Texas Health Worker Tests Positive For Ebola 421
Thomas Eric Duncan, the first person to have been diagnosed in the U.S. with Ebola, and who subsequently died of the disease, was treated at Texas Health Presbyterian Hospital in Dallas. Now, in a second diagnosis for the U.S, an unidentified health-care worker from the hospital has tested positive for Ebola as well. According to the linked Reuters story, Texas officials did not identify the worker or give any details about the person, but CNN said it was a woman nurse.
The worker was wearing full protective gear when in contact with Duncan, Texas Health Resources chief clinical officer Dan Varga told a news conference.
"We are very concerned," Varga said. "We don't have a full analysis of all of the care. We are going through that right now."
...
The worker was self-monitoring and has not worked during the last two days, Varga said.
The worker was taking their own temperature twice a day and, as a result of the monitoring, the worker informed the hospital of a fever and was isolated immediately upon their arrival, the hospital said in a statement.
(Also covered by the Associated Press, as carried by the Boston Globe, which notes that "If the preliminary diagnosis is confirmed, it would be the first known case of the disease being contracted or transmitted in the U.S.")
Robots? (Score:3)
We have robots for ridding explosive ordinance. Considering the humber of healthcare workers that contracted this disease so far, hopefully some remotely controlled robot doctor/nurses would help further quarantine the situation.
We are far from autonomous humanoid robots, but since this isn't a labor saving measure, it should be much easier, as they are rather more like walking drones, how far is current tech from making this possible?
Re: (Score:3, Interesting)
There is virtually nothing (not even Ebola) that can get through basic procedures, even with humans treating them. Even without full isolation, just making sure that direct bodily contact does not occur is enough to stop basically anything - hence why doctors wear rubber gloves even if they digging into your internals with blood everywhere.
Such a thing would be so unbelievably infectious that we'd all have it - planet-wide - within a couple of days. It's just not in the nature of such things to be that in
Re: (Score:2, Insightful)
So you honestly believe those thousands who got infected licked another's bodily fluids?
You may have prestigious friends, or not, but you just sound like an ignorant moron.
Reality is that most people are not as vigilant as professional scientists handling bioweapons that could wipe us out many times over.
If you lived in Africa, you would know how deadly and debilitating HIV/AIDS can be.
Re:Robots? (Score:5, Informative)
So you honestly believe those thousands who got infected licked another's bodily fluids?
Yes. In the countries with widespread Ebola, they have funeral rites that involve touching and kissing the corpse. In some instances, relatives washed the corpse, and then, as a sign of respect, drank the water. These countries have a deep distrust of official authority, including health workers, so there has not been much success at discouraging these traditional practices. Except for a few isolated and quickly contained instances, Ebola has not spread beyond the regions with these practices.
Re:Robots? (Score:5, Informative)
In some instances, relatives washed the corpse, and then, as a sign of respect, drank the water.
Here's a reference, in case anyone finds that incredible [refworld.org]
Also, in some places they don't trust health workers, and actually attack them. They are afraid of the disease, but they are more afraid of the health workers.
Re: (Score:2)
I agree with your overall message, but humans being what they are (not always following the rules), another barrier of protection would not hurt imo.
A salute to your friends for me.
No worse than AIDS, are you kidding? (Score:5, Informative)
AIDS doesn't cause contagious blood, spit, diarrhea, and vomit to go everywhere. Ebola does.
AIDS doesn't infect health care workers who are treating patients unless there's a needlestick or sexual contact. Ebola does, with alarming frequency. Even if you DO have sex with someone with AIDS, it's not 100% that you'll get AIDS.
AIDS can't be spread by sneezing or coughing. It's possible Ebola *is*.
In terms of contagiousness, Ebola seems 10x worse. It's like saying "smallpox is no worse than chickenpox". Maybe if you put them both on a logarithmic plot and back up 50 feet!
--PM
Re: (Score:3)
AIDS doesn't cause contagious blood, spit, diarrhea, and vomit to go everywhere. Ebola does.
AIDS doesn't infect health care workers who are treating patients unless there's a needlestick or sexual contact. Ebola does, with alarming frequency. Even if you DO have sex with someone with AIDS, it's not 100% that you'll get AIDS.
AIDS can't be spread by sneezing or coughing. It's possible Ebola *is*.
In terms of contagiousness, Ebola seems 10x worse. It's like saying "smallpox is no worse than chickenpox". Maybe if you put them both on a logarithmic plot and back up 50 feet!
--PM
The 1918 influenza outbreak killed an estimated 25 million people in it's first 25 weeks, and killed an estimated 50 million in the course of the year. It infected over 500 million people in total.
The regular yearly flu kills anywhere from about 4,000 to 40,000 people a year in the US and infects many many more.
And yet, you don't seem to be panicking about that.
Heart disease kills a million a year. Cancer kills about half that. Car crashes kill about 40,000 a year.
And yet you don't seem to be losing your mi
Re: (Score:2)
Yeah, you shouldn't pull statistics out of your ass.
Re:Robots? (Score:4, Informative)
There is virtually nothing (not even Ebola) that can get through basic procedures, even with humans treating them. Even without full isolation, just making sure that direct bodily contact does not occur is enough to stop basically anything - hence why doctors wear rubber gloves even if they digging into your internals with blood everywhere.
Such a thing would be so unbelievably infectious that we'd all have it - planet-wide - within a couple of days. It's just not in the nature of such things to be that infectious. Ebola is actually no worse than AIDS, from what I can tell from a quick search.
There are so many things wrong with this, it is hard to know where to start...
Many diseases are much more infectious than ebola. I recall from medical school that you can catch chicken pox (if you haven't had it or been vaccinated) from the air two hours after a patient has left the room. Influenza is also much more infectious than ebola, which is why is spreads around the world in weeks/months every year.
Fortunately ebola is not nearly so infectious. But if someone is having continuous watery diarrhea and bleeding everywhere (e.g. Ebola) and your job is to roll them over every hour, while they are thrashing around, to clean up their bloody virus-laden excrement, and your only protection is mask/gloves/gown - well, good luck.
