Patterico's Pontifications

8/4/2014

Ebola: Open Thread

Filed under: General — Dana @ 7:53 pm



[guest post by Dana]

People seem to want to talk about this. It’s here, literally. It’s scary. And unfortunately, the fear-mongering has begun.

I had the opportunity to spend some time with a friend who has been a practicing physician for 30+ years. His take was that bringing the doctor with Ebola back to the U.S. did not come with a high risk factor. Between how Ebola is contracted (not airborne), along with with the extraordinary precautions being taken by Emory, he felt it was low-risk. He also mentioned that having the patient in an outstanding first-world facility would give medical professionals a much needed and necessary opportunity to study the patient’s blood, immunoglobulin, etc. if they hope to get a handle on Ebola and possibly develop a vaccine. He went into a lot more depth, but these are the basics.

–Dana

84 Responses to “Ebola: Open Thread”

  1. Hello.

    Dana (4dbf62)

  2. From the WHO:

    Ebola virus disease (formerly known as Ebola haemorrhagic fever) is a severe, often fatal illness, with a case fatality rate of up to 90%. It is one of the world’s most virulent diseases.The infection is transmitted by direct contact with the blood, body fluids and tissues of infected animals or people. Severely ill patients require intensive supportive care. During an outbreak, those at higher risk of infection are health workers, family members and others in close contact with sick people and deceased patients.

    Ebola virus disease outbreaks can devastate families and communities, but the infection can be controlled through the use of recommended protective measures in clinics and hospitals, at community gatherings, or at home.

    http://www.who.int/csr/disease/ebola/en/

    daleyrocks (bf33e9)

  3. I emailed my friend who lives in South Africa about her thoughts on Ebola, and what they were being told by their media. She said that until very recently, it was really not reported on. Also, they have been given reasurrance: We’ve been told that, as the outbreak is in a region thousands of miles away and because it kills really quickly, anyone infected will be dead/seriously ill before they can make it down to us. Reassuring, isn’t it.

    She provided me with some interesting links, including information about a dedicated hospital for those with suspected viral haemorrhagic fever, their security precautions and just how prepared is South Africa for an Ebola outbreak.

    I am hoping Charlotte will be able to connect to Patterico’s and offer her observations from the continent.

    Dana (4dbf62)

  4. Does CNN have a graphic yet? Something like EBOLA: IS THIS THE END?

    Kevin M (b357ee)

  5. I bet you any traveler with Ebola will still be patted down for nail clippers before they board.

    Kevin M (b357ee)

  6. I don’t expect the current outbreak of the Zairean strain of Ebola to kill many Amerikkkans, its just a horrible way to go; bleeding from every orifice.

    gary gulrud (46ca75)

  7. “She provided me with some interesting links, including information about a dedicated hospital for those with suspected viral haemorrhagic fever, their security precautions”

    Dana – Thanks. Interesting stuff. Why do they have dedicated hospitals and all those security precautions if according to Milhouse and others Ebola is not a very contagious disease?

    Your second link does assert, however, that:

    “Ebola is a highly infectious virus that is transmitted in bodily fluids.”

    daleyrocks (bf33e9)

  8. Africa is a continent. A big, big continent. I don’t mean to be a scold. I think the nation of South Africa would take the same precautions against an infectious disease as any other country regardless of the continent it exists upon.

    I also think that the countries of Liberia, Sierra Leone and Guinea have a problem with an infectious, horrible disease indigenous to a particular area of a very large continent. Could it spread? Certainly. Likely? Not so much.

    Regardless, certain infectious, exotic viral diseases are indeed present in the United States today. The left would like to blame global warming, but the real culprits are Boeing, Airbus and those pesky mosquitoes with their fellow travelers, the left.

    Boeing and Airbus get a pass because they just are doing what markets allow. The left actively tries to prevent the spread of disease because racism.

    I’m not saying the left actually wants to kill brown and black people, but their actions certainly seem to indicate otherwise.

    Ag80 (eb6ffa)

  9. Why do they have dedicated hospitals and all those security precautions if according to Milhouse and others Ebola is not a very contagious disease?

    Your second link does assert, however, that:

    “Ebola is a highly infectious virus that is transmitted in bodily fluids.”

    Infectious != contagious.

    Milhouse (9d71c3)

  10. People carelessly confuse “infectious” with “contagious”, just as they do “poisonous” with “venemous”. But they are not the same thing at all.

    Milhouse (9d71c3)

  11. Copied from the other thread:

    A simple yes or no question helps answer that. Do you believe it is responsible for airlines, health authorities and airport authorities to knowingly allow people diagnosed with Ebola to travel by air commercially with other passengers without taking stringent precautions?

    Without taking any precautions, no, of course not, but those precautions don’t have to be all that stringent. As I linked to above, one of the doctors who first discovered the virus, and has been studying it all his career, says he would have no objection to sitting on a train next to someone who was infected. If I were an airline exec having to decide whether to allow an infected person on board, I’d probably want the patient in a window seat with the two seats next to him empty, and the row in front of him empty as well, just in case he vomits. And when he got off the plane I’d want those two rows disinfected. But that’s just my completely uneducated guess. In any case, what indication do you have that any airline is allowing such passengers without appropriate precautions?

