Ebola is here...Surprise...

[freeski]

Just to throw a little gasoline onto the fire. One reason the spread in Africa is somewhat containable is because of the lack of transportation infrastructure. If Ebola gets a foothold in the US, or any other developed nation for that matter, with the interstates and pretty much free travel anywhere, containment will be almost impossible. Think The Walking Dead.

One of the reasons for so much concern is the scenes you see coming from Africa are very much like you see on The Walking Dead (good episode last night). This along with the fact we really don't know how it will spread in the U.S. and it is a horrible death that will take the life of healthy people unlike the flue which for the most part is only a concern for elderly, weak. Shortski is right if someone is infected in Dallas and travels to Chicago with the 21 day incubation period you could have an explosion of cases. Madhatter is also right, why the hell was this guy allowed in the U.S. to begin with (Obama is overly sympathetic to Africa). Travel should be banned to the U.S. from W. Africa except without a permit.

[Bubba]

And now for a little perspective.

In the three countries in west Africa where Ebola is epidemic, the combined population is approximately 22 million. There are less than 10,000 people infected, according to the latest estimates, and about 50% have died. AIDS and malaria kill far more people per year than Ebola.

In the US, the flu is a far more serious problem. CDC estimates that from the 1976-1977 season to the 2006-2007 flu season, flu-associated deaths ranged from a low of about 3,000 to a high of about 49,000 people. I believe the average annual figure used in the US is an estimate of about 20,000.

Not buying it. Just because more die per year from the flu (and those must be the low resistance elderly and infants) doesn't mean Ebola is not a far greater danger.

We don't fully understand how it is transmitted, even with hazmat suits on.
The rate of fatality is scary high. 50% and up fatality rates is way above the flu. It's not about the number of deaths now.

You can go help out at an AIDS clinic with complete confidence you will not contract the disease. What's your confidence level about being the nurse for the next Ebola patient?

I think travel needs to be restricted and people traveling from affected countries must be quarantined for 3 weeks. Just taking their temperature is insufficient as they might already have the disease and just not have the fever yet. This is one nasty virus, and there should be a zero tolerance policy for this until we know more about it and have adequate training, effective therapies, and understand all the ways it is spread.

Ebola is, in the long run, a far greater danger for sure, and it needs to be stopped in its tracks as quickly as possible so that it doesn't get a foothold here or anywhere outside of Africa. But I'm also saying that other potentially deadly diseases spread with far greater speed to far greater numbers of people, and ebola's spread can be limited with the proper precautions and, if diagnosed, the proper actions are taken. Clearly that was not the case in Dallas, either with the initial patient or the nurse who has since contracted the disease.

As for immigration, we may have to go back to what used to occur at Ellis Island years ago wherein immigrants coming through were checked for disease and quarantined on the spot. Given the 21 day incubation period, we may need to resort to that again. Not sure where or how but it's a consideration for sure. In the meantime, I think the best thing we can do is move patients who are diagnosed with ebola to one of the four hospitals already set up to handle these types of cases. At least that will minimize on-site risk of contagion as we've now seen with the nurse.

[Mister Moose]

Ebola is, in the long run, a far greater danger for sure, and it needs to be stopped in its tracks as quickly as possible so that it doesn't get a foothold here or anywhere outside of Africa. But I'm also saying that other potentially deadly diseases spread with far greater speed to far greater numbers of people, and ebola's spread can be limited with the proper precautions and, if diagnosed, the proper actions are taken. Clearly that was not the case in Dallas, either with the initial patient or the nurse who has since contracted the disease.

Uh, and just exactly what was the proper precaution that wasn't followed in Dallas?

We don't know, skipping ahead to the answer.

And the other thing I have yet to hear mentioned is the "In every campaign there is some idiot that didn't get the word" factor. People screw up. You have to take mistakes into account and base your planning on that. I don't agree that "proper precautions" is a panacea for Ebola. It isn't for teen pregnancy, and we know a ton more about that than Ebola.

