"Have we contained ebola?" Topic

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The Ebola virus has multiplied in a medium of denial. There was the initial denial that a rural disease, causing isolated outbreaks that burned out quickly, could become a sustained, urban killer. There is the (understandable) denial of patients in West Africa, who convince themselves that they have flu or malaria (the symptoms are similar to Ebola) and remain in communities. And there is the form of denial now practiced by Western governments — a misguided belief that an incremental response can get ahead of an exponentially growing threat.

The remarkable success of Nigerian authorities in tracing and defeating their Ebola outbreak has created a broad impression that the disease is contained. Some administration officials are privately citing the news of empty hospital beds in parts of Liberia as a welcome development.

But the disease is not contained within Liberia and Sierra Leone. Aid officials debate the reasons for empty beds in some health-care facilities. Are people infected with Ebola staying at home out of fear (since reporting to a health-care facility must seem like a death sentence)? Is this a dip in infections before the next rise — a phenomenon we've seen before? Are there many more invisible cases beyond the reach of roads and communications? (The relief organization Samaritan's Purse reports finding some remote villages in Liberia decimated by the disease.) The least likely explanation, at this point, is that Ebola has run its course.

Before y'all go crazy (TOO LATE! AHHHH! jk), keep in mind that NO ONE has contracted in the U.S. by casual contact. The only people who have contracted Ebola in the U.S. are all medical workers who were in contact with people in late-stage critical condition.

I.e. people who came in repeated contact with body fluids from a person whose system has been completely compromised.

None of the friends or family members of these medical personnel have contracted the disease.

So unless you're hanging out cleaning up the bloody vomit and feces of an infected person without gloves and with lesions or cuts on your hands, or you are preparing an infected corpse for burial by ritually bathing it with your bare hands, you're probably going to be alright.

This is an article about accidental releases of bio agents from facilities. Ignore the click bait heading. Right at the end they speculate the Ebola outbreak came from cdc centres in africa. I was only interested in the known historical accidents. It is tough to stop things getting out.

If you are interested

link

The answer to the question of 'is Ebola contained in West Africa' the answer is clearly 'no, of course not'. And no one is actually claiming it is contained; the UN and WHO least of all. They have been trying to drum up more resources to deal with the problem for some time, and it's only now that the rest of the world is (very) slowly swinging into action. The article basically sets up a strawman of an 'Ebola complacent public', but there really is no such thing; there's people who are wary but optimistic, people who are wary and pessimistic, and those who are convinced we're all about to die. I think you'll find precious few folks who think it's not a problem at all.

As for withholding information, there's plenty of historical and institutional evidence that points to the fact that withholding information about contagious disease tends to increase the chance of an outbreak, not lessen it. So I suspect that the CDC is in fact providing all of the useful information it knows, albeit incomplete information because the CDC doesn't know everything either. There's definitely still 'unknown unknowns' about Ebola that we're likely to find out to our detriment. But it wouldn't be in the CDC's own best interest to suppress information, so there's not much motivation to keep folks in the dark.

-Will

Also, to be perfectly blunt, I'm glad we (as a society) are dealing with this problem involving a disease that's not as contagious as something like SARS or MERS. If you are learning the ropes in containing international outbreaks of a deadly disease, learning with something that's only contact-contagious while the person is symptomatic is the way to do it.

-Will

If only the US CDC had spent more money on looking for cures to infectious disease we might have a cure for this in place.

Ebola has been contained in bits of West Africa – notably Senegal and Nigeria.

Hopefully Mali can do the same.

It would seem that some US commentators are a little disappointed it hasn't spread across Dallas….

A US doctor who just came back from Africa treating Ebola, is now the 4th US Ebola case …

Ebola is just a media scare story sideshow, more people die of malaria in 2 days than have died of ebola this year.

Love that pic, Terrement!!!

Too good.

What's to worry about?

It's only got a 70% mortality rate.

Certainly, better odds than you get in Vegas, or Atlantic City, right?

Perspective:

As much as I love to fuel a panic, mortality rate and transmissibility are very different things. Ebola has a high mortality rate (your odds of dying are high if you catch it), but very low transmissibility (you aren't likely to catch it even when around someone who has it).

Remember, kids, knowing is half the battle!