    The Liberian-American who died from Ebola in Lagos landed on 7/21 and died on 7/25. The other passengers were not detained or quarantined. Contrary to your assertion, I have read nothing which confirms authorities have been able to track down all the other passengers and that they remain Ebola free to this date, which given the incubation period would now start to become meaningful.

    I think if any passenger on the plane caught it from him we’d have heard of it by now. The lack of such reports indicates that it didn’t happen.

    There is a reason health care professionals quarantine people with Ebola – it is to stop the spread of contagion. Before it is detected and diagnosed, however, how many people can be infected by a person going about their daily routine by a disease that can be passed along through sweat or other bodily fluids, especially in a crowded urban setting?

    Quarantine is wise, but in the normal course of events how many people come in direct contact with your bodily fluids, into an open wound or mucous membrane, on a daily basis? Not too many, I’d think. You have no problem with airlines carrying people with AIDS, do you? Or with working with them, socialising with them, having them walking in the street? We got used to that in the ’90s, and stopped thinking much of it, once we realised just how difficult it was to catch. Ebola isn’t as hard to catch as AIDS, but it’s far closer to that than to the diseases we usually worry about.

    Milhouse (9d71c3)

  12. Dana, I know an epidemiologist who has a lot of experience with infectious diseases. She is certainly a progressive, politically, but I know for a fact she is a fine scientist and knows her stuff. Here is her take:

    http://scienceblogs.com/aetiology/2014/08/02/ebola-is-already-in-the-united-states/

    And a post she wrote some time ago, about another Ebola outbreak:

    http://scienceblogs.com/aetiology/2014/08/02/repost-whats-it-like-to-work-an-ebola-outbreak/

    The press, as usual, is doing what it does best: sell advertising time. Thanks for introducing proportion and reason into this topic of discussion.

    Simon Jester (366475)

  13. Milhouse: Yep.

    Ag80 (eb6ffa)

  14. A passenger at Gatwick Airport in Britain collapsed and died after arrival on the flight from Africa.

    Airport staff spoke of how the woman was apparently sweating and vomiting before paramedics, immigration and airfield operations turned up to take everyone’s details.

    Maybe it isn’t Ebola but it is worrisome. In Africa, the reservoir may be fruit bats .

    “As people go further and further into these rain-forest-type areas, they seem to come more in contact with the reservoirs of the virus,” said Robert Garry, a professor of microbiology and immunology at Tulane University who has worked extensively in West Africa. “In this case, it looks like [people in Guinea] just cut far enough into the forest to find a reservoir.”

    A variety of animals carry viruses that can be transmitted to humans, a process known as zoonosis. While bats are the most likely culprits in this outbreak, gorillas and other mammals can also carry Ebola. As population centers grow and infrastructure expands, researchers like Epstein and Garry say this type of human-animal contact will be on the rise.

    One study, conducted by African and U.S. researchers in 2012, found that some kind of human activity often immediately preceded Ebola outbreaks. A 1994 outbreak, for example, took place after gold miners in Gabon ate an infected gorilla.

    Don’t eat bats and gorillas.

    MikeK (b5c01a)

  15. Ag80,

    You may be right, but there are some distinct differences: The government of SA is even far more corrupt and inept than ours and therefore, would have a much more difficult time effectively stemming any tide of outbreak. Also, there is a high immigrant population from neighboring countries, which could open up the possibility of outbreak. For me, I generally benefit from a closer look at issues that are happening so far away.

    Dana (4dbf62)

  16. The West African papers are warning against eating bats:

    Warning communities that eat bats, he said this is the time for them to desist from consuming it. Similarly, he noted that some communities that worship bats and keep them in their houses should be very careful and stop the act. The report clarifies that domestic animals are not the carriers of the virus.

    Dana (4dbf62)

  17. Simon Jester,

    Thanks so very much for the valuable links. So interesting. And as is usually the case, the more correct information made available, the more informed a concerned public can become and help prevent an hysterical reaction.

    Dana (4dbf62)

  18. Is that “settled science?”

    Jim (145e10)

  19. Dana #15

    You may be right, but there are some distinct differences: The government of SA is even far more corrupt and inept than ours and therefore, would have a much more difficult time effectively stemming any tide of outbreak. Also, there is a high immigrant population from neighboring countries, which could open up the possibility of outbreak.

    ” The government of SA is even far more corrupt and inept than ours” – I wish that we could still say that … sadly, it ain’t so, anymore …

    “Also, there is a high immigrant population from neighboring countries, which could open up the possibility of outbreak.” – and this is different from our current federal administration in what way ?

    What we do have going for us is organisations like the CDC which were set up by competent folk … as far as I understand it, the CDC has been minimally compromised by the current White House …

    Alastor (2e7f9f)

  20. A passenger at Gatwick Airport in Britain collapsed and died after arrival on the flight from Africa.

    Airport staff spoke of how the woman was apparently sweating and vomiting before paramedics, immigration and airfield operations turned up to take everyone’s details.

