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Ebola: It's In The US Now

Interesting article from before the first US case was diagnosed

Ebola Doctor Reveals How Infected Americans Were Cured



Last week two American aid workers who had contracted Ebola while working in west Africa were released from a U.S. hospital and pronounced “recovered.” They had been flown to Emory University Hospital in Atlanta from Liberia earlier this month to receive care in the hospital’s specialized infectious disease unit. Kent Brantly, a physician with the humanitarian group Samaritan’s Purse, and missionary Nancy Writebol, of SIM USA, beat the strain of the disease they had contracted, which kills 52 percent of its victims. Bruce Ribner, medical director of the hospital's Infectious Disease Unit, sat down with Scientific American to explain how the two Americans were cared for, the lessons that could be applied to help patients across Africa and why the hysteria over flying the two individuals back to the U.S. was unfounded.
http://www.scientificamerican.com/article/ebola-doctor-reveals-how-infected-americans-were-cured/
Link to story
 
H had 80 contacts...

The number of people who came into contact with Texas Ebola patient Thomas Eric Duncan has zoomed from as many as 18 to 80, health officials in Texas announced in a statement today.
Duncan, a Liberian man who is the first person diagnosed with Ebola in the United States, is being treated in an isolation unit at Texas Health Presbyterian Hospital Dallas after being brought to the hospital by ambulance earlier this week.
Medical authorities initially said that they were interviewing and monitoring 12 to 18 people, including five children, who had been in contact with Duncan since he arrived Sept. 19. But today Dallas Health Director Zack Thompson told ABC News affiliate WFAA that 80 people who may have come in contact with Duncan are being interviewed.
Thompson said four or five members of Duncan's family are under a "control order" to stay inside their homes.
It's not clear if these four or five people under the control order are the five school age children who were told to stay home from school.
Dr. David Lakey, Texas health commissioner, talked addressed the control order.
"We have tried and true protocols to protect the public and stop the spread of this disease," Lakey said in the statement. "This order gives us the ability to monitor the situation in the most meticulous way."

Authorities say the family members do not currently have symptoms of Ebola, which include fever above 100.5 degrees, headache, nausea, diarrhea or abdominal pain. The order will continue until at least Oct. 19.
Thompson said he was aware of news reports that Duncan had been vomiting before being admitted to the hospital, but said he was not concerned about the vomiting.
Duncan flew from Liberia to Brussels on Sept. 19. He continued to Washington’s Dulles Airport, before flying to the Dallas-Fort Worth Airport on a United Airlines flight.
Authorities with the Centers for Disease Control and Prevention have said airline passengers and flight crew members aren’t at risk for Ebola because Duncan wasn’t exhibiting symptoms until days later, but his diagnosis has left residents in Dallas on edge, with scrutiny for Texas Health Presbyterian Hospital, which allowed the man to leave after he told a nurse he had come from West Africa.
Duncan returned to the hospital by ambulance two days later. He remains in an isolation unit, listed in serious condition.
Mark Lester, the executive vice president of Texas Health Resources, said a communication issue was responsible for the lapse.
“Regretfully, that information was not fully communicated throughout the full team,” Lester said.
 
And how many people have those people contacted and so on and so on. This can get out hand quickly.
 
vetusvates said:
TSST...you're scaring me...
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Sorry. It is a little scary IMHO. I hate sounding like an alarmist but believing in the due diligence of the average person for containment is insane. Like others pointed out, has anything even been done to stop more fly-ins? There seems to be a lack of concern for a virus that kills. :shrugs:

If you lived in Dallas and your kids went to one of those schools would you send them to school?

One infected person contacted now up to 80 people. What happens when we have hundreds or thousands infected?
 
I guess I just don't understand the hysteria over this. It's not super contagious and honestly reminds me of the HIV outbreak in the 80s-90s when everyone was panicking about using the same bathrooms.

Ebola is not contagious unless the person is showing symptoms. Then you have to come in direct contact with the infected person's bodily fluids and have a break in your skin. It just seems unlikely even if you do live in Dallas. Yes this person came in contact with several people but it is unlikely everyone of those people are now infected.

Soap, bleach and disinfectants all kill the virus so wash your hands and avoid anyone that is infected. You will be fine. This is NOTHING like influenza or other highly contagious diseases.
 
