Posted on 08/10/2014 12:46:23 AM PDT by Smokin' Joe
I have spent a little time compiling links to threads about the Ebola outbreak in the interest of having all the links in one thread for future reference.
Please add links to new threads and articles of interest as the situation develops.
Thank You all for you participation.
That is something I have wondered about. If there were any kind of outbreak here, it would be such a big, ugly mess. It's not as if we have tiny homes, with dirt floors and sparse furnishings... Ugh.
Responsibility comes with power. Dr. Fauci is irresponsible, and can best serve the nation by resigning.
I think the problem is more one of priorities and allocation of resources than anything else.
The government owns 95% of Nevada, for instance, and half of the land west of the Mississippi. If it wants to build a lab, it has ample space far from the nearest neighbor.
I disagree. I do not perceive a scientist who looks, talks, and acts like a scientist as being irresponsible.
You would not get significantly different answers, either in content or style, from any scientist. I would have done the same thing in his place.
He gave the best information that he (or anyone else) has.
I think the problem is more one of priorities and allocation of resources than anything else.
The government owns 95% of Nevada, for instance, and half of the land west of the Mississippi. If it wants to build a lab, it has ample space far from the nearest neighbor.
Until this outbreak, Ebola had never captured the public attention. I'm not certain why it is such big news this time around. The fact is that obscure diseases that sporadically affect a handful of people on some distant continent are not a research priority, and never will be. The only reason that Ebola, Marburg, and some of the other hemorrhagic viruses are researched at all is because of concern that they might be used as bioweapons.
Influenza season is coming up, and hundreds of thousands of people are going to die from it. Because of the high death rate, influenza is a research priority all over the world. And that is how it should be.
I don't know about putting a lab in the middle of Nevada or any other desolate place. To get people to come work in a lab, it has to be near a place where people want to live. And no one chooses to live in the high desert.
>>If you watch the C-span link, forward to 03:18:30...
The C-Span 3 video at the link —
http://www.c-span.org/video/?321494-1/hearing-ebola-outbreak-west-africa
goes to 3:00.39
The transcript isn’t any longer either.
Searching the transcript at the 48 something minute mark gets to the Fauci - Burr exchange.
Fauci did mislead on Ebola transmission using touching dead bodies and “it’s a fragile virus” as his misleading messaging.
Did we just see history erased?
Assessment of the Risk of Ebola Virus Transmission from Bodily Fluids and Fomites (From Discussion)
There was a significant discrepancy between the results of virus culture and RT-PCR testing in our study, with many more frequent positive results from RT-PCR. Possible explanations for this finding include virus degradation from breaks in the cold chain during sample collection, storage, and shipping; the greater sensitivity of RT-PCR relative to culture; and, in the case of the saliva specimens, possible virus inactivation by salivary enzymes. The less-than-ideal storage conditions of the specimens in the isolation ward immediately after acquisition and the fact that even the nasal blood from 1 patient was culture negative suggest that some virus degradation indeed occurred. Nevertheless, we cannot exclude the possibility of a true absence of viable virus in the original samples. We hope to be able to repeat this study in the future with better maintenance of the cold chain to resolve this question.
Given that the nasal blood of an infected individual in the midst of clinical symptoms came up negative on culture, this study has a significant problem that the authors noted. Use of this study to make claims regarding transmission without the accompanying qualifier isn't particularly good practice IMO, especially when used to claim that a particular vector is impossible/improbable.
I think the RT-PCR test results are the significant portion of this specific study given the issues surrounding the sample handling.
In a previous post (number 2118) you wrote:
In order for Ebola to become airborne, it would have to 1) infect cells in the upper respiratory system, in the bronchia and possibly alveoli, and 2) be resistant to destruction by drying.
Ebola infects dendritic cells, which are numerous in the respiratory tract. Additionally, the virus has demonstrated very wide tropism in animal models and human samples. Please provide a source for the claim that other respiratory cells are not currently subject to infection and "must" be infected in order for airborne (medical definition) transmission to occur. As far as I am aware, the various cell types of the human respiratory tract are not exempt from Ebola infection.
The phylogenetic analysis of the five ebolavirus species here does not substantially improve on that presented by Baize et al. in that even when partitioning the alignment into coding and non-coding regions we get inconsistent rooting positions for the EBOV clade. We believe that at present no suitable outgroup sequences to root the EBOV phylogeny exist and that a temporal rooting gives the most consistent results.
