Posted on 08/23/2014 8:04:40 AM PDT by null and void
These people sneeze on aircraft all the time..
There is a difference between Aids, Hep B, and other viruses and Ebola. First, if the patient is symptomatic (fever, sweating) there is enough viral load in the patient's sweat to infect others. Objects the patient has sweated on or which have absorbed that sweat can cause infections. It is not just a bloodborne pathogen, and in this case tears, sweat, saliva, all carry sufficient viral load to infect others. This is a Level 4 pathogen (highest biosecurity level) and requires care giver PPE precautions beyond those for Hep or even AIDS.
That those precautions are difficult to take in less wealthy nations is a function of many factors, but not the least of these is the absence of facilities and the protective equipment, and the reuse of equipment we might consider disposable may complicate clinical matters there, and may well be a factor in the high number of medical personnel infected.
While most people have been conditioned to think of 'bodily fluids' to be blood, semen, vaginal secretions, and even feces and urine, note that sweat, saliva, and even tears can carry pathologically significant viral loads with Ebola, and deposit sufficient numbers of organisms on surfaces (especially porous ones) to cause infection of people who come into contact with those surfaces should they contact the surface with an open abrasion or cut or with their hands and rub their eyes, for instance..
Most upper respiratory infections are viral, and antibiotics play little role. They give patients who demand some treatment something to do while they get better... They have absolutely nothing to do with the common cold
In fact the reverse may occasionally happen. The viral common cold may weaken the defenses enough that someone gets a bacterial pneumonia, but it is not often. The standard of care for the common cold is antibiotics because our spoiled population demands the dr treat their condition and will not leave until they have their prescription for antibiotics..... and the exhausted doc who has given the lecture 100 times and been beaten up over it every time just sighs and gives the patient the Rx.
Well joe, where I live, just like anywhere else, anti-biotics are no longer shoved in the patients hands for a simple cold. So yes, you are correct that other symptoms are likely present to initiate a anti-biotic therapy. One of those symptoms could be raspy lungs or a lot of congestion which can lead to various types of more serious lung diseases..
So that is when they prescribe them.
Even if a patient presents with what seems obvious to be the Flu, the same care standard applies if the lungs are involved..
We know now that antibiotics are not entirely harmless as they can mutate a bacteria to becoming something stronger if it survives the treatment.
What I don’t understand in the current treatment regime is the limitation by the prescribing physician to what appears to be a one week treatment when they do use them.
Medicine seems to still be in the dark ages in some respects. The standard care cannot be expected to be perfect in every case, and much of the care today stems from law suit avoidance.
I ran into a situation a couple decades ago where I could not get treated for a out of control dental infection. They kept referring me back to the dentist who had done a extraction, and she had referred me to a doctor...getting it out of her lap.
In a state of panic essentially, I went to the VA where they sent me to the dental department and some old duffer ex military doc too a look, smelled the puss, and put me on a 30 day course of anti-biotics and I can’t even recall the name but they were pretty powerful...and the situation was over in a couple weeks.
You will never catch me trying to say that the medical profession in this country is so good, that Ebola does not have a chance here. I actually think that the profession is highly flawed in a number of ways..
With Ebola, Zaire strain, medical care alone without a killer new drug, only increases the survival rate about 10 %.
That’s practically nothing...in real terms..to a observer..
So it’s not really our general medical care that makes a difference in the danger inherent in ebola. At least I don’t think it is..
I think it’s how fast we isolate a infection disease case and how fast the medical system and it’s associated hospitals respond to a outbreak.
Anyway, That is how I see the issue as it differs from that of the African standard.
Add to that the social customs and the ignorance of the general population as to infections, sanitary conditions, and how to deal with even the simplest of infections, and that combined with the carriers of the disease, keeps the stuff in Africa where it can spread in certain areas, essentially un controlled.
How they let it get this bad when they could have nipped it in the bud when they had the opportunity, is going to be a subject of much debate when this is over..
It appears that medical care people contracted the disease and subsequently spread it to other before they even knew what they were dealing with.