    She may have been sweating and vomiting , but she wasn’t haemorrhaging, and guess what, she turned out not to have ebola. She was sick on a plane; people are sick on planes all the time, and nobody panics. The only reason anyone had to even think about ebola was that she was flying from Africa, which isn’t really enough to justify such speculation.
    Imagine if, back when Mad Cow Disease was a thing, someone got sick on a flight from the UK, and the first conclusion everyone jumped to was that. Even at the height of the nvCJD problem, nearly 100% of sick people in the UK did not have it. The same is true here. Nearly 100% of sick people in Africa do not have ebola.

    Milhouse (9d71c3)

  21. Ag80,

    My comment to you was in response to your first point made re SA, not the rest of your comment.

    Dana (4dbf62)

  22. This is rather OT — although Ebola and the issue of good hygiene do go hand in hand — but I was reading and astounded by an article linked at the drudgreport.com today about how modern toilet facilities in India, even when specially funded and installed by charitable or government groups, aren’t used by many or most people in that part of the world. Such humans apparently still favor urinating and defecating out in the back woods or fields, or wherever, but not in a location that is even semi-hygienic, semi-civilized. (I’m guessing people in such instances also aren’t bothering to carry a roll of toilet paper with them. But perhaps they at least bring along a pack of handi-wipes?!)

    I originally would have attributed such primitiveness (and grubbiness) to a lack of do-gooder policymaking and financial support on the part of the Indian government or hierarchy. IOW, I was willing to accept the assumptions that a naive liberal would have in explaining the reason for that society being such a mess.

    But it’s merely another fascinating example to me of how poor judgment or lousy cultural patterns and not a lack of money, not a lack of enough do-gooderism, not a lack of human kindness (including from the public sector), can be at the core of why a community or society is so very mediocre.

    Hello, city of Detroit!

    Mark (1c4a55)

  23. Thank you, Dana. One of the things I dislike about our modern society is how it positively encourages conspiracy theories. The truth is usually simpler. But it isn’t as exciting.

    Simon Jester (366475)

  24. “Infectious != contagious.”

    Milhouse – Thank you for pointing out the distinction. How does that affect any of your conclusions? It does not affect my statements in any way, shape or form.

    Thus a contagious disease is a disease that is passed from one person to another either by direct contact or through an object that the infected person has touched. Some examples of this type of diseases are measles and chicken pox which can quickly pass on to one person to another. This is why it is seen that if a person catches chicken pox, some more members of his family also fall prey to this disease if they do not take precaution.

    Infectious diseases on the other hand are more dangerous in the sense that they can be contacted by a person even though he may not have come in direct touch with the infected person. This is because these diseases are also air borne or water borne. Air and water become carriers of these infectious diseases.

    Flu, colds and some other viral infections are examples of contagious diseases. They can spread through direct contact such as touching, handshaking or kissing infected person. However you can also catch these diseases when the germs reach you through air as when the patient sneezes or coughs. Using infected person’s towel or any other garment is also a cause of spread of these diseases.

    daleyrocks (bf33e9)

  25. As I wrote on the other thread, there are people who simply get off on scaring people, and I’m convinced that this is what really lies behind most of the fear-mongers such as CSPI, UCS, and Public Citizen. It also lies behind those who are always worried about global cooling, or warming, or stagnation, whichever one the latest data seem to indicate, or about pesticides, GMOs, power lines, etc. There may be other motives as well, but I think at the bottom it’s just their kink. They should just get jobs telling ghost stories, or working at a haunted house or something.

    Milhouse (9d71c3)

  26. The difference I was going for was that although Ebola is terrible once you’ve got it, it’s not very easy to catch. Remember that the definition of a venereal disease (why did they stop calling it that and adopt STD instead, which sounds like a long-distance phone call?) is one that’s so hard to catch that you have to get very close to a carrier before being in any danger. Ebola isn’t quite that hard to catch, but it’s similar. As Professor Piot, who has got to be one of the world’s top experts on the subject, said, he would have no qualms about sitting on a train next to someone with Ebola. That’s not because he’s suicidal, or because he regularly wears isolation suits on the Tube. It’s because Ebola is hard to catch. I.e. it’s not very contagious. What it does to you once you do have it isn’t really relevant to that.

    Milhouse (9d71c3)

  27. As I linked to above, one of the doctors who first discovered the virus, and has been studying it all his career, says he would have no objection to sitting on a train next to someone who was infected.

    That sounds like exactly like the close contact in which the disease could be passed on, sort of like being packed into an airplane. Is this person a Phd or an MD?

    In any case, what indication do you have that any airline is allowing such passengers without appropriate precautions?

    I have absolutely no such indications and the obviously rational answer which is supported by the links in this post is that airlines, health authorities and airport authorities would not knowingly allow it.

    I think if any passenger on the plane caught it from him we’d have heard of it by now. The lack of such reports indicates that it didn’t happen.

    If you have any evidence that they have tracked the passengers of the flight you would care to share I might agree with you, otherwise the incubation period of the disease makes your conclusion a guess at best. If we do not know who and where those passengers are and that they remain healthy, there is simply no way to reach your conclusion.

    Quarantine is wise, but in the normal course of events how many people come in direct contact with your bodily fluids, into an open wound or mucous membrane, on a daily basis? Not too many, I’d think.

