Ebola in The USA

@Finn dAbuzz,

Quote:

I have listened to all of them discuss the travel ban and I have not heard one of them give a coherent answer that actually explains the medical reasons for why it is not a good idea. Concerns for the economic, political and social infrastructures of West African nations are hyperbolic and certainly not medical.

I'm guessing that the airline industry is lobbying against a ban. There's no medical reason for a ban because if no one sick enough to infect someone on the planes would be well enough to travel then there's no basis for it other than alleviating fear. THey (the airlines) don't have any objection, of course, to their passengers going through screening before and/or after their flight because it doesn't affect their bottom line, but asking them to reduce their passenger load or to eliminate entire flights certainly does. The airlines could start refusing to fly in/out of these countries tomorrow. There's no law that says they have to fly there. I'm stunned, actually, that it's the free-market types who are most loudly calling for a gov't ban on the airlines.

2 Replies

@JPB,

They have no stock in the airline industry, would be my guess.

0 Replies

The bottom line is we need to do a better job of recognizing and treating ebola victims here. There will most likely be others. The Duncan case turned out to be the perfect storm in testing the preparedness for such cases. There definitely needs to be more than four hospitals in the country capable of treating these cases and every hospital needs to be able to protect its workers from someone who is hyper-virulent with end stage disease. Hopefully both nurses will recover and none of the remaining contacts will show signs of infection. Today marks the end of the 21 day window period for his contacts in the ambulance and ER who transported/treated his second visit. As of tomorrow, only his isolation caregivers and their contacts will still be in the window period. The risk of their contacts showing symptoms is very low. The risk of his other caregivers showing symptoms is higher but less so with each passing day.

Mr Duncan died on Oct 8 and was cremated on Oct 10. The peak timeline of exposure to early symptoms is 8 to 10 days. As of tomorrow all of his contacts will have passed that window period and can begin to breath a little easier.

1 Reply

@JPB,

JPB wrote:

There definitely needs to be more than four hospitals in the country capable of treating these cases and every hospital needs to be able to protect its workers from someone who is hyper-virulent with end stage disease.

I've talked to a friend, who worked as a standby doctor for a level 4 ward. If there's a patient, you need 25 nurses per patient per day here, plus doctors. (The hospital, he was attached to, had had 110 specialised pesons on the stand-by list.)

Here in Germany, we only had two hopsitals until 1972 - from that time onwards, we got more (now nine, not seven, as I previously wrote).

Despite what Mille suggested, those specialised wards can deal with Bolivian and Argentine hemorrhagic fevers, Marburg virus, Ebola virus, Lassa virus, Crimean-Congo hemorrhagic fever, and similar.

The (international) airports close to those hospitals are especially equipped for level-4 patients as well.

0 Replies

Nate Silver on Why a flight ban wouldn't work.

1 Reply

Our tax dollars at work
Too bad Obama and the Democrats won't play up this sort of achievement. Clearly, big business did not find Ebola profitable enough (yet) to begin working on it, so in steps the government. Thanks to our tax payer dollars, it looks like a new test for Ebola is on its way, one that we diagnose the disease in seconds, not days. As taxpayers, we can all be proud of support for this kind of research.

http://www.ibtimes.com/us-has-test-can-detect-ebola-virus-seconds-its-stuck-lab-1707139

Researchers at a government lab have developed a minimally invasive test for Ebola that could cut the time it takes to diagnose cases of the lethal virus from days and hours to minutes or even seconds, International Business Times has learned. The Department of Energy, which invented the procedure at its Oak Ridge National Laboratory in Knoxville, Tennessee, is now scrambling to find a partner to commercialize the technology.

...

In a solicitation-for-contractors document, DOE describes its test as a “rapid, portable viral diagnostic for RNA viruses,” including, specifically, Ebola hemorrhagic fever. RNA viruses are made from genetic material comprising ribonucleic acid. In addition to Ebola, the DOE said the test can quickly detect Hanta, Dengue, West Nile and several other exotic viruses.

DOE posted its solicitation late Wednesday to a federal contracting database. A public records search showed that as of Friday one contractor had expressed interest: Healtheon Inc., of New Orleans, which manufacturers a range of diagnostic tools. Healtheon president Jasmeet Walia did not immediately respond to a request for more information.

A DOE spokesperson said the agency has been directed to refer all calls related to Ebola to the National Security Council. NSC officials did not immediately return phone calls.

In its solicitation, the DOE said rapid diagnostics “are critical elements of an effective response to viral outbreaks, but are limited by both available technology and implementation. ORNL researchers have developed a diagnostic for active, acute viral infections using a highly fieldable, and nearly reagentless system.”

