HEALTH MAIN EBOLA DISCUSSION THREAD - WEEK OF 8/16/14 - 8/31/14

[bw]

Initially Ebola has extremely high mortality rates, but after it goes through several generations of human passages, it becomes far milder and not particularly threatening.

It becomes milder only when that is an adaptive change, or when there is no longer any selection for virulence and genetic drift toward mildness happens fortuitously. Mildness is an adaptive change when transportation is slow, because victims have to live a while to get by steamship or sailing ship from Tedium to Apathy or Ennui. There is no selection for mildness when Ebola gets on a plane.

 

[Tom McDowell]

It becomes milder only when that is an adaptive change, or when there is no longer any selection for virulence and genetic drift toward mildness happens fortuitously. Mildness is an adaptive change when transportation is slow, because victims have to live a while to get by steamship or sailing ship from Tedium to Apathy or Ennui. There is no selection for mildness when Ebola gets on a plane.

Again - the quote from my post was the former mindset.

Planes trains or boats it makes no difference now.

===

.

 

[Possible Impact]

PzFeed Top News @PzFeed · 3h
EBOLA
NEW: Senegal: 1 case
Congo: 13 dead
Guinea: 430 dead
Liberia: 694 dead
Nigeria: 6 dead
Sierra Leone: 422 dead
Total: 1552 dead

Copyright © 2014 Elsevier Ltd All rights reserved.
The Lancet, Early Online Publication, 29 August 2014
doi:10.1016/S0140-6736(14)61343-X Cite or Link Using DOI


Is respiratory protection appropriate
in the Ebola response?

Jose M Martin-Moreno a, Gilberto Llinás a, Juan Martínez Hernández b

We write to express our concern about one aspect of the response to the
current epidemic of Ebola that has, so far, received little attention,1 lacks
an evidence base, and might be counterproductive.

The primary mode of transmission of Ebola virus is through contact with
infected patients’ secretions (such as blood, vomit, or faeces) directly and
indirectly (for example, from contaminated needles). This transmission
occurs via close family contact or in health-care settings, particularly when
placing orotracheal intubation or when caring for a patient who is vomiting
or bleeding. Ebola is rarely transmitted via an airborne route.2 Although
these routes of transmission are well known,3, 4 most agencies, including
governmental agencies responsible for repatriating western patients, apply
infection-control measures appropriate for airborne diseases.

Excessive precautions could offer reassurance to those responding to
Ebola, yet complete respiratory protection is expensive, uncomfortable,
and unaffordable for countries that are the most affected. Worse, such an
approach suggests that the only defence is individual protective
equipment, which is inaccessible to the general population.

Moreover, the image of workers with spectacular protective clothing might
contribute to the panic in some communities. If this leads people to flee
affected areas it could increase the spread of infection.

It also reinforces the view that some lives are more valuable than others,
already engendered by decisions about the use of experimental
Ebola drug ZMapp.5

We contend that the systematic application of precautionary measures that
protect health-care personnel and others from direct contact (ie, gloves
and waterproof smocks, goggles, masks, and individual rooms or wards in
the hospital) are sufficient to manage most patients (who do not
experience haemorrhage or vomiting). In fact, goggles and masks might
not even be necessary to speak with conscious patients, as long as a
distance of 1—2 metres is maintained (the maximum distance that
infectious droplets might reach). Exceptional precautions, such as
pressurised suits with oxygen tanks, should be reserved for interventions
that generate aerosols (invasive explorations or intubations), specific
situations (eg, massive haemorrhage), or in laboratories where the virus is
cultivated. They are unnecessary in the settings where the virus is most
rampant.

In western Africa now there is a need for rational and efficient use of
protective equipment. This can only be achieved by communicating a
consistent message that the disease is essentially transmitted through
direct contact.

In control of infectious diseases, more is not necessarily better and, very
often, the simplest answer is the best.

​

We declare no competing interests.

References

1 Roddy P, Weatherill D, Jeffs B, et al. The Médecins Sans Frontières
intervention in the Marburg hemorrhagic fever epidemic, Uige, Angola,
2005. II. Lessons learned in the community. J Infect Dis 2007; 196:
S162-67. PubMed


2 Alimonti J, Leung A, Jones S, et al. Evaluation of transmission risks
associated with in vivo replication of several high containment pathogens
in a biosafety level 4 laboratory. Sci Rep 2014; 4: 5824. PubMed


3 CDC. Ebola hemorrhagic fever information packet. Atlanta, GA: Centers
for Disease Control and Prevention, 2009. http://www.cdc.gov/vhf/ebola
/pdf/fact-sheet.pdf. (accessed Aug 27, 2014)


4 WHO. Interim infection prevention and control guidance for care of
patients with suspected or confirmed filovirus haemorrhagic fever in
health-care settings, with focus on Ebola. Geneva: World Health
Organization, 2014. http://www.who.int/csr/resources/who-ipc-guidance-
ebolafinal-09082014.pdf. (accessed Aug 27, 2014)


5 Brady O. Scale up the supply of experimental Ebola drugs. Nature 2014;
512: 233. PubMed


a Department of Preventive Medicine and Public Health, University of
Valencia, 46010 Valencia, Spain

b Preventive Medicine and Public Health Service, Hospital La Paz-Carlos III,
Madrid, Spain

 

[bw]

Again - the quote from my post was the former mindset.

Planes trains or boats it makes no difference now.

Yes, I understood you. My point was that the former belief in lessening lethality was based on a sort of magical "this is how these things do" concept when in fact it was specifically being selected for, and the selection is now gone.

 

[Weft and Warp]

Many of our universities have started up last week and the week before. If you want something to raise your level of concern, consider all the students that have come in from the affected countries.

I'm pretty sure these students haven't gone through any 21 day quarantine. This article from Fox talks about some of those students: http://www.foxnews.com/health/2014/...en-some-students-for-ebola/?intcmp=latestnews

They talk about screening "some" of those students, but what do they mean about screening? Just taking their temperature every day for 21 days? That's not good enough. Asking a couple questions is also not good enough.

I'm certainly not comforted by their screening process.

 

[almost ready]

Now confirmed in Senegal in a student who had lied about having close contact with victims. Thought that would warm your hearts this morning.

