearted maybe , but prehaps they should be a bit more paranoid then the photos of 12 to 20 people in a frame of a body being carried out seems to imply they are.

 

[Linda7NJ]

Ebola Virus Outbreak: Liberia's Largest Newspaper Has A Conspiracy Theory About Fast-Moving Disease, ‘It Was Manufactured By US’

http://www.franchiseherald.com/articles/6587/20140912/ebola-virus-outbreak.htm


I dont know what to think about the news paper printing this ,in middle of the outbreak, It seems it might hinder the resolution (if there is to be one) in a less then positive way. In almost every photo you can see anger in the faces of people there . The are already running away from hospital blaming them for spreading ebola. Which in a way is true to some degree.

Then watch officials ship sick doctors out for better care as their loved ones die by the thousands now. I have also noticed in pictures that there is a lack of education to the population ,such as how risky it is to hang your laundry out on the busy sidewalk. To walk behind a sick person while not wearing shoes. I dont know why a person would leave an deceased person ,feet from their home for days. I wondered why the neighbors just didnt light fire to the body to reduce to risk of infection to themselves?

Cold hearted maybe , but prehaps they should be a bit more paranoid then the photos of 12 to 20 people in a frame of a body being carried out seems to imply they are.

Ya know what....nothing would shock me.
I'm so distrustful ....it doesn't sit well with me either....none of it does.
It's not like it would be the FIRST time.

All IMO


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[Lyra500]

What is the course of treatment ?


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I don't think there is a course of treatment in the same way there is for a bacterial infection.

What seems to help is rehydration, symptomatic treatment (analgsics to help with the incredible pain and I think in some cases sedatives or benzodiazepine type drugs to help with the stress and anxiety). On top of that, close monitoring to identify signs of any bacterial infections and use of appropriate antibiotics to treat those infections.

All of this is hoped to keep the patient strong and free up their immune system to fight off the Ebola virus.

I have to say the article which soulmagent provided a link for was deeply depressing as it didn't sound as if many people were receiving anywhere near this level of care due to lack of capacity and equipment. Also, because they are so overwhelmed, it sounds as if they may be delaying admission of patients until they are almost beyond the point of no return. It is well known that early intervention is the best hope for recovery, so waiting outside knowing you are getting progressively more ill must add to the torture.


Desperate times.

 

[jjenny]

I don't think there is a course of treatment in the same way there is for a bacterial infection.

What seems to help is rehydration, symptomatic treatment (analgsics to help with the incredible pain and I think in some cases sedatives or benzodiazepine type drugs to help with the stress and anxiety). On top of that, close monitoring to identify signs of any bacterial infections and use of appropriate antibiotics to treat those infections.

All of this is hoped to keep the patient strong and free up their immune system to fight off the Ebola virus.

I have to say the article which soulmagent provided a link for was deeply depressing as it didn't sound as if many people were receiving anywhere near this level of care due to lack of capacity and equipment. Also, because they are so overwhelmed, it sounds as if they may be delaying admission of patients until they are almost beyond the point of no return. It is well known that early intervention is the best hope for recovery, so waiting outside knowing you are getting progressively more ill must add to the torture.


Desperate times.

All three American patients got experimental drugs. First two got ZMAPP. And the third some other experimental drug which was not named (presumably an anti-viral). Also, two got blood transfusions from surviving Ebola patients. Which could explain why they aren't dead. They aren't just getting supportive care. As for the immune system, from what I read, immune system is what kills you because the response is too strong.
Here is the article on how immune system kills you during an Ebola infection.

"But when you look at the nitty-gritty details of an Ebola infection, a surprising fact surfaces: The virus isn't what ends up killing you. It's your own immune system."

http://www.npr.org/blogs/goatsandsoda/2014/08/26/342451672/how-ebola-kills-you-its-not-the-virus

 

[Yoda]

Dr. Olivet Buck Dies in Sierra Leone After WHO Denies Funds for Evacuation

http://www.nbcnews.com/storyline/eb...ivet-buck-dies-sierra-leone-after-who-n202991

 

[Lyra500]

All three American patients got experimental drugs. First two got ZMAPP. And the third some other experimental drug which was not named (presumably an anti-viral). Also, two got blood transfusions from surviving Ebola patients. Which could explain why they aren't dead. They aren't just getting supportive care. As for the immune system, from what I read, immune system is what kills you because the response is too strong.
Here is the article on how immune system kills you during an Ebola infection.