    How many people? That depends on how many people are in your family, the nature of your work, where you live, urban versus rural. Remember, when you speak about bodily fluids you are talking about sweat, so putting a hand on the arm of a sweaty person counts. The number could be possibly very large in an African city, factory setting, mine or many other situations. Don’t think in western terms. Why would you believe it to be de minimis?

    daleyrocks (bf33e9)

  28. As I linked to above, one of the doctors who first discovered the virus, and has been studying it all his career, says he would have no objection to sitting on a train next to someone who was infected.

    That sounds like exactly like the close contact in which the disease could be passed on, sort of like being packed into an airplane.

    No, it doesn’t. I ride the NYC subways all the time, and I don’t think I’ve once had anyone else’s body fluids enter my body, as would be necessary to catch Ebola.

    Is this person a Phd or an MD?

    both. Really, why are you questioning his qualifications, when he is one of the world’s top experts on the subject?

    I think if any passenger on the plane caught it from him we’d have heard of it by now. The lack of such reports indicates that it didn’t happen.

    If you have any evidence that they have tracked the passengers of the flight you would care to share I might agree with you, otherwise the incubation period of the disease makes your conclusion a guess at best. If we do not know who and where those passengers are and that they remain healthy, there is simply no way to reach your conclusion.

    Nonsense. There’s no need to track them; if they had come down with Ebola we would know it by now. They would be asked about recent travel and would say that they’d taken this flight, and it would be headline news all over the world. The doctor who treated him after he landed has come down with it; therefore anyone who got it from him on the plane should certainly have already come down with it too.

    Remember, when you speak about bodily fluids you are talking about sweat, so putting a hand on the arm of a sweaty person counts.

    No, it does not. The sweat would still have to get through the skin. There would have to be a break in the skin right where the contact was, or you would have to then transfer it to a mucous membrane such as your eyes or nose, before washing your hands. Possible, but not likely if you’re careful about washing your hands frequently, and before touching your vulnerable parts.

    Milhouse (9d71c3)

  29. The much prettier Dana wrote:

    he felt it was low-risk.

    It is low risk, given all of the precautions being taken. But low risk is not no risk, and they are bringing to the United States a virus which has not been previously seen in the Western Hemisphere. I think that’s stupid.

    The Dana who isn't a physician (f6a568)

  30. Just want to point out – we don’t know what carries the virus before it infects people. The guess is “monkeys and bats” which may just means “non-human mammals”, or it may mean “Specific African species” or it may be entirely wrong. Who knows?

    That’s kinda the point.

    JWB (c1c08f)

  31. My first thoughts are here and following:
    https://patterico.com/2014/08/02/its-my-party-and-ill-cry-if-i-want-to/#comment-1668091

    Selected responses:
    First, also a nod to Simon Jester for some great links.

    In response to comments by Milhouse:
    says he would have no objection to sitting on a train next to someone who was infected.
    I know he said that, my wife pointed that one out to me. I think he was using a bit of hyperbole, if not, I do not respect his clinical judgment, and no one else would who actually works with people with the virus, as no one goes into a patient containment area without being I a suit, even if they are coming in to drop off supplies.

    This is my version of what he was really thinking
    says he would have no objection to sitting on a train next to someone who was infected (and not showing symptoms, and as long as they did not sneeze or cough in my direction, touch me, have a nose bleed and splatter me, or heaven forbid, vomit on me, which people with Ebola are known to do.)

    There’s no need to track them; if they had come down with Ebola we would know it by now.
    I think you are wrong on this, Milhouse.
    First of all, tracking people is exactly how they do contain outbreaks, made possible when the typical outbreak has been in a rural area and not heavily populated.
    Second of all, even if a person knew they were in contact with someone with Ebola, their first thought upon getting a fever might be “Oh, it can’t be Ebola, I’m just coming down with the flu or something, I don’t want to be put into isolation in the hospital for no reason”. And in fact they would often be right, but not 100% of the time.

    I think there is plenty of reason to suspect many people have agenda’s to “put this country in their place” and don’t mind if 25 million deaths take to do it (Billy Ayers and Co.), but I think bringing these 2 Americans to Emory is no more than what it looks like on the surface, concern by Franklin Graham about his people and scientific curiosity by the CDC and folks at Emory.

    But as others have suggested and I’ve said elsewhere, Lagos and Monrovia and other densely populated areas with substandard hygiene, poor medical care, and a barely functioning governmental public health infrastructure, and I can easily see a disaster of epic proportions.

    In Africa you also get distrust of the government, of outsiders, and other tribes or clans within tribes, making things worse. I remember reading something where early on in this outbreak, since it was new to West Africa, some locals were accusing Doctors Without Borders of bringing the disease ion the area and were threatening them.

    MD in Philly (f9371b)

  32. Bill Gates gave a gazillion simoleons to bring free child vaccination to Central Africa. Only about 60% of children are vaccinated. Xenophobia and superstition. Mambo-Jambo, god of the Congo, will hoo-doo you every time.