"Ebola crisis: Senegal becomes fifth West African country to confirm case of deadly virus
Updated 30 Aug 2014, 12:09am
Sat 30 Aug 2014, 12:09am

Senegal has become the fifth West African country to confirm a case of Ebola after a student arrived from neighbouring Guinea carrying the disease.

Health minister Awa Marie Coll Seck said the young man had turned up for treatment at a hospital in the Senegalese capital of Dakar but concealed that he had had close contact with victims in his home country."

Hell, we can laugh but I have family members who deal with students who have just got off the plane with limited English. Worried? Me? Hah. Just numb at this point. This is war, and not time to wring hands. Just keep on going and worry/cry later.

http://fluboard.rhizalabs.com/forum/viewtopic.php?f=5&t=12172&start=8

 

[Countrymouse]

That's entirely possible, bw. I can't fault him for wanting to come home if there's a real possibility he's going to die. I've been horribly sick in a third world country, and given an offer, I would have come home in a skinny minute. That they're using this to "train" the public mind is where I find fault.

There's no doubt the CDC and WHO are misleading the people about this disease. However, I don't think they're so foolish that they would put their personnel at risk by being so lax. In any case, there's nothing we can do about it.

You need to review their HISTORY---what they did when they MAJORLY screwed up with the ANTHRAX scare just a few months ago.


In one of their (I assume Level-4) labs, LIVE anthrax cultures were being studied.

The "normal" protocol was to "deactivate" (i.e., kill) these cultures BEFORE passing them along to lower-grade labs for FURTHER study.

Someone goofed---and didn't.

So they passed LIVE ANTHRAX cultures down to a lower-level lab---one that DID NOT HAVE IN PLACE the correct facilities or handling procedures to ensure the agent would NOT be released, either to workers there OR to the public.

The mistake was discovered when workers in THESE labs, in the course of doing routine tests on what was SUPPOSED to be "dead" anthrax, realized they were reacting as LIVE anthrax---that the cultures were LIVE.

The lower labs (and I don't know that THESE labs WERE part of CDC--they may have been independent "satellite" laboratories, not even on the CDC campus) then notified the CDC.

Upwards of 70 people were exposed to these LIVE ANTHRAX CULTURES....WITHOUT proper biohazard PPE in place (because 'normally' they wouldn't BE receiving LIVE cultures).


Even when the head honchos as CDC KNEW that this gaffe had occurred, they DID NOT IMMEDIATELY NOTIFY THE LOWER-LEVEL LAB WORKERS WHO HAD BEEN EXPOSED as to the full dangers of their exposure or take ANY action---I think it was something like TWO WEEKS LATER before they notified THEM or took any action to secure their health.

Then it was (if memory serves) ANOTHER 10 DAYS before the story broke, or was leaked, or at any rate got out to the GENERAL PUBLIC.

The CDC didn't even tell THEIR OWN EMPLOYEES in other CDC departments on campus what had happened---when it broke on the news, I called my friend who works there to see if she was ok and that was the first she'd heard of it.

So--ALL THAT INTERVENING TIME---these lab workers had not only been exposed THEMSELVES to Anthrax, but were potentially exposing EVERYONE ELSE with whom they came in contact.



YOU STILL WANT TO TRUST THE GOOD MOTIVES AND EXPERTISE OF THE CDC?

 

[Countrymouse]

There's another reason I can think of, besides not wanting panic to spread. That is, the FedGov is almost totally dependent on the revenue they receive all throughout the year (not just 4/15) to be able to keep the lights on in DC.... and keep the ponzi going. Treasury Secretary Lew said, not long ago that the US only has 2 days of "working cash" at any given time. Maybe some days it's 3-4 days... that they have enough to pay the bills... it's not like a couple days give or take, is going to make much difference. They're broke, anyway you look at it.

Obamacare has hit the hospitals with additional "requirements" that are costly too. So they're pinching pennies.

The WHO, back around the first of the month, was trying to fundraise from the UN members to come up with enough money to address this problem. In the process, they admitted that they were in debt to the tune of (I think it was) 1.5 BILLION dollars. So, they've got bills they probably aren't paying in a timely fashion too. And those poor African countries who are depending on a worldwide relief program to come swooping in to save the day... are going to have to take a number. Repeatedly, the WHO has said that stopping the airlines from flying to/from those countries would be counterproductive due to the pressure it would cause on the economy.

That's the unspoken (for the most part) answer to "why" a lot of decisions, right now.

So---basically--

they KNOW we are all living in a building with the roof on fire---

but they're not going to TELL the rest of us that, until the roof falls in.

 

[Countrymouse]

CHISINAU, August 29./ITAR-TASS/.Two Japanese citizens with suspected Ebola symptoms were taken from Chisinau airport to a Moldovan clinic on Friday, Moldovan border guard police said.
The passengers had signs similar to the Ebola virus-caused disease, including a high temperature. They confirmed that they began feeling unwell after returning from southern Africa where they were on a business trip, the border guard press service said.
The Japanese citizens flew from Japan to Moldova via Istanbul.
They were taken to the Moldovan National Public Health Centre

SOUTHERN Africa?


It's now in SOUTH Africa?



Stick a fork in it....we're done.....

 

[SusieSunshine]

From the fox news health link:

"I can see why there would be concern; there's no vaccine for it," said Fatima Nor, an 18-year-old freshman at the University at Buffalo, where about 25 students from Nigeria are enrolled for fall. But she said knowing that the virus is transmitted strictly through direct contact with bodily fluids of sick people, and not by sitting next to someone in class, should be enough to calm nerves.

Wow, it must be safer than the flu. (sarcasm off)

 

[mala]

YOU STILL WANT TO TRUST THE GOOD MOTIVES AND EXPERTISE OF THE CDC?[/B]

I trust them about as far as I can throw them! That's why we all do our own research.

My point is, well, my point is not as strong as it was a few minutes ago. You're bringing me down, CM. <sad smile>

I guess I'll go look at my tent and see if it's in good repair. Looks like I'm going camping.

 

[Medical Maven]

MY COMMENT: With the reports of yesterday afternoon, yesterday evening, and now this morning we have completely gone down the rabbit hole of this roaring wildfire of a pandemic.

Pixie at the PFI Forum just gave an excellent wrap-up of where we are at the moment. (Get your affairs in order).