HVani said:
I guess I just don't understand the hysteria over this. It's not super contagious and honestly reminds me of the HIV outbreak in the 80s-90s when everyone was panicking about using the same bathrooms.

Ebola is not contagious unless the person is showing symptoms. Then you have to come in direct contact with the infected person's bodily fluids and have a break in your skin. It just seems unlikely even if you do live in Dallas. Yes this person came in contact with several people but it is unlikely everyone of those people are now infected.

Soap, bleach and disinfectants all kill the virus so wash your hands and avoid anyone that is infected. You will be fine. This is NOTHING like influenza or other highly contagious diseases.
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Exactly. FWIW I don't know kids at these schools (we live in another district), but I know someone who works at one of them. She seems to be content with the measures that are being taken.

Sent from my phone using Tapatalk
 
HVani said:
I guess I just don't understand the hysteria over this. It's not super contagious and honestly reminds me of the HIV outbreak in the 80s-90s when everyone was panicking about using the same bathrooms.

Ebola is not contagious unless the person is showing symptoms. Then you have to come in direct contact with the infected person's bodily fluids and have a break in your skin. It just seems unlikely even if you do live in Dallas. Yes this person came in contact with several people but it is unlikely everyone of those people are now infected.

Soap, bleach and disinfectants all kill the virus so wash your hands and avoid anyone that is infected. You will be fine. This is NOTHING like influenza or other highly contagious diseases.
Click to expand...
:shrugs: Approximately 640,000 Americans have died from HIV/Aids. There are presently 1.2 million diagnosed with HIV in the USA. I hope this is not on the same scale as HIV because it appears far more deadly once contracted.
 
Bear in mind too that, according to the CDC, there is a 50% mortality rate. A coin flip whether you live or die. This chicken little doesn't want to flip that coin. (I suck at winning coin flips)
 
HerpsOfNM said:
J.H.C.!!!!!!!!!!!!!!!

I could dissect the above sentence with a butter knife and make it look like I used the steady hands of a brain surgeon.

"Case number 2" implies that a 2nd confirmed case exists; it does not. For what I've read thus far, for what is available for all of us who are not privy to the actual HIPAA details, they are simply being monitored AND A DIAGONSIS HAS NOT BEEN GIVEN WHETHER THEY ARE POSITIVE FOR EBOLA.....yet.

is it really that hard to comprehend?! :shrugs: :flames:
This is media sensationalism at its finest thus far, and those of you who have decried a hatred for it and are taking the bait, hook, line, sinker, fishing rod, fisherman, and the blasted boat he/she has cast from. :angry01:

The amount of paranoia and fear mongering is absurd. That said, I'm taking my biology education, understanding I have of select agents, and my wife's microbiology background and peacing out of this conversation.
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Oy Vey, "second case" is the term used in the report. And it is not the media this time that was from the mouth of the Dallas County Health director.
 
As previously stated, it is NOT CONTAGIOUS until symptoms are showing. All the people who have been in contact with that first individual are not a danger to anyone else until they start showing symptoms. At this exact moment in time, they are 'safe'.

Though emphasis should be made that men who recover can shed the virus in semen for up to 2 months, so no sex.
 
Another quote:


"All the focus on the one Ebola patient in Texas is a sign that people are looking at this from the wrong angle- one or two sick people in Texas probably aren't a serious problem because the US has the infrastructure to contain an outbreak. But the outbreak in West Africa is like a fire that is going to be throwing little sparks all over the world, and the fire is doubling in size every 2-3 weeks. If one spark lands in the US today, we can stomp it out fairly quickly. But there are cities in the world with much worse medical care, worse poverty, and much denser populations that are essentially tinderboxes. If we let the rest of the world catch fire, then even our awesome medical system could be overwhelmed two or three years down the road (to say nothing of all the economic and political chaos it would bring). Short version is, any U.S. dollars spent on containing this in Africa right now are probably the single best investment we could possibly make, so if you hear anyone whining about it, smack them in the head."
 