HIV requires that you get infected bodily fluid (usually blood) into your own bloodstream, which is much hard than catching Ebola.
Re: (Score:3)
The big unknown is what 'full protective gear' means. A class A suit? Masks, gloves, Tyvek gown? It would be pretty hard to get an infection in the former (although hardly impossible), rather easy to take the stuff off incorrectly (which turns out to be the hard part) and get a couple of viral particles on you. This will be a teaching point for health care workers - Do It Right. People get tired, they get distracted, they get sloppy. Although Ebola won't jump out an bite you, it still deserves quite a
Re: (Score:3)
Ebola is vastly more infectious than HIV. With HIV you basically need to get blood with a viral load injected to have any certainty of getting it. Transmission rates with vaginal intercourse are in the rates of far below 1% per act. More than half the pregnancies don't even transmit the virus to the baby.
Compare that with Ebola where the virus is in basically present in infectious levels in every bodily fluid spread around to the extent that hospital personnel don't even know how they got it.
HIV, lick it, y
Re: (Score:3)
Ebola is actually no worse than AIDS, from what I can tell from a quick search.
...
Just don't lick it, and you're fine.
I can put AIDs in my mouth all I want and not get AIDs.
If I put Ebola in my mouth, I will get infected with Ebola.
Please stop spreading this nonsense that Ebola is as difficult as AIDs to transmit. It is carried in more bodily fluids, and can be spread by contact with those fluids. It does not require a wound, as AIDs does.
Re:Robots? (Score:5, Informative)
To get to the point that a nurse is infected means that protocol wasn't followed. That it wasn't EVERY nurse and EVERY doctor that touched the patient is quite telling.
We know some details about the nurse that was infected in spain: She touched her face with her hands before disinfecting them.
Yes, protocol wasn't followed. But here's the point: You need to follow protocol 100% of the time to be safe. You only need to make one mistake to be infected. For a virus with such a crazy lethality rate, that's not good. Treating an ebola patient is a lot like playing russian roulette.
Just don't lick it, and you're fine.
Very few of the people who are now dead licked it. Yes, the media loves fear stories and it's overblown, but you're underblowing it.
Spanish nurse (Score:2)
She thinks she may have touched her face with a glove. Nobody is really sure. However, if she did that would show that Ebola is way more contagious than the CDC thinks. That implies transdermal transmission.
Re: (Score:3)
A water/bleach spray down at entrace and exit before taking off gear. The spray down is part of the process in Africa but not in the US , which is just dumb.
Re:Robots? (Score:4, Insightful)
You're kidding me right?
A woman working under biohazard 4 conditions, wearing a hermetically sealed suit, working with a patient she KNOWS has ebola and is infectious; gets Ebola herself, and you are seriously trying to play it off like it's no worse than HIV? Acting like a know-it-all expert on infectious diseases and trying to reassure everyone that this isn't going anywhere and isn't dangerous?
Look, I'm not trying to fear-monger here for the sake of it, and I'm certainly no ebola-expert, but trying to reassure everyone that this is just going to blow over with this idiocy about how safe Ebola is and how nobody can catch it unless they fucking lick infected blood when that is increasingly not the case just sets me right off. Even the media has done a complete 180 on their usual fear-mongering. Let's suppose for a moment that this woman did something out of procedure - she didn't clean her suit or something, and she touched it, then rubbed her eyes.
That's not HIV-level infectious. That's influenza/cold-level infectious, and that is extremely worrying, because the CDC seems to be grossly incompetent in this entire situation and I'm beginning to wonder if the corporations involved who have the potential to make literal billions to trillions off Ebola vaccines aren't giving little nudges here and there to maintain a certain level of incompetence in the matter. We aren't even quarantining Africa - the CDC says that wouldn't do anything. Like hell it wouldn't. The first thing we did when SARS was worrying people was to quarantine and shut down air travel, but apparently we're finding out only just now that this didn't work and won't work for Ebola, so let's just spend millions trying to screen for it ineffectively at the airports into our countries? I'm sorry, I'm not buying this. I'm not buying anything the mass media are telling us about this disease anymore. How many times does the mass media have to lie to people before they stop actually trusting them?
Did you know that one of the Ebola strains quite possibly moved through an air gap to cause infection?
http://www.nature.com/srep/201... [nature.com]
We also know that the Filovirus family can easily become airborne:
http://www.nature.com/nbt/jour... [nature.com]
This virus is spreading into the tens of thousands range in West Africa. That's an immense breeding ground for it to adapt to a new host. We know that Ebola strains can become airborne, and we keep having doctors getting sick with the virus in spite of hefty precautions against it. So why are we assuming it can't be airborne and can't be transmitted during its incubation period? Why are we assuming it has low infectivity when doctors in full protective gear are getting it? When people are literally getting this virus from just touching things that ebola victims have touched? Why is nobody taking precautions in case it IS highly infectious? This isn't some joke of a virus that kills 2% of the people it infects; almost everyone who gets it dies. This isn't something to be jovial and careless around, yet we took more precautions around SARS than anything we're doing with Ebola. It's fucking madness, and I keep seeing people parrot this bullshit that we shouldn't be worried, have nothing to fear if we aren't literally bathing in Ebola-blood like West Africans obviously are, and so on.
No, we DO have something to fear from this - you'd be foolish not to be worried - and I am not satisfied in the least with the way our governments are treating this whole thing. It's almost flippant. I think some serious discussion about this virus getting into western countries uncontrollably needs to seriously start happening. What are you going to do if Ebola ends up in your town? Have you even considered talking about it with your family? With your local community? Is the effort involved in being prepared really worth the risk o
Re: (Score:3)
Ebola is actually no worse than AIDS, from what I can tell from a quick search. So long as there's no bodily fluid contact, you're fine.
I agree with everything else you're saying, but this is absolutely false. AIDS is VERY difficult to get. You won't get AIDS from casual contact with saliva, urine, sputum, or feces. Ebola can be contracted by any of these coming in contact with your eye.
