Ebola virus outbreak

realweirdo

ProfessorPlum wrote: »

That's disappointing. I suppose you have to remember that these health care workers are not used to this kind of barrier nursing, and like everything else, there's a learning curve. Big price to pay for getting it wrong though. I hope that those in charge are looking in depth at the protocols in place to find the weak spots, and will come up with a way to improve them. Quickly.

There's a particular and complex sequence of events to removing the hazmat suits and one mistake by one person can cause an infection. It doesn't matter how good your suit is if you make a mistake taking it off. And mistakes will happen. Fatigue after a long shift might play a part or momentary loss of concentration.

EDit

P_1 wrote: »

I think the most serious issue with Ebola is that it appears that somebody who's infected by it can spread the disease before the symptoms actually present themselves. Its all well and good suggesting that you have the full NBC gear on around a patient who's presenting the symptoms but how can you tell someone who has it but is yet to display the symptoms apart from anybody else?

So far, it appears to be the opposite. The guy in the US presented when he had low grade symptoms and was sent home. He must have come into contact with multiple people at that time yet (so far) none of them have the disease. On the other hand, this person who has just been announced as infected would have come into contact with original patient when he had very severe symptoms (ie, excreting large amounts of virus-laden vomit and faeces). Certainly worrying for the U.S. authorities from a protocol perspective, but much less worrying from a public perspective than, for example, someone getting infected simply by sitting next to an asymptomatic patient on a plane or train. If/when that happens, that is when I think the panic will truly set in.

MadYaker

realweirdo wrote: »

If one of the richest and most advanced nations on earth struggles to contain ebola, what hope for the rest of the world?

If ebola reaches somewhere like Asia in significant numbers, its game over.

Sierra Leone is struggling to contain it. American is not struggling to contain it, yet.

JONJO THE MISER

So she was wearing a full suit and still got it, as other posters have said with such gusto we have nothing to worry about:rolleyes:

realweirdo

MadYaker wrote: »

Sierra Leone is struggling to contain it. American is not struggling to contain it, yet.

Ebola always starts with 1 or 2 cases and then moves from there. And it usually takes about a week before someone is infected and they present symptoms. So there may already be other people infected in the US who don't know yet.

As for airport screening, its possibly a waste of time. The latest nurse showed no symptoms for a number of days such as a high temperature. She probably would have passed airport screening in those early days.

realweirdo

EDit wrote: »

So far, it appears to be the opposite. The guy in the US presented when he had low grade symptoms and was sent home. He must have come into contact with multiple people at that time yet (so far) none of them have the disease. On the other hand, this person who has just been announced as infected would have come into contact with original patient when he had very severe symptoms (ie, excreting large amounts of virus-laden vomit and faeces). Certainly worrying for the U.S. authorities from a protocol perspective, but much less worrying from a public perspective than, for example, someone getting infected simply by sitting next to an asymptomatic patient on a plane or train. If/when that happens, that is when I think the panic will truly set in.

True. Which is why health workers are the focal point of ebola spread. They come in contact with patients when they are in the virus excreting stage.

Contact tracing is the main way to control ebola. But the more cases, the more difficult that becomes. I think the Americans are probably learning how to tackle ebola and may if lucky head it off.

Rums

I think Ebola is being massively overhyped as a threat.

It can only be transferred by people displaying symptoms, by direct contact with bodily fluids such as vomit, sweat, blood, saliva or excrement and by direct contact I mean it actually has to enter through a cut or through the mouth, eyes or nose.
The virus can remain on a surface for a few hours and on blood outside of the body for a few days.... however as long as you don't go rubbing your eyes or putting your hands in your mouth without washing them you won't contract it.
The disease gradually becomes more contagious over time so the corpses of people who recently died of Ebola are b y far the most infectious source.... this and burial rituals (washing the dead body by hand) in the countries in africa that are suffering the brunt of the outbreak are why it has spread so aggressively over there, even then globally atm it would seem that there are only 8,000-10,000 confirmed cases practically all of which are in that western outcrop of sub Saharan Africa.

In a country like Ireland with such a low population density and so few public airports the odds of Ebola being a real threat even if it reached the country in a real way are low, obviously people living in large population centers such as Dublin would be more at risk but the risk can be massively limited by simply carrying some hand sanitiser with you and avoid public transport, public toilets and hospitals.
If there was an Ebola outbreak in the country the last place I would want to be is a hospital given the poor record of many Irish Hospitals performances on the Hygiene front.... Hygiene essentially being the best defence against Ebola.

