EBOLA Can someone please explain to me the difference between American Ebola and African Ebola?

[Betty_Rose]

Admittedly, those are my terms, but I do not understand this.

A couple weeks ago, someone posted a link to a story written by an African survivor on Ebola. She was put into a very primitive room, offered occasional food, and advised to "drink as much as possible," if she wished to survive. Three other women were put into the room with her.

Well, this survivor spared no detail in telling about the horrors of Ebola as it ravaged her body and her system. She credited her survival to her will to live and her steadfast devotion to the 91st Psalm.

That's "Exhibit A."

Then we have the Americans. They're emerging from this dire prediction of "fatal virus" looking well rested, happy, wholesome and well-fed.

They're "Exhibit B."

Is this the same virus that's decimating African countries? Or is our medical care just THAT stellar that these folks have a nice rest while the miracle of medicine does its fine work? And what is it that's happening in these isolation units? Are they people passing through the horrid throes of Ebola? Or are these drugs able to mitigate the symptoms to a point that their suffering is minimal?

I am really baffled.

Thanks in advance for any and all replies.

 

[AzProtector]

I imagine that the Americans are in better health to begin with..steroid laden food, etc

Admittedly, those are my terms, but I do not understand this.

A couple weeks ago, someone posted a link to a story written by an African survivor on Ebola. She was put into a very primitive room, offered occasional food, and advised to "drink as much as possible," if she wished to survive. Three other women were put into the room with her.

Well, this survivor spared no detail in telling about the horrors of Ebola as it ravaged her body and her system. She credited her survival to her will to live and her steadfast devotion to the 91st Psalm.

That's "Exhibit A."

Then we have the Americans. They're emerging from this dire prediction of "fatal virus" looking well rested, happy, wholesome and well-fed.

They're "Exhibit B."

Is this the same virus that's decimating African countries? Or is our medical care just THAT stellar that these folks have a nice rest while the miracle of medicine does its fine work? And what is it that's happening in these isolation units? Are they people passing through the horrid throes of Ebola? Or are these drugs able to mitigate the symptoms to a point that their suffering is minimal?

I am really baffled.

Thanks in advance for any and all replies.

 

[willdo]

Beyond the very apparent differences in medical care available to someone from Africa verses someone from America, generally an American would have a better base of health starting out for a number of other reasons, nutrition, less environmental stresses, access to clean water, etc.,.

 

[eens]

I am not a doctor and I don't play one on TV.

I am only using my common sense having read about this online and recently re-reading The Hot Zone, by Richard Preston. I highly recommend everyone read that book, it was written in 1994 so there is no political correctness and he has no ax to grind, just the facts as he knew them. And don't think the facts regarding ebola have changed.

Anyway, I think the difference between ebola here and ebola in Africa is that we are in the beginning of the epidemic. There are (supposedly) only a few people who have it here so they are getting the absolute best care and treatment known.

When/if it gets out of control here, like in Africa, we will see people bleeding out in their homes and in the streets because no one will want to go near them and hospitals will not be able to take everyone, if there are any health care workers left willing or able to take care of them.

It will be our worst nightmare and I can't imagine how it's going to end.

At least we can pray that it doesn't get out of control here but I am pessimistic about that too. Why would God want this country to be safe from this disease when we have become such an immoral country?

Just my opinion, YMMV.

 

[TerryK]

As Diamonds pointed out on the thread about the nurse being release. They get steroids to lessen inflammation throughout the body but in particular the lungs so they can breath better. Intravenous IVs with glucose and mineral and electrolytes. The steroids cause their face to swell and they gain a little weight. It takes about a week to slowly taper off of a heavy dose so the person probably looks pretty healthy when they leave the hospital.
If they get antibodies while hospitalized the sickness doesn't last as long.
Depending on how far the sickness has progressed before all the treatment begins, the illness can be more severe and the time in the hospital can be longer.
Duncan was very sick before he was hospitalized and it was basically too late to save him. The nurses were caught very early in the progression of the disease and fared much better. I bet the Doc does pretty well also.