So they're worlds apart in terms of how transmissible each is.
Re: (Score:2)
Really just need a water/bleach spray down at entrace and exit before taking off gear. The spray down is part of the process in Africa but not in the US , which is just dumb.
Re: (Score:2)
Not quite. Just thinking dumb humanoid robots that need a puppetmaster would have a lot of uses.
Re: (Score:2)
Not insane, but so deeply in fear that any rationality has left them. A side-effect of various governments (chief among them the US one) spending a lot of effort on keeping people as deeply in fear as possible from things that are no real threats, but can easily be blown up into ones (terrorism, drugs, sex-trafficking, socialism, immigrants, etc.). The results are wimps tat cower in fear all the time and are ready to kill, main, slaughter and torture as the slightest provocation. Of course, they barely qual
Human infections caused by Ebola-Reston (Score:2)
"Human infections caused by Ebola-Reston virus in the US in 1990"
Source: http://www.cdc.gov/ncidod/dvrd... [cdc.gov]
More info: http://en.wikipedia.org/wiki/R... [wikipedia.org]
Yeah. Pigs and monkeys. And in the US and Philippines. Enjoy your day!
Re: (Score:2)
Oh dear, selective quoting at its best / worst. That sentence in full: "Human infections caused by Ebola-Reston virus in the US in 1990 and in the Philippines resulted in no clinical illness."
Protocols (Score:5, Interesting)
The fact that the nurse in Spain, and the one in Dallas both contracted the disease despite wearing full protective gear - and in full knowledge that the patient was infectious - is pretty scarey. You have to imagine that both of those people were fully aware of how dangerous the situation was and were doing their very best to avoid doing anything to compromise their own safety. Clearly we either need better suits or better training, or some kind of a 'buddy system' where two people watch each other to ensure that they don't accidentally do something wrong.
There was a piece on NPR a few days ago that said that the Doctors Without Borders people use a buddy system like this - and despite having hundreds of people on the ground in Africa for a month or more, have only had three staff infections.
Without some improved level of protection, asking doctors and nurses to expose themselves to a disease with a 70% mortality rate (latest WHO estimate...up from 60%), no immunization and no known cure, is asking a lot. Clearly we aren't going to be able to make a vaccine or a cure in any reasonable timescale - so we really need to be working hard to improve protection. The idea of using robots for at least some of the jobs is interesting - but probably impractical for all but the simplest tasks.
We know that this disease can spread exponentially the "base reproduction" figure (the number of people who catch the disease from one infected person) is between 1.7 and 2.3, and it takes 2 to 3 weeks for the infected person to develop symptoms and pass it on. So there is a potential for the disease to double every 3 weeks. We have just a couple of victims in the USA right now, so in a year, we could have a million victims and 700,000 deaths. Clearly, we have to reduce that base reproduction number below 1.0 - but if...with proper protection gear and highly aware workers...both the Spanish and Dallas initial cases were able to spread to one additional victim, we're clearly not going to get anywhere close to a 1.0 rate anytime soon.
Re: (Score:3)
I think a lot of what is going on is that healthcare workers in rich western countries have very little actual experience with an 80% fatal infectious disease.
While they may have training on protocols for dealing with such a disease, they undoubtedly are too busy to actually practice enough to keep current.
With the exception of SARS (and SARS didn't get most places it quite positively could have), we haven't had a real, o my god outbreak in living memory in the western world. So our health care professiona
Re: (Score:2)
I think a lot of what is going on is that healthcare workers in rich western countries have very little actual experience with an 80% fatal infectious disease.
The one in Texas is a registered nurse, and you do not get to be a registered nurse unless you fully comprehend the Germ Theory of Disease.
And unless that nurse has an IQ of 80 and been living under a rock for the past month, she would've been aware of what Ebola is and how easily it can kill you if you get it.
There isn't anything special about Ebola containment that one needs vast amount of experience to master. Any competent healthcare professional would've learned it long ago. It's just a matter of being
Re: (Score:2)
There was a piece on NPR a few days ago that said that the Doctors Without Borders people use a buddy system like this - and despite having hundreds of people on the ground in Africa for a month or more, have only had three staff infections.
I heard that too, so I went looking for more information.
October 04, 2014: Since March 2014, 16 MSF staff members contracted the virus; nine of them have died. [doctorswit...orders.org]
The "three" that NPR reported is probably Doctors Without Borders international staff, with the other infections being local staff.
Wonder if health care workers will give pause (Score:3)
Hospitals (Score:2)
Hospitals..... One of the most contagious places in an area. Being in an environment with the highest concentration of infected people is bad enough, but hospital employees have been known to have less than stellar hygiene. I think an entire technology product sector has had to be created just to encourage employees to wash their hands regularly.
http://www.usatoday.com/story/... [usatoday.com]
I realize we're not supposed to panic.. (Score:3)
I know, if "you only follow procedure" this isn't supposed to be a big deal.
But what's scary is that with a very small number of patients (one) and likely a lot of attention to procedure, a healthcare worker got infected. Sure, we can blame sloppy procedure, but it happened anyway.
What would it look like though if we had a dozen patients or a hundred or a thousand? It's real easy to blame bad procedure, but what makes us think a wider outbreak would have *better* procedures and more attention to detail? We might get better at it (lack of practice may be an issue) and we might make incremental improvements to the kinds of procedures we follow but we might also get worse, lack facilities or the inevitible stress of a larger outbreak might impede vigilance, not improve it.
What scares me about Ebola is how apparently difficult it can be to contain even under ideal conditions.
Texas, go ahead with that secede thing (Score:5, Funny)
After careful consideration, we do actually think that your secession plans make sense after all!
With Best Regards,
The Other 49 States
The Taylor Swift metric (Score:2)
When Taylor Swift has been dumped more times than X, X is laughable in an argument.
Re: (Score:2)
Cleverbot, is that you?