PIXIE'S COMMENTARY:



Yup, it's up there. I went back and highlighted in red so it doesn't get lost.

Many, many, people are contacts of this deceased doctor and are at risk.

The medical staff who treated him, those who cleaned up after him, and the mortuary workers (who were entirely unaware of the danger) are most at risk.

It's a long list.

The same thing is playing out in Dakar, Senegal.

Two of these three "index super-spreader" cases (Sawyer and the Guinean student in Senegal) have one thing in common: deception. The same problem is going to be encountered everywhere. In the West. In the East. And in Africa. No locality is immune.

The problem of flight is common to them both, also. Both had knowledge that they were runners. Sawyer would have continued running on to the ECOWAS conference if the hospital had not stopped him (despite heavy diplomatic pressure).

In the case of the doctor in Port Harcourt, it's hard to accuse him of deception because his patient recovered. But by the time he was taken to the first hospital vomiting blood there must have been a high index of suspicion. It does not appear that that suspicion was acted upon properly either before or just after his death.

A few weeks ago I posted a prediction of the course of the outbreak in Nigeria. I suggested that we'd hear more of tertiary cases when the first of the bunch of hidden contacts began to present at hospitals outside of Lagos with strange symptoms. The doctor in Port Harcourt presented at the hospital last Friday, the day he died. We didn't hear about the case until this week, but my projection was not far off.

My next projection was that fourth-generation contacts would begin to appear at clinics and hospitals in greater numbers and that we'd know we had a problem then. That would be this weekend and next.

This is not rocket science.

All one has to do is count the days of the latency period, averaging the 21 into around 14. Then do it again, extending the count forward.

That there were hidden cases and that the Nigerian authorities did not have a handle on their outbreak (in spite of their protestations) was obvious from the beginning. The level of denials (in patients and officials), the involvement of "big men" and diplomatic privilege, the panic of contacts, all added up to an obvious recipe. Even Sawyer's driver had been on the run for ten days before they were able to track him. And where was he found? Port Harcourt. (He may have even driven the recovered diplomat to his hotel from Lagos, who knows). The driver had indeed been infected, and died.

So then you count the days from the arrival of the driver in Port Harcourt. You count the days from the arrival of the diplomat in Port Harcourt. Then you count the days from the time their contacts met up with them to get a clue as to when the next level of cases will show up.

Then you do it again in Senegal.

It's not rocket science. No surveillance, anywhere, will be able to keep this pattern from happening.

Frieden said the outbreak will be stopped with "meticulous" control. That's not going to happen. The virus has met up with Human Nature to create the perfect storm.

"Plan B," Frieden?

 

[Masterchief117]

Just found out that on the campus where I teach/tutor that we got a girl from Nigeria on the basketball team and we got a professor who is from Sierra Leone (I don't know whether he visited when we had our between semester break for the summer and fall semesters). I am in southern Oklahoma.

Also got students from England and New Zealand on the soccer team and girl from Russia on the basketball team.

 

[Masterchief117]

I trust them about as far as I can throw them! That's why we all do our own research.

My point is, well, my point is not as strong as it was a few minutes ago. You're bringing me down, CM. <sad smile>

I guess I'll go look at my tent and see if it's in good repair. Looks like I'm going camping.

There's plenty of room for you here at Camp Fooked. You'll be in good company.

 

[Melodi]

Yes some lives ARE MORE IMPORTANT THAN OTHERS, if those are the people who have a snowball's chance of helping to treat people who have the disease but no training what-so-ever; I mean yes, this thing is bad enough there may not be a heck of a lot doctors and nurses can do but a lot of the doctors at least, are Western trained. Given the right help and equipment they can treat people (and so can the nurses), let them die first do to stupid exposure for a reason like "don't want to scare people and it gives the impression their lives are of greater value" is a short-sighted as Alexander killing the doctor's who couldn't save his partner and then had no one left alive when he himself became ill. That is "PC" thinking gone mad, again if the equipment did nothing that would be a different story; but it does and once the care-givers are totally gone then there is no one left to help even if a trial vaccine or other protocol is found that might help with symptoms, spread or care of those with the disease.

Basically what this translates into as "we can't afford to protect our health care workers properly so we are just going to write them off along with a good chunk of the rest of the population," I wonder if the people writing these things realize that their gated community is not safe from germs?....

Also, on the man/women in Atlanta; my guess is such a person would probably self quarantine - I would (and have with the bird flu) and I'm sure friends and family would be happy to drop off things for them to get by for 21 days even after coming back from a long trip (we were forced to go out once for medication and fresh supplies because we had been gone, I could have used preps for food but we still had to get medication).

As for altruism, if I were in that situation and as a younger person I did a lot of volunteer work though I was not a medical person (I was exposed to TB though, it wasn't always safe and that was in the US) I think I would opt for the charter flight to the US if it could be done safely but ask to be taken by safe transport to a place I could be in quarantine; if the powers that be were too dumb to help with part B, I would do my best to get to my home with as limited contact as possible (probably wearing at least a mask if I could get one and riding with as few people as possible).

Why would I do this? Because I have enough sense to know that my chances of surviving Ebola in Africa are about zero but go up as high as 50 percent if treated in a modern US hospital especially ones like they have in Atlanta which are specially designed to treat such diseases in full negative pressure isolation and with life support. My hope would be that everything would be done to keep me from getting close enough to anyone to infect them just in case I had been exposed but was not showing symptoms, but if the folks in Atlanta refused to help with that after I got off the charter flight I would just do my best.

Also, waiting in Africa would probably increase the chance of catching the disease (I don't really trust 3rd world quarantine standards all that well) which would mean I might be a risk even after the 21 days and/or need an emergency flight out while contagious like the Americans and Europeans already removed by their countries while ill.

So I think even a humanitarian would probably make the decision to come on home, because none of the choices are good and none of them are safe; but I am very dubious about the "free to walk around, they are perfectly safe" line and like I said, I would hope they at least stayed home alone - if I had family I'd send them away and/or perhaps permit one adult to stay with me but not touch me and stay away as much as possible.

 

[Medical Maven]

MY COMMENT: Here are more details on the Port Harcourt situation, (the final nail in the coffin for any hope of stopping the spread there).

Posted by Pixie at the PFI Forum.