(Note: the other half is fightin' and killin'!)

darth, we do know that. A geometric progression of doubling does not spread as fast as a geometric progression that triples or quadruples. But if each ebola case infects (on average) 2 new cases (or technically, I suppose, anything more than 1.0000 new case) then the disease is spreading. Is my math correct?

And so far, what has the rate been?

doc mcb:
1:2:1; No progression. Geometric regression. People have got to calm down about Ebola. The really disease is in the media where we have a bad case of E-bola.
Pathogens reproduce exponentially but diseases do not spread exponentially or geometrically. So many factors determine how quickly a disease spreads that mathematical modelling of it becomes very difficult and very case/disease specific.
People must be mindful and take common sense precautions but there is no need to over-react.
Cheers and chill-out America.
Rod Robertson.

Rod, okay, if you say so; but if each patient on average infects more than one additional patient, how is the number of infected not growing?

doc mcb:
Good health care and rapid intervention in the USA is stopping Ebola in its tracks. As hospitals get better at understanding and following bio-hazard protocols then the number of domestic infections in hospitals should go down to zero. Then the threat will be from infected and symptomatic persons entering the US. There really is nothing that can be done about that (notwithstanding NY's and NJ's decisions to impose quarantines on incoming personnel from West Africa). With careful monitoring and public awareness of the symptoms to look out for, cases should be detected, isolated and treated well enough to stop the spread of the disease. Ebola is not readily transmissible and with care and common sense, infection due to casual contact should be almost nil.
Quarantines may well be dangerous if they dissuade medical professionals from volunteering to go and help manage the epidemic in West Africa. The more people who have the disease, the greater the 'still unlikely chance' that the virus will mutate and become a more effective and aggressive contagion. If that happens then there could be real problems.
The US should also be more concerned about the Philippines where an endemic simian strain of Ebola jumped from monkeys and apes to pigs. Pigs are used in animal testing for disease and product research because they are very good analogues for humans. If the virus can make the jump from monkeys to humans or from pigs to humans then we are in real trouble. This strain of Ebola is called the Reston-Ebola virus and is airborne transmissible. It was first seen in the US in Reston Virginia in 1989 IIRC but thankfully it did not spread to humans then.
The West African strain of the virus in its present state is much less dangerous to American public health and while it should not be dismissed in the US, diseases like Dengue, Malaria or Tuberculosis are far more dangerous threats at this point.
Cheers.
Rod Robertson

What I find amusing/disturbing about the latest case is the fact that it is a doctor who worked with Doctors Without Borders. I remember reading comments from people that Doctors Without Borders were the go to guys here that we should emulate in our response to ebola.

Which seems to mean that we should self-isolate in our apartment, go bowling, and travel by subway…

I have trouble seeing why a 21 day quarantine would be such deterrent to health care workers. Why would they not wish to be sure that they were not potentially exposing friends, relatives, co-workers, etc. to ebola?

As to the fact that none of the relatives of the US cases have developed ebola, at least in Nigeria (one of the success stories) the 9 victims did include spouses.

If only the US CDC had spent more money on looking for cures to infectious disease xxxx we might have a cure for this in place.

$285 USD million was cut from the CDC FY 2013 budget by Sequestration. Spending more money was/is pretty much out of the question.

As for spending money to look for cures, that has been to a great extent the pharmaceutical companies who now are disincentivized from spending that money.

Drug companies are not going to develop drugs unless there is a market. That's why they scramble every year to develop a vaccine for the latest flu mutation and to manufacture enough to go around. I don't see how they are disincentivized. They make huge profits every year. They are just practicing smart business; wait for the demand, then fill the need.

But you are right Terrement, it's the drug companies that develop the drugs. The CDC develops and coordinates the response strategy.

As long as Ebola is raging in Africa, it's impossible to say with any certainty if we have it under control here in the States. A few people will always get through, no matter how secure you make the border. Ask the Israelis. But so far our response appears to be pretty solid. We'll see.

But all that aside, Rod hits the nail on the head. We should all read his posts and worry about more relevant things, like getting a flu shot, or putting on your seatbelt.

BTW, LOVE the poster Flashman. Definitely puts things in perspective.

Do the math … only 7 – 8 people in the US have or had Ebola … with only one death[caught in Africa], with 3 here who successfully have been cured at this time … What is the population of the US ? 7-8-10 people are statisically insignificate. As noted … More die of the flu every year, 15,000 -20,000, which is airborne, unlike Ebola. Which you have to have contact with bodily fluids, as we all know. The real perceived threat, IMO, is 24hr News beating a story to death and not enough FDR type moments provided by politicos, etc. … I think as has been said, "The only thing we have to fear … is fear itself !"

