Actually I do get Mortality and Morbidity Weekly notifications, and have since I first got online as a side effect of having worked with USDA contacts. [I have a fair number of odd and interesting contacts from various jobs over the past almost 40 years I have held assorted jobs.] And yes I was aware that it happened.
Why do you think I am so twitchy about the wonderfully strict precautions being taken?
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actually, A/C can make a huge difference - it is understood how the virus spreads and healthcare workers such as the two the OP is about know how to stop it, they put on the protective gear and take it off in a careful, specific way.
the fact that they got sick is probably due to messing up due to exhaustion and HEAT. I heard a radio interview earlier today where the healthcare worker said it is likely 115 degrees in those suits and they tolerate them as long as they can.
you think that might possibly have something to do with accidentally reaching up to wipe sweat out of your eyes even though you know what the danger is?
The huge difference here is that the incoming patients are known positives. The monkeys imported to Reston were not known to be positive when they arrived and all of the transmission occurred before the diagnosis was made.
There are a lot of different reasons that the containment could have gone wrong overseas. We can take the current strain to Atlanta & study how it might have changed (if it has changed) and Know… or we can stick our heads in the sand and Guess.
Knowing means we might be able to send people into hotzones w/o dying in the future.
Guessing means… well what do I care? Not me or my kid… and after we make this another “All Obama’s Fault” media blurb, it’ll just fade into the background noise after the election.
More pie?
I’m not sure that I buy R0xCFR as a meaningful measure of risk. But, the more important issue is that the Ebola R0 is based on transmission in rural Africa without medical intervention. It is completely unrealistic to assume that this R0 will hold in the US, especially with patients that are known to be positive and quarantined in a modern hospital. There’s no data yet to measure the R0 in the US, but I would expect it to be far below 1. By definition, that means it won’t spread.
I have a very low opinion of most Drs. but the medical people who, like Doctors Without Borders, put their health, lives, and earning power into these horribly dangerous situations around the world out of compassion are among the few true heroes we will ever see. Any thought that they should be refused the absolute best care possible is low and foul and brings shame on anyone who thinks it let alone speaks it.
yes!
The current outbreak is of the EBOV (Ebola Zaire) subtype which has proven to be the most lethal variant during previous outbreaks. Transmission patterns have previously shown close contact with bodily fluids is required.
The concern with the two American patients is how exactly they became infected and if it is possible that there was airborne contamination as is known to be possible with the REBOV (Reston) subtype. They think that they might have been infected during the decontamination process by contact with an infected coworker or possibly by contact outside the clinical setting.
Containment at Emory is more than adequate to prevent an outbreak from there. But in the slight chance that EBOV is becoming capable of airborne transmission then there is a very real danger of outbreak in the United States from a patient zero who arrives in the US in a pre-symptomatic condtion. Early symptoms of Ebola are sufficiently vague as to be confused with other conditions. Unless direct contact with a known infected patient is suspected based upon patient history then Ebola probably would not be suspected. The patient may defer seeking medical treatment until symptoms progress.
And as to working in hot suits… air conditioning helps. Much better than the conditions doctors in Africa are dealing with. Some report loss of as much as 5 liters of sweat withing a one hour rotation in a protective suit. Kit up time can be around 30 minutes. Decontamination adds another 30 minutes at least. The physical rigors are requiring serious efforts to rehydrate personnel including IV fluids. A rotation in a proper space suit in a BSL4 lab is much more bearable.
Does the United States allow polio sufferers to be evacuated to the United States? Of the four, that is the closest match to ebola: this level of quarantine is not applicable for diseases we have already exterminated (smallpox), or diseases which are already present in the general population (HIV).
aruvqan, Red Stilettos pretty much wrote my reply.
Red Stilettos, as I said it’s a poor metric but it’s not my job (or expertise) to work that out and it seemed like a not bad idea to scale contagion/ with virulence to rank the risks.
Grumman consider the outcry if you brought an HIV positive American back to the US. It’s a much stealthier virus, it’s apparently more contagious than ebola and has an equivalent case fatality rate. It does however hide better and kills slower. Would we really be having this discussion if the infected Americans had contracted HIV?
Leaving everything else aside, I’m afraid they’ll likely be dead before they get home.
HIV much harder to spread.
We already have cases of HIV in the wild in the United States, so there is pretty much no benefit in keeping an ocean between ourselves and one additional case. That is not true of polio or ebola, which are at this point restricted to specific regions and are not already endemic to the United States.
The contagion values for HIV are 3.5 while Ebola comes in at 2.5. That means HIV is more contagious and there’s the added factor of ebola’s value being determined based on conditions significantly more hospitable than an American hospital setting that’s expecting the arrival of 2 patients.
So the arrival of an unknowing HIV carrier is less detrimental to public safety than the controlled arrival and treatment of two patients with a virus that is as virulent and slightly less contagious?
Ebola is a well studied disease with a well known route of infection. It’s not particularly contagious. The current epidemic has killed under 1000 people, in areas of the world where sanitation is questionable, at best. The chances of anyone being exposed to the virus in the U.S. from these patients is very small, and the chance of any sort of epidemic in the U.S. from these patients is essentially zero.
Ebola is already gasp on our shores in labs across the country. Transporting, storing and working with Ebola and other BSL 4 agents is not particularly rare. And no doubt these patients will be in a much more protected environment than many of the small labs that currently work with Ebola.
Again, it has a high death rare and it’s ugly, but objectively it’s not exceptionally easy to catch. If this was an air- spread infection this would be a completely different story. But in the US, it is basically impossible for the general public to end up in close contact with bodily fluids from two high-profile ultra-isolated patients.
The amount of ignorance and scare malingering here is crazy. It reminds me of anti-vaxers.
I said harder to spread, meaning methods of transmission, not rates of transmission. I apologize if I wasn’t clear.
Over the entire life of the patient. If HIV had those numbers over a three week lifespan instead of ten years, it would be a much bigger problem.
A quick multiple choice quiz for you:
Ebola, a highly contagious, deadly disease not currently found in the United States is like:
Worth repeating…
It’s been in the United States since 1976. Hasn’t escaped from a lab in almost 40 years. I’m not terribly concerned with it doing so now.
For the record, there have been four documented lab accidents involving Ebola.
The first such accident was at the Microbiological Research Establishment at Porton Down (UK) in 1976. This was the early days of Ebola research, the disease only having emerged that same year. The investigator’s illness was described as mild and he recovered.
The next such incident was in February of 2004 at the USAMRID lab at Fort Detrick, Maryland. The patient voluntarily entered an isolation facility at Fort Detrick for a quarantine period, but she was first given time to go home and sort out her personal affairs. She never fell ill.
And the another such accident was in May of 2004 in Russia at the Vector lab. The researcher fell ill after a needlestick injury and she died two weeks later.
The last such accident was in 2009 in Hamburg, Germany. The researcher was given a trial vaccine developed in Canada. She did not fall ill.
There have been many other accidents in the field. These are only the lab accidents at research facilities which are designed to deal with handling and research of such viruses.