[Bubba]

Ebola is, in the long run, a far greater danger for sure, and it needs to be stopped in its tracks as quickly as possible so that it doesn't get a foothold here or anywhere outside of Africa. But I'm also saying that other potentially deadly diseases spread with far greater speed to far greater numbers of people, and ebola's spread can be limited with the proper precautions and, if diagnosed, the proper actions are taken. Clearly that was not the case in Dallas, either with the initial patient or the nurse who has since contracted the disease.

Uh, and just exactly what was the proper precaution that wasn't followed in Dallas?

We don't know, skipping ahead to the answer.

And the other thing I have yet to hear mentioned is the "In every campaign there is some idiot that didn't get the word" factor. People screw up. You have to take mistakes into account and base your planning on that. I don't agree that "proper precautions" is a panacea for Ebola. It isn't for teen pregnancy, and we know a ton more about that than Ebola.

Maybe precaution isn't the best word. The one they're using is protocol. There's an assumption, at least, that some error was made in removal of the contaminated protective gear. They're basing that on their knowledge of how ebola is transmitted. Could the experts be wrong. Yes, of course, but there's no evidence to show they are. Time will tell.

[steamboat1]

Sound familiar?

http://www.theaidsinstitute.org/node/259

[madhatter]

Ebola is, in the long run, a far greater danger for sure, and it needs to be stopped in its tracks as quickly as possible so that it doesn't get a foothold here or anywhere outside of Africa. But I'm also saying that other potentially deadly diseases spread with far greater speed to far greater numbers of people, and ebola's spread can be limited with the proper precautions and, if diagnosed, the proper actions are taken. Clearly that was not the case in Dallas, either with the initial patient or the nurse who has since contracted the disease.

Uh, and just exactly what was the proper precaution that wasn't followed in Dallas?

We don't know, skipping ahead to the answer.

And the other thing I have yet to hear mentioned is the "In every campaign there is some idiot that didn't get the word" factor. People screw up. You have to take mistakes into account and base your planning on that. I don't agree that "proper precautions" is a panacea for Ebola. It isn't for teen pregnancy, and we know a ton more about that than Ebola.

Maybe precaution isn't the best word. The one they're using is protocol. There's an assumption, at least, that some error was made in removal of the contaminated protective gear. They're basing that on their knowledge of how ebola is transmitted. Could the experts be wrong. Yes, of course, but there's no evidence to show they are. Time will tell.

ACTUALLY...

CIDRAP: "We Believe There Is Scientific Evidence Ebola Has The Potential To Be Airborne"

http://www.zerohedge.com/news/2014-10-1 ... e-airborne" onclick="window.open(this.href);return false;

http://www.cidrap.umn.edu/about-us" onclick="window.open(this.href);return false;


Who is CIDRAP? "The Center for Infectious Disease Research and Policy (CIDRAP; "SID-wrap") is a global leader in addressing public health preparedness and emerging infectious disease response. Founded in 2001, CIDRAP is part of the Academic Health Center at the University of Minnesota."

The full punchline from the CIDRAP report:

We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.
To summarize, for the following reasons we believe that Ebola could be an opportunistic aerosol-transmissible disease requiring adequate respiratory protection: i) Patients and procedures generate aerosols, and Ebola virus remains viable in aerosols for up to 90 minutes; ii) All sizes of aerosol particles are easily inhaled both near to and far from the patient; iii) Crowding, limited air exchange, and close interactions with patients all contribute to the probability that healthcare workers will be exposed to high concentrations of very toxic infectious aerosols; iv) Ebola targets immune response cells found in all epithelial tissues, including in the respiratory and gastrointestinal system; v) Experimental data support aerosols as a mode of disease transmission in non-human primates.


the full article is quite long. There have been other similar studies posted recently as well...

[madhatter]

Dallas Nurse Caught Ebola Because CDC Protocols Are Inadequate

http://www.zerohedge.com/news/2014-10-1 ... inadequate" onclick="window.open(this.href);return false;

A nurse in Dallas has caught Ebola even though she was wearing full protective gear.

The Centers for Disease Control says she must have broken protocol, or else she couldn’t have caught it. Maybe she did … or maybe CDC assumptions are overly-optimistic.

