Dallas Ebola Patient Dies

[cooltigger21 0]

1. This is not a new disease. Ebola virus disease has occurred in limited outbreaks since 1976, and much has been learned about how to prevent transmission over the past 38 years.
   
2. Ebola is not spread by the airborne route. It is spread by direct contact with the bodily fluids or tissues of a person who is ill. This fact means that widespread transmission in the U.S. is very unlikely to occur. Body fluids include saliva, mucus, vomit, feces, sweat, tears, breast milk, urine, and semen.
   
3. Preventing transmission does not require high-tech equipment that is not routinely available. Simple barriers, such as gowns, gloves, masks and eye protection are what is required.
   
4. Every hospital in the U.S. should be able to deal with an imported case of Ebola, using strict standard contact and standard droplet isolation.
   
5. The challenge is to have a heightened awareness and to consider the diagnosis in patients who are ill, have traveled from the affected countries within the 21-day incubation period, and have had direct contact with a person stricken with Ebola.
   
6. The epidemic nature of the disease in West Africa reflects a complex interplay of factors that do not exist in the U.S. An epidemic of Ebola in this country is extremely unlikely. Having said that, with the sheer number of infected persons in West Africa, it is nearly certain that more cases will arrive in the U.S.; they need to be promptly recognized, diagnosed, and isolated.
   
7. Ebola is only transmitted by persons who have already become ill. It is not transmitted during the asymptomatic incubation period.
   

http://blog.fletcher...ommunity/ebola/

All that is known but why we refuse to shut off travel to people from the affected areas is beyond me. Who gives a damn if it hurts their feelings or not.

[Proud Tiger 4,261]

Ebola is not spread by the airborne route.........not yet. But a CDC doctor said it could mutate into a dangerous virus that is.

[AUUSN 823]

http://m.theatlantic.com/infocus/2014/10/wrapped-in-plastic-preparing-for-ebola/100827/

[cptau 169]

1. This is not a new disease. Ebola virus disease has occurred in limited outbreaks since 1976, and much has been learned about how to prevent transmission over the past 38 years.
   
2. Ebola is not spread by the airborne route. It is spread by direct contact with the bodily fluids or tissues of a person who is ill. This fact means that widespread transmission in the U.S. is very unlikely to occur. Body fluids include saliva, mucus, vomit, feces, sweat, tears, breast milk, urine, and semen.
   
3. Preventing transmission does not require high-tech equipment that is not routinely available. Simple barriers, such as gowns, gloves, masks and eye protection are what is required.
   
4. Every hospital in the U.S. should be able to deal with an imported case of Ebola, using strict standard contact and standard droplet isolation.
   
5. The challenge is to have a heightened awareness and to consider the diagnosis in patients who are ill, have traveled from the affected countries within the 21-day incubation period, and have had direct contact with a person stricken with Ebola.
   
6. The epidemic nature of the disease in West Africa reflects a complex interplay of factors that do not exist in the U.S. An epidemic of Ebola in this country is extremely unlikely. Having said that, with the sheer number of infected persons in West Africa, it is nearly certain that more cases will arrive in the U.S.; they need to be promptly recognized, diagnosed, and isolated.
   
7. Ebola is only transmitted by persons who have already become ill. It is not transmitted during the asymptomatic incubation period.
   

http://blog.fletcherallen.org/community/ebola/

If 3 and 4 are true why do all the US personnel working with it appear to be wearing something more like hazmat suits.

Is that because they gold plate the level of protective clothing?

These health workers still get infected sometimes as they take the suits off or violate some isolation rule. A U.S. Doctor and nurse and a Spanish nurse both got if while wearing protective clothing. And a victims infected airborne body fuilds from sneezing, coughing, sweat, even talking causes some to spit could get to another person nearby.

[AUDub 11,158]

If 3 and 4 are true why do all the US personnel working with it appear to be wearing something more like hazmat suits.

Is that because they gold plate the level of protective clothing?

