Ebola outbreak - general thread #6

[Hiandmighty]

Rachel Maddow did a great job explaining the progression of Ebola from the time a patient starts to show symptoms on her show last night.

You can watch it here.

The risk of infection rises along with the progression of the disease in an Ebola patient. In later stages, the patient is producing massive amounts of bodily fluids loaded with the Ebola virus. The risk for health care workers peaks when the patient is approaching death, apparently when the two health care workers in Texas were involved in Duncan's treatment.

But now they are saying the two nurses were probably infected when he was first admitted to the hospital and they weren't required to wear protective suits...

 

[Hiandmighty]

Google 'em and then call or e mail? JMO

I've been searching their website.... And nothing...

 

[Jersey*Girl]

When did Nina get moved to Emory?

They mentioned yesterday they were considering moving her to Emory but hadn't said either way yet afaik. Only considering it I think...

 

[TexMex]

I'd like to find verification of this from CIDRAP itself. Has anyone run across anything?

http://www.cidrap.umn.edu/news-pers...ers-need-optimal-respiratory-protection-ebola

We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.1

The minimum level of protection in high-risk settings should be a respirator with an assigned protection factor greater than 10. A powered air-purifying respirator (PAPR) with a hood or helmet offers many advantages over an N95 filtering facepiece or similar respirator, being more protective, comfortable, and cost-effective in the long run.

We strongly urge the US Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) to seek funds for the purchase and transport of PAPRs to all healthcare workers currently fighting the battle against Ebola throughout Africa—and beyond.

 

[Jersey*Girl]

I'd like to find verification of this from CIDRAP itself. Has anyone run across anything?

CIDRAP posted it theirselves.

 

[Jersey*Girl]

http://www.cidrap.umn.edu/news-pers...ers-need-optimal-respiratory-protection-ebola

We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.1

The minimum level of protection in high-risk settings should be a respirator with an assigned protection factor greater than 10. A powered air-purifying respirator (PAPR) with a hood or helmet offers many advantages over an N95 filtering facepiece or similar respirator, being more protective, comfortable, and cost-effective in the long run.

We strongly urge the US Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) to seek funds for the purchase and transport of PAPRs to all healthcare workers currently fighting the battle against Ebola throughout Africa—and beyond.

Jinx omg

 

[Harmony 2]

For members new to following the ebola threads and the mod warnings therein. Please take note of the following mod note by Bessie:

MOD NOTE: Lay off those who already have suffered, and instead focus on the DISEASE itself, and the measures taken to contain it and control its spread, plus the obstacles.

 

[SStarr33]

He did more than give verbal commands. He grabbed hold of the red contamination bag and held it open while they dumped things in and those things touched his hands. Why is everyone lying so much?

It really is insulting.

 

[Hiandmighty]

http://www.cidrap.umn.edu/news-pers...ers-need-optimal-respiratory-protection-ebola

We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.1

The minimum level of protection in high-risk settings should be a respirator with an assigned protection factor greater than 10. A powered air-purifying respirator (PAPR) with a hood or helmet offers many advantages over an N95 filtering facepiece or similar respirator, being more protective, comfortable, and cost-effective in the long run.

We strongly urge the US Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) to seek funds for the purchase and transport of PAPRs to all healthcare workers currently fighting the battle against Ebola throughout Africa—and beyond.

That's a good start, thanks. That looks to be an opinion submitted by two researchers? Anyway.... Looking for the recommendation to the CDC.

Thanks again. My husband is a doctor and I try to keep him updated...

 

[TexMex]

Google 'em and then call or e mail? JMO

Later in the CIDRAP commentary

There has been a lot of on-line and published controversy about whether Ebola virus can be transmitted via aerosols. Most scientific and medical personnel, along with public health organizations, have been unequivocal in their statements that Ebola can be transmitted only by direct contact with virus-laden fluids2,3 and that the only modes of transmission we should be concerned with are those termed "droplet" and "contact."

These statements are based on two lines of reasoning. The first is that no one located at a distance from an infected individual has contracted the disease, or the converse, every person infected has had (or must have had) "direct" contact with the body fluids of an infected person.

This reflects an incorrect and outmoded understanding of infectious aerosols, which has been institutionalized in policies, language, culture, and approaches to infection control. We will address this below. Briefly, however, the important points are that virus-laden bodily fluids may be aerosolized and inhaled while a person is in proximity to an infectious person and that a wide range of particle sizes can be inhaled and deposited throughout the respiratory tract.