ProfessorPlum

realweirdo wrote: »

There's a particular and complex sequence of events to removing the hazmat suits and one mistake by one person can cause an infection. It doesn't matter how good your suit is if you make a mistake taking it off. And mistakes will happen. Fatigue after a long shift might play a part or momentary loss of concentration.

I think that was my point. The protocols may need working on.

ceadaoin.

realweirdo wrote: »

There's a particular and complex sequence of events to removing the hazmat suits and one mistake by one person can cause an infection. It doesn't matter how good your suit is if you make a mistake taking it off. And mistakes will happen. Fatigue after a long shift might play a part or momentary loss of concentration.

Medical professionals working in normal hospitals just don't have the proper training or experience in using these suits. I don't know why they aren't transferring cases to the speciality hospitals that have dealt with the patients who were brought back from abroad. They are properly equipped to deal with BSL4 containment and it's not like they're overwhelmed with patients. Those nurses and doctors are trained for these procedures so it would make more sense and would minimize the risk of further transmission.

youtube!

Suspected case in Hawaii...


http://www.cbsnews.com/news/ebola-concerns-prompt-hawaii-patient-to-be-placed-in-isolation/

My name is URL

JONJO THE MISER wrote: »

So she was wearing a full suit and still got it, as other posters have said with such gusto we have nothing to worry about:rolleyes:

She wasn't wearing a full protective suit according to news reports. She was wearing a gown, gloves, mask and a shield (basically this). You wouldn't get away with wearing that if handling viruses in a lab setting.. I don't know why that's the setup when dealing with highly infectious patients.

This is what fully protective suits look like - https://www.google.ie/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0CCEQFjAA&url=http%3A%2F%2Fwww.dupont.com%2Fproducts-and-services%2Fpersonal-protective-equipment%2Farticles%2Fprotective-clothing-for-ebola-virus-disease.html&ei=oKE6VLXzC8rfatqdgLAM&usg=AFQjCNFc0j8gcL8zPSN1dUZf42J9cXjpjw&sig2=LXpiVYbSFvtRbuzDu6QU-A

ProfessorPlum

Rums wrote: »

I think Ebola is being massively overhyped as a threat.

It can only be transferred by people displaying symptoms, by direct contact with bodily fluids such as vomit, sweat, blood, saliva or excrement and by direct contact I mean it actually has to enter through a cut or through the mouth, eyes or nose.
The virus can remain on a surface for a few hours and on blood outside of the body for a few days.... however as long as you don't go rubbing your eyes or putting your hands in your mouth without washing them you won't contract it.
The disease gradually becomes more contagious over time so the corpses of people who recently died of Ebola are b y far the most infectious source.... this and burial rituals (washing the dead body by hand) in the countries in africa that are suffering the brunt of the outbreak are why it has spread so aggressively over there, even then globally atm it would seem that there are only 8,000-10,000 confirmed cases practically all of which are in that western outcrop of sub Saharan Africa.

In a country like Ireland with such a low population density and so few public airports the odds of Ebola being a real threat even if it reached the country in a real way are low, obviously people living in large population centers such as Dublin would be more at risk but the risk can be massively limited by simply carrying some hand sanitiser with you and avoid public transport, public toilets and hospitals.
If there was an Ebola outbreak in the country the last place I would want to be is a hospital given the poor record of many Irish Hospitals performances on the Hygiene front.... Hygiene essentially being the best defence against Ebola.

I agree that there is a lot of hype around Ebola, but your 'simple' measures for containment (avoid public transport) would see major cities paralysed and the normal services we all take for granted thrown into diss array. We can't tell people just to avoid hospitals, or they will die from other, treatable illnesses, just like they are in Africa at the moment.

ProfessorPlum

ceadaoin. wrote: »

Medical professionals working in normal hospitals just don't have the proper training or experience in using these suits. I don't know why they aren't transferring cases to the speciality hospitals that have dealt with the patients who were brought back from abroad. They are properly equipped to deal with BSL4 containment and it's not like they're overwhelmed with patients. Those nurses and doctors are trained for these procedures so it would make more sense and would minimize the risk of further transmission.

I can't imagine any medical personnel working in hospital in the US or Europe have much experience dealing with a level 4 threat. Most any traing that's been done has been in the last few weeks.

EDit

youtube! wrote: »

Suspected case in Hawaii...


http://www.cbsnews.com/news/ebola-concerns-prompt-hawaii-patient-to-be-placed-in-isolation/

The article is from Oct 2, ie 10 days ago. I'm fairly sure that they would have confirmed if it was a real case by now (and if it was a real case, it'd be all over the news)

ceadaoin.