But the whole point of protocols for dealing with life-and-death situations is to have backup systems, redundancy and a margin of error in case something goes wrong.

In other words, if a mistake could be fatal, you don’t just hope that there’s no human error or natural accident. You build safety systems in so that – if something goes wrong – no one dies.
Safe Removal of Protective Suits

CDC head Frieden said today that removal of protective clothing is one of the easiest ways to get exposed to Ebola, if done incorrectly.

He also said that it is “not easy to do right.”

Yes …and the protocol should reflect those facts.

Specifically, the CDC protocol should require:

(1) Spraying of bleach or other disinfectant or uv light on the healhcare worker’s protective clothing before it is removed

(2) A buddy system, where an infectious disease specialist helps the healthcare worker take off their protective clothing without exposing themselves in the process

Respirators

Even the CDC now admits that Ebola can be spread if a carrier coughs or sneezes into the face of a healthcare worker.

And numerous scientists say that Ebola can be spread via aerosols created by vomit or the flushing of a toilet.

As such, CDC protocols must require frontline healthcare workers treating Ebola patients to wear respirators.
Phone Screening

Doctors should not have to guess whether patients have just come from Ebola hotzone countries like Liberia, Sierra Leone or Guinea.

Receptionists at doctor’s offices and hospitals around the country must ask the patient on the phone – before they come in – whether they’ve recently traveled there.

If the answer is yes, extra caution should be used to examine the patient … or they should be sent to specialist facilities which know how to spot and handle potential Ebola patients.

Postscript: We think a travel ban from hotzone countries should be enacted. But if we're not going to do that, let's at least have a real screening test ...
30-Minute Test

A majority of Americans support banning all flights to the United States from countries experiencing an Ebola outbreak.

Screening people at West African airports with a thermometer can’t work, and is just for show.

But Japanese scientists have developed a test which can determine if someone has Ebola within 30 minutes. And the test is cheaper than the one currently being used in West Africa.

So – if we’re going to continue to allow folks from West Africa to fly into our country – why don’t we demand that they get tested for real?

A health agency like the World Health Organization, UN or Centers for Disease Control should buy the international airports in the hotzone countries one of the Japanese testing kits.

Then all travelers should be tested while they’re waiting for their flights.

[madhatter]

WHO Warns Up To 10,000 Ebola Cases Per Week By December

http://www.zerohedge.com/news/2014-10-1 ... k-december" onclick="window.open(this.href);return false;

As The BBC reports, the WHO says it is alarmed by the number of health workers exposed to the disease and warned the epidemic threatens the "very survival" of societies and could lead to failed states. "Any sense that the great effort that's been kicked off over the last couple of months is already starting to see an impact, that would be really, really premature," Aylward said, as WHO further warned the number of new Ebola cases may jump to 10,000 a week by Dec. 1 as the deadly viral infection spreads - "the virus is still moving geographically and still escalating in capitals, and that’s what concerns me

The Ebola epidemic in west Africa is set to reach a peak of between 5,000 and 10,000 cases a week by early December – up to 10 times the current official figure – before international action is likely to reverse the rise, the World Health Organisation has predicted.

Dr Bruce Aylward, who recently took charge of the WHO’s operational response to the crisis, also warned on Tuesday not to misinterpret the official Ebola lethality numbers. The latest figures show 8,914 cases and 4,447 deaths so far, suggesting that about half the patients recover, but may only show half the real toll.

“We anticipate that the number of cases [per week] occurring by that time will be 5,000 to 10,000,” he said. “It could be higher, it could lower, but it’s going to be in that ballpark.”

[madhatter]

Second Texas Healthcare Worker Tests Positive For Ebola

http://www.zerohedge.com/node/495693" onclick="window.open(this.href);return false;

As the Texas Department of State Health reported an hour ago, just three days after the shocking announcement that the late Thomas Eric Duncan had managed to infect one nurse in the first person-to-person transmission of Ebola on US ground, a second Texas Health Presbyterian Hospital worker has been infected with the deadly virus.

From the official statement:

Second Health Care Worker Tests Positive for Ebola
News Release
Oct. 15, 2014



A second health care worker at Texas Health Presbyterian Hospital who provided care for the first Ebola patient diagnosed in the United States has tested positive for the disease.