 

[ClaireNC]

I do find it remarkable that the people that shared space and took care of TD have not fallen ill. The reasons I have thought of are:

1. The others have a natural immunity to this strain of ebola.
2. The amount of virus secreted in the beginning stages 0-4 days is very minimal.
3. The family was aware of his contact with the pregnant neighbor, suspected ebola, were watching for symptoms and immediately isolated TD. (This conflicts with was said by the family, but also explains some questionable comments/actions).

moo

I agree Yoda or a combination of the three. I do think that Louise's family suspected ebola when he got sick and took some level of precaution. The one daughter has some medical training and mentioned that she had instructed her mother to not sleep in the bed, etc. She also said that she stressed to the hospital staff that Duncan had just arrived from West Africa.

I'm sure I have read somewhere that ebola is most contagious during the period close to death - or where the person is critically ill - and immediately after death. I'm afraid I can't find the exact source which states this.

If true, it would make sense as Duncan had close contact to a woman only hours before her death, and the nurses infected with ebola both in Spain and the US also had contact with ebola victims during the most critical phase, prior to death.

I read the same thing Sluether87. The person is most contagious in the later stages/just prior to and soon after death. That way I understand it is that virus load increases as it gets worse, (there are more virus cells in the body) and that is combined with the fact that the body is excreting or expelling more "fluids".

 

[sonjay]

Hypothetical Question for the posters here:

Let's imagine this situation gets out of hand and outbreaks DO occur in various areas. Imagine the authorities send out a bulletin saying there was possible exposure to ebola at an event in your community, an event YOU attended (movie theater, car show, you paid cash and are untraceable) and they ask that EVERYONE that attended identify themselves so that those folks could be put in gov run isolation for "your own safety".

Would you identify yourself? Or would you wait and see if you showed symptoms? Would you TRUST the authorities at this point?

Absolutely not. I would be afraid that if I didn't already have it, they would give it to me through their incompetence. I would self-isolate and self-monitor. I absolutely would not go out in public nor expose myself to anyone else for the duration of the incubation period, but I would not put my trust in the so-called experts nor place my life in their hands. So far, they have not done anything to justify a belief that they would deal with the situation safely.

 

[Isabelle]

You are misunderstanding - the report was that it (in opinion of some) has the potential. It is not known it is airborne, and cases in US are supporting such :moo:

The article specifically mentions Friedan and that information being disseminated is wrong and outmoded. That is a very strong statement. (Sorry are you talking about the article in the Inquisitor, thanks)

 

[cady]

I'm wondering the same. Thomas met Louise in a refugee camp after fleeing due to the fighting in that area many years ago. She came from Liberia I think, or somewhere near there? Anyone remember? Anyway, she had gotten pregnant with their son while in the refugee camp. She came to America but for some reason he didn't and went back to his home once e fighting subsided. I don't remember if she was pregnant when she fled Africa or of she had the baby there before coming here. Either way, is it possible she and their child were exposed to something that forms a natural barrier against Ebola?

Maybe. I keep thinking that there is an (possibly) ancient genetic immunity that some populations in West Africa may carry..........or, that their original roots are further inland where the ebola viruses are thought to have originated.....but who knows how many mutations have taken place? No idea. Just wondering. JMO

 

[Isabelle]

Maybe. I keep thinking that there is an (possibly) ancient genetic immunity that some populations in West Africa may carry..........or, that their original roots are further inland where the ebola viruses are thought to have originated.....but who knows how many mutations have taken place? No idea. Just wondering. JMO

Just about anything is possible.

 

[Jersey*Girl]

It really is insulting.

Extremely insulting, especially now that passenger lists have become available to the CDC and decontamination of the airplane has taken place...yet he just holds open a bag without proper protection.

Re the pic of the guy that was next to the patient getting into a plane - she was wearing protective gear and so were her medical handlers. It looked to me like the guy could have been ok considering everyone else was wearing full body protection, therefore whatever was present in the patient would have been contained in her gear. Or no?

 

[Jersey*Girl]

That's a good start, thanks. That looks to be an opinion submitted by two researchers? Anyway.... Looking for the recommendation to the CDC.

Thanks again. My husband is a doctor and I try to keep him updated...

More that just researchers - they're national experts on respiratory protection and infectious disease transmission. I posted some important parts a couple pages ago.

 

[Hiandmighty]

I posted it on my FB page and tagged my husband. I wanted to have something for medical people to read and consider, thanks!

 

[cady]

Just about anything is possible.

YUP We are all newbies at this, more or less. A genome map of Louise would be really interesting.....and a genealogy search. Just dreaming, here. LOL. JMO

 

[Ladylub]

Extremely insulting, especially now that passenger lists have become available to the CDC and decontamination of the airplane has taken place...yet he just holds open a bag without proper protection.

Re the pic of the guy that was next to the patient getting into a plane - she was wearing protective gear and so were her medical handlers. It looked to me like the guy could have been ok considering everyone else was wearing full body protection, therefore whatever was present in the patient would have been contained in her gear. Or no?

Had he not touched things (ie the red bag and the arm of a guy in the suit) I think I would feel more at ease. Since he did I think he needs to be on lock down for 21 days.