Yes. There is debate within the medical community as to whether or not the pressurized suits are necessary. They tend to scare the more often than not backward folk they're trying to treat.

These health workers still get infected sometimes as they take the suits off or violate some isolation rule. A U.S. Doctor and nurse and a Spanish nurse both got if while wearing protective clothing.

And I would bet they weren't vigilant in removing or using the PPE. The nurse admitted as much in a phone interview. She thinks she touched her face with a gloved hand, which is a big no-no when dealing with a patient on contact precautions.

And a victims infected airborne body fuilds from sneezing, coughing, sweat, even talking causes some to spit could get to another person nearby.

The sneezing and coughing, yes. The sweat and spit from talking are stretching it. I can't see those being aerosolized. The main threat with them would be contact. Even then, aerosols are to be expected with a patient on droplet precautions. That is not considered airborne per se. These aerosols are heavy and settle very quickly.

[cptau 169]

If 3 and 4 are true why do all the US personnel working with it appear to be wearing something more like hazmat suits.

Is that because they gold plate the level of protective clothing?

Yes. There is debate within the medical community as to whether or not the pressurized suits are necessary. They tend to scare the more often than not backward folk they're trying to treat.

These health workers still get infected sometimes as they take the suits off or violate some isolation rule. A U.S. Doctor and nurse and a Spanish nurse both got if while wearing protective clothing.

And I would bet they weren't vigilant in removing or using the PPE. The nurse admitted as much in a phone interview. She thinks she touched her face with a gloved hand, which is a big no-no when dealing with a patient on contact precautions.

And a victims infected airborne body fuilds from sneezing, coughing, sweat, even talking causes some to spit could get to another person nearby.

The sneezing and coughing, yes. The sweat and spit from talking are stretching it. I can't see those being aerosolized. The main threat with them would be contact. Even then, aerosols are to be expected with a patient on droplet precautions. That is not considered airborne per se. These aerosols are heavy and settle very quickly.

Yes, it's not drifting in the air, just propelled throught it. which I guess is the reason for the 3 foot rule that was set for safety and they may need to make it a little further to make sure.

[AUDub 11,158]

Yes, it's not drifting in the air, just propelled throught it. which I guess is the reason for the 3 foot rule that was set for safety and they may need to make it a little further to make sure.

Even with all that, I can almost guarantee you that, were a patient to come to our hospital with Ebola, they would almost assuredly place them in a negative pressure isolation room with a tent, make us wear our respirators and the whole shebang concerning PPE out of an abundance of caution.

[homersapien 11,393]

1. This is not a new disease. Ebola virus disease has occurred in limited outbreaks since 1976, and much has been learned about how to prevent transmission over the past 38 years.
   
2. Ebola is not spread by the airborne route. It is spread by direct contact with the bodily fluids or tissues of a person who is ill. This fact means that widespread transmission in the U.S. is very unlikely to occur. Body fluids include saliva, mucus, vomit, feces, sweat, tears, breast milk, urine, and semen.
   
3. Preventing transmission does not require high-tech equipment that is not routinely available. Simple barriers, such as gowns, gloves, masks and eye protection are what is required.
   
4. Every hospital in the U.S. should be able to deal with an imported case of Ebola, using strict standard contact and standard droplet isolation.
   
5. The challenge is to have a heightened awareness and to consider the diagnosis in patients who are ill, have traveled from the affected countries within the 21-day incubation period, and have had direct contact with a person stricken with Ebola.
   
6. The epidemic nature of the disease in West Africa reflects a complex interplay of factors that do not exist in the U.S. An epidemic of Ebola in this country is extremely unlikely. Having said that, with the sheer number of infected persons in West Africa, it is nearly certain that more cases will arrive in the U.S.; they need to be promptly recognized, diagnosed, and isolated.
   
7. Ebola is only transmitted by persons who have already become ill. It is not transmitted during the asymptomatic incubation period.
   

http://blog.fletcher...ommunity/ebola/

All that is known but why we refuse to shut off travel to people from the affected areas is beyond me. Who gives a damn if it hurts their feelings or not.