EDit wrote: »

The article is from Oct 2, ie 10 days ago. I'm fairly sure that they would have confirmed if it was a real case by now (and if it was a real case, it'd be all over the news)

Yeah, that was confirmed not to be ebola ages ago.

My name is URL wrote: »

She wasn't wearing a full protective suit according to news reports. She was wearing a gown, gloves, mask and a shield (basically this). You wouldn't get away with wearing that if handling viruses in a lab setting.. I don't know why that's the setup when dealing with highly infectious patients.

This is what fully protective suits look like - https://www.google.ie/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0CCEQFjAA&url=http%3A%2F%2Fwww.dupont.com%2Fproducts-and-services%2Fpersonal-protective-equipment%2Farticles%2Fprotective-clothing-for-ebola-virus-disease.html&ei=oKE6VLXzC8rfatqdgLAM&usg=AFQjCNFc0j8gcL8zPSN1dUZf42J9cXjpjw&sig2=LXpiVYbSFvtRbuzDu6QU-A

At the news conference Dr Frieden said she was wearing the full PPE and wasn't in the group being monitored because of this. She only treated the patient after ebola had been confirmed so if she was only wearing gloves, gown and a mask then that is a serious breach of protocol.

Also, in other worrying news

For public health workers screening more than 1,000 air travelers who arrive each week in the United States from Ebola-stricken West Africa, one symptom above all others is supposed to signal danger: fever.

So long as an individual's temperature does not exceed 101.5 degrees and there are no visible symptoms of Ebola, health authorities say it should be assumed the person is not infectious.

Yet the largest study of the current outbreak found that in nearly 13% of "confirmed and probable" cases in Liberia, Sierra Leone, Guinea and elsewhere, those infected did not have fevers.

The study, sponsored by the World Health Organization and published online late last month by the New England Journal of Medicine, analyzed data on 3,343 confirmed and 667 probable cases of Ebola.

http://www.latimes.com/nation/la-na-1012-ebola-fever-20141012-story.html#page=1

ProfessorPlum

Well, I think anybody who has an informed opinion has said that screening at airports is a waste of money, so hardly news really. It's just politicians wanting to be seen to be doing something. They'd be better sending the money to west Africa to help the effort there.

ceadaoin.

ProfessorPlum wrote: »

Well, I think anybody who has an informed opinion has said that screening at airports is a waste of money, so hardly news really. It's just politicians wanting to be seen to be doing something. They'd be better sending the money to west Africa to help the effort there.

Yes the screening is nothing but a PR exercise. But temperature checking seems to be the main way that they are monitoring any at risk people. If fever isn't always present then it is possible that a case might be missed until more symptoms develop, increasing the risk of others becoming infected. Really there are so many unknowns with this disease.

ProfessorPlum

Fever is just one one the ways at risk people are monitored - they're also monitoring or asking about 'symptoms' - these have to be self reported - eg aches, fatigue etc. there's no test for that. Fever is a 'sign' - something that has to be looked for and found. Maybe that's why it sounds like they're only looking for fever.

WakeUp

so the Canadians are advising any of their nationals living in the three most affected countries to leave and return to Canada. I think our foreign affairs department should do likewise and issue the same directive to any Irish nationals that are living over there thinking of coming back. if they are thinking of coming back to Ireland now is the time to do it. not later right now. and if they do come back a mandatory quarantine should be set up and them placed into it whilst being monitored. it would be prudent I think to follow the Canadians lead and do this now. just to be sure.

________________________________________________________

Health Minister Rona Ambrose is urging Canadians in three countries in West Africa where the Ebola virus is raging to consider leaving now.

The federal government issued a travel advisory Friday aimed at 216 Canadians who live in Guinea, Liberia, and Sierra Leone

"Today we are asking Canadians living in Sierra Leone, Guinea and Liberia to consider leaving by commercial means while they are still available," Ambrose said in Edmonton Friday.
http://www.cbc.ca/news/politics/ebola-outbreak-canadians-in-3-west-african-countries-advised-to-leave-1.2795808

TheBeardedLady

Rumour has it the nurse in Madrid is improving!

JohnDaniels

Thanks for the article written by the doctor who caught Ebola. It was a really eye opening read which offered some great personal insight into the disease and what its victims go through.

JohnDaniels

Thanks for the article written by the doctor who caught Ebola. It was a really eye opening read which offered some great personal insight into the disease and what its victims go through

WakeUp

TheBeardedLady wrote: »

Rumour has it the nurse in Madrid is improving!

apparently she is conscious and sitting upright.

Reuters images showed Romero alert and sitting upright in her hospital room with an oxygen mask strapped to her face and responding to the hospital staff attending to her. She had taken a turn for the worse two days ago, health authorities said, and is still considered critical.

