It's here. Now. 1 in the hospital and 18 under observation including 5 school age children. In Texas? I would have expected it first in NY, Boston or LA.
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It's here. Now. 1 in the hospital and 18 under observation including 5 school age children. In Texas? I would have expected it first in NY, Boston or LA.
They are now reporting a second confirmed case associated with the first.
There is a 10,000 strong Nigerian community in Dallas and their airport is an international hub. That is a "perfect storm" situation.
That a person just returning from Nigeria (he informed them of that) was treated for flu like symptoms and returned home is criminal negligence on the part of the ER doctor.
I will bet that the entire hospital staff is in lynch mob mode!
Especially the lab!!!
They would have isolated his specimens, used hazmat suits and had specific protocols for biohazard disposal if warned. Now everyone from the phlebotomy staff, the candy striper that carried the specimens to the lab, all the techs, and the janitorial staff have to consider themselves EXPOSED.
Epidemiology 101......
Do not allow travel from areas where there is an outbreak like ebola. Too bad we have community organizers running things, whose advisers are afraid to offer a contrary view to that of the king.
That is a terrible shame, to be sure.Quote:
Originally Posted by kyratshooter
This I doubt. I have no doubt that there will be some amount of this understandable sentiment, but I'm willing to bet that much of the staff and even a flock of medical professionals form outside will line up for the chance to get first hand experience with a novel tropical infectious disease which has never (aside from a non-human-pathogenic strain seen only in a primate research facility) been seen outside of it's home continent before this outbreak, with full consideration for the importance and duty of making sure things return to that prior norm.Quote:
I will bet that the entire hospital staff is in lynch mob mode!
I am always willing to consider that I may be wrong, but this is not the first time in this very outbreak that 'not here' has slowed the response. It happened in Nigeria, and that is the first country involved which has seemed by medical protocols to have stopped it's outbreak. We are far better suited to handle this even than they and of course my prayers are with all those currently concerned.
Sorry for the rant.
Nope Canid, most hospital staff is present to help, and readily do so using the proper precautions, but do not feel compelled to have some one else needlessly sacrifice their lives.
My wife was a long term Medical professional and these kinds of things make them fighting mad!
By not being properly warned they came in direct contact with EBOLA, then quite possibly took it home to their husbands, wives and children.
This complication, like most others, could have been stopped by a physician following proper protocols. This outbreak can be directly laid at the feet of a careless MD and they are being very careful NOT to release the name.
Every medical professional in the entire world is at risk of contacting ebolavirus and any number of other infectious diseases at all times, and particularly so during any active international outbreak, full stop. You find me the medical professional who doesn't already know that and I'll recommend a change of career.
This is not to say I don't understand; I can't stand to see a potential and anticipatable crisis mismanaged either.
The article I read said he informed a nurse of his travels and he/she failed to report it. All it takes is one person too busy to not make the connection. As for hazmat suits, the CDC has been recommending to hospitals over the last month that they do NOT use them. Their position is the use of unfamiliar equipment stands a better chance of cross contamination and infection. Since ebola is not air borne the use of gown, gloves and surgical mask is sufficient. Here's an article in the Annals of Medicine that discusses precautions.
"The CDC recommends placing patients with suspected or confirmed Ebola in a single-patient room and instituting contact and droplet precautions (1). These entail donning a fluid-impermeable gown, gloves, a surgical mask, and either goggles or a face shield. If the patient has “copious” secretions, the CDC also recommends shoe and leg coverings. If an aerosol-generating procedure is planned (such as intubation or bronchoscopy), the CDC recommends wearing an N95 mask and placing the patient in a negative-pressure room. Despite this guidance, many hospitals are planning to place all patients in negative-pressure rooms at all times, to compel all personnel to wear full-body hazardous material (HazMat) suits, and to require N95 masks or powered air-purifying respirators rather than surgical masks at all times.
Hospitals' decisions to maximize precautions are understandable given the horrific mortality of this disease and reports of ongoing transmission in African hospitals. Fears among U.S. providers are undoubtedly further spurred by the dramatic footage of ambulance workers in Madrid, Spain, and Atlanta, Georgia, wearing full-body HazMat suits and personal respirators to transport infected patients. However, these excessive measures are unwarranted...