The health care worker reported a fever Tuesday and was immediately isolated at the hospital.

Health officials have interviewed the latest patient to quickly identify any contacts or potential exposures, and those people will be monitored. The type of monitoring depends on the nature of their interactions and the potential they were exposed to the virus.

The worker was among those who took care of Thomas Eric Duncan after he was diagnosed with Ebola.

The preliminary Ebola test was run late Tuesday at the state public health laboratory in Austin, and results were received at about midnight.

Confirmatory testing on a separate specimen will be conducted by the Centers for Disease Control and Prevention in Atlanta.

Ebola is spread through direct contact with bodily fluids of a sick person or exposure to contaminated objects such as needles. People are not contagious before symptoms such as fever develop.

Surely the CDC's Tom Frieden will say this is perfectly expected: after all the CDC, which promised it would "stop Ebola in its tracks in the US" just two weeks ago, changed its tune and said to expect more cases.

As of this moment, equity futures are not happy, and certainly not transports, which after a seesaw session in which airline stocks rebounded following a deep oversold condition, are about to become even more oversold as the US public responds to increasingly unpleasant Ebola pandemic news by deciding to "just stay home this weekend."

And now we await the CDC to explain how this is all due to another breach in protocol for a disease which still is clearly not airborne.

guess they forgot the alcohol lotion eh cat puke?

[madhatter]

Nurses at Texas hospital: 'There were no protocols' about Ebola

http://edition.cnn.com/2014/10/14/healt ... ?hpt=hp_t1" onclick="window.open(this.href);return false;

"The protocols that should have been in place in Dallas were not in place, and that those protocols are not in place anywhere in the United States as far as we can tell," National Nurses United Executive Director RoseAnn DeMoro said. "We're deeply alarmed."

On the day that Thomas Eric Duncan was admitted to the hospital with possible Ebola symptoms, he was "left for several hours, not in isolation, in an area where other patients were present," union co-president Deborah Burger said.

Up to seven other patients were present in that area, the nurses said, according to the union.

At first, protective gear nurses were wearing while treating Duncan left their necks exposed.

Nurses got no "hands-on" training about using protective gear.

The nurses "feel unsupported, unprepared, lied to and deserted.

This nurse was being blamed for not following protocols that did not exist. ... The nurses in that hospital were very angry, and they decided to contact us," DeMoro said.




Yeah the USA is prepared for this ....NOT...

[madhatter]

Lethal experimental infections of rhesus monkeys by aerosolized Ebola virus.

http://www.ncbi.nlm.nih.gov/pubmed/7547435" onclick="window.open(this.href);return false;

1995 Aug;76(4):227-36.

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. The illness was clinically identical to that reported for parenteral virus inoculation, except for the occurrence of subcutaneous and venipuncture site bleeding and serosanguineous nasal discharge. Immunocytochemistry revealed cell-associated Ebola virus antigens present in airway epithelium, alveolar pneumocytes, and macrophages in the lung and pulmonary lymph nodes; extracellular antigen was present on mucosal surfaces of the nose, oropharynx and airways. Aggregates of characteristic filamentous virus were present within type I pneumocytes, macrophages, and air spaces of the lung by electron microscopy. Demonstration of fatal aerosol transmission of this virus in monkeys reinforces the importance of taking appropriate precautions to prevent its potential aerosol transmission to humans.

Pathology of experimental aerosol Zaire ebolavirus infection in rhesus macaques.