Well, I am speculating here, but it might be because there are unintended consequences that could be worse than what we are doing now (presumably with heightened screening). For example:

1) Time is critical. Hindering travel would slow any assistance by hindering travel of experts in and out of the country, theirs as well as ours.

2) It would definitely encourage those who really want or need to get here (or return here) to pursue alternative ways of getting here, which would be, by definition illegal, so you could have wind up having even more people entering with the virus with a blockade than without.

3) I would be very expensive to implement.

4) It would be disruptive to the airline industry and any associated industries and businesses that rely on the the normal flow of economic traffic via the airlines.

5) It would create political resentment in the affected countries, perhaps complicating relief efforts.

6) Bottom line (and the most important), it would hinder or further delay immediate action. The primary strategic consideration in halting this outbreak is speed. The longer you take to smother it, the more unlikely it will get smothered. It's simple math. We (the developed world) have already squandered a lot of time.

Our best defense as a country is to halt it in Africa. Occasional cases in the US need to be dealt with the same urgency and professionalism as with an outbreak of a small fire on a ship. But if we don't stop it in Africa it will eventually bleed us dry, no matter what.

How's that for hysteria?

[homersapien 11,393]

Ebola is not spread by the airborne route.........not yet. But a CDC doctor said it could mutate into a dangerous virus that is.

You got a link for that?

[homersapien 11,393]

If 3 and 4 are true why do all the US personnel working with it appear to be wearing something more like hazmat suits.

Is that because they gold plate the level of protective clothing?

Yes. There is debate within the medical community as to whether or not the pressurized suits are necessary. They tend to scare the more often than not backward folk they're trying to treat.

These health workers still get infected sometimes as they take the suits off or violate some isolation rule. A U.S. Doctor and nurse and a Spanish nurse both got if while wearing protective clothing.

And I would bet they weren't vigilant in removing or using the PPE. The nurse admitted as much in a phone interview. She thinks she touched her face with a gloved hand, which is a big no-no when dealing with a patient on contact precautions.

And a victims infected airborne body fuilds from sneezing, coughing, sweat, even talking causes some to spit could get to another person nearby.

The sneezing and coughing, yes. The sweat and spit from talking are stretching it. I can't see those being aerosolized. The main threat with them would be contact. Even then, aerosols are to be expected with a patient on droplet precautions. That is not considered airborne per se. These aerosols are heavy and settle very quickly.

Yes, it's not drifting in the air, just propelled throught it. which I guess is the reason for the 3 foot rule that was set for safety and they may need to make it a little further to make sure.

A truly airborne pathogen can be transmitted by the affected person simply breathing it into the air.

[douggwilliams 61]

And in AL. Probably over precaution, but good on them. I would hate to be on this plane tho.

http://www.al.com/news/birmingham/index.ssf/2014/10/passenger_with_symptoms_of_ebo.html#incart_river

Sorry, link

[cooltigger21 0]

I'm normally not one to get caught up in worry over possible epidemics. I still remember the hysteria over the bird flu. For some unknown reason I just get a bad feeling about Ebola,maybe because it is such a nasty deadly thing. I believe in the American health care system. I am still wary though.

[AUDub 11,158]

And in AL. Probably over precaution, but good on them. I would hate to be on this plane tho.

http://www.al.com/news/birmingham/index.ssf/2014/10/passenger_with_symptoms_of_ebo.html#incart_river

Sorry, link

Going to be fun sending out fire and rescue in full hazmat everytime someone gets airsick.

[AUDub 11,158]

Ebola is not spread by the airborne route.........not yet. But a CDC doctor said it could mutate into a dangerous virus that is.

You got a link for that?

That's something no human virus has done in the time we've been studying them.

