Ebola - can UK cope in a crisis?

[Phanerothyme]

Anyone remember reading "The Hot Zone"?

 

It's absolutely right to divert resources to help control the outbreak if possible, and to be extremely vigilant in observing it as it progresses.

 

There's never a need for panic, but something like Ebola could be really bad if it isn't smartly dealt with, whether that's by containment, a vaccine, or more drastic, morally objectionable, methods justified on the grounds of the greater good.

[ECCOnoob]

A more sensible opinion from a medical journalist cutting through the mainstream media's typical sensationalist guff.

 

http://www.vox.com/2014/10/4/6905303/ebola-scared-quarantine

 

For those who cannot be bothered to read it here are a few parts that caught my eye.

 

It's reasonably straightforward for sophisticated public-health systems — which America has, and which West Africa often doesn't — to stop. Even now, amidst the (accurate!) talk of the "worst Ebola outbreak ever," there are only around 7,000 confirmed cases — a far cry from the roughly 200 million malaria cases each year Funny how there is not a headline grabbing Malaria outbreak all over the news eh?

 

and this little snippet from a New York writer, researcher and general surgeon comments....

 

In a 1996 case in South Africa, a patient spent twelve days in a high-level hospital sick with an illness that wasn't recognized as Ebola until after he was discharged. Some three hundred health-care workers took care of him. None contracted the disease. A 1995 study of a Congo outbreak looked at seventy-eight household members who lived with patients with Ebola who did not directly touch them or their fluids after they became sick. Again, none contracted the disease. Funny how that is not mentioned in the media.

 

A quick search on the net has show EBOLA "crises" occurring in 1976, 1977, 1979, 1989, 1990, 1994, 1996, 1997, 2000, 2001, 2002, 2003, 2004, 2007, 2008, 2012 and 2013. Now we have this year's outbreak.

 

Each year has been a wildly different increase or decrease in the number of infected humans surviving and those unfortunate to suffer tragic deaths. In each year the locations of the outbreak too are wildly different including some in the USA as early as 1990 and a known case in the UK back in 1976.

 

Whilst I am certainly not saying that WHO, governments and our own NHS should not be on standby and precautions prepared the media hysteria is just ridiculous and makes the problem 10x worse than it is.

 

An "outbreak" in a small village is manipulated by an editor into a "national epidemic" which then becomes a "government crisis" which then sets off all the other governments into "taking precautions" which then set off a public reaction and "panic" which then is reported all over the headline news creating even more knee jerk reactions and panic.

 

Enough already. Time for some real facts and figures. Enough spin and sensationalism

Edited October 9, 2014 by ECCOnoob

[Anna B]

A more sensible opinion from a medical journalist cutting through the mainstream media's typical sensationalist guff.

 

http://www.vox.com/2014/10/4/6905303/ebola-scared-quarantine

 

For those who cannot be bothered to read it here are a few parts that caught my eye.

 

It's reasonably straightforward for sophisticated public-health systems — which America has, and which West Africa often doesn't — to stop. Even now, amidst the (accurate!) talk of the "worst Ebola outbreak ever," there are only around 7,000 confirmed cases — a far cry from the roughly 200 million malaria cases each year Funny how there is not a headline grabbing Malaria outbreak all over the news eh?

 

and this little snippet from a New York writer, researcher and general surgeon comments....

 

In a 1996 case in South Africa, a patient spent twelve days in a high-level hospital sick with an illness that wasn't recognized as Ebola until after he was discharged. Some three hundred health-care workers took care of him. None contracted the disease. A 1995 study of a Congo outbreak looked at seventy-eight household members who lived with patients with Ebola who did not directly touch them or their fluids after they became sick. Again, none contracted the disease. Funny how that is not mentioned in the media.

 

A quick search on the net has show EBOLA "crises" occurring in 1976, 1977, 1979, 1989, 1990, 1994, 1996, 1997, 2000, 2001, 2002, 2003, 2004, 2007, 2008, 2012 and 2013. Now we have this year's outbreak.