This...regarding a Microbiologist/MD...

http://www.ajc.com/news/news/doctor-boards-flight-in-ebola-protection-suit-to-p/nhZk8/

This...100...while contagious...

http://www.nytimes.com/2014/10/03/us/dallas-ebola-case-thomas-duncan-contacts.html?_r=0

And this...on Liberia prosecuting Patient Zero...for lying on Airport Questionnaire before flying to Dallas...

http://houston.cbslocal.com/2014/10/02/liberia-plans-to-prosecute-man-who-brought-ebola-into-us-for-allegedly-lying-on-airport-questionnaire/

Chip said:
This is from August, but I think there is a lot of perspective there: http://www.theguardian.com/commentisfree/2014/aug/05/ebola-worrying-disease
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Chip, I superlatively hope to the depths of my being that this will be true.
Having worked in a hospital, where illness and tragedy are in every day's work, (and sputum, blood, vomit and poop were all on the daily menu), I think my perspective and feelings are surely myopic.
 
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Low risk is not zero risk:

Gilsdorf A et al. Guidance for contact tracing of cases of Lassa fever, Ebola or Marburg haemorrhagic fever on an airplane: results of a European expert consultation. BMC Public Health, 2012:
"The reviewed studies show a low risk of transmission in the early phase of symptomatic patients, even if high risk exposure occurred. However, risk of transmission may increase in later stages of the disease with increasing viral titres and increased viral shedding."
​
Dowel SF et al. Transmission of Ebola Hemorrhagic Fever: A Study of Risk Factors in Family Members, Kikwit, Democratic Republic of the Congo, 1995. Journal of Infectious Diseases, 1999:
"No exposure during the incubation period was associated with additional increased risk, and there was no increased risk for conversing, sharing a meal, or sharing a bed with a sick person during the early phase of illness."
"It is also important that 4 family members [of 173] who were exposed only in the prehospital phase were infected. Thus, the risk from exposure to a patient in the early stages of illness cannot be completely discounted. This fact is important for public health control measures, since even mildly ill persons may pose some risk, for example, to fellow passengers on an airplane."
​
And a couple thoughts:



Symptoms are a warning that the probability of infectivity has increased, NOT that now a person has abruptly transitioned from non-infectious to infectious and the probability gets worse as the symptoms get worse and the viral load gets higher.
Again, as I keep saying, since the consequence of being wrong is so dire, we should be erring on the side of caution, not counting on probability to protect us.





source?
This conflicts with repeated clear messages from ID experts




No, it does not. They are just simplifying. People with a higher viral titer are most likely going to have more symptoms, thus be more infectious. They assume that because they have measured high titers in infected people with symptoms and have a harder time detecting the virus in people prior to symptoms. Infectivity is probably function of viral load, they assume. As the viral load increases, then the probability of infection increases. Again, this is assumed, but it is likely to be true.
However, transmission is just not that well known and understood for any strain, let alone this one. No one can give you definitive references regarding human transmission with this outbreak because they do not exist. All of it is conjecture based on past experience, not on human-human transmission studies. No one should be claiming anything definitively. That is why I use probabilities because those you can immediately see from the data we currently have. Until we know exactly how each person contracted it, via what route, we can only estimate probabilities.
I read a lot of people making assumptions, including the CDC, about how people got infected, and that is really not warranted until we know for sure given that the consequences are so dire. Even transmission routes of low probability have to be blocked, especially if we do not want to provide selective pressure for those routes.


*************

I just think people should think for themselves- not blindly follow CDC's simplified directives which are aimed at quelling the general public's fears.
 
Just heard a news confrence from dallas, The patient was exposed to ebola when he carried a pregnant woman into a hospital in liberia, then he lied on his health form so he would not have to cancel his trip. The dallas health dept. tried to get the family to cooperate and stay in their home, but they refused and the health dept. got a court order to forse them into quarinteen. They are now in process of contacting 80- 100 people including the childs school mates.

I heard in an interview the morning that even though it is not an air bourn virus if a sickpeople cough or sneeze they can spread it if you are exposed to these fluids. so just use some common sense, carry antibiotic hand wipes and use them often, like after you handle public use items like phones, wipe the handsets or shopping carts, wash or wipe hands often, and stay out of crowds. I would not panic either but a little caution will not hurt. Besides its flu season and we all take these precautions anyway.
 
I believe in thinking for one's self but panic and worry help no one. Be smart, wash your hands, and you'll be fine. If you work in the medical field in the Dallas area, a bit more caution is needed.

The man currently infected got it while helping a very sick, very pregnant lady to the hospital. He had direct contact and sadly he caught it.

I think people in the medical field directly dealing with the disease are at the greatest risk but it's still a pretty low risk. The guy on the street has very little to worry about.
 
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