Ebola

[Benzgirl]

I think everyone by now has heard of the 2nd patient. She flew from Dallas to Cleveland and back over last weekend to visit relatives in Akron. She visited 3 relatives in Ohio that are employed by Kent State.
The Plain Dealer and all of the TV stations have been running news non-stop on this.

http://www.cleveland.com/healthfit/i...rt_maj-story-1

[Kevin]

I wonder whether our for-profit hospital system is really equipped to handle a national outbreak like this. It would seem they have every incentive to not diagnose or treat ebola patients. While that may be illegal, it doesn't mean that it's not going to happen.

[MaggieXi]

Can we get a definition of a person being "isolated" and "monitored", because I'm pretty sure someone who is isolated and monitored isn't going to be allowed to fly!

[shirley1929]

Originally Posted by MaggieXi

Can we get a definition of a person being "isolated" and "monitored", because I'm pretty sure someone who is isolated and monitored isn't going to be allowed to fly!

My understanding is monitored =/= isolated.

Monitored basically means checking your temperature 2x a day and reporting the results to the person who is keeping track of such things. You are free to go and do as you please, so long as you are self-monitoring.

Isolated is what they are doing after there is a suspected case. And it's pretty much what you think it means.

I do think it odd that the 2nd patient went off on a plane flight, but I don't believe she was given any restrictions where she should not have been doing so.

[PersistentDST]

Originally Posted by Benzgirl

I think everyone by now has heard of the 2nd patient. She flew from Dallas to Cleveland and back over last weekend to visit relatives in Akron. She visited 3 relatives in Ohio that are employed by Kent State.
The Plain Dealer and all of the TV stations have been running news non-stop on this.

http://www.cleveland.com/healthfit/i...rt_maj-story-1

This is hitting EXTREMELY close to home for me right now. I can't concentrate. I went to college with the patient, and she is a really sweet girl. And I am very close friends with some of her family members. Please send your prayers to them as they really need them. Thank you in advance.

[shirley1929]

Originally Posted by PersistentDST

This is hitting EXTREMELY close to home for me right now. I can't concentrate. I went to college with the patient, and she is a really sweet girl. And I am very close friends with some of her family members. Please send your prayers to them as they really need them. Thank you in advance.

Ugh. I am so sorry. Heard they were sending her to Emory hospital in Atlanta, yes? I think she'll be in a much more suited place to deal with her needs there. Hopefully she's a blood type match for one of the survivors like Nurse #1 (Pham) is.

The Dallas part is hitting pretty close to home for me & the reason why I'm watching so closely. I know a ton of people that live right around where both nurses live.

[PersistentDST]

Originally Posted by shirley1929

Ugh. I am so sorry. Heard they were sending her to Emory hospital in Atlanta, yes? I think she'll be in a much more suited place to deal with her needs there. Hopefully she's a blood type match for one of the survivors like Nurse #1 (Pham) is.

Yes, she is going to go to Emory. The good thing is that she is holding up. Praying it continues.

[ComradesTrue]

I agree that for profit hospitals are not the best place to be dealing with this, and I was saying the exact same thing the day Duncan got admitted. Dallas has two large regional hospital systems (Baylor and UT Southwestern). Both are going to have medical faculty that are on cutting edge of everything because they are teaching hospitals. UT Southwestern, especially, is accustomed to seeing rare and difficult cases.

We are in the stages of any big stories where "details" are coming out rapidly. Some will prove true, others will be discounted. One report earlier today is that the staff taking care of Duncan did not have gowns for 2 days. I find that hard to believe, but if that is the case, then wow. I am also very troubled that anyone who had contact with him was allowed to fly. This is straight out of a sci-fi movie, for crying out loud.

And now for a rant:
If one more idiotic person in my social media feed declares that we need to close our borders then I may punch my computer. Let's use logic:

1. Okay, borders are closed. No flights into US from West Africa
2. Guess what? No flights would be going TO West Africa
3. Guess who is on the flights going to that regions? Aid Workers. Guess who would need to be able to get home? Aid Workers.

We need scores of aid workers (both medical hands and others with supplies) to solve the sad state going on in West Africa. People are reacting because this is on our soil now, but thousands of individuals have already died, and the prediction is that those numbers will grow exponentially. We have a responsibility to help those who have a great need, whether they are Americans or citizens of another country.

Close the border and this could wipe out entire countries. And guess what? It would still be able to travel to the US. People in Africa travel by foot and car. They can get to nearby countries, and then get to Europe. Last I check there were plenty of planes coming to the US (or Canada or Mexico) from Europe.

[honeychile]

Originally Posted by PersistentDST

This is hitting EXTREMELY close to home for me right now. I can't concentrate. I went to college with the patient, and she is a really sweet girl. And I am very close friends with some of her family members. Please send your prayers to them as they really need them. Thank you in advance.