Infected diplomat takes Ebola to Port Harcourt

AUGUST 29, 2014 BY SUNDAY ABORISADE, CHUKWUDI AKASIKE AND BUKOLA ADEBAYO
http://www.punchng.com/news/infected-diplomat-takes-ebola-to-port-harcourt/?

[snip]

“Enemuo’s widow, who is also a medical doctor and who cared for him during his illness, has taken ill. She is being quarantined.

‘‘A few hours ago, results of the test carried out on samples taken from Dr. Enemuo came back and was positive of EVD.”

A resident of Port Harcourt, said in her Facebook post, that the latest development was a calamity.

“It’s quite a calamity unfolding in Port Harcourt. Unfortunately, the city’s health facilities are not quite ready to contain Ebola at the moment,” she lamented.

The resident said Enemuo, before he took ill on Tuesday, “operated on a woman on Monday presumably after treating the diplomat.”

She wrote, “He (Enemuo) fell ill next day Tuesday and died last Friday. No one knew about the hotel angle which was a very big risk he took…and unethical thing to do.

“He was ill for three days and then started vomiting blood. He was first rushed to one hospital where he was rejected and then taken to Good Heart Hospital whose owner is a Cardiologist and a consultant physician with the University of Port Harcourt Teaching Hospital. He died there.

“The doctor that died practises in East West Road, Rumuokoro…Sam Steel clinic. The wife, also a doctor, has a three-month-old baby.

“As it is, there may have been well over 200 contacts of this devilish diplomat who lured his young doctor friend to treat him secretly and went back to Lagos. We have to look at the health workers in the Good Heart Hospital, Sam Steel Clinic, the members of staff of the hotel and its guests, those who travelled with the diplomat in the same vehicle(s) or aircraft from Lagos to Port Harcourt, the late doctor’s family members. The list goes on and on.”

The resident, who is an educationist, added that what played out in this latest development was what she called the “Ostrich mentality of our people.”

She said, “My own take is what is with the foolishness of people who suspect they have Ebola not wanting to subject themselves to straight testing. Don’t they know quick detection could save their lives and those of others?”

Another resident said she was particularly worried that Ebola had reached Port Harcourt, a city where according to her, social and economic activities are very high.

He said, “Look, I am troubled that this virus in here with us. I am disturbed because I know this state cannot easily trace people who came into contact with the so-called diplomat and the doctor that died.

“I fear that many of the contacts must have travelled to neighbouring states like Abia, Akwa Ibom, Bayelsa, Delta and even Cross River State.”

Sahara Reporters said on Thursday that Good Heart Hospital, and the hotel where the ECOWAS diplomat allegedly received treatment in Port Harcourt, had been shut down.

However, a member of the Emergency Operation Centre for Ebola in Lagos, Prof. Oyewale Tomori, has argued that the Federal Government and the Lagos State government should not be blamed for the death of the medical doctor in Port Harcourt.

Tomori told one of our correspondents on Thursday that some of the people who had had primary contact with Sawyer, did not cooperate with the monitoring and surveillance committee by evading surveillance.

He said, “Initially many people who came into contact with Sawyer were not forthcoming with the truth. It was difficult to trace some contacts who did not leave any address. They could not trace the ECOWAS diplomat for days. Surveillance is the duty of everyone. And we must follow international guidelines and regulation. If we take your temperature and say we will be back tomorrow by 8am to take another, we expect that you should cooperate, but that was not the case.

“Some even travelled, and their people were also not ready to disclose where they went. Some even denied the degree of contact that they had with Sawyer.”

Tomori who is also a professor of virology noted that though there were no sanctions yet for those who evade surveillance, such individuals pose great health risk to the nation.

To further contain the outbreak, Tomori advised doctors to treat every case of high fever, vomiting and stooling as a suspected case of Ebola.

He added, “I will say with the new dimension, doctors should assume the worst when they see patients with high fever who are vomiting and stooling. Those with three symptoms of the disease must be put under observation and isolated, while waiting for a test result.

“It is important that we get laboratories where test results can be out within two or three hours. That way you can quickly isolate and begin taking necessary precautions to contain it within the health facility.”

 

[mala]

There's plenty of room for you here at Camp Fooked. You'll be in good company.

Thanks. I enjoy the folks who post here. Wish we were camping for happier reasons.

 

[Melodi]

Just found out that on the campus where I teach/tutor that we got a girl from Nigeria on the basketball team and we got a professor who is from Sierra Leone (I don't know whether he visited when we had our between semester break for the summer and fall semesters). I am in southern Oklahoma.

Also got students from England and New Zealand on the soccer team and girl from Russia on the basketball team.

Ireland is full of Nigerians and my husband's medical school has a lot of international students, some from Africa and the Middle East - his dorm mates just for the Summer were think from Senegal, but there is as much danger from travelers who are 100 percent American or European who go (or went) to these places and come back from vacation. Thankfully, at the moment because of limited air travel and the knowledge of the epidemic not many more are going but people are still coming back.

I've already written about my concerns about the medical students (both Western and from elsewhere) who do their tropical medicine practical in Africa (often in Nigeria as a matter of fact) who will now be returning for their last year of classes as well as regular doctors who have taken a Summer to do charity work. This is very common, though again I think a lot of the non-missionary type people have probably left already, so you won't have nearly so many people like Dr. Paul doing eye surgery in Central America while congress was on break - but that's exactly the type of humanitarian work a lot of doctors (even very highly paid ones) often quietly do and of course normally Africa is a popular destination because things are so bad there (and a person can do so much good even in a short period of time with the correct skill set).

 

[Medical Maven]

More background on the "runner" in Senegal. Posted by Pixie at the PFI Forum.


A first case of Ebola found in Senegal

AFP August 29, 2014 At 3:08 p.m.
http://www.liberation.fr/monde/2014...ola-identifie-au-senegal_1089510?xtor=rss-450

A young Guinean infected with the virus traveled to Senegal after leaving his country. Quarantined, it would nevertheless "in a satisfactory condition."

First Ebola patient was identified in Senegal, a young Guinean, who has been placed in quarantine, said Friday the Senegalese Minister of Health, Awa Marie Coll Seck. Guinean health services had reported Wednesday "the disappearance of a person infected with Ebola virus would have visited Senegal person," said the minister at a press conference. "The person has been located at Fann (Dakar, ed.) This is a young Guinean who was immediately quarantined, "she has said.