Re: (Score:3)
No, there is no need to panic. Get a grip on your fantasies.
Re: (Score:3)
You know, I've heard that many times now, yet Ebola continues spreading. And every new case gives it new opportunities to evolve further. So perhaps it would be better to panic and spend some serious dough to crush the outbreak while it's still possible, rather than wait for it to turn into the doomsday scenario a deadly and highly contagious disease has every potential to become?
Re:For those who said "No need to panic" (Score:5, Insightful)
yet Ebola continues spreading.
No, no really. There are more and more victims in Guinea, Sierra Leone, and Liberia. But it was stopped in Senegal and Nigeria. All African nations are not the same. In terms of institutions and infrastructure, Guinea, Sierra Leone, and Liberia are at or near the bottom. While primitive by Western standards, Senegal and Nigeria are far more functional countries. If they were able to control and contain the disease, then more developed countries should not have much difficulty doing the same.
Re: (Score:2)
Re: (Score:3)
How do you know it was stopped in Nigeria? Because the Nigerian government, who have a strong incentive to protect their billions of dollars in trade with the rest of the world say they stopped it?
No. We know it because US health authorities [bbc.com] and the WHO [who.int] reported it.
Re: (Score:3)
Re: (Score:3)
Furthermore Ebola never did reach Nigerian cities. When it does, it will be the same disaster as the other countries.
Unlikely. Nigeria has twice the literacy rate of Sierra Leone, three times the per capita GDP, a much stronger public health system, and working government institutions. It is a democratic country, with leaders answerable to the electorate. Nigeria has plenty of problems, as any country does (well, maybe not Denmark), but compared to Liberia, Sierra Leone, or Guinea, it is not even close to the same level of dysfunction.
There is no need to panic (Score:5, Insightful)
You know, I've heard that many times now, yet Ebola continues spreading.
And it is still correct. There is no need to panic. Ebola gets WAY more press than the severity of the actual risk justifies.
Basically stop freaking the hell out. The people that can and will deal with this outbreak are dealing with it. Panic will accomplish nothing productive. Quite the opposite in fact.
So perhaps it would be better to panic and spend some serious dough to crush the outbreak while it's still possible, rather than wait for it to turn into the doomsday scenario a deadly and highly contagious disease has every potential to become?
First off, ebola is NOT "highly contagious". It's actually rather hard to get. Unless you have been in direct contact with the sweat, blood, tears, feces or other bodily fluids of a symptomatic ebola patient then you have nothing to worry about. Medical personnel who are treating such patients directly are at highest risk for obvious reasons. This is nothing shocking though it probably means someone made a mistake.
It is incorrect that "every" pathogen has to potential to become a "deadly and highly contagious disease". Go talk to an infectious disease doctor and they will tell you that the biology of most viruses and bacteria prevents them from ever becoming a threat to humans. It's actually quite hard for that to happen even in a rapidly mutating virus which ebola is not. What you are suggesting is almost as unlikely as all the air in the room suddenly deciding to be on just one side of the room because, hey, it's theoretically possible. The real world probability of most viruses and bacteria mutating into something harmful to humans is actually vanishingly small if not actually zero.
Re: (Score:3)
But where is the evidence of a pandemic? It's only a few thousands at this stage.
The evidence is continued exponential growth of Ebola to recent past. It appears that the rate of infection may be slowing down [npr.org] in the worst of the three primary countries of infection, Liberia. If true, fears of pandemic are overstated.
If instead, cases continue to climb exponentially, but patients are staying away from hospitals, then you still have the eventual pandemic problem looming on the horizon.
Extrapolation (Score:3)
The evidence is continued exponential growth of Ebola to recent past.
Be careful of extrapolation [xkcd.com].
Re:Extrapolation (Score:4, Interesting)
For example, Ebola [wikipedia.org] has made this transition to airborne transmission before. Influenza has been transmitted by diarrhea before. Bubonic Plague is another disease that has managed the transition to airborne transmission. And of course, AIDS was readily transmitted by blood transfusion and shared needle use even though that's not its original mode of transmission. So there's four examples right there, including Ebola itself.
The variety of Ebola that is suspected of being transmittable via small particle dispersal is the Reston variant. It has not been proven that the Reston variant is transmittable by small particle aerosol dispersion, just suspected. It's worth noting that the Reston variant is not pathological in humans. No humans who have acquired it have become ill. The presence of influenza virus in children's diarrhea is not necessarily a new mode of transmission. It may have always been present but no one looked for it until very recently. Just as influenza has shown up in bird shit since forever, it doesn't seem unreasonable that it might be present in the diarrhea of children. From what I've been able to find out it does not appear that influenza has mutated and is being transmitted through a new mode. Pneumonic plague is not a new mode of transmission, and the bacterium that causes it is the same as the one that is transmittable by insect bites. Besides, plague is not a virus. AIDS has always transmitted via bodily fluids. Blood transfusions and shared needles are still transfer by bodily fluid.Every virus that can survive in the blood is transmittable by these means by default. None of the examples that you provided qualify as an example of a virus changing its mode of transmission.
Re: (Score:3)
This is why Africa was finally made barren of human inhabitants in 1980...
Also this is what, two cases in the US, three? Maybe 5 total outside of Africa, and almost all of them among health workers collateral to treating confirmed Ebola-suffering patients?
Re:For those who said "No need to panic" (Score:5, Interesting)
As someone who lived through the SARS [wikipedia.org] panic in Asia, I would say no, we're not "there" yet. Apparently it has taken a bit longer than it should have for the rank-and-file health workers in the USA to get clued in on this, but I would venture to say that the number of them who remain unaware of this threat today is approximately zero. If anything, I'd expect to see a lot more "false alarms" than actual infections in the next few weeks.
Once the public is aware, the infection rate will plummet. Because of SARS, I still avoid doorknobs and elevator buttons whenever possible (use your keys, lighter, sleeve, etc. to buffer such contact), it just makes sense to do so. Once the protocols for avoiding Ebola become widely known, this so-called "epidemic" will quickly dissipate.
