Ebola

[pinksequins]

Thanks -- I am thinking of a typically wet bathtowel after a shower. One still rubs it all over one's body. I am also thinking of bar soap used to wash hands after using the toilet.

[pinksequins]

CNN has posted an interesting article on Gigi the robot.

[NorthernMom]

Yes....in the early stages of infection there is not a lot of virus present in saliva or mucous. It also doesn't cause sneezing or coughing. So the likelihood that someone with very early disease would sneeze in your eye, or similar, is pretty darn low. The average person who is not a close family member or health care worker, would not be coming in contact with other fluids. Also....once people are at the point of having significant vomiting or diarrhea, they are probably not out and about. And certainly not at the stage where they'd be experiencing any bleeding issues related to the virus.

[IUHoosiergirl88]

Originally Posted by Outlaw 1963

I don't trust it. For one, folks don't know enough about it. And two, folks haven't been properly trained in handling patients with the virus.

You can not trust it all you want. However, the virology community actually knows a lot about Ebola, more than other hemorrhagic fevers that we don't see as often. The American public just doesn't have a high enough level of scientific literacy to understand if the data were presented to them. Fear is an easier response than educating one's self

[IUHoosiergirl88]

Fruit bats are a reservoir for many nasty little diseases--Ebola being one of them. Bush creatures (monkeys, animals, whatever) come in contact with or eat infected bats, humans eat bushmeat and get infected. Rinse and repeat, that's caused every outbreak since the discovery of the Ebolavirus family (yes, there's different ones) in the summer of 1976. It probably was around before then, but that's the first time it was officially discovered and named.

In this outbreak, patient zero is assessed to be a 2 year old child in Guinea who died at the end of December 2013. (http://who.int/csr/disease/ebola/ebo...t-big.png?ua=1)

[IUHoosiergirl88]

Originally Posted by Outlaw 1963

^^^goddamn! I think we need flight restrictions or something LOL.

That's a logical thought, but they'll probably backfire and make the disease harder to control. If someone tells you you can't do something--what's the one thing you want to do? You want to do that thing. Plus, there aren't any direct flights from Liberia -> USA, so you'd have to stop ALL flights. And that is going to go over like a lead balloon.

The solution to this is twofold--make sure hospitals here are prepped (Texas Presbyterian wasn't, but tried to act like they were) and get folks on the ground in Liberia to get it contained. The UN acknowledged they blew this one, but it can be contained and burn out, just like it always has in the past. The bigger difference in this case is that it made its way into the big cities, whereas usually it hangs out in rural, isolated areas.

[cheerfulgreek]

Originally Posted by Outlaw 1963

But then again, monkeys seem to spead most of that craziness.

Nah. Although apes and monkeys are more closely related to humans, they have provided few diseases. Herded livestock and rodent pests are more frequent sources of human infections. The greater the population density of the animals a disease infects, the more opportunity that disease has to grow more virulent, to evolve new variants, and to spread.

[pinksequins]

And poultry.

As for flights, the two that have to date been most problematic are domestic, not international.

[ASTalumna06]

http://m.huffpost.com/us/entry/5998486

We have the technology, and we certainly have the money to keep Ebola at bay. What we don't have is communication. What we don't have is a health care system that values preventative care. What we don't have is an equal playing field between nurses and physicians and allied health professionals*[I]and[/] patients. What we don't have is a culture of health where we work symbiotically with one another and with the technology that was created specifically to bridge communication gaps, but has in so many ways failed. What we don't have is the social culture of transparency, what we don't have is a stopgap against mounting hysteria and hypochondria, what we don't have is nation of health literate individuals. We don't even have health-literate professionals.

[IUHoosiergirl88]

Originally Posted by Outlaw 1963

Then where are these animals getting these diseases from? I'm just trippin at why they can't just come up with a vaccine like they do for other illnesses.

Most of these viruses and bacteria have been around long before humans have been here and will be around long after humans leave. If you want some reading material to illustrate this: "Level 4 Virus Hunters of the CDC" is a great book.

But it came over here from Africa, though. I think they should keep it under control here since about 3 people that we know of have it in the US. Then, from that point on, stop folks from going to those countries in Africa that harbor the virus, and vise versa. Because all that's going to happen is folks are going to keep bringing it up in here.

If healthcare workers want to go over to Africa and aid the victims, then they need to keep their asses there until a vaccine/cure is developed.

It came over here from Africa via Brussels, Belgium. If you ban travel from West African nations, those nations just aren't going to stamp passports--many nations do this now to obfuscate where their residents are actually coming from. If this happens, it looks like your patient zero came from Belgium, NOT West Africa. You've now made it harder to solve your problem of identifying people at risk. Now, everyone who came off an international flight displaying flu-like symptoms is an 'at risk' Ebola patient. You just took the risk pool from small to extremely large...and that's bad.


You keep throwing around a vaccine/cure like it's some easy thing to pull out of a hat. It's not--we have one possibly effective treatment (ZMAPP)--but that may prove in the long term to be no better than standard health practices. Ebola isn't a lucrative or high profile disease for pharmaceutical researchers, so developing a vaccine isn't high on their priority list. Ebola IS interesting for them because it is similar to a number of other related filoviruses, so if you knock out one you might be able to apply it to those other filoviruses...but maybe not.