"The results of the tests at the Pasteur Institute were positive," said Awa Marie Coll Seck, adding that the patient was "in a satisfactory condition." "The system was strengthened to prevent spread of the disease from this imported case," assured the minister.

This is the first confirmed case in Senegal, bordering Guinea, one of three countries primarily affected by Ebola, after several false alarms.

According to the Minister of Health, the young Guinean is a student at a university in Conakry and was gone for three weeks before the teams Guinean epidemiological surveillance inform Senegal. "We're taking back the entire route and revisit all those who have been in contact" with the patient, she has said.

Senegal had yet closed on August 21 its borders with Guinea because of the epidemic, more than three months after it reopened. "This measure is extended to air and sea borders for aircraft and ships from the Republic of Guinea, Sierra Leone and Liberia," had said the Interior Ministry.
________________

MY COMMENT:
New Ebola is starting to edge its way up into Saharan Africa. I just read a story today about how the chaos in Libya is greatly increasing the number of boat refugees attempting to cross over into southern Europe.
Map and information on Sub-Saharan Africa:
http://splashman.phoenix.wikispaces.net/Theme+5+Regions+SYHWDM

 

[Steve308]

From the fox news health link:

"I can see why there would be concern; there's no vaccine for it," said Fatima Nor, an 18-year-old freshman at the University at Buffalo, where about 25 students from Nigeria are enrolled for fall. But she said knowing that the virus is transmitted strictly through direct contact with bodily fluids of sick people, and not by sitting next to someone in class, should be enough to calm nerves.

Wow, it must be safer than the flu. (sarcasm off)

I guess it never occurred to her that she might be sitting in a seat that was infected by the person sitting there in the class before her...I know she is only 18 years old, but don't they only let the smart kids into college? ;^)

Steve308

 

[Countrymouse]

I trust them about as far as I can throw them! That's why we all do our own research.

My point is, well, my point is not as strong as it was a few minutes ago. You're bringing me down, CM. <sad smile>

I guess I'll go look at my tent and see if it's in good repair. Looks like I'm going camping.

sorry about that, Mala---I don't mean to make you sad.

I've been reading a LOT of Psalm 91 and watching kitten videos and such.

At least you can thank your stars you don't live in Atlanta (I suppose you don't?)...

 

[Possible Impact]

Yes some lives ARE MORE IMPORTANT THAN OTHERS, if those are the people who have a snowball's chance of helping to treat people who have the disease but no training what-so-ever; I mean yes, this thing is bad enough there may not be a heck of a lot doctors and nurses can do but a lot of the doctors at least, are Western trained. Given the right help and equipment they can treat people (and so can the nurses), let them die first do to stupid exposure for a reason like "don't want to scare people and it gives the impression their lives are of greater value" is a short-sighted as Alexander killing the doctor's who couldn't save his partner and then had no one left alive when he himself became ill. That is "PC" thinking gone mad, again if the equipment did nothing that would be a different story; but it does and once the care-givers are totally gone then there is no one left to help even if a trial vaccine or other protocol is found that might help with symptoms, spread or care of those with the disease.

Basically what this translates into as "we can't afford to protect our health care workers properly so we are just going to write them off along with a good chunk of the rest of the population," I wonder if the people writing these things realize that their gated community is not safe from germs?....

Also, on the man/women in Atlanta; my guess is such a person would probably self quarantine - I would (and have with the bird flu) and I'm sure friends and family would be happy to drop off things for them to get by for 21 days even after coming back from a long trip (we were forced to go out once for medication and fresh supplies because we had been gone, I could have used preps for food but we still had to get medication).

As for altruism, if I were in that situation and as a younger person I did a lot of volunteer work though I was not a medical person (I was exposed to TB though, it wasn't always safe and that was in the US) I think I would opt for the charter flight to the US if it could be done safely but ask to be taken by safe transport to a place I could be in quarantine; if the powers that be were too dumb to help with part B, I would do my best to get to my home with as limited contact as possible (probably wearing at least a mask if I could get one and riding with as few people as possible).

Why would I do this? Because I have enough sense to know that my chances of surviving Ebola in Africa are about zero but go up as high as 50 percent if treated in a modern US hospital especially ones like they have in Atlanta which are specially designed to treat such diseases in full negative pressure isolation and with life support. My hope would be that everything would be done to keep me from getting close enough to anyone to infect them just in case I had been exposed but was not showing symptoms, but if the folks in Atlanta refused to help with that after I got off the charter flight I would just do my best.

Also, waiting in Africa would probably increase the chance of catching the disease (I don't really trust 3rd world quarantine standards all that well) which would mean I might be a risk even after the 21 days and/or need an emergency flight out while contagious like the Americans and Europeans already removed by their countries while ill.

So I think even a humanitarian would probably make the decision to come on home, because none of the choices are good and none of them are safe; but I am very dubious about the "free to walk around, they are perfectly safe" line and like I said, I would hope they at least stayed home alone - if I had family I'd send them away and/or perhaps permit one adult to stay with me but not touch me and stay away as much as possible.

Melodi,

Will you ask your husband to give his opinion of the Lancet article?
(Also, any of his classmates who would not mind being anonymously quoted?)
I am still sitting here stunned by this recommendation/proposal,
the medical community backlash should be "Icelandic". (Heat, steam, lava, and largely unpronounceable...)

 

[mala]

http://www.scientificamerican.com/article/ebola-doctor-reveals-how-infected-americans-were-cured/

Ebola Doctor Reveals How Infected Americans Were Cured

Good read on what docs learned caring for the two ebola patients at Emory. Some parts:

"What we found in general is that among our Ebola patients, because of the amount of fluid they lost through diarrhea and vomiting, they had a lot of electrolyte abnormalities. And so replacing that with standard fluids [used in hospital settings] without monitoring will not do a very good job of replacing things like sodium and potassium. In both of our patients we found those levels to be very low. One of the messages we will be sending back to our colleagues is even if you don’t have the equipment to measure these levels, do be aware this is occurring when patients are having a lot of body fluid loss.