Re: (Score:2)
It's not too late until it makes the jump to central/south American as well as Asian shitholes. Than things get real ugly, real fast. Imaging Ebola infected Brazilian crackheads who are convinced the hospitals are holding out a cure.
Re: (Score:2)
Highly trained workers are getting infected.
Exactly as happened with SARS. Most of the infections were among health workers.
the rate of transmission is phenomenal. The death rate upon infection is phenomenal.
Yes, the death rate is high, but the transmission rate is low. The common flu is far more transmissible. And even though its death rate is much lower, the flu kills many times more people each year than Ebola will ever affect in the USA.
Re: For those who said "No need to panic" (Score:4, Insightful)
Highly trained workers... hmm...
Before you go on a tangent, think about this:
Look at the average person who works with you.
Note his abilities, how he handles himself, how he acts and how he does his work.
Note that this is what we call "a professional"
Now reevaluate that statement about "highly trained workers".
In my experience, 9 out of 10 times "professional" only means getting paid to do it. It's not a statement of quality.
Re: (Score:2)
For those who said "No need to panic" ... are we there yet?
No. Panicking does nothing, except perhaps make you look like an irrational moron. Like all those people panicking about terrorism after 9/11; idiots.
Re: (Score:3)
Ok, then let me rephrase my question that you'll probably find below:
What does being afraid of it accomplish?
Re:For those who said "No need to panic" (Score:4, Insightful)
No.
We MIGHT (and I stress "might") be getting to time to panic the first time we get an ebola victim who hasn't been to Africa, and hasn't been in contact with any known Ebola victim.
Note that this case is one of the 48 people who are currently being monitored due to contact with that ebola victim who brought it here from Africa.
Re: (Score:2)
We MIGHT (and I stress "might") be getting to time to panic the first time we get an ebola victim who hasn't been to Africa, and hasn't been in contact with any known Ebola victim.
Uh, Ebola spreads through contact, so by your logic it still wouldn't be time to be concerned if every last person on earth contracted the disease...
Panic of course is never helpful. However, extreme vigilance is. I think we're really underestimating the ability of this to get out of control.
Re: (Score:3)
By my logic, if you people start getting ebola with no KNOWN ebola contact, it's time to think about maybe panicking.
Because that would mean an unidentified reservoir of ebola in the country. Which is potentially disastrous.
So long as we have a clear eye on patient zero and everyone in contact with him, we don't need to be terribly worried....
Re: (Score:2)
So long as we have a clear eye on patient zero and everyone in contact with him, we don't need to be terribly worried....
Well, that would be true if we didn't have opportunities for new infections, and if we REALLY had a clear eye on everybody in contact with patient zero. As far as I understand it they were basically all told to stay home and are on the honor system. That really doesn't strike me as a responsible way to manage public health. I don't want to punish anybody, but this is a serious matter - by all means shower them with support, but at least post a guard to ensure nobody goes in or out of their homes.
Re: (Score:2)
Note that this case is one of the 48 people who are currently being monitored due to contact with that ebola victim who brought it here from Africa.
While I agree We should not panic, this case is not 1 of the 48 according to NPR.
Re:For those who said "No need to panic" (Score:5, Insightful)
For those who said "No need to panic" ... are we there yet?
Nope. And we never will be. Panicked people make stupid decisions that make the situation worse.
One thing these outbreaks in Europe and the US show - we don't know enough about Ebola.
There is no "outbreak" in the US or Europe. And not knowing enough about Ebola is not the same as saying we know nothing about Ebola, and what we know says there is not going to be an outbreak here -- just a few isolated cases of transmission. Thus far there have been one confirmed case of endemic transmission in the US and one in Europe, both nurses. The other "cases" were people with other viral diseases. One transmission does not an "outbreak" make, except to people who are panicky. It's normal in a situation like this for "suspected cases" to pop up all over the place. What do you expect, with the media spreading panic.
The CDC is now saying that the transmission in TX was caused by a "breach of protocol", which is not surprising given that the barrior protocols are exacting and onerous.
Re:For those who said "No need to panic" (Score:4, Interesting)
I don't want to misattribute something to the CDC, but what I read was glaringly clear on this point.
What the unnamed party said, was, "there HAD to be a breach of protocol, because this person is infected. However, we haven't identified what the breach was yet"
Circular reference?
Re: (Score:3)
To answer your question, if you mean *absolutely* prevent, the answer is nothing. But that's not the right question. The question is whether this will be transmitted at such a rate that it can result in sustained "endemic" transmission. "Endemic" is defined as a situation where each person infected in a location on average infects at least one other person. There may be a handful of transmissions from this index case, but it will fizzle out.
People worried about Ebola becoming endemic based on what's happe
Re: For those who said "No need to panic" (Score:5, Insightful)
I'm sure that there's a protocol you could follow to prevent catching the flu from flu patients, too, but I doubt it would be practical to practice medicine at the same time. I think that as Western medical personnel are beginning to be infected, it becomes less easy to just say "the training/equipment/conditions were the problem". At some point, we need to look at how the containment protocol interacts with the treatment protocol, and see if it actually works.
Remember, correctly executed withdrawl is just as effective a form of birth control as a correctly applied condom, but a greater share of condom users use them correctly than those who attempt pulling out.
Re: (Score:3)
Remember, correctly executed withdrawl is just as effective a form of birth control as a correctly applied condom, but a greater share of condom users use them correctly than those who attempt pulling out.
Here were some of the problems [wikipedia.org] with the studies you've alluded to:
A noted limitation to these previous studies' findings is that pre-ejaculate samples were analyzed after the critical two-minute point. That is, looking for motile sperm in small amounts of pre-ejaculate via microscope after two minutes – when the sample has most likely dried – makes examination and evaluation "extremely difficult."[4] Thus, in March 2011 a team of researchers assembled 27 male volunteers and analyzed their pre-ejaculate samples within two minutes after producing them.