The Ebola outbreak is a great opportunity for people to educate themselves on public health, science, and how things work in the pharmaceutical industry.

[cheerfulgreek]

Originally Posted by Outlaw 1963

Then where are these animals getting these diseases from? I'm just trippin at why they can't just come up with a vaccine like they do for other illnesses.

Different contagious diseases spread in different ways. Some diseases are spread directly by rodents, but more often, insects act as intermediaries. Most diseases spread by rats and mice are actually carried by the fleas, lice, or ticks that live on the rodents. The way an infection spreads, greatly affects whether it becomes milder over the ages, stays much the same, or gets more virulent.

In my experience with some of my patients, a lot of times some of these viruses/diseases can be difficult to eradicate, because different diseases evolve at different rates. Generally, the fewer genes that are involved, the more rapidly the diseases evolve. Like with viruses, they evolve much faster than bacteria, because they have fewer genes. The fewer the number of genes, the more rapidly an organism can change yet remain functional.

For example, higher organisms have approximately 10,000-50,000 genes, bacteria have about 500-5,000 genes, and viruses have about 3-1,000 genes. So, the fewer genes, the more likely mutations will be tolerated and the faster evolution may occur. So, coming up with a solution is not as easy as you think it should be.

[pinksequins]

IUHoosier, thank you so much for the education! I particularly like how you illustrated that knee-jerk "solutions" actually compound and do not alleviate the risk. Exercising common sense -- which seemed to be in short supply in recent episodes -- can go a long way in managing risk.

Though I am not hanging out with wet towel at-risk folks, I am curious about the "shelf-life" of bugs and good health management practices. The Xenex robot probably is noisy like a CAT SCAn, but I like that it uses environmentally friendly xenon and see a lot of potential uses with proper use and without the knock-on effects of triclosan. Norovirus on cruise ships -- be gone! MRSA -- be gone!

[shirley1929]

Originally Posted by Outlaw 1963

If healthcare workers want to go over to Africa and aid the victims, then they need to keep their asses there until a vaccine/cure is developed.

I kinda get what you're thinking, but the reality is people are going to get through borders and on flights no matter how much "locking down" we do of the borders. Plus, it's not cool to tell people "don't go helping the people who need it because you won't be welcome back". The rest of the world mostly thinks we're jerks (my opinion, of course) so why perpetuate that stereotype? If there aren't planes coming this way (due to locked down borders) then our humanitarian efforts can't get back that direction. Simple airline economics.

My understanding is that SARS (a few years ago) killed more people and was FAR more contagious than Ebola. Did we lock down our borders (or even discuss it?) to Asian countries then? Of course not. We shouldn't now either.

Go get a flu shot - that's probably your biggest viral threat right now & there IS a vaccine for that one!

IU Hoosier...thanks so much for all the good info! I find it very interesting reading. You too, CheerfulGreek.

[LAblondeGPhi]

Originally Posted by Outlaw 1963

I'm just trippin at why they can't just come up with a vaccine like they do for other illnesses.

Ditto what IUHoosierGirl and CheerfulGreek said - vaccines aren't just an easy thing to whip up.

It takes big bucks and resources to develop vaccines. Where was the real incentive to spend that kind of money for a disease that, while terrifying, had infected fewer than 2,500 people globally over the almost 40 years since it first popped up? (prior to the 2013-14 outbreaks, of course)(source)

Even if you do have the money and the will, it can take years to develop treatments. It depends on the nature of the virus and how wily it is.

Originally Posted by shirley1929

My understanding is that SARS (a few years ago) killed more people and was FAR more contagious than Ebola. Did we lock down our borders (or even discuss it?) to Asian countries then? Of course not. We shouldn't now either.

I looked up the SARS outbreak the other day, because my memory was that SARS was much less scary than Ebola. The outbreak of 2002-03 killed fewer than 800 people, and had a fatality rate a little under 10% (source). The current Ebola outbreak has killed more than 4,500 people, and the fatality rate is likely between 50-70% (source).

I don't know about how contagious one is versus the other, but based on this thread, I suspect you're right that SARS is more contagious.

If we really want to talk about contagious, can we talk about how freaking contagious MEASLES is? There was a kid in the DC area who got measles last year, and public health officials were reporting all the locations this kid had been to while contagious but asymptomatic. Non-immune folks have up to a 90% chance of contracting it by getting near a contagious person.

[IUHoosiergirl88]

Originally Posted by LAblondeGPhi

If we really want to talk about contagious, can we talk about how freaking contagious MEASLES is? There was a kid in the DC area who got measles last year, and public health officials were reporting all the locations this kid had been to while contagious but asymptomatic. Non-immune folks have up to a 90% chance of contracting it by getting near a contagious person.

Measles actually has a high R-naught value (aka the average number of people a sick person gets sick in an average uninfected population). The average measles patient infects 12-18 people, if it weren't for vaccines!

Just for comparison:
Measles: 12-18
Pertussis: 12-17
Diptheria: 6-7
Smallpox: 5-7
Polio: 5-7
Rubella: 5-7
Mumps: 4-7
HIV/AIDS: 2-5
SARS: 2-5
Influenza (1918 Spanish flu pandemic): 2-3
Ebola: 1-2