 

Each year has been a wildly different increase or decrease in the number of infected humans surviving and those unfortunate to suffer tragic deaths. In each year the locations of the outbreak too are wildly different including some in the USA as early as 1990 and a known case in the UK back in 1976.

 

Whilst I am certainly not saying that WHO, governments and our own NHS should not be on standby and precautions prepared the media hysteria is just ridiculous and makes the problem 10x worse than it is.

 

An "outbreak" in a small village is manipulated by an editor into a "national epidemic" which then becomes a "government crisis" which then sets off all the other governments into "taking precautions" which then set off a public reaction and "panic" which then is reported all over the headline news creating even more knee jerk reactions and panic.

 

Enough already. Time for some real facts and figures. Enough spin and sensationalism

 

That's quite reassuring. Thanks.

[firemanbob]

Ebola in the air? A nightmare that could happen.

By Elizabeth Cohen, Senior Medical Correspondent

http://edition.cnn.com/2014/09/12/health/ebola-airborne/

 

Today, the Ebola virus spreads only through direct contact with bodily fluids, such as blood and vomit. But some of the nation's top infectious disease experts worry that this deadly virus could mutate and be transmitted just by a cough or a sneeze.

 

"It's the single greatest concern I've ever had in my 40-year public health career," said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "I can't imagine anything in my career -- and this includes HIV -- that would be more devastating to the world than a respiratory transmissible Ebola virus."

 

The World Health Organization says its scientists are unaware of any virus that has dramatically changed its mode of transmission.

 

Osterholm and other experts couldn't think of another virus that has made the transition from non-airborne to airborne in humans. They say the chances are relatively small that Ebola will make that jump. But as the virus spreads, they warned, the likelihood increases.

 

Every time a new person gets Ebola, the virus gets another chance to mutate and develop new capabilities. Osterholm calls it "genetic roulette."

 

As of October 1, there have been more than 7,100 cases of Ebola, with 3,330 deaths, according to the World Health Organization, which has said the virus is spreading at a much faster rate than it was earlier in the outbreak.

 

Ebola is an RNA virus, which means every time it copies itself, it makes one or two mutations. Many of those mutations mean nothing, but some of them might be able to change the way the virus behaves inside the human body.

 

That book chronicles the 1989 outbreak of Ebola Reston, which was transmitted among monkeys by breathing. In 2012, Canadian researchers found that Ebola Zaire, which is involved in the current outbreak, was passed from pigs to monkeys in the air.

 

Dr. James Le Duc, the director of the Galveston National Laboratory at the University of Texas, said the problem is that no one is keeping track of the mutations happening across West Africa, so no one really knows what the virus has become.

 

One group of researchers looked at how Ebola changed over a short period of time in just one area in Sierra Leone early on in the outbreak, before it was spreading as fast as it is now. They found more than 300 genetic changes in the virus.

 

"It's frightening to look at how much this virus mutated within just three weeks," said Dr. Pardis Sabeti, an associate professor at Harvard and senior associate member of the Broad Institute, where the research was done.

 

Even without becoming airborne, the virus has overwhelmed efforts to stop it.

 

 

 

Based on the above it seams prudent to limit the spread of Ebola by limiting the moving of those people that have come into contact with it.

 

http://www.cdc.gov/vhf/ebola/transmission/

When an infection does occur in humans, the virus can be spread in several ways to others. Ebola is spread through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola.

Once someone recovers from Ebola, they can no longer spread the virus. However, Ebola virus has been found in semen for up to 3 months. People who recover from Ebola are advised to abstain from sex or use condoms for 3 months.

Edited October 9, 2014 by firemanbob

[cgksheff]

If you read carefully what was actually said before being "interpreted" by all and sundry, you will see that nothing has made a "transition from non-airborne to airborne".

What was said was quite sensibly explaining that the disease is spread by contact with bodily fluids. Those fluids include blood, vomit, sputum etc.

Some of those fluids can still be infectious when away from the body e.g. a pool of vomit or bloody sheets.

Similarly, if the fluid is spat at you or projected straight into your face via sneeze, you can be infected.

 

That "sneezing in your face" now becomes "transition to airborne" after going through the Chinese Whispers of the sensationalist press and internet posters.