This approach indicates that the outbreak in Guinea is likely caused by a Zaire ebolavirus lineage that has spread from Central Africa into Guinea and West Africa in recent decades, and does not represent the emergence of a divergent and endemic virus.
As the GP sequences show, without more diverse sequences, especially those from the animal reservoir, it is difficult to narrow down the estimates of when and through what means the Central African EBOV lineage has been introduced into West Africa.
I haven't located any information on the analogous pneumoviridae protein or comparison with the Ebola version. If you find something please share.
Burr knew what he was talking about, and knew what he was asking.
Black Agnes forwarded what I think is the most coherent, understandable paper about what R0 is (basic reproduction rate).
R0 is actually made up of three factors:
R0 = (infection/contact) x (contact/time) x (infection/time)
R0 = tau x mean c x d
Burr was asking about d - how long can the virus remain viable on the door handle of a taxi cab?
Tau is the probability that if you come into contact with the disease that you will catch it. Mean c, or c-with-A-line-over-it, is the number of times you will come into contact with an infected person, or the infection itself. It’s called ‘mean c’ because it is an average - the average, or mean, number of times you’ll come into contact with it.
If Fauci doesn’t know what the d is, that’s troubling, since that is testing you don’t have to do with humans.
All you want to know is how long will the virus stay viable OUTSIDE the body. Inside the body, the answer to that is ‘forever’ essentially, even when you are dead.
You can do something about live, infected people, or dead ones. What is impossible to know is whether you end up having to burn a 787 up because once the virus is in the cabin, it can remain viable there for d amount of time.
They took everything the nurse that came down with Ebola (she survived through Zmapp) and burned it. Ipad, Iphone, etc. Burned it. Not cleaned it. They burned it.
That disclosure was telling, especially when you put it together with testimony that the R0 on this is 5 to 20? If it isn’t an airborne pathogen, then it is one of the most durable virus ever outside the body.
Remember, the first factor - tau - can’t exceed 1.0 (its a probability)
This is why the decision to bring it back to the US might have been a really bad one if the virus has the kind of durability Burr thinks it might.
Mean c is a standard probability problem right out of a college text:
“A person carries a germ into the passenger cabin of an airplane and sits on the aisle seat of the very middle row on the left side of the aircraft. From the time he reaches his seat and fastens his seat belt, he falls asleep - not eating any food nor using the restroom. When he wakes, he unfastens his seat belt and exits the aircraft, using the back of the seat in front of him to get out of the row.
Given a tau of 0.5 (50/50 chance if you touch the same place the guy touched you’ll pick up the virus), a mean c of 1 (this is the only point at which you’ll come into contact with it, say in one day) and a d of 24 hours - how many people that day are going to catch and come down with Ebola?
Keep in mind that the health care personnel decided that burning the ipad was the only sure way of disinfecting it. If they had any confidence in being able to clean an iPad, which isn’t exactly made of suede and covered with fine groves, don’t you think they would have? Especially since she ended up surviving?
Burr was the smartest guy up there. I did like Harkin’s reaction to the fact he didn’t know who was running the show in Africa. When he found out, he almost slipped and said “they shouldn’t be running anything . . .”
ExDemMom, I can believe you and Faluci, or I can believe the MSDS for Ebola that states Ebola was aersolized by pigs — via sneezes — and makes clear the EVD is a Hell on Earth fomite and STD threat.
EBOLAVIRUS PATHOGEN SAFETY DATA SHEET - INFECTIOUS SUBSTANCES
http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php
“INFECTIOUS DOSE: Viral hemorrhagic fevers have an infectious dose of 1 - 10 organisms by aerosol in non-human primates Footnote 41.
MODE OF TRANSMISSION: In an outbreak, it is hypothesized that the first patient becomes infected as a result of contact with an infected animal Footnote 22.
Person-to-person transmission occurs via close personal contact with an infected individual or their body fluids during the late stages of infection or after death Footnote 1 Footnote 2 Footnote 22 Footnote 42.
Nosocomial infections can occur through contact with infected body fluids for example due to the reuse of unsterilized syringes, needles, or other medical equipment contaminated with these fluids Footnote 1 Footnote 2.
Humans may be infected by handling sick or dead non-human primates and are also at risk when handling the bodies of deceased humans in preparation for funerals Footnote 2 Footnote 10 Footnote 43.
In laboratory settings, non-human primates exposed to aerosolized ebolavirus from pigs have become infected, however, airborne transmission has not been demonstrated between non-human primates Footnote 1 Footnote 10 Footnote 15 Footnote 44 Footnote 45.