1 Reply

@bobsal u1553115,

Quote:

DOE’s technology, as is the case with PCR testing, would only work on individuals who are symptomatic. Humans can harbor the Ebola virus for as long as three weeks before showing signs such as severe headaches, diarrhea and vomiting.

Which means the sensitivity of the test is about the same as the current PCR test ~7500 viral copies/mL which contradicts an earlier statement in the article.

Quote:

Safdar cautioned, however, that rapid virus testing may not be as accurate as PCR. Rapid testing for human immunodeficiency virus (HIV), which has been available for several years, is known to deliver a very small percentage of false positives, though no false negatives. “This may be better at ruling people out than ruling them in,” said Safdar.

I agree that rapid test, i.e., dipstick, methods are preferable for large scale screening, the fact remains that this test would be only beneficial on patients who are already showing symptoms and would not close the window period of detection (sensitivity) over PCR and is less specific than PCR. Both methods are capable of producing false negative results in asymptotic infected patients.

0 Replies

@Finn dAbuzz,

Finn,

The scientists are saying a few things very clearly.

1. Ebola is not highly infectious in a modern Western Society. It is not easily transmitted.

2. There is no significant risk of an Ebola Epidemic in the US.

3. There is no need for an air travel ban, and in fact such a ban may be counter-productive.

You apparently don't agree with the scientists. You seem to be dithering by saying that you aren't clear what the scientists, but it isn't hard to see.

If you accepted the scientific fact that there is no significant risk of an ebola epidemic in the US, would this change your opinion on what the policy should be?

2 Replies

@maxdancona,

From reuters

Quote:

GALVESTON, Texas, Oct 19 (Reuters) - A Dallas hospital lab worker who spent much of a cruise holiday in isolation after possible exposure to Ebola has tested negative for the disease, and in Texas some of the dozens of people still being monitored were expected to be cleared on Sunday and Monday.

The Carnival Magic docked in the port of Galveston, Texas after a week-long cruise that included being denied docking by Belize and Mexico because of the presence of the woman on board.

The precautions taken over the Texas lab worker reflected anxiety over the spread of Ebola.

1 Reply

@Walter Hinteler,

As an aside: the first confirmed Briton to have contracted Ebola, William Pooley, 29, will fly back to Sierra Leone this evening and will continue his work helping to treat people with the disease there. He has said he is "delighted" to able to return and he wants to "prevent as many deaths as possible".

1 Reply

@Walter Hinteler,

Does he have immunity to the virus now?

2 Replies

Grumbles re Ohio episode -

The business of shutting down a school where a boy attended, a boy who had been on the plane that nurse #2 flew in - the nurse with a 99.5 fever, not a 101.5 fever, has me baffled. By all I've read so far, she was not contagious at that time.
I'd be interested in your take, JPB.

Olivier, I think he's cleared, and certainly has antibodies to the Ebola virus, so his serum can possibly help others.

2 Replies

@Olivier5,

I read somewhere that if you survive the ebola, you have immunity lasting ten years. Although they're not fully certain if the immunity applies to other strains (mutated, etc.) of ebola.

0 Replies

From the BBC website. My brackets.

Quote:

He(Pooley) has since made a full recovery and has donated his blood for medical research.....

The extent of any immunity Mr Pooley will have to the virus is unclear.

Having recovered from Ebola, his immune system should be able to fight the infection.

However, doctors are not certain how long the immunity will last or whether he is completely resistant.

But Mr Pooley added: "It's massively safer for me to work there now than it was before."

http://www.bbc.co.uk/news/health-29680400

2 Replies

@izzythepush,

Thanks for the info.

0 Replies

@izzythepush,

Thanks.

0 Replies

@Olivier5,

From what I've read they aren't sure how much crossover antibody protection a cured individual has re reinfection and/or other strains. If he's going back to the same location then chances are good he'd only be exposed to the same strain, but the risk of reinfection is unknown. He says he's going to assume he can be reinfected and act accordingly.

0 Replies

@ossobuco,

I think the "abundance of caution" approach is warranted at this point. It's probably unnecessary but until there's more data available on the efficacy of the virus to infect others here (so far it's only end-stage caretakers) they're taking a better safe than sorry approach. It's highly unlikely any of her contacts will show signs of illness from her casual exposure, but even that remote chance is better controlled with self monitoring (at this point anyway).

2 Replies

@JPB,

All that i've read and heard has it that the carrier is not contagious until symptoms begin to manifest.

1 Reply

Well, this is good news!

Quote:

The Spanish nurse who became the first person to contract Ebola outside West Africa has now tested negative for the virus, the Spanish government says,

The result suggests Teresa Romero, 44, is no longer infected - although a second test is required before she can be declared free of Ebola.
Source

0 Replies

Ebola in The USA

Related Topics

Quick Links

My Account

able2know