...Exceeding these recommendations may paradoxically increase risk. Introducing new and unfamiliar forms of personal protective equipment could lead to self-contamination during removal of such gear. Requiring HazMat suits and respirators will probably decrease the frequency of provider–patient contacts, inhibit providers' ability to examine patients, and curtail the use of diagnostic tests. Patients without Ebola may also inadvertently be harmed because Ebola precautions will be required for all suspected cases even though malaria and other infections are more likely in patients from West Africa presenting with fever. Using extra gear inflates patients' and caregivers' anxiety levels, increases costs, and wastes valuable resources. More insidiously, requiring precautions that exceed the CDC's recommendations fans a culture of mistrust and cynicism about our nation's public health agency."
http://annals.org/article.aspx?articleid=1899515
Here's a quick checklist for supplies if anyone is interested. We have some folks on here that are new to planning so this is more for them. The list mentions an electrolyte replacement for dehydration as the result of vomiting or diarrhea. An easy one to make and remember is 1 quart of water, a handful of molasses or honey (Just make sure it's real honey not that store bought crap) and a pinch of salt.
http://healthvermont.gov/panflu/docu...t-combined.pdf
Up to 80 people are now being watched in Texas.
http://www.bbc.com/news/world-us-canada-29462431
And some responsible information:
http://time.com/3451161/the-good-new...la-in-america/
The thing that concerns me the most is that we are just one mutation away from it becoming airborne.
http://www.dailymail.co.uk/news/arti...-airborne.html
That has always been the case, and not only for ebolavirus. One or a handful of mutations.
It it's any consolation, it has not mutated in ten years. Of course, that doesn't meant it can't or won't only that it hasn't. Infectious disease is given an R0 value (R naught). The higher the R0 the faster the disease will spread. Measles, for example, has an R0 of 17-18 meaning that if one person has measles they are likely to infect 17-18 other people and those individuals will each infect another 17-18 people and so on. The reason is measles is both transmitted by air and can be contracted before the host exhibits any symptoms.
Ebola, on the other hand, has an R0 of 1-2. It's actually pretty hard to catch requiring direct contact with a patient that is showing symptoms AND you must come in contact with the patient's body fluids such as vomit, blood or other fluids. There is actually some pretty good literature being circulated on it at the moment.
Well, the opportunity certainly exists for spread from this patient. http://www.thegatewaypundit.com/2014...his-apartment/
There's no doubt the medical team hosed the pooch on this one. I've tried to put myself in the nurse's shoes and think he made some passing comment of having been to Nigeria, the nurse being very busy and not really processing what he had just said and you tend to look for the most obvious solution instead of some far fetched thingy. Flu would have been a natural diagnosis given where he was and his symptoms. So I don't necessarily blame them for having missed him the first time around. Medical folks are just people and they are prone to mistakes just like the rest of us. Unfortunately, some mistakes in that profession lead to death. At this point, I'm pretty confident they'll get a handle on it. I hope I'm not making a mistake thinking that.
Listening to the radio this morning....
Apparently a "clean-up" team was hired to clean the place where he was staying. After doing so, they came to the sudden realization (?) that they were not qualified nor equipped to remove the hazmat from the site so they left it. I believe that people are well meaning in this, but need to realize their limitations.
They guys were apparently short a transport permit that the state issues. The article I read said they only do the cleaning but not the transporting. They found out the permit had not yet been issued so they delayed the clean up until it can be transported.
"Brad Smith of the Cleaning Guys, which was hired to sanitize the apartment, said his company is ready to go but a permit issue has stopped them from entering the home. Smith says a specialized permit, which is handled by the state government, is needed to transport this type of unprecedented hazardous waste on Texas highways. Cleaning Guys specializes in hazmat and biohazard cleaning services, but it does not transport the materials.It's unclear how long it will take to get the proper permits.
"This is a unique situation," Smith said. "Once awarded, our hazmat teams will be allowed back inside to do their jobs."
Louise told CNN's Anderson Cooper that she used bleach to clean her apartment, "but it's not clear to me how systematic the cleaning was," Cooper said. "
http://www.kwch.com/news/health/clea...-home/28383914
Well, that's a little reassuring.
What's interesting to me is how little prepared we are even when we've handled some pretty serious past events. We are missing things left and right that should have been caught and handled on the front end. One could say live and learn but in this case you might not live to learn.
Patient admitted to Howard University Hospital in DC with Ebola-LIKE symptoms. better to be safe than sorry, This patient had visited Nigeria
See, that's not so hard. Though it should be noted that Nigeria has not had active transmission of Ebola in a month.
Well you can call me a skeptic, but it almost seems like if you simply walk into the room of an ebola patient, you can get it. The nurse that just got it was trying to use the correct protocal, and still got it. I think this stuff can transfer from one to another much easier than they are willing to admit.
In a place like Dallas, it just one infected person goes to a couple of malls and touches a bunch of stuff, ebola could spread like wild fire!
They should close the borders and not let anybody fly that is from countries where people have widespread infections. And especially not let them fly here!
But they will lolligag around untill the US has widespread infections and we will all be living in a SHTF situation. I think this is already being grossly mishandled and the CDC is more worried about people panicking than really preventing wide spread infections.
I think we'll find the nurse became infected while removing the protective gown, mask and gloves. There is a specific CDC recommended procedure for disrobing after treating an ebola patient. Deviating from that protocol, even slightly, can result in infection. Even the CDC recognizes that fact and has said there will probably be additional medical staff infections. In addition, Mr. Duncan had some pretty advanced life support including intubation and kidney dialysis. Both procedures brought the nursing staff into close personal contact with saliva and blood. I don't know but one can assume he also had vomiting and/or diarrhea in the later stages since those are typical symptoms. In addition, periodic blood samples were taken to monitor electrolyte levels. The CDC is now suggesting that blood samples only be taken once per day instead of the previously recommend several times per day.