2013 May;50(3):514-29. doi: 10.1177/0300985812469636. Epub 2012 Dec 23.

http://www.ncbi.nlm.nih.gov/pubmed/23262834" onclick="window.open(this.href);return false;

There is limited knowledge of the pathogenesis of human ebolavirus infections and no reported human cases acquired by the aerosol route. There is a threat of ebolavirus as an aerosolized biological weapon, and this study evaluated the pathogenesis of aerosol infection in 18 rhesus macaques. Important and unique findings include early infection of the respiratory lymphoid tissues, early fibrin deposition in the splenic white pulp, and perivasculitis and vasculitis in superficial dermal blood vessels of haired skin with rash. Initial infection occurred in the respiratory lymphoid tissues, fibroblastic reticular cells, dendritic cells, alveolar macrophages, and blood monocytes. Virus spread to regional lymph nodes, where significant viral replication occurred. Virus secondarily infected many additional blood monocytes and spread from the respiratory tissues to multiple organs, including the liver and spleen. Viremia, increased temperature, lymphocytopenia, neutrophilia, thrombocytopenia, and increased alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase, total bilirubin, serum urea nitrogen, creatinine, and hypoalbuminemia were measurable mid to late infection. Infection progressed rapidly with whole-body destruction of lymphoid tissues, hepatic necrosis, vasculitis, hemorrhage, and extravascular fibrin accumulation. Hypothermia and thrombocytopenia were noted in late stages with the development of disseminated intravascular coagulation and shock. This study provides unprecedented insight into pathogenesis of human aerosol Zaire ebolavirus infection and suggests development of a medical countermeasure to aerosol infection will be a great challenge due to massive early infection of respiratory lymphoid tissues. Rhesus macaques may be used as a model of aerosol infection that will allow the development of lifesaving medical countermeasures under the Food and Drug Administration's animal rule.


so way the hell back in 1995 they KNEW that aerosol particles can cause infection...and now in 2014 its supposedly a surprise to the CDC and texas health officials? SURPRISE!!!! those who read ZH aren't surprised at all...

[freeski]

A second healthcare worker tests positive. You've got to be kidding me. Either there was lax control in the way the patient was handled or we do not fully understand how ebola is transmitted. With only one case in the U.S. why wasn't he transferred to one of the four hospitals set up to handle these cases. The CDC dropped the ball here.

And why was the patient sent away from the hospital with a 103 degree temp when he went to the hospital the first time after traveling from W. Africa. I would have kept him, Madhatter would have kept him. How could a doctor make the decision to send him on his marry way. Funny how we have not heard from the doctor that made that decision.

Oh well at least we have a topical Halloween costume for the kids this year.

[madhatter]

A second healthcare worker tests positive. You've got to be kidding me. Either there was lax control in the way the patient was handled or we do not fully understand how ebola is transmitted. AEROSOL see above from 1995With only one case in the U.S. why wasn't he transferred to one of the four hospitals set up to handle these cases. The CDC dropped the ball here. The CDC has said ANY major hospital in the US should be equipped to handle ebola, ya believe em? I don;t and neither do the people who work there...

And why was the patient sent away from the hospital with a 103 degree temp when he went to the hospital the first time after traveling from W. Africa. I would have kept him, Madhatter would have kept him. from entering the country...How could a doctor make the decision to send him on his marry way. Funny how we have not heard from the doctor that made that decision.

Oh well at least we have a topical Halloween costume for the kids this year.

[madhatter]

CDC Demands 132 Passengers That Flew With 2nd Ebola Patient Report For Testing

http://www.zerohedge.com/news/2014-10-1 ... rt-testing" onclick="window.open(this.href);return false;

But, but, but they said it wasn't contagious unless you came into contact with bodily fluids. According to the CDC, the 2nd health-care worker infected with Ebola traveled on Frontier Flight 1143 from Cleveland to Dallas on October 13th and are asking all 132 passengers on the flight to get tested. One question... what about the thousands of people that those 132 passengers came in contact with in the last 2 days?

NEW TEXAS EBOLA PATIENT FLEW DOMESTICALLY NIGHT BEFORE FEVER APPEARED -- CDC

Via Bloomberg,

Second health-care worker with Ebola
traveled on Frontier flight 1143 from Cleveland to Dallas on
Oct. 13, CDC says in e-mailed statement.



