Ebola question | Imamother

amother

Wed, Oct 01 2014, 7:17 pm

Those of us who read the news are aware of the man who was recently traveled from Liberia to the U.S.: he has tested positive for Ebola in s Texas hospital. Reporters and doctors keep stressing that it is the medical opinion that his fellow passengers are not at risk for infection because Ebola can only be transmitted via fluids and not air like a cold. What I don't get is WHY if that is the case have over 300 medical professionals become infected during this outbreak, some of whom were wearing the contaminant "spacesuits"?!?! Why, if it is not easily spread are health experts recommending extreme isolation procedures? Why is it so difficult to contain in Africa even with sub par medical treatments and facilities? I'm not asking as a conspiracy theorist, but because I'd like to understand better. We don't isolate hepatitis, hiv, or even meningitis in a similar fashion to how we see Ebola being isolated.

amother

Wed, Oct 01 2014, 7:32 pm

zaq wrote:

hepatitis, HIV and meningitis have treatments that have withstood the test of time; Ebola's treatment has not and we don't know yet how effective it is. Until more is known, the better part of valor is discretion.

ok I have considered that as well; however it still does not explain how a fluid born and non air born disease has infected over 300 medical workers. You'd think they would know how to be careful. I'm just confused.

Think1st

Wed, Oct 01 2014, 7:46 pm

http://www.who.int/mediacentre.....3/en/

Transmission

Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.

So according to UN/WHO any Health-care worker infected was not wearing protective gear etc.If you have any source stating otherwise please provide it

Isolation is not always practical, but is a powerful tool.

Last edited by Think1st on Wed, Oct 01 2014, 7:56 pm; edited 4 times in total

Frumdoc

Wed, Oct 01 2014, 7:47 pm

It is a viral haemorrhagic fever. The patient bleeds out from every orifice in their dying hours, spraying virus in that blood in projectile vomit, from their eyes, ears, bloody diarrhoea etc.

In makeshift fever hospitals, essentially big tents, in Africa, it is easy to imagine how someone exposed to multiple people vomiting and excreting virus infected blood constantly is at risk of catching it.

In a Western hospital with a single person, who is not yet vomiting blood or bleeding from his eyeballs, so lower risk of spreading the virus (still some risk), the overall risk of catching it is lower.

Read the blog of the senior doctor in Liberia who died, it is very enlightening as to the circumstances they are working in and the horrific risk they are under, as well as the general dire state of heath care in some parts of rural Africa.

And we do take the risk of hepatitis and HIV very seriously, wearing appropriate protection in high risk patients and taking prophylaxis when exposed. But they rarely vomit virus infected blood, trust me, when I have treated people with hep C who are projectile vomiting their entire blood volume onto the floor and us, we wear spacesuits. You just won't see it as it takes place in restricted areas for your own protection.

FranticFrummie

Wed, Oct 01 2014, 7:50 pm

What researchers don't want to tell us, is that they really don't know right now.

The Reston Ebola virus was airborne. They think that this time around it may be mutating in the same direction. I believe that there are 5 or 6 strains active in Africa at this time, and no one knows what will happen because Ebola has an extremely fast mutation rate.

http://www.cnn.com/2014/09/12/.....orne/

Frumdoc

Wed, Oct 01 2014, 7:54 pm

amother wrote:

There is knowing, and there is discovering a small nick in your protective clothing after a shift surrounded by infected patients, or a seepage of infected bodily secretions up your leg to a mosquito bite which you didn't even feel as it eroded through your elasticated footwear, or knowing it is a choice between your own safety and possibly saving someone else's life. Doctors and nurses put themselves at risk all the time, it is part of the normal psyche. Those who work especially those who volunteer to work in high risk areas know what they are exposing themselves to.

It is impossible to eliminate all risk, you can only limit it. In an environment where every move you make can risk your life, of course some of those will occur and some will die.

Dolly Welsh

Wed, Oct 01 2014, 7:57 pm

Frumdoc, isn't there a drug that cures it, called Z-MAPP? Related to nicotine?

And hasn't there been a big recent investment in producing a lot of Z-MAPP quickly, even though it is so new, because it seems so promising?