"Our two patients also gained an enormous amount of fluid in their tissues, what we call edema. In Ebola virus disease there is damage to the liver and the liver no longer makes sufficient amount of protein; the proteins in the blood are very low and there is an enormous amount of fluid leakage out into the tissues. So one of the takeaway messages is to pay closer attention to that and perhaps early on try to replace some of these proteins that patients’ livers lack."

"The other thing I would hope we would get across to the public is this is a disease where we don’t have to have a lot of secondary infections—if we follow standard infection-control procedures. We had 26 people giving direct patient care to these patients and we did not have any secondary infections at all, and that’s as we expected.

We were using contact precautions and droplet precautions. Fortunately, we don’t have to go to that level of protection [wearing protective full-body suits like in west Africa]. You wear whatever you need so that the blood and body secretions don’t come into contact with you, depending on the quantity of fluids. We used gowns and gloves and foot coverings of the health care workers in order to prevent contact with the body materials of these individuals. Our approach was what CDC recommends: you wear a mask and goggles or a face shield to prevent that infection. Some of the nurses spending three to four hours in patients’ rooms were more comfortable wearing hoods than masks and face shields, though those would have been adequate. We can manage care with minimal chance for secondary spread. It’s not as though we brought the plague to American shores."

Is this true that they only wore CDC recommended PPE?

(CM, no worries! Just needed a bit of a wakeup call, that's all.)

 

[Possible Impact]

http://www.scientificamerican.com/article/ebola-doctor-reveals-how-infected-americans-were-cured/

Ebola Doctor Reveals How Infected Americans Were Cured

Good read on what docs learned caring for the two ebola patients at Emory. Some parts:





Is this true that they only wore CDC recommended PPE?

(CM, no worries! Just needed a bit of a wakeup call, that's all.)

In the protocol, do you cross the fingers on your left or right hand, to ward off the Ebola virus and increase luck?
( I'm sure they wrote it down in the procedures, but I can't find it right now...)

On a positive note, looks like milk thistle extract might be helpful for Liver function,
in patients who are capable of recovery.
http://en.wikipedia.org/wiki/Silybum_marianum

 

[almost ready]

Things are getting rough again - riots in Guinea.

Riots in Guinea as officials accused of transmitting Ebola​

2014-08-29 14:32
File: AFP

File: AFP

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Conakry - Riots broke out in Guinea's second-largest city Nzerekore over rumours that health workers had infected people with the deadly Ebola virus, a Red Cross official and residents said on Friday.

A crowd of young men, some armed with clubs and pistols, set up barricades across the southern city on Thursday and threatened to attack the hospital before security forces moved in to restore order.

Gunshots were fired by the rioters and several people were injured, said Youssouf Traore, president of the Guinean Red Cross.

"A rumour, which was totally false, spread that we had sprayed the market in order to transmit the virus to locals," Traore said. "People revolted and resorted to violence, prompting soldiers to intervene."

Local Red Cross workers had to flee to the military camp with their medical equipment.
2014-08-29 14:32

http://www.news24.com/Africa/News/R...icials-accused-of-transmitting-Ebola-20140829

 

[mala]

The Rivers State government says it has moved the wife of the late Dr. Ike Enamoah, the doctor, who died of the suspected Ebola virus in the state.

The state government said the widow of the deceased doctor was moved to Lagos to enable workers in the state concentrate on the tracing of contacts and placing them under surveillance.

The State Commissioner for Health, Sampson Parker made this known while giving update of the case of Ebola in the state.

He said the number of contacts have increased to 160, adding that the state government now has about two hundred personnel who have volunteered their time and man-power to assist the state government.

“Only one case is symptomatic and that is the wife of the late Doctor, Ike Enamoah. You know that she had close contact with him.

more at link:
http://www.nigerianbulletin.com/threads/ebola-sick-wife-of-dead-ph-doctor-relocated-to-lagos.90154/

 

[mala]

Rehydration is KEY

I have read at least three different places for three different survivors that rehydration is key. Although IV is preferred, one man drank a bottle of water every hour and ate some rice, and he survived.

Here's some info on rehydration, specifically how to make an oral electrolyte and how to rehydrate someone rectally (assuming diarrhea doesn't prevent it)

http://en.hesperian.org/hhg/Where_Women_Have_No_Doctor:How_to_Give_Fluids_to_Treat_Shock

Another Oral rehydration fluid recipe is:
1/4 Tsp Salt (Sodium Chloride)
1/4 Tsp Lite Salt (Potassium Chloride)
1/4 Tsp Baking Soda
2 1/2 Tbsp Sugar
1 liter clean water

(I don't know if this belongs on this thread, if not mods, please delete.)

 

[Doomer Doug]

Doomer Doug actually hates it when his Doomer predictions come true.

We are now at the edge of the abyss.
Fact One. It is now ABSOLUTELY CLEAR that local health and government officials, either through lack of knowledge, corruption, incompetence, have allowed several clearly exposed people to Mr. Sawyer to evade the system. The results of that will be catastrophic. The ENTIRE outbreak in Port Harcout can be traced to ONE MAN who "fled" after being exposed to Mr. Sawyer. He then set off an infection cycle completely unknown to local authorities until the doctor who treated him in secret died one week ago. How many additional people were exposed to the Ebola virus by the diplomat, the doctor who died, and now his wife. We may safely assume the person he operated on is now infected. At any rate, Port Harcout is totally out of control, plus being a major travel and commerce hub.

Fact Two. The infected nurse created a second infection cycle in the eastern city, that we have had NO information out of at all.

Fact Three. The Senegal case also highlights the corruption and incompetence of local authorities. The man ran around, clearly infected and symptomatic, for a looong time before getting to Senegal. Again, how many people did he infect on his journey.

Fact Four. The social collapse is now in full bore, full blown and active phase. There is NO functional government in Liberia at all. The riots in Guinnea indicate they are headed down the same road.

Fact Five. Doomer Doug now sees NO CHANCE, REPEAT NO CHANCE AT ALL, that the worst case scenario in West Africa will not play out over the next six months at a minimum.

Given the 2 to 21 day infection cycle, like it has been said this is not rocket science. We will start to see cases in Port Harcout within the next three weeks. We will start to see cases, may have already seen unreported cases, in the eastern Nigerian city. We will start to see cases in Sengal, West Point etc soon.