Viral shedding has been observed in nasopharyngeal secretions and rectal swabs of pigs following experimental inoculation Footnote 29 Footnote 30. INCUBATION PERIOD: Two to 21 days Footnote 1 Footnote 15 Footnote 17.
COMMUNICABILITY: Communicable as long as blood, body fluids or organs, contain the virus.
Ebolavirus has been isolated from semen 61 to 82 days after the onset of illness, and transmission through semen has occurred 7 weeks after clinical recovery Footnote 1 Footnote 2 Footnote 59 Footnote 60.”
...and later in the document —
“PHYSICAL INACTIVATION: Ebola are moderately thermolabile and can be inactivated by heating for 30 minutes to 60 minutes at 60°C, boiling for 5 minutes, or gamma irradiation (1.2 x106 rads to 1.27 x106 rads) combined with 1% glutaraldehyde Footnote 10 Footnote 48 Footnote 50.
Ebolavirus has also been determined to be moderately sensitive to UVC radiation Footnote 51.
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. A study on transmission of ebolavirus from fomites in an isolation ward concludes that the risk of transmission is low when recommended infection control guidelines for viral hemorrhagic fevers are followed Footnote 64.
Infection control protocols included decontamination of floors with 0.5% bleach daily and decontamination of visibly contaminated surfaces with 0.05% bleach as necessary.”
When you then check the following link from the above document —
Laboratory Handling and Transporting Specimens from Patients Under Investigation for EVD
Laboratory personnel handling these types of clinical specimens are recommended to don the following personal protective equipment (PPE); â– double gloves; â– fluid-resistant, impermeable laboratory gown, over the lab coat; â– either a combination of approved particulate respirators (e.g., N95, or N100) and eye protection (e.g. goggles/face shields/shroud), or powered air purifying respirators (PAPRs).
Specimens from patients under investigation for Ebola virus disease should not be manipulated on an open bench.
Activities with the potential to create infectious aerosols(e.g., pipetting, centrifugation, aspiration, slide preparation) should be carried out in a certified Biological Safety Cabinet (BSC)Footnote 1,Footnote 2,Footnote 3, in a minimum CL 2 laboratory.
Blood cultures should be prepared in a closed system.
When this is not possible, manipulations should be undertaken in a certified BSC in a CL 2 laboratory with the use of appropriate PPE as identified above. Sub-culturing of blood cultures has the potential to generate aerosols and should be done only when essential to patient care.
This should be done in a certified BSC with the use of additional PPE as identified above, and the decision to subculture should be predicated on the clinical status of the patient and based on an on-going risk assessment.
Sample separation (e.g. blood, serum) should be undertaken using sealed centrifuge cups or a sealed centrifuge head that are unloaded in a certified BSC.
Blood smears: Malaria should be ruled out from travellers returning with a fever. Only thin Blood smears should be done (no thick smears) and repeated as necessary (e.g., if the first thin Blood smear is negative).
It is recommended that dipstick tests from patients that are under investigation for EVD, should be performed only on inactivated blood.
All manipulations should be undertaken in a certified BSC with the use of appropriate PPE as identified above.
After air drying in the BSC, thin Blood smears should be fixed with absolute methanol (for 5 minutes) followed by 10% buffered formalin (for 15 minutes).
All reagents should be sterilized prior to disposal.
PCR, if available on-site, may be considered a safer option, as routine extraction procedures are sufficient to inactivate the virus.
Inactivation manipulations should be undertaken in a certified BSC in a CL 2 laboratory with the use of appropriate PPE as identified above.
Automated analyzers may be used after performing a local risk assessment for the potential for aerosol generation.
If ports or vents are present on the system that may generate aerosols, it is recommended that the machine be contained, either in a BSC, plexiglass or flexible film cover, or through the use of HEPA’s.
After use, analyzers should be disinfected as recommended by the manufacturer or with a 500 parts per million solution of sodium hypochlorite (1:100 dilution of household bleach: 1/4 cup to 1 gallon water) after use.
You find out that simple things like pipetting or slide preparation are sufficient to aersolize Ebola.
While the article said that there wasn’t much risk of Ebola slime infection unless their was blood involved, however, see the following admission from that article —
Nevertheless, we cannot exclude the possibility of a true absence of viable virus in
the original samples. We hope to be able to repeat this study in the future with
better maintenance of the cold chain to resolve this question.”