[autigeremt 6,652]

Can a bloodborne or body fluid-borne virus be transformed by a single mutation into an airborne agent (a "flyer"), as the scare scenarios imply? It's conceivable. But it's "probably unlikely," according to virologist Beth Levine, M.D., director of virology research in the infectious diseases division at Columbia University's College of Physicians and Surgeons. "Single amino acid mutations can change the tropism [the residential preference] of a virus" in some experimental situations, Dr. Levine says, "but there haven't been any examples of such mutations actually occurring in nature, changing a virus from a bloodborne or bodily fluid route of transmission to a respiratory route."

So, says Dr. Levine, "The media's claim is not totally without scientific basis. But there are no precedents for it, and it's unlikely.

Excerpt from Columbia University article.

[AUDub 11,158]

Can a bloodborne or body fluid-borne virus be transformed by a single mutation into an airborne agent (a "flyer"), as the scare scenarios imply? It's conceivable. But it's "probably unlikely," according to virologist Beth Levine, M.D., director of virology research in the infectious diseases division at Columbia University's College of Physicians and Surgeons. "Single amino acid mutations can change the tropism [the residential preference] of a virus" in some experimental situations, Dr. Levine says, "but there haven't been any examples of such mutations actually occurring in nature, changing a virus from a bloodborne or bodily fluid route of transmission to a respiratory route."

So, says Dr. Levine, "The media's claim is not totally without scientific basis. But there are no precedents for it, and it's unlikely.

Excerpt from Columbia University article.

Correct. But as I said in post 89 and bolded above, there is no precedent for that having ever happened to a human virus, and it's highly unlikely it would happen in the span of a single outbreak anyway.

link

In a recent New York Times OpEd entitled What We're Afraid to Say About Ebola, Michael Osterholm wonders whether Ebola virus could go airborne:

"You can now get Ebola only through direct contact with bodily fluids. If certain mutations occurred, it would mean that just breathing would put one at risk of contracting Ebola. Infections could spread quickly to every part of the globe, as the H1N1 influenza virus did in 2009, after its birth in Mexico."

Is there any truth to what Osterholm is saying?

Let's start with his discussion of Ebola virus mutation:

"But viruses like Ebola are notoriously sloppy in replicating, meaning the virus entering one person may be genetically different from the virus entering the next. The current Ebola virus's hyper-evolution is unprecedented; there has been more human-to-human transmission in the past four months than most likely occurred in the last 500 to 1,000 years."

When viruses enter a cell, they make copies of their genetic information to assemble new virus particles. Viruses such as Ebola virus, which have genetic information in the form of RNA (not DNA as in other organisms), are notoriously bad at copying their genome. The viral enzyme that copies the RNA makes many errors, perhaps as many as one or two each time the viral genome is reproduced. There is no question that RNA viruses are the masters of mutation. This fact is in part why we need a new influenza virus vaccine every few years.

The more hosts infected by a virus, the more mutations will arise. Not all of these mutations will find their way into infectious virus particles because they cause lethal defects. But Osterholm's statement that the evolution of Ebola virus is 'unprecedented' is simply not correct. It is only what we know. The virus was only discovered to infect humans in 1976, but it surely infected humans long before that. Furthermore, the virus has been replicating, probably for millions of years, in an animal reservoir, possibly bats. There has been ample opportunity for the virus to undergo mutation.

More problematic is Osterholm's assumption that mutation of Ebola virus will give rise to viruses that can transmit via the airborne route:

"If certain mutations occurred, it would mean that just breathing would put one at risk of contracting Ebola. Infections could spread quickly to every part of the globe, as the H1N1 influenza virus did in 2009, after its birth in Mexico."

The key phrase here is 'certain mutations'. We simply don’t know how many mutations, in which viral genes, would be necessary to enable airborne transmission of Ebola virus, or if such mutations would even be compatible with the ability of the virus to propagate. What allows a virus to be transmitted through the air has until recently been unknown. We can’t simply compare viruses that do transmit via aerosols (e.g. influenza virus) with viruses that do not (e.g. HIV-1) because they are too different to allow meaningful conclusions.