"Teresa Romero's condition has undergone no significant changes and is still serious, but stable," a government Ebola committee said in a statement on Saturday afternoon.
http://www.trust.org/item/20141011204601-mv1tp/?
http://www.newsnow.co.uk/h/Hot+Topics/Ebola+Outbreak

youtube!

26 crew were given the all clear and let go on their merry way! Now what exactly were the tests they were given because if it was just temperature then we could well see our first cases very very soon as it takes 3 weeks to incubate. All this talk from the government saying there are no direct flights between the west african nations affected and Ireland doesn't matter a dam when there is shipping trade still happening !

Lord Trollington

youtube! wrote: »

26 crew were given the all clear and let go on their merry way! Now what exactly were the tests they were given because if it was just temperature then we could well see our first cases very very soon as it takes 3 weeks to incubate. All this talk from the government saying there are no direct flights between the west african nations affected and Ireland doesn't matter a dam when there is shipping trade still happening !

Ships captain gave the HSE a clean bill of health which allowed the ship to dock.

Anyone travelling from affected countries into Ireland should be quarantined on arrival.

I can't imagine there are many coming to Ireland from these countries at the moment so it shouldn't be hard to monitor.

ceadaoin.

WakeUp wrote: »

apparently she is conscious and sitting upright.

Reuters images showed Romero alert and sitting upright in her hospital room with an oxygen mask strapped to her face and responding to the hospital staff attending to her. She had taken a turn for the worse two days ago, health authorities said, and is still considered critical.

"Teresa Romero's condition has undergone no significant changes and is still serious, but stable," a government Ebola committee said in a statement on Saturday afternoon.
http://www.trust.org/item/20141011204601-mv1tp/?
http://www.newsnow.co.uk/h/Hot+Topics/Ebola+Outbreak

That's good news. They got some ZMapp for her. Seems like it worked.

youtube!

Another suspected case this time in Boston...


http://boston.cbslocal.com/2014/10/12/man-with-ebola-like-symptoms-isolated-at-braintree-hospital/

youtube!

http://losangeles.cbslocal.com/2014/10/12/lax-possible-ebola-patient-on-united-flight-from-jfk/

...and now a plane from JFK to LAX has been stopped on the runway for over an hour and a half while a Hazmat team assemble, What if it's just a flu or something..world going crazy!

ceadaoin.

youtube! wrote: »

Another suspected case this time in Boston...


http://boston.cbslocal.com/2014/10/12/man-with-ebola-like-symptoms-isolated-at-braintree-hospital/

Hopefully just another false alarm. Although, this person had come back from Liberia a couple of weeks ago.

Seems like if it is ebola, you don't hear about it until it's been confirmed and the patient is in hospital. The nurse diagnosed today was admitted into the hospital on Friday but not a peep about it until this morning.

CelticRambler

LuckyLloyd wrote: »

'But malaria kills X every year and the flu kills Y. Ebola has only killed a few thousand.'

Shut up, shut up, shut up!!

Malaria and the flu do kill huge numbers and it is regrettable. However, they do not knock off young and healthy people, the general mortality rate is low and medical treatments can be applied that significantly improve outcomes. Malaria is an unfortunate crises of the poverty of the developed world.

Ebola has a mortality rate presently of 50% and medical intervention is limited in scope and ineffective in terms of improving outcomes. It is also growing expotentially over an extended period for the first time.

I'm not saying it's time to crack each other's skulls open nor am I saying that third world lives are any less valuable than our own. But trite dismissals on the basis of other public health issues being in existence are irritating.

Akrasia wrote: »

You dont seem to grasp the implications of exponential growth

Actually, I do. Having training in statistics and disease epidemiology comes in handy sometimes. :cool:

All "epidemics" have exponential growth when people first start taking them seriously - even non-infectious non-disease epidemics - so the fact that we're seeing more cases now than a year ago is perfectly normal. It doesn't mean it's going to continue into the future. For that, you need to look at the basic reproduction number (R0)

For Ebola, the R0 value is more than one, so it won't die out, but less than 2 which puts it lower than 'flu, SARS, HIV and way way way way way lower than measles (R0=12-18).

Did our mothers all panic and run around like headless chickens when we got measles? No they didn't ... or at least my generation's mothers didn't. There's a sizeable chunk of the boards.ie population that's never even seen a case of measles because ye were all vaccinated, and I'm sure there are some on here who object to having their own children vaccinated because they think measles is a mild illness.

So l'll stand by my earlier comment: there is no Ebola crisis - it's just an interesting spike in an otherwise ordinary virus's life, but it makes great "reality" TV news.