The 2007 test team’s samples _ran out of liquid nitrogen cooling_ for their Ebola samples between Africa and its virus culture testing by the CDC in Atlanta.
Which, given the infection rates we are seeing in Liberia and elsewhere, means the samples went bad in transit due to the coolent break in the transportation chain.
The bottom line is we still don’t know the human infection rate from non-blood based human body fluids in the environment.
http://www.voanews.com/content/ebola-outbreak-liberia-united-nations/2454137.html?
The WHO said more than 700 more Ebola cases emerged in West Africa in one week, a statistic that shows the outbreak is accelerating. Just three weeks ago the number of new cases was around 500 for a one-week period.
The number of people believed to have killed is now more than 2,600, an increase of roughly 200 from the last estimate, WHO said Thursday. Most deaths have been in Liberia.
Just under half of the 5,300 cases of infection were recorded in the last three weeks, according to the WHO.
Officials said 318 health care workers have been sickened, and about half have died.
>snip<
The Liberia numbers have not been updated since 8 Sept 2014 and thus are not included in the above tabulation announced today Thursday 18 Sept 2014.
18 September 2014
This is the fourth in a series of regular situation reports on the Ebola Response Roadmap1. The report contains a review of the epidemiological situation based on official information reported by ministries of health, and an assessment of the response measured against the core Roadmap indicators where available. Additional indicators will be reported as data are consolidated.
The data contained in this report are based on the best information available. Substantial efforts are ongoing to improve the availability and accuracy of information about both the epidemiological situation and the implementation of the response.
Following the roadmap structure, country reports fall into three categories: those with widespread and intense transmission (Guinea, Liberia, and Sierra Leone); those with an initial case or cases, or with localized transmission (Nigeria, Senegal); and those countries that neighbour areas of active transmission (Benin, Burkina Faso, Côte d’Ivoire, Guinea-Bissau, Mali, Senegal). An overview of the situation in the Democratic Republic of the Congo, where a separate, unrelated outbreak of Ebola virus disease is occurring, is also provided (see Annex 1).
OVERVIEW
The total number of probable, confirmed and suspected cases (see Annex 2) in the current outbreak of Ebola virus disease (Ebola) in West Africa was 5335, with 2622 deaths, as at the end of 14 September 2014 (table 1).
Countries affected are Guinea, Liberia, Nigeria, Senegal and Sierra Leone.
Figure 1 below shows the total number of cases by country that have been reported in each epidemiological week between the start of 30 December 2013 (start of epidemiological week 1) and end 14 September 2014 (epidemiological week 37: 8 to 14 September).
>snip everything to Liberia<
LIBERIA
The number of newly reported cases is still rising week on week, primarily driven by a continuation of the recent surge in cases in the capital, Monrovia (figure 3). The number of new cases reported from Lofa county, which borders the Guinean districts of Macenta and Gueckedou, has not increased in week 37 though it is too soon to say whether incidence has stabilized in Lofa.
>snip chart<
In the past few months, staff from WHO, US CDC and other partners have been working closely with the Liberian Ministry of Health to improve data collection and to integrate sources of data to provide the best possible picture of this rapidly evolving outbreak. Some of this work includes consolidating several different databases and cross-checking numbers of cases reported by the Government of Liberia against cases from laboratory test results.
During this process, many cases previously classified as probable and suspected are being reclassified, while at the same time approximately 100 previously unreported cases have been found. These new figures will be published soon, and will reflect significant improvements in data collection, and therefore provide a more accurate understanding of the situation. Liberia remains the country worst affected by the epidemic.
>snip everything else<
Short form, the WHO is reporting everplace but Liberia and total cases went up by 500 to 5,335.
Liberia is getting a new unified Ebola database and “approximately 100 previously unreported cases have been found.”
This appears to be in addition to whatever has happened since 8 Sept. 2014.
My take away is that we are likely over 6,000 cases, rather than 5,300 (+), if the WHO’s preliminary scrubbed Liberia data is added.
“Nine missing after Guinea Ebola team attacked in remote southeast”
Because this couldn’t possibly be any worse or anything...
“COMMENTARY: Health workers need optimal respiratory protection for Ebola”
“Editor’s Note: Today’s commentary was submitted to CIDRAP by the authors, who are national experts on respiratory protection and infectious disease transmission. In May they published a similar commentary on MERS-CoV. Dr Brosseau is a Professor and Dr Jones an Assistant Professor in the School of Public Health, Division of Environmental and Occupational Health Sciences, at the University of Illinois at Chicago.”
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