The researchers found that 11 of the 27 men (41%) produced pre-ejaculatory samples that contained sperm, and 10 of these samples (37%) contained a "fair amount" of motile sperm (i.e. as few as 1 million to as many as 35 million).
Of course, that study as well is not completely definitive either.
However, two things need to be kept in mind. First, the study suggests that some men can leak sperm into their pre-ejaculate (though the authors do not extrapolate on this supposition and the possible causes of such a phenomenon). Second, the authors admit that some of their subjects who submitted sperm-positive pre-ejaculate samples could have actually used their ejaculate – due to failure of producing pre-ejaculate – to avoid the "embarrassment" of not producing pre-ejaculate.
So I'd say, the jury is still out on this question.
Re: For those who said "No need to panic" (Score:4, Insightful)
The barrier protocols are quite onerous. It doesn't need to be idiocy, fatigue is enough to induce human error. Experts have pointed to this as a factor in the spread of Ebola in West Africa; aside from the fact that most people have access to medieval levels of health care, or facilities that lack things like latex gloves, supplying hospitals with equipment is not enough. The workload of health care workers has to be kept light enough that they can take the extreme precautions needed without making errors.
It is also possible that the barrior protocols have a bug somewhere in them.
Re: (Score:3)
The problem in these African nations is that the virus' main victims have been predominantly among the few trained health care workers they had.
If you live in the developed world, you don't even think about the doctor:patient ratio, which is probably somewhere around 1:400 in your country. In Liberia, the ratio was about 1:100,000 (back in 2008). That means in this entire country of 4 million people, they had about 40 doctors - about the same as one typical urban American hospital. These are the only peop
Re:For those who said "No need to panic" (Score:5, Informative)
Let's see: total number of Ebola Patients in the U.S. is ... 1. Mssr. Duncan is dead and cremated and no longer spreading the disease. So, the answer is "no".
You didn't bother reading the summary or the article, did you? Not just 1, Mr. Duncan. The next victim is the trained, well-equipped health care professional who - despite having far better protection and awareness than the vast majority of people in the world - just tested positive for having caught the virus from him.
What's your point in ignoring that glaring little dose of reality?
Re: (Score:3)
We had 0.
Then Mr Duncan arrived. We had 1.
Then Mr Duncan died. We had 0.
Then the nurse tested positive. We have 1.
We've never had more than one case. Unless the guy in Boston who went to renew his prescription and complained about muscle aches tuns out to test positive. In which case there are two cases.
In comparison, every year, between 3,000 (confirmed) and 49,000 (estimated) people in the US die from influenza.
Re: (Score:3)
Re: (Score:2)
Sloppy procedure.
Re:worker wearing full protective gear (Score:5, Informative)
Does anyone know how the virus can penetrate a hermetically sealed suit?
It cant, but when the health worker does not use care to disinfect and properly remove the gear, he/she may not as well have worn the suit in the first place.
One of the workers infected in africa admitted that that was the cause of their infection; accidentaly touching their bare skin with the outside of the suit.
Re: (Score:2)
Does anyone know how the virus can penetrate a hermetically sealed suit?
It cant, but when the health worker does not use care to disinfect and properly remove the gear, he/she may not as well have worn the suit in the first place.
One of the workers infected in africa admitted that that was the cause of their infection; accidentaly touching their bare skin with the outside of the suit.
This is completely true, but it is very much a blame-the-victim mentality. I really don't care whose fault it is that mistakes get made. I think this just points to the need to really step up our game if we want to stay ahead of this. We're acting like the worst possible outcome of this situation is that people will stop going to the mall or getting on planes, and our policies are designed to try to prevent that from happening.
Re: (Score:2)
I think this just points to the need to really step up our game if we want to stay ahead of this.
What do you suggest doing to 'step up our game?'
Re: (Score:3)
I think this just points to the need to really step up our game if we want to stay ahead of this.
What do you suggest doing to 'step up our game?'
I would initially greatly restrict travel (air, land, and sea) out of Africa and limit it to those involved in aid efforts. Those workers would be carefully observed. If a tight quarantine could be imposed at a level of granularity smaller than the entire continent, then I'd be willing to lift travel bans on the entire continent after they were effective for an incubation period with no sign of spread. However, it is hard to contain a disease area as large as the current outbreak, and the entirety of the
Re: (Score:2)
She was not infected in Africa, she was infected in Spain.
Re:1st or 2nd transmission within the US? (Score:5, Informative)
But last week it was reported that Sgt. Michael Monning contracted ebola while trying to get the quarantine order signed.
No, it says a possible second Ebola victim. He didn't actually have the symptoms of Ebola, but felt sick, and since he had been in Thomas Duncan's apartment, he went to get checked out just in case. But his test for Ebola was negative.
Re: (Score:3)
http://www.khou.com/story/news... [khou.com]
"Monnig was transported to Texas Health Presbyterian inside an ambulance protected with plastic on the inside. Once there, his blood was drawn. He was cleared of the Ebola virus the next day."
Re: (Score:2)
nonsense, more likely contaminated objects were not properly isolated to sick area and not disposed of properly. Carelessness can get one maimed or killed in the real world.
By the way, "not airborne" does not included someone sneezing or coughing droplets right on you.
Re: (Score:3)
Yup, nothing to worry about. We've had all of about three people in the US with the disease so far with no more than one in any hospital at a time, and yet the workers still manage to get themselves infected. That is under fairly ideal conditions - these patients are actually in specialized isolation wards and they can dedicate personnel to them and generally isolate them from the rest of the hospital.
So, 3 sick patients leads to 1 sick healthcare worker. That isn't a particularly good ratio. If we had
Unjustified extrapolation (Score:3)
So, 3 sick patients leads to 1 sick healthcare worker. That isn't a particularly good ratio. If we had 100 people with Ebola then you'd expect 33 sick healthcare workers, and then you'd expect those to go on an infect another 11, then another 4, and then one more for good measure. If you're keeping count that is 50 healthcare workers in total, from treating 100 sick people.