MANDT2, cDC's seems to have had plenty of money to spend on gay bars, bike paths, community development projects and other issues that don't seem to be related to infectious disease control which they funded with money that was supposed to be for infectious disease control. If they could develop a cure for Ebola they could save a lot of lives in Africa. Or do we not care about those people? I think a few more people in Africa have died from Ebola than have been married to Kim Kardashian.

The CDC's budget has been increased very significantly over the last ten years, so that little, bipartisan sequester cut has little to do with it.

What's needed is a shakeup at the CDC, to weed out the incompetent people who think less than full head-to-toe coverage of doctors, nurses, and other caretakers is an adequate safety protocol.

For my money, KK should be quarantined for life……

Can iz gets it from cheezburgerz Kyote? Iz worried nows az iz liks an eatz lotz cheezburgerz?? Very Worred. Mouzzer-98. PS must iz marry KimKardashiz for curz az iz very very worridz now if I mutz. Gettin furball finking boutz it now.

And in the latest news….

Nina Pham (one of the Dallas nurses) has been discharged as cured and virus free. So… Even if you do get it, you can be cured. So much for the 'ebola can't be stopped!' crowd…

Now if ebola paranoia was as curable, that would be a coup…. (But fear and ignorance is terminal, I'm afraid).

Hey! Kyoteblue! I thought you were going to hold that gently used hazmat suit for me! (so I can put it in my ex-Y2K bunker, now ebola pandemic bunker). Oh, you can keep the toilet paper…

Oh…. Too close, too close Ya can't be too careful!

cDC's seems to have had plenty of money to spend on gay bars, bike paths, community development projects and other issues that don't seem to be related to infectious disease control which they funded with money that was supposed to be for infectious disease control.

Bobgnar-

The only info I could find your comments were pundit sites and a story by Bobby Jindal, hardly objective or expert sources. But that's neither here nor there. There is waste in any large organization. If you want to make a case that the CDC is especially wasteful, then you will need to cite some expert sources with some hard numbers.

If they could develop a cure for Ebola they could save a lot of lives in Africa.

Like I and others have said here, the CDC doesn't do drug development and testing. The drug companies do. And in fact, the CDC primarily deals with outbreaks in the U.S. The rest of the world is the domain of the World Health Organization (WHO). If you want to blame something for this outbreak getting as far as it has, blame the WHO. It's pretty clear that they were out-to-lunch on this.

Or do we not care about those people?

I'm not sure what you are getting at here. Of course we do, at least some of us.

The CDC's budget has been increased very significantly over the last ten years, so that little, bipartisan sequester cut has little to do with it.

That's not correct Mako. The CDC's budget did go up about from about $7 USDB to about $7.8 USDB in 2010, I believe the injection of funds was for distribution and administration of flu shots and such that year. In 2011 it was cut back to about $6.8 USDB. 2012 was about the same, and 2013 cut another $285 USDM. It's all there on any of several .gov sites.

What's needed is a shakeup at the CDC, to weed out the incompetent people who think less than full head-to-toe coverage of doctors, nurses, and other caretakers is an adequate safety protocol.

Two nurses were infected by a patient who checked into the hospital bleeding, puking, and squirting, in other words the worst possible circumstances. It is most likely that they were infected while removing their protective gear, which is the most dangerous part of this type of case. We'll probably never know for certain.

The CDC sets the guidelines, but the hospital is responsible for the administration of these protocols. I can tell you for a fact that these can vary significantly from one hospital to another. I have experienced it first hand.

Certainly, this thing has not gone perfectly, but when you consider the magnitude of the challenge and the fact that only seven(?) Americans have been infected and all, so far have survived, I think one could argue that in spite of some stumbling in the beginning (primarily by the Dallas hospital personnel), it's been handled quite well.

@ darthfozzywig
your earlier post reminded me of an old joke:

Half the girls in this college have VD,
The other half have TB,
So sleep with the ones who cough!

On a more serious note, the British nurse who had Ebola and survived, has now returned to Africa to resume his work.

It looks like ebola has been contained, but ebola paranoia is still running rampant – at least in some quarters.

No

There will be more and more cases of it until it is here to stay.

You will know them by their words.