    In the United States, AIDS started out as a disease of only male homosexual sex tourists. They gave it to local IV drug addict male prostitutes who gave it to other addicts through needles. Still not enough to get the government to fund research for a vaccine and free anti-retrovirals so they infected the blood supply to make it everybody’s problem. I can imagine the same deliberate attempt to make ebola the Western World’s problem too.

    nk (dbc370)

  33. What a great time for Obamaney404care!

    gary gulrud (46ca75)

  34. Thanks for the link, Gary.

    nk, do you really think that “they” purposefully infected the nation’s blood supply, or is that you being provocative?
    I think there were many things that were done “PC” wrong about HIV, but I have always thought the blood supply and especially hemophilia clotting factors were just the result of the limits of the science at the time, and the long “incubation” period of HIV.
    Retroviruses were not discovered/described until the early 70’s or so. Had HIV hit even 5 years sooner we would have had a longer period of trying to figure out what was what.
    Got to go now.

    MD in Philly (f9371b)

  35. Still not enough to get the government to fund research for a vaccine and free anti-retrovirals so they infected the blood supply to make it everybody’s problem.

    Rubbish. The disease was not identified as a syndrome until the fall of 1981 and was not publicized in the popular press until the late summer of 1982. It was not identified as having been produced by infectious agent until the spring of 1984, though that was suspected beforehand. Testing of blood donors began in early 1985. As soon as the first time a carrier donated some blood, the blood supply was infected. That would have been as early as 1978 and as early as 1983 there were hemophiliacs and transfusion recipients with the disease.

    Art Deco (ee8de5)

  36. Maybe it isn’t Ebola but it is worrisome.

    The authorities have already announced it was not Ebola. People get sick on airplanes as a matter of routine and the woman was 72 years old (and not hemorhaging)

    Art Deco (ee8de5)

  37. Here’s an excerpt from CBS Atlanta, 8/5/14, Doctor: Ebola Outbreak Is ‘Spinning Out of Control’

    “This cluster of cases in Lagos, Nigeria is very concerning,” said Dr. Tom Frieden, director of the U.S. Centers for Disease Controls and Prevention, which is dispatching 50 experienced disease control specialists to West Africa.

    “It shows what happens if meticulous infection control, contact tracing, and proper isolation of patients with suspected Ebola is not done. Stopping the spread in Lagos will be difficult but it can be done,” he said…

    A senior doctor working for a leading medical organization in Liberia told CBS News that Ebola is “spinning out of control” in West Africa because it is so difficult to contain. The doctor stated that what has made this outbreak different from others is that this one spread in urban areas.

    ropelight (359d46)

  38. The government that brought you ObamaCare, Fast-n-Furious, Solyndra, Shovel Ready Jobs, Unemployment Under 8%, the Gulf Oil Spill, IRS Suppression of the TEA Party, Benghazi, exchanged a turncoat deserter for terrorist leaders, and NSA snooping, is going to prevent Ebola from invading our nation, even if they can’t stop hundreds or thousands of illegal aliens from doing exactly that every day of the week.

    ropelight (359d46)

  39. Containment does require the cooperation of knowledgeable, motivated people. The villages of Liberia, especially in the days after decades of civil war, may not be filled with people with all 3 characteristics.

    Public health has done a pretty good job in general, I think, with keeping on top of TB and syphilis, so I think they can do it when political agendas do not get in the way.

    MD in Philly (f9371b)

  40. Political agendas would never get in the way of doing the right thing in the US.

    JD (b4e6c6)

  41. If it was discovered that conservatives were more likely to die from Ebola than libs, then maybe, Houston, we would have a problem.

    MD in Philly (f9371b)

  42. A first-hand account of the current outbreak:

    This part of that article surprises and unnerves me because I’ve previously been under the impression that most people infected with Ebola look overtly, dramatically sick well before they succumb to it.

    [Dr. Oliver Johnson] added: ‘What shocking is how healthy the patients look before they die and how quickly they decline.

    ‘A number of the Ebola patients I’ve seen look quite fit and healthy and can be walking around until shortly before their deaths.’

    ^ Some people posting to a news website who’ve seen video of the American doctor infected with Ebola shown walking into the hospital in Atlanta on his own, without special assistance, have implied he therefore can’t be as ill as previously described. Now I don’t know what to think or believe.

    Mark (1c4a55)

  43. MD – Perry would actively endorse such a thing.

    JD (b4e6c6)

  44. In general of course and for the good of all mankind, just not in his back yard.

    ropelight (359d46)

  45. People are not infectious until they begin to show symptoms, which is good.
    It can, however, take a person from just becoming ill to death in a precipitous fashion.
    This depends on the strain. Some forms which are “milder” have a fatality rate closer to 40% and are not as obvious as Ebola.

    My bet is that Brantly was probably over the worst of his illness by the time he arrived, but that is only a guess. Certainly, when plans were being made, it would have been unclear which direction his condition would go. Remember, that even if he did not receive the test serum (which I have read that he eventually did, just not the first dose), he did receive a transfusion from one of his previous patients who had recovered. (The assumption being the blood would contain anti-Ebola antibodies which would help fight off the disease).
    Also, Brantly was in a position to get care from the onset of his illness, so he was not already dehydrated and weakened by the time he got to medical care.

    MD in Philly (f9371b)

  46. “No, it doesn’t. I ride the NYC subways all the time, and I don’t think I’ve once had anyone else’s body fluids enter my body, as would be necessary to catch Ebola.”