Extrapolation [xkcd.com] from small numbers is rarely a sensible idea.
Re: (Score:2)
It would be easily spread by coins and monetary notes, though, wouldn't it?
Re:Everybody Panic! (Score:4, Insightful)
Simplest explanation is always right.
No. Most likely. But in the absence of more information, most certainly NOT "always right".
Re:Everybody Panic! (Score:5, Insightful)
well no, I bet a dollar there was a tear in his suit. Simplest explanation is always right.
Be prepared to lose a dollar. The protocol for donning and removing the protective gear is very complex, and very hard to get perfect. When putting the suit on, it's possible to get gaps between the goggles and suit without even knowing it. And when taking it off, a tiny flap of the contaminated suit brushing against a clean surface is almost impossible to detect.
In contrast, Tyvek suits are very hard to tear unless you're doing hard physical labor in a rough environment. Most hospital settings don't have the infectious care nursing staff crawling through piles of dirty rebar or squeezing along rough mortared brick walls.
Re:Everybody Panic! (Score:5, Interesting)
What I don't understand: Wouldn't it be possible to put the wearer through a disinfectant decontamination shower before he or she takes off the suit?
Re: (Score:3)
Decontamination shower is part of the protocol in Africa, but not in the US. The doctors in the US need to be trained better on this.
Re:Everybody Panic! (Score:4, Insightful)
Re:Everybody Panic! (Score:5, Insightful)
What I don't understand: Wouldn't it be possible to put the wearer through a disinfectant decontamination shower before he or she takes off the suit?
There is a strong protocol, and yes, it includes decontamination sprays. As I understand it the protocol includes a disinfectant spray before taking off the suit, a hand spray after removing the first layer of gloves, then another disinfectant spray after stripping. And the gloves and suit are all supposed to come off inside-out, always turning the the hot side to the inside.
Remember that any suit that can protect the wearer against virus is also impermeable to air. That means the suits heat up. They are sweating profusely as soon as they get their suits on, and they can only remain suited up for less than an hour before roasting in their own juices. When every surface is soaked in sweat, it's impossible to recognize when it's the patient's infectious sweat or your own.
We know the best practical approach is to use a buddy system, and have them help each other. Even so, the first buddy to disrobe is still handling the infectious materials while helping the other to strip, so they still have to be vigilant. Repeat that clothing protocol every other hour for a long work day, week after week, and if the wrong piece of fabric ever accidentally brushes on you any time during the process you may get infected with a disease that has a 60% chance of killing you. Or if this is your first time dealing with an Ebola case, how do you know you've followed the protocol perfectly?
Now, cross the ocean. Place all of that in the context of extreme poverty; chronic suit, glove, equipment, and doctor shortages; wailing and shrieking family members; orphaned babies that may be infected; contaminated water supplies; relentless heat; men who tell rumors that Ebola is a disease from the West that is being spread by doctors and is being used to kill Africans, or that Ebola doesn't exist; populations frightened by the presence of workers in "moon suits" coming to collect their dead relatives; a culture that grieves by touching the bodies of the dead; and the dozens of other deadly diseases that still strike Africans constantly, including malaria, dengue fever, AIDS, hepatitis, typhoid fever, and chronic diarrhea caused by rampant bacterial and protozoal infections. Oh, and attacks on clinics by gunmen.
It's almost as if the disease evolved itself to adapt to collapsing health care systems in impoverished nations.
Re:Everybody Panic! (Score:4, Interesting)
well no, I bet a dollar there was a tear in his suit. Simplest explanation is always right.
Be prepared to lose a dollar. The protocol for donning and removing the protective gear is very complex, and very hard to get perfect. When putting the suit on, it's possible to get gaps between the goggles and suit without even knowing it.
Goggles?! - Proper biohazard suits are full-body and pressurized, with a full-head hood and absolutely
no openings in the vicinity of the head. Or any place on the front side of the body for that matter.
And when taking it off, a tiny flap of the contaminated suit brushing against a clean surface is almost impossible to detect.
Eh, again? - There's a multi-step decontamination procedure before taking off the suit.
Taking off a still-contaminated suit would be a major fuckup, and a (potentially) contaminated suit should never
be in an environment where any "un-suited" contact can happen.
Have a look at how this works at the BSL-4 level [vimeo.com] (skip to about minute 13).
What kind of amateurs are running this place?
Re: (Score:3)
Actually my understanding is that they are not treating patients with the full suits on. The decision to just do face masks, gloves, etc. was pretty common it seems now... I think people have gotten more lax with Ebola simply because wearing the full suits is hot and tough to deal with for a long epidemic like we're seeing. It sounds like the nurse in question wasn't in full protective gear. I agree with the idea this shouldn't be happening... How many of these places really have full training for BL-4 dise
Re:Everybody Panic! (Score:5, Informative)
I had brunch with my friend this morning, who is an MD PhD in infectious disease and works in a BSL-4 laboratory from time to time, so I asked about this.
BSL-4 is a standard that only applies to laboratories, the same standards aren't necessarily applied to clinical environments, and in the case of Ebola are major overkill. Ebola can't travel through the air, so positive pressure suits aren't appropriate, and they still have to be taken on and off, and that's when health workers seem to get infected. People who "test positive" for Ebola are not contagious, only people who have symptoms are, and they can only pass the disease through contact with bodily fluids -- this usually implies touch, since hemorrhagic fevers cause people to give off all kinds of gross effluent, but it's just not like a "virus" one gets from casual contact, like, say, rubella.
The fact is, Ebola isn't that contagious -- HIV is more virulent, and these two are nothing compared to the influenza or SARS. It's bad that health workers can get it, but this is still one person, so on a completely epidemiological basis it's really not a big deal. Characterizing a single case as somehow indicative of the safety of these procedures is sensationalism.
Re:Everybody Panic! (Score:4, Insightful)
So basically you're just anxious, because none of this "seems right" in complete absence of empirical evidence?
Somebody in a modern clinical environment who supposedly knew what they were doing got infected.