CDC asking 132 passengers on flight to call 1-800-CDC-INFO, plan to begin interviewing passengers about flight, monitoring those who need it



Health-care worker exhibited no signs, symptoms of illness while on flight, according to crew



Frontier Airlines Statement

“At approximately 1:00 a.m. MT on October 15, Frontier was notified by the CDC that a customer traveling on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth on Oct. 13 has since tested positive for the Ebola virus. The flight landed in Dallas/Fort Worth at 8:16 p.m. local and remained overnight at the airport having completed its flying for the day at which point the aircraft received a thorough cleaning per our normal procedures which is consistent with CDC guidelines prior to returning to service the next day. It was also cleaned again in Cleveland last night. Previously the customer had traveled from Dallas Fort Worth to Cleveland on Frontier flight 1142 on October 10.

Customer exhibited no symptoms or sign of illness while on flight 1143, according to the crew. Frontier responded immediately upon notification from the CDC by removing the aircraft from service and is working closely with CDC to identify and contact customers who may traveled on flight 1143.

Customers who may have traveled on either flight should contact CDC at 1 800 CDC-INFO.

The safety and security of our customers and employees is our primary concern. Frontier will continue to work closely with CDC and other governmental agencies to ensure proper protocols and procedures are being followed.”


yeah this is contained....

[madhatter]

Second Ebola-Infected Nurse Identified, Was Symptomatic With 99.5 Degree Fever While Flying

http://www.zerohedge.com/news/2014-10-1 ... ile-flying" onclick="window.open(this.href);return false;

Just about an hour ago, the CDC's Tom Frieden held a press conference in which he tried to diffuse the CDC's incompetence for a allowing healthcare workers who cared for the now deceased "Index Patient" Thomas Eric Duncan, to board a plane. A worker, who as was reported earlier today, was confirmed sick with the deadly virus. Still, in order to defend his agency from accusations of gross incompetence, of which it clearly is guilty, Frieden said that...

NEW PATIENT HADN'T BEEN BLEEDING OR VOMITING BEFORE FLIGHT

... Although, he promptly pushed the ball of blame back in her court adding that:

NEW PATIENT KNOWINGLY EXPOSED TO EBOLA,SHOULDNT HAVE FLOWN

But what is worse, is that as the WaPo reports the nurse had a fever of 99.5 degrees Fahrenheit before boarding a passenger jet on Monday, a day before she reported symptoms of the virus and was tested, according to public health officials. "Even though there appeared to be little risk for the other people on that flight, she should not have traveled that way, Thomas Frieden, director of the Centers for Disease Control and Prevention, said during a news conference Wednesday."

“She should not have flown on a commercial airline,” Frieden said.

The reason he said that is that since she was clearly symptomatic, she was also contagious. Which explains why the CDC is scrambling to uncover all those passengers who may have flown with her.

Furthermore, the nurse has now been identified: "The health-care worker was not identified by public health officials, but family members told Reuters and the Dallas Morning News that her name is Amber Vinson, a nurse at Texas Health Presbyterian Hospital. She was part of a team that had cared for Thomas Eric Duncan, a Liberian man who flew to Texas and was diagnosed with Ebola last month, during his hospitalization in Dallas. Duncan died last week. Nina Pham, a nurse who also cared for Duncan, was diagnosed with Ebola on Sunday."

And where it gets simply ridiculous is that not only did the nurse fly once, she flied a second time, this time from Cleveland to Texas on Monday.

Vinson, who flew from Dallas to Cleveland on Friday, flew back to Texas on Monday, a day after Pham was diagnosed. She reported a fever on Tuesday and was isolated and tested for Ebola.



Still, the fact that she boarded a commercial flight raises the question of how much the other 50 health-care workers who entered Duncan’s room could have traveled or moved around in recent days. The CDC recommends controlled movement on private flights or vehicles for people who may have been exposed to Ebola, Frieden said.


AND

It Begins: HazMat-Wearing Passenger Spotted At Airport

http://www.zerohedge.com/news/2014-10-1 ... ed-airport" onclick="window.open(this.href);return false;

Last week we hinted at what was to come as Ebola fears spread across America. Today, we get confirmation. As The Daily Caller reports, one passenger at Dulles International Airport outside Washington, D.C. is apparently not taking any chances. A female passenger dressed in a hazmat suit - complete with a full body gown, mask and gloves - was spotted Wednesday waiting for a flight at the airport.



what next?