    Milhouse – You must be reading something different than me, because nothing I have read requires fluids entering your body in some obvious way for transmission of the disease, that merely touching will suffice. Absorption through skin contact will work, so bumping someone sweating profusely from a high fever in a crowd or on a crowded train or plane will work. If you have information which claims otherwise, please share it with us. This doctor sounds like a complete loon.

    “Nonsense. There’s no need to track them; if they had come down with Ebola we would know it by now. They would be asked about recent travel and would say that they’d taken this flight, and it would be headline news all over the world. The doctor who treated him after he landed has come down with it; therefore anyone who got it from him on the plane should certainly have already come down with it too.”

    Your answer is just redundant nonsense. We are only just learning of the Doctor’s symptoms. Why would we not just be learning about the symptoms of the other passengers if we knew who and where they are? You are just repeating yourself.

    “No, it does not. The sweat would still have to get through the skin.”

    How does sweat get out through the skin? Can viruses be absorbed through pores in the skin? The medical sites I’ve visited suggest the disease can be passed by touching without requiring breaking in the skin. Please share links suggesting otherwise.

    daleyrocks (bf33e9)

  47. Yes, I believe gays deliberately infected the blood supply, in the same way Gaetan Dugas, “Patient Zero”, deliberately spread the disease across the United States after he knew what he had and what he was doing. I believe it was an “I’m taking you with me” attitude among some of the infected. I believe that a few random pints of infected blood would not have resulted in the volume of the contamination in the blood supply. Hemophiliacs and major surgery patients were not likely to be themselves donors geometrically enlarging the contamination. The blood supply was being fed the virus by donors who could still conceal their symptoms.

    nk (dbc370)

  48. 48. I would have to say that a blasé attitude toward risks in general bespeaks of Amerikkkan hubris.

    “Pride goeth before destruction”.

    We have 75 countries comprising the origin of illegals traversing our southern borders.

    gary gulrud (46ca75)

  49. I have the utmost respect for you, nk, but I am not quite so sure of your conclusion at #49. I well remember the *possibility* that HIV resulted from bad vaccine development (racing with other researchers for a Nobel Prize) by Hilary Koprowski (famously described in “The River”). That turned into a media circus, and finally petered out when the elderly Koprowski provided samples from the 1950s demonstrating HIV had nothing to do with his not-awe inspiring program in Africa.

    All it would take would be one or two people stating that they wanted to infect the blood supply—and the media circus would have been incredible. Again, like Dugas, there were “bug chasers” from that period…but they were fine with admitting it as they died. So it would be with any conspiracy to intentionally infect the blood supply.

    I have always had trouble with conspiracies. People always, always want to brag about their role in them.

    Again, I write that with all due respect to you and your valuable contributions to this comments section.

    Simon Jester (c8876d)

  50. I’m telling people that I have ebola.
    Those words are doing the job.

    Keeping people away!!

    mg (31009b)

  51. Just post a lawn-sign in your front yard proclaiming your home an Ebola Sanctuary!

    askeptic (efcf22)

  52. lol, askeptyic

    mg (31009b)

  53. What about wrapping africa in a condom?

    mg (31009b)

  54. 48. I would have to say that a blasé attitude toward risks in general bespeaks of Amerikkkan hubris.

    gary – I am only addressing risks in Africa and of the disease spreading there. Others I believe are focused the possibilities of Ebola spreading to America.

    When medical professionals, the CDC and WHO state the standard treatment protocol for Ebola patients is to isolate them and for the health care professionals treating them to wear full protective gear including rubber boots, rubber aprons, HEPA face masks, goggles, head caps, and double gloves, I find it absolutely ludicrous for people to assert that they would have no problem riding next to people suffering from Ebola on subways or airplanes. That is just bull headed delusional thinking or outright lying at its finest.

    daleyrocks (bf33e9)

  55. mg (31009b) — 8/5/2014 @ 10:03 am

    Fire is a wonderful disinfectant.
    Can we nuke an entire country?

    askeptic (efcf22)

  56. nk, I know (knew) of individual patients with HIV who had deliberately infected other individuals through sex and sharing needles. There was a case where apparently an infected dentist deliberately infected several patients (a selection of different demographics without risk factors) through contaminated injection of Novocain, and I would not be surprised if there were instances of people with HIV who deliberately infected the blood supply.
    But I think the timeline of when HIV was introduced, the lag before people became sick with AIDS, and the further lag before a screening test was available accounts for much of the problem without any mass conspiracy. Over my career there have been a number of cases where people claimed they got it from a blood transfusion who actually had associated conditions that suggested otherwise (eg, also having rectal herpes, for example).
    In addition, I think once upon a time (I do not know now) people were paid for donating plasma to be used in purifying clotting factors and other things, and it ended up that the procedures used to kill all known infectious agents did not inactivate HIV. Many people who made money selling plasma probably were involved in high risk activities, again some of this occurred before people were symptomatic with HIV infection.
    The average time between infection with HIV and symptoms* was thought to be 9 years when I last was up to date on such things, that’s a long time to be donating blood and not know any better.

    *Actually, I’m fuzzy at the moment if it is 9 years between first symptoms or 9 years before an illness that defines AIDS, maybe the latter, but the general point is the same.