That right there is empirical evidence of something not being right.
And in your sample of 10 (or 20, who knows!) one person became ill, because, we dunno, but it sounds fishy.
It doesn't to you? "Well, they have to take off those contaminated suits, and some will get infected while
doing that. Shit happens." really isn't the right approach here.
What recommendations would you make, if you were, say, a public health official? Everyone who develops illness has to be treated in something akin to a BSL-4 facility?
No, but how about "don't mix clean and unclean environments, and follow proper decontamination
procedures while moving between them, and before undressing"?
Have you any idea how many plane flights that would require, just to cite one small aspect of the logistics?
Huh? Plane flights? Are we still talking about a controlled clinical environment in a big American city?
And all this to protect from a disease vector that's completely unsubstantiated in the literature?
Or do you do like Judge Clay Jenkins [time.com], and personally go to the family's house in shirt-sleeves and drive them to a new home? Which approach is more appropriate? Which one balances our available resources against the actual concrete threat of the disease? Which one is actually workable?
You're losing me here.
Re: (Score:3)
Do you even know how this case of infection occurred?
I don't. You, however, speculated about contaminated suits which "still have to
be taken on and off, and that's when health workers seem to get infected."
Which really shouldn't happen.
you're the one who says he knows, or rather knows enough to know there was a systemic problem and not one merely attributable to failure to follow established protocols.
Please tell me where I said that.
Huh? Plane flights? Are we still talking about a controlled clinical environment in a big American city?
There are only about a dozen BSL-4 facilities in the US; if you want to establish the principle that patients must be treated in such a facility, you will be moving A LOT of them.
1.) I don't. My video example above was meant as a "look at how the pros do it".
2.) You do expect "A LOT" of Ebola patients in the US?
you seem to think every metro in the US has a world-class biohazard facility and infrastructure, and has plenty to spare on a wild goose chase of isolating minimally-virulent ebola patients, and you can't seem to understand that your fears are based completely on your own speculation and snap judgement. Your conceptualization of this disease, and the means required to contain it, constitute the textbook definition of cargo cult science.
Hm? What part of "don't mix clean and unclean environments" is cargo cult?
Also: I'm not afraid.
Just to clarify: I'm not talking about the Ebola outbreak a
Re: (Score:3)
And neither coughing or sneezing are Ebola symptoms.
Re: (Score:3)
well no, I bet a dollar there was a tear in his suit. Simplest explanation is always right.
My favorite part about this is how it gives the lie to all the xenophobic rationalizations that people in various African nations were contracting Ebola because of $DANGEROUS_TRIBAL_FUNERARY_CEREMONY.
Ebola is transmitted through bodily fluids including sweat and aerosolized saliva (produced by sneezing). Containing bodily fluids in a social context—especially saliva and sweat—is virtually impossible and probably makes Ebola a lot more contagious than the talking heads are letting on.
Re:Everybody Panic! (Score:4, Informative)
One problem is to most healthcare workers, all of their training on blood-borne pathogens is geared primarily toward AIDS, unfortunately HIV is a very labile with a fairly high infectious dose, so basically if you do just about anything you kill it and it remains infectious in the environment for minutes to an hour if you do nothing. Ebola on the other hand is a robust virus with a very low infectious dose (1 -10 virus), anything strong enough to guarantee a 99.999% kill rate is going to also dissolve plastic, peel the paint off the walls and corrode any metals to uselessness.
Re: (Score:3)
1:10 bleach solution is one of my favorites, but what it lacks is the guarentee, in this case manufacturer's product liability insurance. It doesn't disolve plastic, but repeated and prolonged contact does oxidative damage and embrittlement. It also does a number on latex paint but not immeadiatly and it will corrode metal even stainlees steel and colbalt-chrome alloy.
Re: (Score:3)
According to NBC, this is exactly what appears to have happened.
The NBC report is pure speculation. Nobody knows. It's just as likely aerosolized cough droplets, which is another thing the CDC insisted couldn't possibly happen.
Where are all those Slashdot posters who scream "Stop blaming the victim" now? Too scary to stand on principles?
When it comes to a choice if blaming the victim or admitting that their protocol is woefully inadequate, the CDC seems to take the low road.
Re: (Score:3)
No, I was talking about the CDC blaming the victim for breaking protocol, when it is clearly their own protocol that is at fault here.
Doctors without borders uses a much stricter protocol, with a buddy system for donning and doffing, and they have had
a much better record in keeping their people safe in absolutely horrible conditions.
Re: (Score:3, Insightful)
Re: (Score:2)
We have the same in Europe. At least one health care worker here has been infected and will probably die because someone thought it's smart to bring people infected with a 90% lethality virus home for treatment. Good job.
From March till now, the mortality rate for ebola infected Government and NGO workers has been around 55%.
It's higher for the the rest of the infected, as they usually have preexisting medical problems which renders them less able to fight the virus.
Re:hubris (Score:4, Informative)
Don't let facts get in the way of your rant.
This latest case arose because of a man who arrived in the US like any normal person would. He was not flown under quarantine for treatment, he developed the disease already in the US.
Considering the record so far, it's far safer to fly people back to the US for treatment than to let them arrive on their own even if they show no signs of the disease. This allows us to reach a single conclusion and no other: that Dallas hospital has some explainin' to do.
If your advice had been followed, that man would still have died in the US, infecting this other person, and those who were successfully treated in the US may have died due to not having access to the same level of care.
Ignorant arm chair critics + propagandists at Fox (Score:3)
The CDC and respective officials around the world train and plan for this stuff. Sure, some political idiocy always exists and sometimes makes problems worse (or blows them out of proportion) but overall the experts are making informed reasonable decisions. Naturally, propagandists twist anything to their own ends and the armchair critics who have way more confidence then competence (which BTW, is a big problem in the USA...go find the studies which prove it.)
Europe isn't banning relations with whole nati
Re: (Score:3)
They also weren't putting IVs in him and taking care of him while he was bleeding out the ass and vomiting during his final few days on earth.