Ebola virus outbreak

realweirdo

ProfessorPlum wrote: »

No it hasn't, and it isn't.

Yes it has. Miss no stars has explained it in more detail than I can as she has a better knowledge of the maths and science behind this than me.

I repeat the R value is pretty much irrelevant. A HIV patient on average will infect 4 people in their entire lives, which could be anything up to 40 years after infection. An ebola patient can infect 2 people. Ebola infection usually lasts 21 days in total.

The period of contagiousness is usually the last week. So an ebola patient can infect 2 people in a single week. If an ebola patient lived 40 years, in a highly contagious phase, you'd be talking

2x52x40 to get an equivalent R comparison to HIV.

You understand now? It's not that difficult!

blackwave

Interesting piece from the Washington Post with simulations of how Ebola compares to other diseases in terms of how quickly an infection spreads and number of deaths caused.

http://www.washingtonpost.com/wp-srv/special/health/how-ebola-spreads/

jsd1004

realweirdo wrote: »

I don't really have time or inclination for word games with you. I'm glad you don't think I'm racist however and I'm also glad you have come around to the view ebola victims should be isolated.

realweirdo wrote: »

Yes it has. Miss no stars has explained it in more detail than I can as she has a better knowledge of the maths and science behind this than me.

I repeat the R value is pretty much irrelevant. A HIV patient on average will infect 4 people in their entire lives, which could be anything up to 40 years after infection. An ebola patient can infect 2 people. Ebola infection usually lasts 21 days in total.

The period of contagiousness is usually the last week. So an ebola patient can infect 2 people in a single week. If an ebola patient lived 40 years, in a highly contagious phase, you'd be talking

2x52x40 to get an equivalent R comparison to HIV.

You understand now? It's not that difficult!

By how would a HIV patient infect 4 people in their life?

freqeunt_guest

realweirdo wrote: »

It's cold, but logical. Here's my suggestion, all the bleeding heart liberals in the west suit up, travel out to west africa and volunteer to fight this epidemic. Then you will see what principles they actually have. It's one thing when someone else has to confront it, its another when they have to confront it.

saw a piece on the news this evening where a guy from dublin was getting ready to travel to liberia to help out

how irresponsible can people be , that guy should not be let back into the country for at least a year

ProfessorPlum

miss no stars wrote: »

It's irrelevant when not taken in the context of the period for which the infected victim can pass on infection. It's useful when you put it in temporal context. That's the point I'm trying to make for the third time. Simply saying "oh but it's R number is 2 which is only half of that of HIV" is useless without considering the time over which those infections occur.

I think I already explained it to you earlier. You claim ebola is highly contagious. It is not. The R number is useful. I compared Measles, a highly contagious disease with an R number of 18, to ebola with an R number of 2. Temporally, they would be similar.

ProfessorPlum

realweirdo wrote: »

Yes it has. Miss no stars has explained it in more detail than I can as she has a better knowledge of the maths and science behind this than me.

I repeat the R value is pretty much irrelevant. A HIV patient on average will infect 4 people in their entire lives, which could be anything up to 40 years after infection. An ebola patient can infect 2 people. Ebola infection usually lasts 21 days in total.

The period of contagiousness is usually the last week. So an ebola patient can infect 2 people in a single week. If an ebola patient lived 40 years, in a highly contagious phase, you'd be talking

2x52x40 to get an equivalent R comparison to HIV.

You understand now? It's not that difficult!

no. no no. See my previous post.

realweirdo

miss no stars wrote: »

It's irrelevant when not taken in the context of the period for which the infected victim can pass on infection. It's useful when you put it in temporal context. That's the point I'm trying to make for the third time. Simply saying "oh but it's R number is 2 which is only half of that of HIV" is useless without considering the time over which those infections occur.