 

Nothing has changed.

[firemanbob]

If you read carefully what was actually said before being "interpreted" by all and sundry, you will see that nothing has made a "transition from non-airborne to airborne".

What was said was quite sensibly explaining that the disease is spread by contact with bodily fluids. Those fluids include blood, vomit, sputum etc.

Some of those fluids can still be infectious when away from the body e.g. a pool of vomit or bloody sheets.

Similarly, if the fluid is spat at you or projected straight into your face via sneeze, you can be infected.

 

That "sneezing in your face" now becomes "transition to airborne" after going through the Chinese Whispers of the sensationalist press and internet posters.

 

Nothing has changed.

 

They now think the Spanish nurse caught it from her glove, much like people catch a cold, someone with Ebola sneezes onto a door handle, someone else touches the door handle then they eat a sandwich and they catch Ebola.

[cgksheff]

Does the virus persist once the fluid has dried?

[firemanbob]

Does the virus persist once the fluid has dried?

 

I don't know, assuming that it doesn't, how long does saliva or urine on a door handle take to dry and how many people could touch that door handle before it does, I would think that their is a constant stream of people entering and leaving the public toilets in a place like meadow hall.

 

http://www.webmd.com/news/20141006/how-get-ebola

 

The only way Ebola gets into the air is in large droplets of vomit or saliva. These droplets are heavy and wouldn’t be able to travel very far.

 

In theory, people might be able to catch it if someone coughed or sneezed directly onto them, but people who get Ebola generally don’t cough or sneeze.

 

 

Unless they also have a cold or flu which is very common in the UK.

 

Bottom line is they have no Idea how fast Ebola will spread in place like London because its always been in small remote places in Africa.

Edited October 9, 2014 by firemanbob

[RonJeremy]

Well let's hope the governments around the world press the global pharmaceuticals to provide their drugs/equipment at cost, so we're not all lining their executives' pockets in the process, and more people can be helped.

 

The reason we have such good healthcare nowadays is down to the drugs companies research into illnesses. Treatment and prevention. It's not because nurses are so lovely and caring or because NHS staff have been to lots of meetings and equality awareness courses with tea and lots of biscuits. It's down to the companies motivated by increasing profit producing these drugs to cure people. The executives, shareholders, pension funds etc who all are motivated by increasing wealth have increased life expectancy and made life and dying more comfortable are amazing.

[firemanbob]

Does the virus persist once the fluid has dried?

 

Just found this.

 

http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php

Public Health Agency of Canada

 

http://www.publichealth.gc.ca

 

 

Zaire ebolavirus (ZEBOV), which was first identified in 1976 and is the most virulent and is a member of the Filoviridae family. The Ebola-Zaire and Sudan strains are especially known for their virulence with up to 90% fatality rate.

 

 

SURVIVAL OUTSIDE HOST: Filoviruses have been reported capable to survive for weeks in blood and can also survive on contaminated surfaces, particularly at low temperatures (4°C) Footnote 52 Footnote 61. One study could not recover any Ebolavirus from experimentally contaminated surfaces (plastic, metal or glass) at room temperature Footnote 61. In another study, Ebolavirus dried onto glass, polymeric silicone rubber, or painted aluminum alloy is able to survive in the dark for several hours under ambient conditions (between 20 and 250C and 30–40% relative humidity) (amount of virus reduced to 37% after 15.4 hours), but is less stable than some other viral hemorrhagic fevers (Lassa) Footnote 53. When dried in tissue culture media onto glass and stored at 4 °C, Zaire ebolavirus survived for over 50 days Footnote 61. This information is based on experimental findings only and not based on observations in nature. This information is intended to be used to support local risk assessments in a laboratory setting.

 

http://www.bbc.co.uk/news/science-environment-20341423

Canadian scientists have shown that the deadliest form of the ebola virus could be transmitted by air between species.

 

In experiments, they demonstrated that the virus was transmitted from pigs to monkeys without any direct contact between them.

 

The researchers say they believe that limited airborne transmission might be contributing to the spread of the disease in some parts of Africa.

Edited October 9, 2014 by firemanbob