If all the Ebola cases are caught as early as the two nurses, and the people get immediate and good treatment, I bet the survival rate goes up dramatically. Maybe as high as 90%.

 

[TerryK]

I am not a doctor and I don't play one on TV.

I am only using my common sense having read about this online and recently re-reading The Hot Zone, by Richard Preston. I highly recommend everyone read that book, it was written in 1994 so there is no political correctness and he has no ax to grind, just the facts as he knew them. And don't think the facts regarding ebola have changed.

Anyway, I think the difference between ebola here and ebola in Africa is that we are in the beginning of the epidemic. There are (supposedly) only a few people who have it here so they are getting the absolute best care and treatment known.

When/if it gets out of control here, like in Africa, we will see people bleeding out in their homes and in the streets because no one will want to go near them and hospitals will not be able to take everyone, if there are any health care workers left willing or able to take care of them.

It will be our worst nightmare and I can't imagine how it's going to end.

At least we can pray that it doesn't get out of control here but I am pessimistic about that too. Why would God want this country to be safe from this disease when we have become such an immoral country?

Just my opinion, YMMV.

Eens basically nailed it.
American Ebola = better and more immediate treatment, possible treatment with antibodies, lower death rate.
African Ebola = much poorer and delayed treatment, higher death rate

 

[WalknTrot]

The victims in the U.S. have received blood serum from that first surviving Doc who was transported over here. It transmits some anti-bodies and has given the later victim's immune system a jump on the virus. Yes, it can make a HUGE difference.

Unfortunately, there aren't that many survivors carrying anti-bodies at the moment, but the more we cure here, the more of a pool of immune serum we have to draw from.

 

[Doomer Doug]

One of the reasons Ebola is now totally out of control in West Africa relates to system infrastructure in my opinion.

The base health level of the average American, compared to the average West African is superior. We are not dealing with malnutrition, serious health issues, or public sanitation issues.

The average American has access to clean, running, indoor, fresh water. They have access to a functional toilet and do not live on streets full of feral animals, human waste, garbage etc.

The West Point slum had 75,000 people with two toilets. They lived in shacks with no water, no sewage treatment etc.

The Duncan family lived in a modern, relatively clean apartment. It had fresh water, flushing toilets, garbage service and they had access to fresh food and medical care.

I can only conclude the American Ebola virus is no different than the African one. The difference is in the cultural practices, no washing the dead in the USA, as well as the superior environmental conditions in the USA.

Ebola is going to be harder to get in the USA, even under the same type of exposure as West Africa. If 5 members of a West African family had been exposed to Duncan, in their filthy hovel, with no sewage, public health access, fresh water or garbage pickup they would have likely died.

The Duncan family piggybacked on the relatively high standard of living, as well as the fundamental, basic level of public health services and systems in the USA.

It matters whether people have a toilet, fresh water, garbage pickup and a clean apartment in terms of Ebola.

 

[bluelady]

I was also thinking that our cultural practices might make a difference.

First of course is better nutrition...even for people who eat fast food crap here, at least they're getting plenty of calories, and body fat to sustain them, and immunity is probably generally better. Food supply is cleaner...no infected bats or monkeys. Our food and water are cleaner, water supply is chlorinated. We have plenty of running water, clean toilet & hand washing facilities, better laundry facilities with hot water.

In general our living conditions are less crowded, especially sleeping arrangements, and we tend to have a big "personal space". We no longer prepare family bodies for burial ourselves, or have intimate funeral/burial practices.

Grandbaby is calling so have to go. I'm sure there are more differences, but those are a few. The only pluses I can see there would be more fresh air than we have in the open for those not in crowded cities, and probably fewer/no chemicals/pesticides.

 

[jazzy]

that seems to explain a question i had on another thread---i guess that makes sense.

 

[Countrymouse]

Admittedly, those are my terms, but I do not understand this.

A couple weeks ago, someone posted a link to a story written by an African survivor on Ebola. She was put into a very primitive room, offered occasional food, and advised to "drink as much as possible," if she wished to survive. Three other women were put into the room with her.