My impression is it was given to some people with Ebola recently, in the US, and it worked very well for them.

So that is very hopeful.

Just what I heard. I am no expert, surely.

Frumdoc

Wed, Oct 01 2014, 8:03 pm

Dolly Welsh wrote:

It is very experimental. They may have recovered anyway. But hopefully it will be some kind of treatment. They released it out of desperation, rather than because it was proven. You can't really do a trial to test such drugs.

It is all very interesting, but I hope it burns out, rather than causing an apocalyptic type worldwide plague. Makes the Yomim Neroim davening quite poignant, especially unetaneh tokef.

We have had a few possible cases, but all were negative, bh.

The best option would be a vaccine to prevent the disease even if infected, as the cascade of events leading to death are difficult to stop even if the infection is treated. Most people die of their bodily response to such viruses rather than the overwhelming infection itself, and multi organ failure is almost impossible to reverse.

Last edited by Frumdoc on Wed, Oct 01 2014, 8:06 pm; edited 1 time in total

Scrabble123

Wed, Oct 01 2014, 8:05 pm

Think1st wrote:

http://www.who.int/mediacentre/factsheets/fs103/en/

Transmission

Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.

So according to UN/WHO any Health-care worker infected was not wearing protective gear etc.If you have any source stating otherwise please provide it

Isolation is not always practical, but is a powerful tool.

Think1st: I find it incredibly ironic that you are posting information from the World Health Organization. Aren't those the same people you have accused of knowing injecting "so-called toxins" into children? Do you find their information reliable all of a sudden. I trust the WHO, and I hope that you will come to trust them as well. Keep reading their website: it has wonderful medical information.

We can obviously assume that the medical professionals infected were infected either through not practicing strict infection/contamination control, but I'm sure that many who were infected were wearing the spacesuits. They probably became infected when they removed their suits and were exposed to fluids on the outside of those suits, if they had a tear in their suits, a mosquito bite, etc. as frumdoc has pointed out.

Frumdoc: Your post was well to the point. Would you please provide the link to the blog you are referencing? I'd like to read it.

amother

Wed, Oct 01 2014, 8:08 pm

Frumdoc wrote:

It is all very interesting, but I hope it burns out, rather than causing an apocalyptic type worldwide plague. Makes the Yomim Neroim davening quite poignant, especially unetaneh tokef.

Why is a worldwide plague even something to think about if it is easily contained in Western hospitals?

FranticFrummie

Wed, Oct 01 2014, 8:25 pm

amother wrote:

Why is a worldwide plague even something to think about if it is easily contained in Western hospitals?

AIDS is not easily transmissible, and is a much more fragile virus than Ebola. Look how many people it's killed so far. 30+ years into the AIDS epidemic, and we STILL don't have a clue about a vaccine or a cure. The best you can hope for is a life full of very expensive medication.

Now, imagine someone with Ebola doesn't make it to the hospital on time. Imagine the family members are ignorant of the risks and become infected. Imagine they are illegal immigrants, have warrants out for arrest, or some other reason for not seeking help. Maybe their just afraid of the stigma against their family. They'll continue to infect everyone they come in contact with.

Suppose someone who is just infected, but not showing any symptoms yet, and they go to donate blood. This is what happened with the AIDS virus, and the US blood supply became tainted. Many people who had hemophilia or major surgery became infected and died.

If someone with Ebola was a harlot, how many customers could he / she infect in one night? What about a waitress with a cut on her finger? Use your imagination, it shouldn't be hard to see what a huge threat this could be.

It could be the ultimate in biological warfare. IS could infect people and send them over from countries that aren't being monitored, like England and France. Boko Haram would be happy to send IS some Ebola to practice with. I'm sure that there are some wannabe martyrs who would turn themselves into bio-bombs for the cause.

Frumdoc

Wed, Oct 01 2014, 8:30 pm

amother wrote:

Why is a worldwide plague even something to think about if it is easily contained in Western hospitals?

Easily contained if a single infected individual attends without haemorrhagic symptoms, not if tens or hundreds of people, let alone thousands of people become ill. All services would become completely overwhelmed very quickly. Many many people would die.