Totally agree. If an ebola victim lived as long as the average HIV victim, the R value for the average ebola victim would be of the order of several thousand. They'd infect 2 people a week, 52 weeks a year for several decades.

freqeunt_guest

dalyboy wrote: »

According to the W.H.O its not an airbourne virus and is only spread "through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids". In other its all but impossible to contract this virus in normal every day activities. I for one will sleep well while I laugh at the idiots on tv wearing their masks and protective suits. The only way this virus will make it to Ireland is if it is purposely planted here.

nonesense , currently , their is no screening programme at dublin airport or dublin port , aid workers and medical staff who are out there helping might well carry it back with them , travel to those badly effected countries ( both in and out ) need to be banned without delay

realweirdo

ProfessorPlum wrote: »

I think I already explained it to you earlier. You claim ebola is highly contagious. It is not. The R number is useful. I compared Measles, a highly contagious disease with an R number of 18, to ebola with an R number of 2. Temporally, they would be similar.

And as Miss No Stars explained to you, it's irrelevant without the time frame.

miss no stars

ProfessorPlum wrote: »

I think I already explained it to you earlier. You claim ebola is highly contagious. It is not. The R number is useful. I compared Measles, a highly contagious disease with an R number of 18, to ebola with an R number of 2. Temporally, they would be similar.

But you haven't considered the precautions against transmission. A spanish nurse allegedly provided with and correctly using BSL2 protective equipment contracted Ebola in a hospital environment.

I'm not saying the R number isn't useful, I'm saying that comparing apples with oranges isn't useful. Comparing the R number for Ebola (dead and gone in about 3-4 weeks) with the R number for HIV (alive after decades with modern medicine and no need for BSL4 protective equipment) is a false comparison.

ProfessorPlum

realweirdo wrote: »

Totally agree. If an ebola victim lived as long as the average HIV victim, the R value for the average ebola victim would be of the order of several thousand. They'd infect 2 people a week, 52 weeks a year for several decades.

Oh Christ. They don't. The sick ones don't live. The survivors survive, and can infect others for upto maybe 90 days. We think. After that they don't continue to infect others. There are no further cases as a consequence of that patient. So the R number is 2. It just is.

realweirdo

ProfessorPlum wrote: »

Oh Christ. They don't. The sick ones don't live. The survivors survive, and can infect others for upto maybe 90 days. We think. After that they don't continue to infect others. There are no further cases as a consequence of that patient. So the R number is 2. It just is.

2 in a week.

So let's imagine someone gets infected with HIV today. How many people do you think they will have infected by this time next week? 4?

Spring Onion

realweirdo wrote: »

I don't really have time or inclination for word games with you. I'm glad you don't think I'm racist however and I'm also glad you have come around to the view ebola victims should be isolated.

http://www.youtube.com/watch?v=5j2F4VcBmeo

1:10

ProfessorPlum

realweirdo wrote: »

And as Miss No Stars explained to you, it's irrelevant without the time frame.

See my post. Comparing to measles. Temporally similar.

miss no stars wrote: »

But you haven't considered the precautions against transmission. A spanish nurse allegedly provided with and correctly using BSL2 protective equipment contracted Ebola in a hospital environment.

I'm not saying the R number isn't useful, I'm saying that comparing apples with oranges isn't useful. Comparing the R number for Ebola (dead and gone in about 3-4 weeks) with the R number for HIV (alive after decades with modern medicine and no need for BSL4 protective equipment) is a false comparison.

I never did compare to HIV. I compared to measles, just for you. Not a false comparison at all.

ProfessorPlum

realweirdo wrote: »

2 in a week.

So let's imagine someone gets infected with HIV today. How many people do you think they will have infected by this time next week? 4?

I do give up.

Explain your problem with R numbers with reference to measles please.

realweirdo

ProfessorPlum wrote: »

See my post. Comparing to measles. Temporally similar.




I never did compare to HIV. I compared to measles, just for you. Not a false comparison at all.

And measles is an even worse comparision. How many measles cases are fatal, given that 50% of ebola cases are fatal.

In all seriousness you might as well quote the R value for headlice.

miss no stars

ProfessorPlum wrote: »

See my post. Comparing to measles. Temporally similar.




I never did compare to HIV. I compared to measles, just for you. Not a false comparison at all.

What on earth is your problem? I responded saying that those claiming Ebola is anything short of a massive public health risk because HIV has an R number twice as high are talking absolute crap.