Well, this survivor spared no detail in telling about the horrors of Ebola as it ravaged her body and her system. She credited her survival to her will to live and her steadfast devotion to the 91st Psalm.

That's "Exhibit A."

Then we have the Americans. They're emerging from this dire prediction of "fatal virus" looking well rested, happy, wholesome and well-fed.

They're "Exhibit B."

Is this the same virus that's decimating African countries? Or is our medical care just THAT stellar that these folks have a nice rest while the miracle of medicine does its fine work? And what is it that's happening in these isolation units? Are they people passing through the horrid throes of Ebola? Or are these drugs able to mitigate the symptoms to a point that their suffering is minimal?

I am really baffled.

Thanks in advance for any and all replies.

Brantley's blood serum?

 

[Doomer Doug]

Even something as simple as the number of people living per room will have a major impact on Ebola infection rates. The Duncan family likely had more physical space between family members, than in Africa. They likely had a two bedroom apartment for five people, versus 20 people living in one hovel.

 

[Mprepared]

Brantley's blood serum?

And he suffered. He said it was from the pits of hell or something like that, so it does not sound like even being in America he had it easy. There have been other survivors besides him, so did he receive a blood transfusion from someone else?

 

[eens]

Are these people immune now? That would be good to know.

 

[2x2]

And he suffered. He said it was from the pits of hell or something like that, so it does not sound like even being in America he had it easy. There have been other survivors besides him, so did he receive a blood transfusion from someone else?

Yes ,Dr. Brantley got a blood xfusion from a survivor.
My photographic memory is running out of film.

 

[bluelady]

And he suffered. He said it was from the pits of hell or something like that, so it does not sound like even being in America he had it easy. There have been other survivors besides him, so did he receive a blood transfusion from someone else?

Yes, IIRC he received a transfusion while still in Africa.

 

[PatrolPatriot]

American ebola served as President for the past 8 years, African Ebola is a disease.

 

[packyderms_wife]

It matters whether people have a toilet, fresh water, garbage pickup and a clean apartment in terms of Ebola.

Actually this is true with almost all diseases, virii, etc.

I know many members here become quite frustrated with the talking bobble heads telling everyone to wash their hands, especially after going to the bathroom, and to NOT touch their faces, but you'd be amazed at how far this advice goes in keeping us from catching a ton of diseases. In a nut shell basic hygiene can save your life!

 

[libtoken]

One key factor with Duncan versus his nurses was that he was B+.

That meant that A+ Brantley could NOT donate blood/plasma to Duncan.

Perhaps West Africa needs a "Food for you and 20 others for a month in exchange for each unit" for survivors?

 

[WalknTrot]

Are these people immune now? That would be good to know.

Probably are, at least for the strain they had, anyway. But nobody knows how long. Much research to be done.

 

[libtoken]

I can almost see this:

If sex is infectious for about three months:

Brothels of "Guaranteed Ebola Survivors"?

 

[Nowski]

Eens basically nailed it.
American Ebola = better and more immediate treatment, possible treatment with antibodies, lower death rate.
African Ebola = much poorer and delayed treatment, higher death rate

IMHO, this is the reason that the sea lift and air bridge are being setup now,
to bring them over here.

Be safe everyone.

Regards to all,
Nowski

 

[Satanta]

"American Ebola" was brought here intentionally.

 

[FarmerJohn]

And he suffered. He said it was from the pits of hell or something like that, so it does not sound like even being in America he had it easy. There have been other survivors besides him, so did he receive a blood transfusion from someone else?

I think it has to do with a potential serum donor being of the appropriate blood type, as well as sufficiently out of Ebola recovery.

 

[FarmerJohn]

One key factor with Duncan versus his nurses was that he was B+.

That meant that A+ Brantley could NOT donate blood/plasma to Duncan.

Perhaps West Africa needs a "Food for you and 20 others for a month in exchange for each unit" for survivors?

Not bad idea.

 

[pinkelsteinsmom]

"American Ebola" was brought here intentionally.

this

 

[Betty_Rose]

One key factor with Duncan versus his nurses was that he was B+.

That meant that A+ Brantley could NOT donate blood/plasma to Duncan.