    MD in Philly (f9371b)

  57. I have some reason for my theory. Read about David J. Acer at http://www.nytimes.com/1993/06/06/weekinreview/aids-and-a-dentist-s-secrets.html and at http://www.ncbi.nlm.nih.gov/pubmed/7803152.

    From the first link: A possible motive was suggested by Edward Parsons, a nurse who was a friend of Dr. Acer. He told The Palm Beach Post last year that Dr. Acer had said to him in 1988 that mainstream America was ignoring AIDS because it affected mostly homosexuals like himself, hemophiliacs and drug addicts. “When it starts affecting grandmothers and younger people, then you’ll see something done,” Mr. Parsons said Dr. Acer told him.

    He did talk about it. Others covered it up. There was a conspiracy of silence about AIDS from the start. Gays did not want to be quarantined or have their bathhouses shut down. ACT-UP, with its slogan “Silence Is Death”, was organized to follow a different strategy.

    nk (dbc370)

  58. I believe that a few random pints of infected blood would not have resulted in the volume of the contamination in the blood supply.

    You had in 1980 about 3.5 million men who were incorporated into the gay subculture or at least cruising every once in a while. Some of them were indubitably blood donors, some were indubitably infected, and some were both. There would have been thousands of people walking around with that virus before the first news reports hit the airwaves in the summer of 1982 and a six digit quantum by the time the National Cancer Institute announced that the causal virus had been isolated (in 1984). Doses of Factor-VII for hemophiliacs are composed of contributions from the donations of scads of individuals, so the viruses in one infected donor was multiplied many fold. (I was told by my doctor in 1986 that the HIV infection rate among hemophiliacs was then 100%). By 1983 there were already scores of cases which had appeared among hemophiliacs and transfusion recipients and it was not a sure thing that the disease was even of the infectious variety at that point; those scores of people were likely infected months or years earlier. If malicious homosexuals worked to infect the blood supply, they’d have done so between the summer of 1982 and March 1985 against a backdrop of uncertainty about just what properties this disease actually had.

    Art Deco (ee8de5)

  59. It is reasonable to suppose that David Acer did infect his patients because infection by medical personnel was so rare, because the people infected (Kimberley Bergalis was one) had no other risk factors, and because some complicated (and disputed) DNA testing identified a common source for all five infections. What those five people had in common was that they were on David Acer’s patient roll.

    N.B. Kimberley Bergalis’ appointments with David Acer were years after routine testing of blood donations was implemented.

    Art Deco (ee8de5)

  60. the more correct information made available, the more informed a concerned public can become and help prevent an hysterical reaction.

    Unfortunately, correct information needs to compete with the more voluminous BS information. See vaccination or school shootings. How long did it take before the “virus alerts” stopped?

    Kevin M (b357ee)

  61. For what it’s worth:

    http://www.thegatewaypundit.com/2014/08/ebola-airborne-verified-studies-show-airborne-transmission-of-deadly-virus-nih-lancet-osha/

    Abstract
    The potential of aerogenic infection by Ebola virus was established by using a head-only exposure aerosol system. Virus-containing droplets of 0.8-1.2 microns were generated and administered into the respiratory tract of rhesus monkeys via inhalation. Inhalation of viral doses as low as 400 plaque-forming units of virus caused a rapidly fatal disease in 4-5 days.

    Added bonus:

    Scientists report that Ebola may be present in more animals than previously thought. So far, it has been detected in chimpanzees, gorillas, fruit bats, monkeys, antelopes, porcupines, rodents, dogs, pigs and humans.

    There are links to the studies at the site.

    Steve57 (ba12a7)

  62. The Ebola outbreak is a bigger story in the US than it is in South Africa. The official line has been that, as the disease kills rapidly, anyone infected will show symptoms before gaining entry into the country. The fact that Ebola has now reached Lagos, a city with daily direct flights to this country, seems not to worry the authorities.

    Charlotte (f56ecd)

  63. Our ‘authorities’ are pre-occupied with members of the terrifying Sovereign Citizen Movement.

    askeptic (efcf22)

  64. god i hate ebola

    happyfeet (8ce051)

  65. No more monkey meat burritos for you Mr. Feets.

    daleyrocks (bf33e9)

  66. right?

    ebola ruins everything

    happyfeet (8ce051)

  67. I dunno Mr. Feets. I think vampires are pretty much okay with the Ebola. They can pretty much slurp the blood off the surface of people bleeding out and don’t have to bite. There are some pretty hawt looking woman vampires out there I would not want to see go hungry. Trust me, I saw them on Netflix.

    daleyrocks (bf33e9)

  68. Steve57 (ba12a7) — 8/5/2014 @ 11:33 am
    It may be the case that aerosolized HIV would cause infection as well, but since there are no naturally occurring sources of aerosolized HIV in the environment, no matter how much a person with AIDS coughed, it makes no difference. So, scientists shooting Ebola mist into an animal that later gets sick does not impress or worry me.
    The report of monkeys “without direct contact” getting it is worrisome, but they go on to say, “The most likely route of infection of the control monkeys was aerosol, oral or conjunctival exposure to virus-laden droplets secreted or excreted from the experimentally inoculated monkeys.”

    Whatever that means, I know of no evidence that Ebola is readily transmitted through respiratory secretions like influenza, the common cold, or chickenpox.