An inconvenient truth:

"It is true that spending for the CDC has dipped ever so slightly since 2011, but the cuts followed years of massive increases. Overall, since 2000, CDC outlays have almost doubled, from $3.5 USD billion to $6.8 USD billion (in 2014 constant dollars). Moreover, in January, the Republican-controlled House actually passed legislation that increased CDC spending for 2014 by $567 USD million — $300 USD million more than was requested by President Obama".

Nearly doubling, especially when considered in constant dollars, is a pretty significant increase, at least to me.

From:

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Oh, and as mentioned above, here are some interesting projects that people in government have spent out hard-earned tax money on:

"On the other hand, the NIH has managed to find $1.5 USD million to study why lesbians have a tendency to be overweight, while gay men do not. There was also nearly $1 USD million for a study on the sex life of fruit flies, which revealed the shocking news that male fruit flies are sexually attracted to younger female fruit flies. Then there was $688,000 USD spent to determine why people like Seinfeld reruns. It is even possible that the $355,000 USD spent on studies of how fast husbands and wives calm down after a fight might have been better used for that elusive Ebola vaccine.

But why prioritize when you can demand more money?".

Mako- Discussion of NIH grants (and the politically motivated objections) more properly belongs on the Blue Fez. (And I'm too at a loss as to what that. or this entire thread for that matter, has to do with gaming).

On a more serious note, the British nurse who had Ebola and survived, has now returned to Africa to resume his work.

Why is this "on a more serious note"? What's your point?

This man is clearly a dedicated health care/aid worker with a bottomless pit of courage.

@deephorse, I don't disagree, but if you read the post properly, you'll see it followed a joke (of sorts)

This man is clearly a dedicated health care/aid worker with a bottomless pit of courage.

Wonder if the airlines charge extra for those oversize brass balls of his?

Legio4, influenza is no more airborne than ebola could be. It is spread by aerosol means, i.e. by contaminated droplets of bodily fluids.

At this time that has not been ruled out for ebola transmission.

The agency claiming a lack of funding for an ebola vaccine was the NIH not the CDC.

As to containment, until it is contained in Africa, it hasn't been contained as the most recent case in New York shows.

And once again the charge of racism raises its ugly head in a discussion that wasn't.

New expulsion rules are going to be a joy to see in action…

Kyoteblue:
If not toy soldiers then at least another spirited debate about quantities and quality of toilet paper needed to survive the next pandemic, natural disaster or alien aggression visited upon us. I lean towards soft, multi- ply, generic TP as the best option for surviving the zombie apocalypse.
Rod Robertson.

Whadda think I got in my ex-Y2K/now ebola pandemic bunker? And I'm with Rod; only the soft, multi-ply TP, thank you…

Kyoteblue:
Lots of room for hoarding TP! You'll be the "King of the World".
coastal2:
Ummmm! Soft.
Cheers.
Rod Robertson

"Toilet paper." Bah! You guys are pikers.

Real survivalists have been using dried corncobs for years, in preparation for the End Times.

Until the corn runs out . . .

Uproar In Italy Over U.S. Troops Being ' Ebola Quarantine' At An Amercain Base Near Venice Rather Than In The U.S.

"The decision to put a dozen American soldiers returning from Liberia into quarantine for Ebola at their base near Venice rather than in the United States sparked controversy in Italy on Wednesday.

"They shouldn't have been sent here, they should do their quarantine for Ebola at home," said the president of the region's assembly, Luca Zaia, insisting "it would have been more respectful" of the United States to have "thought about the risks posed to local citizens".

The Messaggero daily spoke of fears among the local population, with a rise in the number of calls to the emergency services from worried citizens…"

Full article here
link

Amicalement
Armand

We seem to love our dog dog populations more than our fellow man.

My past travel history has left the impression that dog quarantines are done as a waiting period, to make sure they won't later develop and spread rabies to other dogs.

If the dog is already showing even a hint, the dog is not even allowed to travel. But if the dog is not displaying symptoms, yet it is traveling from a country with a HiGH incidence of rabies into a country with little to none, expect a quarantine. And the owner is not allowed to take the dog out of the customs facility to conduct the quarantine himself.

Has that changed?

QUESTIONS:

A) Is the purpose of a quarantine to isolate an exposed subject until such time as the incubation period has passed?

B) Or is it for those subjects who have already begun showing symptoms?