One approach to this conundrum would be to take a virus that does not transmit among mammals by aerosols – such as avian influenza H5N1 virus – and endow it with that property. This experiment was done by Fouchier and Kawaoka several years ago, and revealed that multiple amino acid changes are required to allow airborne transmission of H5N1 virus among ferrets. These experiments were met with a storm of protest from individuals – among them Michael Osterholm – who thought they were too dangerous. Do you want us to think about airborne transmission, and do experiments to understand it – or not?

The other important message from the Fouchier-Kawaoka ferret experiments is that the H5N1 virus that could transmit through the air had lost its ability to kill. The message is clear: gain of function (airborne transmission) is accompanied by loss of function (virulence).

When it comes to viruses, it is always difficult to predict what they can or cannot do. It is instructive, however, to see what viruses have done in the past, and use that information to guide our thinking. Therefore we can ask: has any human virus ever changed its mode of transmission?

The answer is no. We have been studying viruses for over 100 years, and we've never seen a human virus change the way it is transmitted.

HIV-1 has infected millions of humans since the early 1900s. It is still transmitted among humans by introduction of the virus into the body by sex, contaminated needles, or during childbirth.

Hepatitis C virus has infected millions of humans since its discovery in the 1980s. It is still transmitted among humans by introduction of the virus into the body by contaminated needles, blood, and during birth.

There is no reason to believe that Ebola virus is any different from any of the viruses that infect humans and have not changed the way that they are spread.

I am fully aware that we can never rule out what a virus might or might not do. But the likelihood that Ebola virus will go airborne is so remote that we should not use it to frighten people. We need to focus on stopping the epidemic, which in itself is a huge job.

[autigeremt 6,652]

Just posting information, Ben. Don't get defensive.

[AUDub 11,158]

Just posting information, Ben. Don't get defensive.

Defensive? I'm not being defensive. What good is a discussion without counterpoints?

[Proud Tiger 4,261]

Pot calling kettle black?

[AURaptor 1,125]

Too bad our dear & fluffy Organizer in Chief is baffled by simple , and so are his loyal myrmidons.

"myrmidons"?

Your $5 college word of the day.

myrmidon - A faithful follower who carries out orders without question.

A henchman. Unscrupulous lackey.

[autigeremt 6,652]

Just posting information, Ben. Don't get defensive.

Defensive? I'm not being defensive. What good is a discussion without counterpoints?

I wasn't making a point, just offering information. That's why I said what I said.

[AUDub 11,158]

I wasn't making a point, just offering information. That's why I said what I said.

One of the big things being harped on by the fearmongers is the possibility of the virus mutating to become airborne. I apologize for confusing you with them.

[autigeremt 6,652]

I wasn't making a point, just offering information. That's why I said what I said.

One of the big things being harped on by the fearmongers is the possibility of the virus mutating to become airborne. I apologize for confusing you with them.

Anything is possible but an airborne virus is very, very unlikely. The worst part of Ebola is the droplets from sneezing and coughing.

[AUtiger98 24]

I wasn't making a point, just offering information. That's why I said what I said.

One of the big things being harped on by the fearmongers is the possibility of the virus mutating to become airborne. I apologize for confusing you with them.

I agree with the fear mongering on the virus becoming airborne. There's enough to worry about without the hypothetical situations.

However, I do read stories like this one where experts say they fear it becoming airborne. The experts don't seem to have a political agenda, so my next thought is maybe the media forces them to answer what if questions to generate viewers. (Note: I'm not implicating CNN as the only one doing this) http://www.cnn.com/2014/09/12/health/ebola-airborne/

[homersapien 11,393]

I'd like to know more about the physics of how a virus can be airborne. I suspect molecular weight might come into play.

And from a chemical standpoint, how does such a virus dissociate from a fluid environment into the air?

I don't know the relative mw of ebola to air-borne viruses nor the qualitative differences in surface chemistry, but I would expect the possibility to be virtually nill. (At least based on my relative ignorance. )