I think that a lot of errors in judgment were made, and then fear set in..which made matters much worse and caused people to flee, carrying the disease with them and they were not stopped.
Yup.....quarantine...20-21 days if I have it correct..or if they have the time, they can test..and then release if there are no antibodies..
Asymptomatic people who have had the opportunity to contract the disease can be more dangerous then someone who you know has it.
One would hope the government does not just take you out and shoot you as a prophylactic measure..but they could..:-)
However we have plenty of experience with quarantines, going back to the early 20th century.
I don’t agree totally with that, but I do in part.
Saliva, of course can contain blood from bleeding gums.. as can sweat in a person who is in the final stages of the disease where capillaries are breaking down and blood gets into the lymphatic system..so at that point anything from the body of the infected is infectious.
But that does not happen initially and a person who is in the final stages would not likely be travelling as I said before..at least a dozen times..
This is really a good thing in a way, to contain the spreading of the disease and it’s what they should be very aware of when they need to stop a outbreak. Everyone should be quarantined who has come into recent contact with the infected. Those with questionable contact should be held for investigation but not with the others..Of course they should use every tool at their disposal and assume contamination.
But the fact is, the observed shedding of the virus only occurs in the final stages unless there is some other reason for bleeding, such as a injury. But the viral loads are lower along with the risks in general...
None of these assumptions are written in stone. They are only good for risk assessment in a general way but you have to prepare for exceptions and known unknowns..
No risk is 0..not even if the patient has been buried under six feet of earth.
But we do have a good sense for the probable, the possible, and the improbable.
Note I did not say impossible.
Nor I. Zithromax was handed out like jellybeans at Easter locally, one course to the kid with an ear infection. It is seldom prescribed now, simply because it is generally ineffective. All the kids I knew who were given it re-lapsed. Had there been a more extended course of medication, the infections might have been eliminated. Augmentin has been more effective, for those not allergic to the Amoxycillin in it, with a more extended course.
I think that a lot of errors in judgment were made, and then fear set in..which made matters much worse and caused people to flee, carrying the disease with them and they were not stopped
On this we agree, although denial is probably as great or a greater factor in the spread of the disease as fear.
The locals in Africa are suspicious of westerners, of nontraditional practices, and funerary practices and superstitions probably account for a large number of cases--therein lies the fear.
More will die by being cordoned off in an effort to keep healthy people that way on one side of the line while condemning others on the other side. It's ugly.
But, then there are the members of the medical community who underestimated the pathology they were dealing with, those who were tired and for only a critical moment careless, and some who were simply unfortunate enough to be vomited upon, splattered with the blood or sweat of a deranged patient, most of whom are already dead.
But I don't see the greatest danger as a good healthy (still rational) fear of a pathogen that kills roughly 50% of the people who get it (so far).
It is that there are those who for whatever reason, be it economic, or the simple underestimation of pathogenic potential and the capability for communication of the disease, will not admit the possibilities in the event the disease gets in the wild on a continent where populations are far more mobile, where people contact the same surfaces others contact dozens of times daily, etc.
Not to fear the disease personally, but to understand that this is nothing to be taken lightly.
Yes, people do fly in and out of Africa daily, for work or other reasons--to all over the US.
Flight time, considering a 21 day incubation period, is plenty short enough for the disease to hitchhike around the globe.
So, simply enough, stop the flow of people in and out of the region, contain the disease. That's a start.
Denial can lead to pandemic.
Fear, of the good, healthy and rational type, leads to prevention.
You throat is part of both your G-I and respiratory tracts.
A cough or sneeze past Ebola caused bleeding smooth muscles in the throat aerosolize Ebola in the blood soaked particles propelled by that cough or sneeze. Ditto for vomit.
Yup...agree with all of that..
There are also measures that can be taken as a precausion, like the use of infrared scanners to detect body temperature at all transportations hubs..
Yes, you will scoop up some people with the flu, but these are dangerous travel times..
In the US, people with the flu are asked to remain at home by most employers. I don’t see a difference between traveling and working and I think it’s a idea that could have some helpful effects in certain international airports for both passengers and people on both ends..