Perhaps West Africa needs a "Food for you and 20 others for a month in exchange for each unit" for survivors?

Remember - way back in the day - they'd offer transistor radios to men who were willing to have a vasectomy?

 

[medic38572]

Wonder what happens with diabetics in this treatment.

As Diamonds pointed out on the thread about the nurse being release. They get steroids to lessen inflammation throughout the body but in particular the lungs so they can breath better. Intravenous IVs with glucose and mineral and electrolytes. The steroids cause their face to swell and they gain a little weight. It takes about a week to slowly taper off of a heavy dose so the person probably looks pretty healthy when they leave the hospital.
If they get antibodies while hospitalized the sickness doesn't last as long.
Depending on how far the sickness has progressed before all the treatment begins, the illness can be more severe and the time in the hospital can be longer.
Duncan was very sick before he was hospitalized and it was basically too late to save him. The nurses were caught very early in the progression of the disease and fared much better. I bet the Doc does pretty well also.

If all the Ebola cases are caught as early as the two nurses, and the people get immediate and good treatment, I bet the survival rate goes up dramatically. Maybe as high as 90%.

 

[Dare7]

You already know, don't you? The steroids would send their glucose levels rocketing right out to the milky way & beyond!

Lots of insulin needed to bring it down somewhere in the vicinty of not going into a diabetic coma & trying to keep it stable. Last time I was an inpatient on a round of steriods (pre insulin dependency), they could hardly hold my g/l at 400ish+ with repeated tests & injections. This was in a neuro ICU where there was always at least one RN in the room 24/7 & checking everything, including my g/l, hourly. I was fine with diet control & metformin for 5 years after that rather scary event, then I suddenly (without warning of any sort) went brittle & am now insulin dependent.

 

[Adino]

american ebola answers to a czar

changes the whole thing

 

[brokenwings]

Oh my goodness I am dying from laughing!!!

American ebola served as President for the past 8 years, African Ebola is a disease.

 

[naturallysweet]

I worry about these patients who seem to be recovering and released fast.

Ebola is very hard to test for. A person often has to be showing symptoms for days before they test positive.

The troubling part comes from the stories that I have read in Africa about several people who came down with Ebola, appeared to recover for days to a week, and the sickened again and died. Who is to say that Ebola won't pull another head fake here? With the patient appearing to recover and the amount of virus in their blood going to undetectable levels as their bodies fight the disease. Only to later come back and.....

 

[Mulder]

I worry about these patients who seem to be recovering and released fast.

Ebola is very hard to test for. A person often has to be showing symptoms for days before they test positive.

The troubling part comes from the stories that I have read in Africa about several people who came down with Ebola, appeared to recover for days to a week, and the sickened again and died. Who is to say that Ebola won't pull another head fake here? With the patient appearing to recover and the amount of virus in their blood going to undetectable levels as their bodies fight the disease. Only to later come back and.....

I have had similar thought about these people potentially becoming the new Typhoid Mary's.

 

[BH]

If Obama were Jewish, American Ebola would be Kosher....

 

[Mark D]

The ONLY good thing about the current trans-ocean epidemic, is that most pathogens tend to become more communicable and less deadly as they expand through a population, because it ensures the bug's reproduction. There's a big polysyllabic word for that process, but I can't remember it right now...

By way of example: Mosquito-proofing homes worldwide directly led to the malaria parasite becoming less lethal because hardening homes with screens and weatherproofing meant that only the less aggressive strains of malaria managed to persist long enough to infect human hosts.

Although the ease of contracting New Ebola has gone up, the lethality appears to be declining, even without A Team First World care. And, now that New Ebola is in a few First World nations, there is enormous motivation to study the BLEEP out of it and create effective treatment protocols. I dare say that, in twelve months, the case fatality rate in modern nations will be VERY low... Not that I'd want to risk contracting New Ebola, but I'm betting that it's not going to be the death sentence it was originally thought to be - and that is without any kind of vaccine being available.