One final thing, the mainstream media is not actually "reporting" the higher times four infection and death rates. What they are now doing, which is what both WHO and the CDC are doing, is bury the times four in the articles I read. The highlighted figures are still the 3,000 infected, along with 1,500 now dead. The times four show 12,000 infected and 6,000 dead. AGAIN, THIS IS WITHIN SPITTING DISTANCE OF THE WHO SAYING 20,000 CASES. Gang, we are going to be at 20,000 cases by the end of the week.

Yep, Nigeria is closing the barn door, adding a new lock and proudly proclaiming they are "dealing with the situation." Well, they have not, are not and have no ability to deal with the Ebola situation.

Assuming the two Japanese, who "came" from South Africa are confirmed Ebola then it means the DRC variant is now all over the rest of Africa.

Africa is gone. Triage will be used to seal it off. It is all now about spin control for WHO and the CDC. It is all about CYA, and coming up with excuses for the hearings and trials.

If DragonCon does indeed serve as a vector for Ebola to get into the USA, it will mean the collapse of the liberal PC state at the least. Maybe Obama has been told how bad Fukushima and Ebola, along with the illegal hordes coming over the southern border are going to be. Add in an ISIS attack in Conus and wouldn't you spend all your time golfing? LOL Nero fiddled while Rome burned; Obama golfed while the USA collapsed.

Prepare yourself for an Ebola epidemic that is eventually going to kill tens of millions in Africa alone.

 

[ainitfunny]

I have read at least three different places for three different survivors that rehydration is key. Although IV is preferred, one man drank a bottle of water every hour and ate some rice, and he survived.

Here's some info on rehydration, specifically how to make an oral electrolyte and how to rehydrate someone rectally (assuming diarrhea doesn't prevent it)

http://en.hesperian.org/hhg/Where_Women_Have_No_Doctor:How_to_Give_Fluids_to_Treat_Shock

Another Oral rehydration fluid recipe is:
1/4 TEASPOON REGULAR Salt (Sodium Chloride)
1/4 TEASPOON Lite Salt (Potassium Chloride)
1/4 TEASPOON Baking Soda
2 1/2 TABLESPOONS (which is the same as 7 and a half TEASPOONS) SUGAR (because 1 TABLEspoon=3 TEASPOONS)
1 liter clean water

(I don't know if this belongs on this thread, if not mods, please delete.)

Yes, YES, YES! YES! it DOES BELONG HERE!
It will probably SAVE MORE LIVES than all the other posts

EVERYONE.... PRINT OUT THAT RECIPE AND KEEP IT WHERE IT CAN BE QUICKLY FOUND!
GO BUY OR MAKE ABSOLUTELY SURE YOU HAVE ALL THE INGREDIENTS TO MAKE IT!!
Some people who do not cook may not already have baking soda or "LITE SALT"(POTASSIUM CHLORIDE)
You need BOTH POTASSIUM CHLORIDE AND SODIUM CHLORIDE!!
I am going to MAKE AT LEAST one 2 liter bottle of it and keep it in the fridge.
Thank you, thank you, THANK YOU, MALA!!

 

[Intestinal Fortitude]

Doomer Doug actually hates it when his Doomer predictions come true.

We are now at the edge of the abyss.
Fact One. It is now ABSOLUTELY CLEAR that local health and government officials, either through lack of knowledge, corruption, incompetence, have allowed several clearly exposed people to Mr. Sawyer to evade the system. The results of that will be catastrophic. The ENTIRE outbreak in Port Harcout can be traced to ONE MAN who "fled" after being exposed to Mr. Sawyer. He then set off an infection cycle completely unknown to local authorities until the doctor who treated him in secret died one week ago. How many additional people were exposed to the Ebola virus by the diplomat, the doctor who died, and now his wife. We may safely assume the person he operated on is now infected. At any rate, Port Harcout is totally out of control, plus being a major travel and commerce hub.

Fact Two. The infected nurse created a second infection cycle in the eastern city, that we have had NO information out of at all.

Fact Three. The Senegal case also highlights the corruption and incompetence of local authorities. The man ran around, clearly infected and symptomatic, for a looong time before getting to Senegal. Again, how many people did he infect on his journey.

Fact Four. The social collapse is now in full bore, full blown and active phase. There is NO functional government in Liberia at all. The riots in Guinnea indicate they are headed down the same road.

Fact Five. Doomer Doug now sees NO CHANCE, REPEAT NO CHANCE AT ALL, that the worst case scenario in West Africa will not play out over the next six months at a minimum.

Given the 2 to 21 day infection cycle, like it has been said this is not rocket science. We will start to see cases in Port Harcout within the next three weeks. We will start to see cases, may have already seen unreported cases, in the eastern Nigerian city. We will start to see cases in Sengal, West Point etc soon.

One final thing, the mainstream media is not actually "reporting" the higher times four infection and death rates. What they are now doing, which is what both WHO and the CDC are doing, is bury the times four in the articles I read. The highlighted figures are still the 3,000 infected, along with 1,500 now dead. The times four show 12,000 infected and 6,000 dead. AGAIN, THIS IS WITHIN SPITTING DISTANCE OF THE WHO SAYING 20,000 CASES. Gang, we are going to be at 20,000 cases by the end of the week.

Yep, Nigeria is closing the barn door, adding a new lock and proudly proclaiming they are "dealing with the situation." Well, they have not, are not and have no ability to deal with the Ebola situation.

Assuming the two Japanese, who "came" from South Africa are confirmed Ebola then it means the DRC variant is now all over the rest of Africa.

Africa is gone. Triage will be used to seal it off. It is all now about spin control for WHO and the CDC. It is all about CYA, and coming up with excuses for the hearings and trials.

If DragonCon does indeed serve as a vector for Ebola to get into the USA, it will mean the collapse of the liberal PC state at the least. Maybe Obama has been told how bad Fukushima and Ebola, along with the illegal hordes coming over the southern border are going to be. Add in an ISIS attack in Conus and wouldn't you spend all your time golfing? LOL Nero fiddled while Rome burned; Obama golfed while the USA collapsed.

Prepare yourself for an Ebola epidemic that is eventually going to kill tens of millions in Africa alone.

have you been reading my mind?

I think we are well beyond 20.000 dead already. Lots of bush villages are gone back to nature.