    My bet is South Africa is not talking about it for the same reasons that many people in West Africa ignore what public health officials there say, they don’t want to deal with it.

    nk, your info is what I mentioned before. I have no doubt that some may have infected the blood supply purposefully, but I do not think one needs to use that as the main reason for blood-transfusion related HIV in the early years.
    For example, my guess is that there was more than one dentist in the US with AIDS, but we have no info to suggest others did what this fellow did.

    I think there are much bigger things to worry about in the US.
    If I was in Monrovia or Lagos, I would be very worried.

    MD in Philly (f9371b)

  69. netflix for sure has some naughty vampire action

    it’s getting to where you can’t even watch netflix with your mom anymore

    unless your mom’s really into naughty vampire action

    happyfeet (8ce051)

  70. Having considered the arguments of counsel and expert, the Court will allow an additional jury instruction to the charge of premeditated murder. The jury may, instead, find the defendants guilty of reckless homicide. Regardless of motive, it was criminal for the HIV-infected to donate blood.

    nk (dbc370)

  71. Cowboys and vampires are what’s turning the Barbara Cartland ladies on, in the romance book market too, these days.

    nk (dbc370)

  72. > Regardless of motive, it was criminal for the HIV-infected to donate blood.

    It was criminal of them to donate *if they knew or should have known they were infected*.

    Given the lead time between exposure and development of symptoms, and given the number of years between the first illnesses and the identification of HIV as the cause, there’s a *lot* of space for people to have donated without knowing that doing so was harmful.

    aphrael (69561e)

  73. i was almost bludgeoned to death by The Normal Heart the other day but i got through it

    needed a little more Glee and a little less bludgeon i think

    happyfeet (8ce051)

  74. what i learned from it number one is don’t throw groceries at sick people

    no matter how much you want to

    just don’t

    happyfeet (8ce051)

  75. gary-
    your link is what Steve57 put up at #63 and is what I was responding to.
    Can Ebola be spread if a man-made (not occurring in nature) aerosol is sprayed into the face of a susceptible animal? Yes, but so what. HIV might be spread that way to, but it doesn’t make any difference, as HIV aerosols do not occur unless specifically man made.
    The second part still sounds like what we know, close direct contact with an animal or person with the disease, especially someone sick enough to have died, puts you at risk of infection, which is why strict isolation is followed.
    None of these findings suggest that there is a risk of wide-spread transmission via a respiratory route like with influenza, chickenpox, etc.
    But they do add to the idea that the “lab doc” who would sit next to an infected person on a train/bus was being cavalier or using hyperbole, and not sound judgement.

    MD in Philly (f9371b)

  76. But they do add to the idea that the “lab doc” who would sit next to an infected person on a train/bus was being cavalier or using hyperbole, and not sound judgement.

    Many people who have done smart things have also made blunders, including more than one Nobel Prize winner.

    MD in Philly (f9371b)

  77. 78. Thanks for the elaboration, Doc.

    gary gulrud (46ca75)

  78. Yesterday Nigeria had two cases, the dead American Stewart and his doctor, today 5 cases and a dead nurse.

    gary gulrud (46ca75)

  79. That news from Nigeria, if it is true, is not at all surprising to me and consistent with what I have said before. Medical personnel and perhaps others were exposed to a critically ill person with Ebola unknowingly and without appropriate precautions. That is typical, and it could have happened in your backyard (front-yard?) had his timing to come to the Twin Cities been different.

    What happens next is the issue. When it is a medical missionary in the middle of rural Africa there are relatively few people to track down and isolate (though the resources may also be scant until help arrives), and the outbreak is kept under control. Lagos, Nigeria is very, very different. Will they be able to mobilize the resources and have the cooperation of those involved to contain the outbreak? Possibly, if they had already started active planning for such a scenario, which maybe they had, since they have identified the cases already, rather then people being sick at home cared for by family or in another hospital with unsuspecting staff.

    I guess what has made this outbreak bad already, is that instead of an isolated community like previous Ebola outbreaks, there is a lot of travel back and forth between the affected areas in Guinea, Sierra Leon, and Liberia; so as soon as they have one village under control they hear news of another sick person elsewhere.

    MD in Philly (f9371b)

  80. MD in Philly – The story on Yahoo reporting on the five cases of Ebola in Lagos indicates that the plane carrying the infected Liberian-American who died had a stopover in Togo on the way, but no information on whether anyone deplaned. It also confirmed that medical personnel in Lagos did not initially diagnose the illness as Ebola.

    daleyrocks (bf33e9)

  81. I saw that Saudi Arabia has quarantined someone and has cancelled approval for people coming to Mecca from the affected countries,
    and a report that a priest and two nuns with Ebola were being airlifted back to Spain, their country of origin, after catching the disease working at a charity hospital.

    I think right about now, or yesterday, officials are scrutinizing air traffic, etc. I would not be surprised if there are a number of small outbreaks in developed countries, all contained, before this is over.
    Metropolitan areas in less developed regions, such as Lagos, pose much more of a threat, especially if the government and public panic and/or lose confidence in what is being done.

    Meanwhile, I wonder how things are going in Monrovia and elsewhere.

    MD in Philly (f9371b)


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