Praying for your friend - she is a very beautiful woman. So sad that she's in the midst of planning her wedding amidst all of this.

[thetalady]

Had to come to Presby for a doctor appointment. The media are swarming at another entrance. Going no where near that.

[IUHoosiergirl88]

Originally Posted by candygirl200413

As a public health major, this REALLY interests me, and also finally gets me closer to thinking what I want to do for grad school down the road. IUhoosiergirl I love all the information you provided!

You are very very welcome! I have a grad degree in bio and work in the field, although not in a lab. As strange as it sounds, Ebola has always been one of my 'favorites; because it's close to the perfect virus--but it's not.

For anyone who cares, norovirus is probably the most 'perfect' virus.

[Benzgirl]

Originally Posted by PersistentDST

Yes, she is going to go to Emory. The good thing is that she is holding up. Praying it continues.

Keeping your friend in my thoughts. I'll be flying out on Friday but will follow her progress while I'm on vacation.

[als463]

Originally Posted by IUHoosiergirl88

You are very very welcome! I have a grad degree in bio and work in the field, although not in a lab. As strange as it sounds, Ebola has always been one of my 'favorites; because it's close to the perfect virus--but it's not.

For anyone who cares, norovirus is probably the most 'perfect' virus.

After complaining about being sick of hearing about Ebola, I was really intrigued by your background and interest in it. I have to ask as I am no expert in biology, why is it considered the most 'perfect' virus? Is that because it's hard to detect or something?

[IUHoosiergirl88]

Originally Posted by als463

After complaining about being sick of hearing about Ebola, I was really intrigued by your background and interest in it. I have to ask as I am no expert in biology, why is it considered the most 'perfect' virus? Is that because it's hard to detect or something?

So the 'perfect' virus is one that's highly contagious so it's easily transferred from host to host, is shed/released very rapidly by the host (via sneezing, coughing, sweat, pus, whatever), evolves quickly to get around both the immune system and medical countermeasures, evokes limited immunity so you can get the same virus over and over, and is only moderately virulent so it doesn't kill off all potential hosts. Ideally, they're also pretty environmentally stable, but that's able to be bypassed--just look at influenza's seasonal outbreaks. You may also want a virus that lays 'dormant' in the host while still remaining infective, so you can pass it on to others even if you yourself are not showing any ill effects.

Ebola fits a lot of those criteria, but not all of them. It's highly contagious because it requires a low viral load (i.e. the amount of virus you come in contact with) to infect, but it's not airborne so it's not transferred as easily. Patients do shed high viral loads--check. It doesn't mutate THAT rapidly when compared to other viruses--but there's not a good treatment for it at this point. It does invoke limited immunity, but it's appearing like that immunity may be stronger than we think. Finally, it's pretty virulent and obviously kills off a high percentage of its hosts, so eventually it 'burns out.'

Norovirus, on the other hand, is INCREDIBLY contagious, you shed high viral counts (some studies have shown 10^5 to 10^11 viral copies per gram of poo or vomit), it mutates extremely fast, immunity is pretty much nonexistent, and fits that moderate virulence category. It's also extraordinarily stable.

Interestingly enough, when it comes to viruses, you actually don't want high virulence because oftentimes, with that comes decreased infectivity or contagiousness.

[als463]

Originally Posted by IUHoosiergirl88

So the 'perfect' virus is one that's highly contagious so it's easily transferred from host to host, is shed/released very rapidly by the host (via sneezing, coughing, sweat, pus, whatever), evolves quickly to get around both the immune system and medical countermeasures, evokes limited immunity so you can get the same virus over and over, and is only moderately virulent so it doesn't kill off all potential hosts. Ideally, they're also pretty environmentally stable, but that's able to be bypassed--just look at influenza's seasonal outbreaks. You may also want a virus that lays 'dormant' in the host while still remaining infective, so you can pass it on to others even if you yourself are not showing any ill effects.

Ebola fits a lot of those criteria, but not all of them. It's highly contagious because it requires a low viral load (i.e. the amount of virus you come in contact with) to infect, but it's not airborne so it's not transferred as easily. Patients do shed high viral loads--check. It doesn't mutate THAT rapidly when compared to other viruses--but there's not a good treatment for it at this point. It does invoke limited immunity, but it's appearing like that immunity may be stronger than we think. Finally, it's pretty virulent and obviously kills off a high percentage of its hosts, so eventually it 'burns out.'

Norovirus, on the other hand, is INCREDIBLY contagious, you shed high viral counts (some studies have shown 10^5 to 10^11 viral copies per gram of poo or vomit), it mutates extremely fast, immunity is pretty much nonexistent, and fits that moderate virulence category. It's also extraordinarily stable.

Interestingly enough, when it comes to viruses, you actually don't want high virulence because oftentimes, with that comes decreased infectivity or contagiousness.

This was all really informative. Thanks for sharing, IUHoosiergirl88.