(I think that's the most positive post I've ever made on TB2K - which probably means catastrophic doom is imminent. I'd better pick up some Whisky on the way home from the Os Center tonight)

 

[Krayola]

And he suffered. He said it was from the pits of hell or something like that, so it does not sound like even being in America he had it easy. There have been other survivors besides him, so did he receive a blood transfusion from someone else?

I read a first-hand account from someone at Samaritan's Purse who was taking care of Brantly in Africa. They said he got blood serum from a 14 yr old boy that he helped cure while in Africa. Then they received the shipment of ZMapp but only had enough for one patient. Brantly said give it to Ms. Writebol. They were waiting on it to thaw (the medicine was frozen and had to thaw before administering it). During that timeframe, Brantly's condition suddenly worsened and he was near death (in spite of receiving serum from a survivor.)

The person in charge over there prayed about it and decided to split the dosage of ZMapp in half and administer half to Brantly and half to Writebol. I am thinking that the serum from the 14 yr old survivor may not have done much to help but the ZMapp did. I am wondering if the reason so many people over here are surviving is because most of them have gotten transfusions from Brantly who could possibly still have the antibodies he received from ZMapp.

This is in addition to the fact that they all got treatment earlier and have better care. In Africa, they don't even get IV's most of the time because it is too dangerous for the HCW's to administer.

 

[medic38572]

Exactly what I know. Was given prednisone for mold reaction and it shot my glucose to 418 which caused me to get insulin 5 hrs later. My question is will they actually be able to keep it controlled! Glucose being eaten by the virus glucose being given to increase glucose followed by insulin after steroids. And that's before or after the stored glucose in the liver is depleted. It is going to be one heck of a balancing act! DKA is going to be either easy to control or there will be lots of elevated sugars. Then try and control the Nausea and Vomiting from the DKA. Zofran? If they are hypotensive. Gonna be a mess. Although I miss EMS in many ways I am sorta glad I am not practicing or on the front line at this time.

You already know, don't you? The steroids would send their glucose levels rocketing right out to the milky way & beyond!

Lots of insulin needed to bring it down somewhere in the vicinty of not going into a diabetic coma & trying to keep it stable. Last time I was an inpatient on a round of steriods (pre insulin dependency), they could hardly hold my g/l at 400ish+ with repeated tests & injections. This was in a neuro ICU where there was always at least one RN in the room 24/7 & checking everything, including my g/l, hourly. I was fine with diet control & metformin for 5 years after that rather scary event, then I suddenly (without warning of any sort) went brittle & am now insulin dependent.

 

[TerryK]

Wonder what happens with diabetics in this treatment.

Why would you ask if you already know?

I had pneumonia and was hospitalized the same as Dare7 and was immediately given steroids.
My blood sugar did go up. I'm a Type II and for the first time I had a nurse giving me insulin.
A week and a half later, out of the ICU and the regular hospital room I was back to no insulin and controlling blood glucose with diet and metformin alone.
Now with a ketogenic diet I no longer need metformin. Just diet alone.

Anyway while hospitalized for pneumonia, couple shots of insulin was nothing compared to not being able to breath.

 

[summerthyme]

Why would you ask if you already know?

I had pneumonia and was hospitalized the same as Dare7 and was immediately given steroids.
My blood sugar did go up. I'm a Type II and for the first time I had a nurse giving me insulin.
A week and a half later, out of the ICU and the regular hospital room I was back to no insulin and controlling blood glucose with diet and metformin alone.
Now with a ketogenic diet I no longer need metformin. Just diet alone.

Anyway while hospitalized for pneumonia, couple shots of insulin was nothing compared to not being able to breath.

I think the point is we have a LOT of diabetics in this country and IF steroids are being used for this (interesting to me, because when we were talking about cytokine storm in influenza, steroids were reported to be "useless" and "likely to cause more problems due to immune system depression) that factor is going to cause one more potentially serious difficulty in caring for them if they get Ebola.

In Ebola patients, every blood draw and needle stick (especially in the later/severe phases of the disease) are very dangerous to the caregiver.

Just more to think about.

Summerthyme

 

[Neargone]

Are these people immune now? That would be good to know.

Good question. And can that immunity be harvested somehow to treat others?