"But when you look at the nitty-gritty details of an Ebola infection, a surprising fact surfaces: The virus isn't what ends up killing you. It's your own immune system."

http://www.npr.org/blogs/goatsandsoda/2014/08/26/342451672/how-ebola-kills-you-its-not-the-virus

Those are just five patients out of thousands, so I don't think what they received actually counts as the standard course of treatment. There aren't even any doses of ZMAPP remaining at this point (or at least only a very limited number of doses) and they are still testing the vaccine so for the thousands of patients remaining, those treatments are not an option.

I was answering about the treatment that the majority of patients would receive.

This is from the WHO website:

Vaccine and treatment

No licensed vaccine for EVD is available. Several vaccines are being tested, but none are available for clinical use.

Severely ill patients require intensive supportive care. Patients are frequently dehydrated and require oral rehydration with solutions containing electrolytes or intravenous fluids.

No specific treatment is available. New drug therapies are being evaluated.

This is from the NHS Choices website in the UK:

How is it treated?
There's currently no licensed treatment or vaccine for Ebola virus disease, although potential new vaccines and drug therapies are being developed and tested.

Patients need to be placed in isolation in intensive care. Dehydration is common, so fluids may be given directly into a vein (intravenously). Blood oxygen levels and blood pressure need to be maintained at the right level and body organs supported while the patient's body fights the disease and any other infections are treated.
ZMapp is an experimental treatment that can be tried, although it has not yet been tested in humans for safety or effectiveness. The product is a combination of three different antibodies that bind to the protein of the Ebola virus

This is from the CDC website:

Treatment of Ebola

No specific vaccine or medicine (e.g., antiviral drug) has been proven to be effective against Ebola.

Symptoms of Ebola are treated as they appear. The following basic interventions, when used early, can increase the chances of survival.
•Providing intravenous fluids and balancing electrolytes (body salts)
•Maintaining oxygen status and blood pressure
•Treating other infections if they occur

This is from the Medecins Sans Frontieres site:

No specific treatment or vaccine is yet available for Ebola.

Standard treatment for Ebola is limited to supportive therapy. This consists of hydrating the patient, maintaining their oxygen status and blood pressure and treating them for any complicating infections.

Despite the difficulty of diagnosing Ebola in its early stages, those who display its symptoms should be isolated and public health professionals notified.

Supportive therapy can continue with proper protective clothing until samples from the patient are tested to confirm infection.

Once a patient recovers from Ebola, they are immune to the strain of the virus they contracted.

As for the immune system - yes, the cytokine storm causes death, but it is still patients with a more resistant immune system who survive - and they do this because their immune system is able to mount a more effective response earlier in the disease course before the cytokine storm kicks in. That is why survivors are immune to Ebola - their immune systems have developed antibodies.

That is also why administering serum from an Ebola survivor helps - their immune systems produced antibodies which are still present in the serum.

The following article outlines what we know (not really an awful lot) about why those who survive Ebola do so.

http://www.livescience.com/47203-ebola-how-people-survive.html

When a person becomes infected with Ebola, the virus depletes the body's immune cells, which defend against infection, said Derek Gatherer, a bioinformatics researcher at Lancaster University in the United Kingdom, who studies viral genetics and evolution. In particular, the Ebola virus depletes immune cells called CD4 and CD8 T lymphocytes, which are crucial to the function of the immune system, Gatherer said

But if a person's immune system can stand up to this initial attack — meaning their immune cells are not as depleted in the first stages of infection — then studies suggest they are more likely to survive the disease.

"The patients that survive it best are the ones who don't get such a bad [immune] deficiency," Gatherer told Live Science.

But if the body is not able to fend off this attack, then the immune system becomes less able to regulate itself, Gatherer said. This means the immune system is more likely to run out of control and release a "storm" of inflammatory molecules, which cause tiny blood vessels to burst, leading in turn to a drop in blood pressure, multi-organ failure and eventually death

.

There may also be genetic factors predisposing some people to being more resistant to the infection.

 

[Soulmagent]

I was thinking over the idea of the blood from survivors being used to treat current infected persons and was thinking why the blood and not the bone marrow, So i googled and came upon a 2003 article about the subject .

Ebola virus: immune mechanisms of protection and vaccine development.''

http://www.ncbi.nlm.nih.gov/pubmed/12698920