Play the various worldwide plague spreading online games or projections to see what might happen with various degrees of mortality or type of spread. It really is very scary if you want to worry about it.

Scrabble, I can't find the blog I was thinking of, but here are some others. Their dedication in the face of such a lack of equipment, even to protect themselves properly, is quite unbelievable. Inspiring and a bit on the crazier side. Not for the average joe on the street. I have a friend out there at the moment, she has saved so many hundreds of lives of women and children over the last 5 years it is mindblowing.

http://blogs.msf.org/en/staff/.....-blog

http://blogs.msf.org/en/staff/.....black

http://www.msf.org.uk/article/.....-zone

http://blogs.msf.org/en/staff/.....shift

Think1st

Wed, Oct 01 2014, 8:34 pm

To scrabble :

I agree with you regarding reading WHO reports

This UN/WHO document was one of my eye openers

http://www.childinfo.org/files.....n.pdf

Scroll down to the Australia page then USA & Canada or Qatar see how may babies per 1,000 die each year & how many vaccines they get

Compare to Japan Iceland Singapore Sweden

You want to blame pollution compare Japan vs Australia ?

Affluence Iceland vs USA ?

Japan lowest mortality rate & only 30% exclusive breastfeeding @ 3 months http://www.internationalbreast.....re/F2

Australia More than 2x death rate 39% exlusive nursing @3 months
https://www.breastfeeding.asn......ralia

zaq

Wed, Oct 01 2014, 8:34 pm

amother wrote:

Why is a worldwide plague even something to think about if it is easily contained in Western hospitals?

1. An infection may be contained once a patient is admitted and isolated, but just as in many other infections, people are contagious long before they even realize they have a problem. Ebola starts out looking a lot like seasonal flu, and people don't suspect Ebola till it gets worse. (btw seasonal flu is also a killer. tens of thousands of people die in the US every year as a result of seasonal flu. But I digress. )That's why health authorities in Texas are frantically trying to figure out with whom the Texas patient had contact from the time he returned to the US till he was hospitalized, as all those people are at some measure of risk.

2. Not everyone who gets sick, even in the Western world, gets to a hospital.

3. A pandemic could overwhelm the resources of even the finest healthcare system in the world. You want to prevent people from getting sick in the first place, not just care for them once they get sick. And it's not just because prevention is cheaper than treatment.

4. Ask not for whom the bell tolls; it tolls for thee.

HonesttoGod

Wed, Oct 01 2014, 8:39 pm

What I can't understand is why they didn't half ALL flights coming out of infected areas right away.
Or screen every person going on board.
Obviously it will spread if the cousins neighbor or a person infected who saw that person last week flies with 50 people to france and then another 60 to who knows where!

Scrabble123

Wed, Oct 01 2014, 8:44 pm

HonesttoGod wrote:

Are you suggesting that everyone flying out of West Africa should be quarantined for 21 days to ensure they do not develop Ebola? I believe that airports are asking a series of questions to all travels from high risk areas and such individuals are undergoing a basic medical exam. They can't lock these people up for 3 weeks. This Texan was not showing any signs of infection when he entered the U.S. What is mind boggling is why the hospital sent him home after he said he had ben in West Africa. Maybe anyone returning from high risk areas needs to be checked up on by a medical professional daily for 21 days like they are doing in West Africa to the family members of infected individuals.

Think1st

Wed, Oct 01 2014, 8:47 pm

To zaq

http://www.cdc.gov/flu/about/d.....s.htm

Annual flu death are only estimates as states are NOT required to report

Only Flu deaths in children were made a nationally notifiable condition in 2004, and since then, states have reported flu-related child deaths in the United States through the Influenza Associated Pediatric Mortality Surveillance System.

approx 100 children annually http://www.cdc.gov/mmwr/pdf/wk/mm6036.pdf

HonesttoGod

Wed, Oct 01 2014, 8:48 pm

Scrabble123 wrote:

HonesttoGod wrote:

Exactly.
I mean maybe it is not practical but there are soooo many ways to prevent this. Obviously things slip through cracks but this case is just so silly. Did the nurses not know about ebola? I mean say africa to me these days and I think ebola, and no I am not a nurse.