I addressed your point about measles. When assessing risk you assess:

Likelihood of occurrence (a factor of inherent contagiousness AND the speed at which new infections occur)
AND
the consequence of occurrence

Ebola is still coming out way up there.


I never said it was the most contagious disease in the world. I said it's highly contagious when you factor in the time it takes to spread and the fact that despite massive precautions against transmission, new infections still occur.

I said that when you add that in to the 50% mortality rate it's a highly dangerous disease.

ProfessorPlum

realweirdo wrote: »

And measles is an even worse comparision. How many measles cases are fatal, given that 50% of ebola cases are fatal.

In all seriousness you might as well quote the R value for headlice.

Ok, in all seriousness, WTF does fatality got to do with R numbers. And you might well quote the number for head lice if you want to quantify how contagious it is, and move on to the CFR if you want to quantify how deadly it is.

realweirdo

I'd much rather get measles than ebola! In fact I'm pretty sure most Irish people had measles at one stage or another.

WakeUp

ProfessorPlum wrote: »

Your link is to a crank conspiracy theory type website, and the link in that to the peer reviewed medical paper is to a blog.

However, one thing a medical student learns early on (as most of the exams are negative marking MCQ's) if there's a choice of an 'always' or 'never' answer in medicine, the right answer is probably not that one.

the link does take you a blog which is signed of at the end by this guy...

The German physicians, led by Dr. Timm H. Westhoff of the Department of Nephrology at the Carité Campus Benjamin Franklin in Berlin, noted in a virology blog published Feb. 12, 2009, that acute viral infections such as Ebola hemorrhagic fever may cause little or no clinical symptoms in a so-called “inapparent infection” yet may be contagious.

“A well-known example is poliovirus: over 90% are without infections,” Westhoff and his colleagues continued. “During an inapparent infection, sufficient virus replication occurs in the host to induce antiviral antibodies, but not enough to cause disease. Such infections are important for the spread of infection, because they are not easily detected.”


10.1093/ndt/gfn693 - this is is also at the end of the blog which redirects you to the oxford journal though it appears to be just the abstract synopsis with a list of other articles citing the research.

in the original wnd article - The German physicians published in 2008 the fundamental medical research that formed the basis for their blog comments - this sentence is hyperlinked and again redirects you to the oxford journal - full.

ProfessorPlum

miss no stars wrote: »

What on earth is your problem? I responded saying that those claiming Ebola is anything short of a massive public health risk because HIV has an R number twice as high are talking absolute crap.

I addressed your point about measles. When assessing risk you assess:

Likelihood of occurrence (a factor of inherent contagiousness AND the speed at which new infections occur)
AND
the consequence of occurrence

Ebola is still coming out way up there.


I never said it was the most contagious disease in the world. I said it's highly contagious when you factor in the time it takes to spread and the fact that despite massive precautions against transmission, new infections still occur.

I said that when you add that in to the 50% mortality rate it's a highly dangerous disease.

Ohh hold on there - major shifting of goal posts!

You said that R number was useless when talking about how contagious a disease was, and despite it's R number of 2, that Ebola was a highly contagious disease. Which it's not.
Now you're bringing in mortality, which has nothing what so ever to do with contagiousness. Nothing.
And assessing risk - nope, you hadn't mentioned that either.

Nobody is saying Ebola isn't a highly dangerous disease - that just wasn't your argument in the first place.

ProfessorPlum

realweirdo wrote: »

I'd much rather get measles than ebola! In fact I'm pretty sure most Irish people had measles at one stage or another.

Seriously, not the point. Where is the brick wall.:(

ProfessorPlum

WakeUp wrote: »

the link does take you a blog which is signed of at the end by this guy...

The German physicians, led by Dr. Timm H. Westhoff of the Department of Nephrology at the Carité Campus Benjamin Franklin in Berlin, noted in a virology blog published Feb. 12, 2009, that acute viral infections such as Ebola hemorrhagic fever may cause little or no clinical symptoms in a so-called “inapparent infection” yet may be contagious.