Although it may appear to conflict with one’s civil rights, if it makes sense to me, it can’t be all that bad..
Yeah, yeah.....sure...not denying that...
The basis of the argument again is that someone who is hemorrhaging...(we used to call the disease a hemorrhagic fever) will be far too sick to travel and it will be patently obvious is they are shedding virus as the result of the late stage.
Their energy levels would be approaching the bottom of the tank. If they could walk at all, they would be not walking far without drug assistance like a amphetamine.
This is why these travel incidents don’t happen in the real world. They are either asymptomatic and not shedding, or they never made it to the airport.
The same “anti-stigma non-discrimination” messaging was put out by Bush’s CDC during the SARS crisis.
This is much more than an Obama problem. It’s a widespread mental illness that is killing the West, and Republicans and Democrats are both affected.
IT IS THE JOB OF THE PUBLIC HEALTH AUTHORITY TO DISCRIMINATE DURING EPIDEMICS. That is their function. That is the rationale for their existence.
Knowing the government’s high level of stupidity, it would be too much to expect them to provide quarantined people with food and water.
I will do my best, but I will not have access to my references until Tuesday.
Neither Marburg nor Ebola aerosolize easily; the only means would be mechanical. Also, these viruses do not mutate quickly. The main reason is that the filovirus family of viruses only have a single strand of genetic material that contains all 8 of their genes. Thus, they cannot trade genes with other viruses the way flu viruses trade genes. Most mutations in Ebola render it unable to "survive" or have a neutral effect! making it very slow to mutate. While we cannot say that Ebola will never be able to transmit through natural aerosols, we can be reasonably certain that it does not transmit in that fashion now.
Let me nit-pick a little here to point out that droplet transmission is NOT aerosol transmission. Many people seem to be confused on that. You can breathe a droplet or have it contact a mucous membrane or tiny break in the skin, but it does not travel beyond a few feet before falling to the ground. Aerosols are tiny, and can persist in the air for hours and travel more than a few feet.
< /nit-pick >
It’s the reflexive collective mindset that lead one AA hire to complain about designating one hard drive as a master controlling other slave drives.
No thinking involved, pure Pavlovian/Orwellian behavior infesting the system top to bottom.
Thank, and Bless, you!
Droplet transmission is not the same thing as airborne or aerosol transmission. The difference is important in the open, and at distances.
Airborne could get through the average HVAC system, droplets will not.
At closer ranges of 3-5 feet, droplets could be a problem.
Thanks for the ping!
Differences of opinion are how the truth emerges.
The CDC and medical authorities of other governments agree that Ebola virus can remain alive for "several" days outside the host in a victim's dried secretions on INERT surfaces.
http://www.msdsonline.com/resources/msds-resources/free-safety-data-sheet-index/ebola-virus.aspx
SURVIVAL OUTSIDE HOST: The virus can survive in liquid or dried material for a number of days
Then this came out:
http://www.tfmetalsreport.com/comment/423176#comment-423176
My personal take on transmission is that the ability of the virus to be transmitted is being vastly underestimated. While not strictly "airborne", it is clearly very transmissible with very few particles via mucous membranes - recall Ken Isaacs statement about the eye. Droplets, even microscopic, from respiratory or other bodily secretions (sweat, urine, blood, feces) can apparently act very effectively as agents of transmission when landing on fomites (inert surfaces like table tops, seats/chairs, clothing).It appears from the clinical observations in West Africa that the virus is exquisitely capable of being expelled onto fomites, transferring to another person (via the hands or garments) and then infecting the person through the most minute exposure to a mucous membrane like the eye or the oral mucosa or the respiratory tract.
Remember that only a very few microscopic virion particles could effectively cause an active clinical infection. This spread would then appear to be like airborne transmission while not strictly fitting that definition.
Another source then amplified this to:
http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php
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.
How long does Ebola virus in dried secretions on inert surfaces remain capable of infecting new victims BY SKIN CONTACT?
My concern here is that retail food establishments, aka grocery stories, can be contaminated by dried Ebola secretions for a period of several days. This would be horrendous, so I'd appreciate your careful thinking about this.
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