Dan
TMP link

Odd then that there's not a single case of Ebola ever recorded that can't be attributed to known vectors…

The panic which the US public is exhibiting over a well understood disease is alarming.

I can only assume few bother to study science in that nation.

Panic sells, Stu.

Terrement- No news there. Everything you mentioned is already well known among infectious disease researchers.

Stu- i'm afraid you're right.

Ebola paranoia is far more contagious than the virus…

From the CDC –

In the laboratory setting, non-human primates with their heads placed in closed hoods have been exposed to and infected by nebulized aerosols of Ebola virus.28,29 In a different experiment, control monkeys were placed in cages 3 meters away from the cages of monkeys that were intramuscularly inoculated with Ebola virus.30 Control and inoculated monkeys both developed Ebola virus infection. The authors concluded that "fomite and contact droplet" transmission to the control monkeys was unlikely, and that airborne transmission was most likely,30 but they did not discuss the potential behaviors of caged non-human primates (e.g., spitting and throwing feces) that might have led to body fluid exposures.31 Similarly, an outbreak of Reston virus (Reston ebolavirus species, which does not cause EVD in humans) infection occurred in a quarantine facility housing non-human primates in separate cages and the transmission route could not be confirmed for all infected primates. Multiple animal handlers developed antibody responses to Reston virus suggesting asymptomatic infection was occurring in humans with direct animal contact and implicating animal handling practices in transmission between primates.32 In a different study, piglets that were oronasally inoculated with Ebola virus were able to transmit infection to caged non-human primates that were placed 20 cm from the piglets.33 The piglet and primate cubicle design did not permit the investigators to distinguish among aerosol, small or large droplet, or fomite transmission routes, and it was noted that pigs are capable of generating infectious short range aerosol droplets more efficiently than other species. A more recent experiment that was specifically designed to further evaluate the possibility of naturally-occurring airborne transmission of Ebola virus among non-human primates showed no transmission of Ebola virus from infected to control primates placed 0.3 meters apart in separate open-barred cages and ambient air conditions, but with a plexiglass divider that prevented direct contact between the animals.

Now,I am in SW Colorado a long way from an international airport. Not terribly worried about me and mine. Just rather appalled by some government reactions in this country.

As to the science illiteracy and ebola paranoia being confined to the US -

Australia has suspended the issuance of visas to travellers from Guinea, Liberia and Sierra Leone. Travellers from these countries who hold permanent visas can enter Australia if they have been quarantined for 21 days prior to arrival, while those who have received non-permanent visas and who have not departed for Australia will have their visas cancelled.

Then there are nearly 30 other countries with some form of travel restrictions -

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Welcome to the club…

Don't think anyone else has tried quarantining someone who has tested negative for Ebola though….

The problem is that you test negative until you 'have it.'

The virus does not enter the bloodstream where it will be picked up by the standard tests until it is well established. Tests on the liver and spleen where the virus initially resides are not standard.

So currently victims test 'clean' until they are not…

P.S. If s simple blood test was all that was needed there would be no need for travel bans or quarantines…

Hey guys, have you not been watching the News ? Ebola is so yesterday ! It's all about a bigger and more dangerous threat here in the US … elections !!!!!!! OH NOOOOoooo !!!!!!

"A quarantine is used to separate and restrict the movement of persons; it is a 'state of enforced isolation'. This is often used in connection to disease and illness, such as those who may possibly have been exposed to a communicable disease.
The term is often erroneously used to mean medical isolation, which is "to separate ill persons who have a communicable disease from those who are healthy."
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In other words, sick people are not the ones that end up quarantined.

This is interesting …

"Communicable diseases for which apprehension, detention, or conditional release of persons are authorized must be specified in Executive Orders of the President.
Executive Order 13295 (Revised List of Quarantinable Communicable Diseases, April 4, 2003) and its amendments (executive orders 13375 and 13674) specify the following infectious diseases: (1) cholera, (2) diphtheria, (3) infectious tuberculosis, (4) plague, (5) smallpox, (6) yellow fever, (7) viral hemorrhagic fevers (Lassa, Marburg, Ebola, Crimean-Congo, South American, and others not yet isolated or named), (8) severe acute respiratory syndromes, and (9) influenza, from a novel or re-emergent source. In the event of conflict of federal, state, local, and/or tribal health authorities in the use of legal quarantine power, federal law is supreme."

Dan