“A well-known example is poliovirus: over 90% are without infections,” Westhoff and his colleagues continued. “During an inapparent infection, sufficient virus replication occurs in the host to induce antiviral antibodies, but not enough to cause disease. Such infections are important for the spread of infection, because they are not easily detected.”


10.1093/ndt/gfn693 - this is is also at the end of the blog which redirects you to the oxford journal though it appears to be just the abstract synopsis with a list of other articles citing the research.

in the original wnd article - The German physicians published in 2008 the fundamental medical research that formed the basis for their blog comments - this sentence is hyperlinked and again redirects you to the oxford journal - full.

A lot of maybes there, but like I said, always and never are dirty words in medicine!

realweirdo

I think miss no stars has explained this amply. Its the temporal issue that is key along with the fatality rate and the life expectancy of infected patients.

I am sure miss no stars will also concur that the fact that fatality rate is relatively low for this outbreak of ebola makes it even more serious than previous outbreaks. It possibly has a longer encupation period as well.

Here's an interesting comparison with the spanish flu of the early 20th century. I think there are some similarities.

http://www.rense.com/general63/ebola.htm

ProfessorPlum

realweirdo wrote: »

I think miss no stars has explained this amply. Its the temporal issue that is key along with the fatality rate and the life expectancy of infected patients.

I am sure miss no stars will also concur that the fact that fatality rate is relatively low for this outbreak of ebola makes it even more serious than previous outbreaks. It possibly has a longer encupation period as well.

Here's an interesting comparison with the spanish flu of the early 20th century. I think there are some similarities.

http://www.rense.com/general63/ebola.htm

Yada yada. It's just not the point the two of you were arguing though. Was it?

miss no stars

ProfessorPlum wrote: »

Ohh hold on there - major shifting of goal posts!

You said that R number was useless when talking about how contagious a disease was, and despite it's R number of 2, that Ebola was a highly contagious disease. Which it's not.
Now you're bringing in mortality, which has nothing what so ever to do with contagiousness. Nothing.
And assessing risk - nope, you hadn't mentioned that either.

Nobody is saying Ebola isn't a highly dangerous disease - that just wasn't your argument in the first place.

No, I said it was useless when you refuse to consider time spans.

ProfessorPlum

miss no stars wrote: »

No, I said it was useless when you refuse to consider time spans.

So please explain your assertion that it is highly contagious, given it's R number of 2 vis a vis Measles, which has an R number of 18, and is infectious in a similar time frame.

realweirdo

ProfessorPlum wrote: »

Seriously, not the point. Where is the brick wall.:(

To put it bluntly, yes ebola, particularly this version is highly contagious. The temporal issue is still the key, but somehow I doubt you will ever grasp this concept and I'm wasting my time explaining it to you.

As for measles, its not in the same ballpark as ebola, it too is irrelevant. SARs might be a better comparision, but my understanding the fatality rate with SARs was something like 10%.

Another point is, people have an assumption that unless something is airborne such as via a sneeze or cough, its not highly contagious.

The only good way to look at ebola is that people don't really become contagious until they are at a late stage. And when they are at a late stage, most people have the sense not to go near them. However all indications are it is still spreading exponentially in Africa.

WakeUp

ProfessorPlum wrote: »

A lot of maybes there, but like I said, always and never are dirty words in medicine!

perhaps they are. though Im just pointing out the fact that the blog article is signed off by Westhoff and his research published in the oxford journal. lest there be any confusion about "conspiracies" or things like that. if you want to argue against his findings please feel free to do so. I for one would be genuinely interested in reading your hypothesis.

ProfessorPlum

WakeUp wrote: »

perhaps they are. though Im just pointing out the fact that the blog article is signed off by Westhoff and his research published in the oxford journal. lest there be any confusion about "conspiracies" or things like that. if you want to argue against his findings please feel free to do so. I for one would be genuinely interested in reading your hypothesis.

God, I'd have to have a good trawl thru the paper. Busy trying to get through to these two about the difference between contagiousness and risk, or seriousness or something. I'm sure there's some merit in the research, but generally research that can't (or hasn't) been replicated doesn't get much attention. Maybe it'll get a bit more of a look in now we have this latest outbreak.