 

[Doomer Doug]

WHO is now "predicting" 20,000 cases of infection "before it is all over." I am thinking I want whatever type of drug is in the coffee urns at WHO and CDC headquarters. LOL

I look at the FACTS, as best as I can tell under the fog of lies, misinformation, deceit and spin control, and I see a situation in which people with Ebola can't get ANY medical treatment, much less effective medical treatment. This means there are now THOUSANDS of infected people just wandering around West Africa, especially Liberia. West Point, well if you released a mental facility patient, didn't give him meds for a month, and then told them to come up with an "Ebola treatment" plan for West Point, you would get what you have as the "official plan." You would seal off the area completely. This would guarantee everybody would be exposed to infected people. You would then allow the lack of food, clean water and the THREE PAY TOILETS to deal with the 50,000 to 75,000 people there.

Liberia is simply gone, gang. It will be piles of rotting corpses by Christmas at the latest. More likely by Halloween, and that is likely to be overly optimistic. I mean, what do people, medical people, government people, think is going to happen to a confined, infected population sealed into a small area?

 

[Intestinal Fortitude]

Does Caterpillar Corp have any drone operated earth movers to bury the dead?

 

[mala]

No worries, Doomer Doug! The slum is open again.

DAKAR, Senegal (AP) — Liberia says it will open up a slum in its capital where thousands of people were barricaded to contain the spread of Ebola.

Information Minister Lewis Brown says lifting the quarantine Saturday morning will not mean there is no Ebola in the West Point Slum.

But authorities feel confident they can screen for the sick and that the community now actively fighting the disease.

The slum of 50,000 people in Liberia's capital was sealed off more than a week ago, sparking unrest and leaving many without access to food or safe water.

http://newsok.com/liberia-to-unseal...op-ebola/article/feed/728483?custom_click=rss

 

[Doomer Doug]

Flamethrower tanks, D-9 with a BIG blade and perhaps napalm from Warthogs at 500 feet. It will be Medevial in Africa soon enough. In Africa the hot and humid climate will eventually deal with the bodies the dogs and vermin haven't eaten. Yep, the psychological impact of a true Ebola epidemic, much less a global pandemic, is going to scar the human species for 300 years, just like the Black Death did in 1348. Our political elite will be stripped of moral authority and will be lucky to avoid being shot.

 

[Intestinal Fortitude]

DAKAR, Senegal (AP) — Liberia says it will open up a slum in its capital where thousands of people were barricaded to contain the spread of Ebola.

Information Minister Lewis Brown says lifting the quarantine Saturday morning will not mean there is no Ebola in the West Point Slum.

But authorities feel confident they can screen for the sick and that the community now actively fighting the disease.

The slum of 50,000 people in Liberia's capital was sealed off more than a week ago, sparking unrest and leaving many without access to food or safe water.

http://newsok.com/liberia-to-unseal...op-ebola/article/feed/728483?custom_click=rss

Open the pressure cooker and release the zombie horde!

 

[Doomer Doug]

MALA PLZZZZZ




Um, I realize that insane actions are now common in Liberia, but even by their insane level this is, well out there.

They are going to screen 75,000 people for Ebola using what witch doctors?

People show no symptoms and then infect other people. The timing is horrible. All of the people who were exposed to the fleeing patients or the infected looters are going to be showing symptoms in the next few days or so.

This is good for comic relief, in the gallows humor we are all going to die way.

 

[mala]

Um, I realize that insane actions are now common in Liberia, but even by their insane level this is, well out there.

They are going to screen 75,000 people for Ebola using what witch doctors?

People show no symptoms and then infect other people. The timing is horrible. All of the people who were exposed to the fleeing patients or the infected looters are going to be showing symptoms in the next few days or so.

This is good for comic relief, in the gallows humor we are all going to die way.

This isn't funny. It's a horror show.

How to ensure a rapid spread of a deadly virus:

1) Take 20 infected individuals.
2) Place them in a third world slum containing 75,000 people with no sanitation.
3) Cordon off said slum.
4) Starve and terrify the people for a week.
5) Open doors and watch them scatter to the four corners of the country.

Stephen King never could have dreamed this up, and he has a very good imagination.

 

[jaw1969]

Um, I realize that insane actions are now common in Liberia, but even by their insane level this is, well out there.

They are going to screen 75,000 people for Ebola using what witch doctors?

People show no symptoms and then infect other people. The timing is horrible. All of the people who were exposed to the fleeing patients or the infected looters are going to be showing symptoms in the next few days or so.

This is good for comic relief, in the gallows humor we are all going to die way.

I see no good end for this ...by this time next year there will be less that Half the mouths to feed WORLD WIDE the exponential curve is just getting started TEOTWAWKI IS HERE...

 

[mala]

Quebec girl in isolation after showing possible Ebola symptoms

CTVNews.ca Staff
Published Friday, August 29, 2014 6:23PM EDT

A Quebec girl who recently returned from a trip to Sierra Leo is under observation in a Gatineau hospital after showing possible symptoms for the Ebola virus.
The girl, along with her mother, had been visiting family in the West African country.
Outaouais Region health officials say the girl was brought to the hospital with a high fever, and is now in an isolation unit.
However, officials don’t believe the girl came into contact with anyone carrying Ebola. The only way to contract the virus is through contact with a carrier’s bodily fluids.
Every suspected case of the virus in North America has tested negative.
The World Health Organization warns that 20,000 people could become infected with Ebola before the outbreak in West Africa is contained.
So far, more than 1,550 people have died from the virus.

http://www.ctvnews.ca/health/health...ter-showing-possible-ebola-symptoms-1.1983546

 

[Baloo]

Flamethrower tanks, D-9 with a BIG blade and perhaps napalm from Warthogs at 500 feet. It will be Medevial in Africa soon enough. In Africa the hot and humid climate will eventually deal with the bodies the dogs and vermin haven't eaten. Yep, the psychological impact of a true Ebola epidemic, much less a global pandemic, is going to scar the human species for 300 years, just like the Black Death did in 1348. Our political elite will be stripped of moral authority and will be lucky to avoid being shot.

Never happen--political elite stripped part. They will be the new feudal overlords.
Either because people want protection from the rape gangs or because they have the military and will force it on us.
Sorry, AR-15s don't beat tanks.