There was no issue with Duncan flying into the U.S. He was not contagious at the time. So closing the borders would be an unnecessary and economically staggering thing to do. The costs would be in the hundreds of billions of dollars. It would probably bankrupt the airline industry alone.
Science is science. You can't fake that. Ebola has an extremely low infection rate. Go back and read post 52. Literally thousands of independent health care professionals have been involved with Ebola all along. From places like Doctors Without Borders as well as other governmental agencies from other countries. China has had a military hospital in Africa for a couple of months. Far longer than the U.S. military. And remember, of the 80 folks being monitored that were in possible contact with Mr. Duncan none of them have tested positive.
You would be better off being worrying about D68 and taking precautions from it than Ebola. Internationally, Ebola is a mere radar blip compared to malaria or seasonal flu.
Ebola is a virus and as such can mutate without giving the science and medical professionals heads up.
We've seen it over and over again in other viral diseases starting with the flu.
I am going to err on the side of extreme caution and general distrust on anything "they" have to say.
That's fine and your concern of mutation is accurate. Like any good, respectable virus it has mutated. Over and over. However, it has not changed the way it is transmitted in over a decade. And distrusting anything "they" have to say is also distrusting all the independent medical personnel that have been on the front lines for years.
http://www.nature.com/news/ebola-vir...preads-1.15777
The only reason folks are up in arms over Ebola is because it makes great press. If D68 were receiving the same level of press Ebola has folks were be scared skitless. We had a family meeting yesterday and talked about D68 with relation to the grandkids. At the rate it is spreading it certain to be coming to a family near you soon. If it hasn't already.
http://www.cdc.gov/non-polio-enterov...outbreaks.html
It's beginning to get a fair amount of attention. The apparent paralytic cases should strike a bit closer to home for those who remember or have learned much about poliomyelitis, particularly given the close relation of Enterivirus D68 and poliovirus species. Of course one should keep in mind that they are about as closely related to rhinovirus group, and the predominance of the disease does seem to be respiratory in nature but if I had children - or loved ones who were not immunocompetent - I would be legitimately concerned.Quote:
Originally Posted by Rick
I'm also keeping my eye on the rising prevalence of West Nile Virus, which has become extremely common in my area and is emergent in many states recently.
Oh, believe me, I am just as concerned about D68 and we have a building full of kids. And crowds the minute we step outside.Quote:
If D68 were receiving the same level of press Ebola has folks were be scared skitless. We had a family meeting yesterday and talked about D68 with relation to the grandkids. At the rate it is spreading it certain to be coming to a family near you soon. If it hasn't already.
http://www.cdc.gov/non-polio-enterov...outbreaks.html
As far as trusting or distrusting all the independent medical personnel that have been on the front lines for years: what I really distrust is the disemination of information to the general public. Not necessarily lying, but not telling the entire truth for fear of igniting panic. So...unless one has the time to study it all as though it was for a dissertation (I don't) the only thing to do is be super-duper cautious and read between the lines when common sense dictates.
Our governor has been giving speeches that "it's highly unlikely that ebola will ever come to MA." There was a scare yesterday and they still have not confirmed the patient in Boston does not have ebola (not showing ALL the CDC symptoms.) But it's that simple, Governor. All someone has to do is get off the plane at Logan INTERNATIONAL airport and stay a week or two. It doesn't matter that there are no direct flights to Africa. Those things called "connections" ring a bell? http://www.bostonherald.com/news_opi...m_dubai_flight
Anyway, I'm not particularly fearful of this ebola. Just cautious. Always.
Now a flu that knocks me on my butt for a week. That is far more likely and would suck.
In fact, Mr. Dunkin did a connecting flight through Brussels to Washington to Dallas. Could just as easily have been Brussels to Washington to Boston.
Texas health officials say second healthcare worker at Dallas hospital tests positive for Ebola.
http://www.foxnews.com/health/2014/1...ospital-tests/
I just saw that. That's terrible.
Yep there it goes, another case nobody knew about that has been running around in public, and is infected. That virus can actually survive on a dry surface I think for 4 hours. So the nurse wipes her mouth or nose, goes to the mall, touches door handles, clothes hangers, hand rails, elevator buttons, any number of things can get touched!Quote:
Originally Posted by canid
Then little kids in the mall touch the same things and are always putting their fingers in their mouths. Now I am not a viral expert, but mathematically there are huge odds that this disease can spread like wildfire. All it is going to take is one infected contageous person to be out in public for a few days and it is going to explode!
If this stuff is so hard to get, then why have 2 nurses got it so far when they were fully gowned up. What chance does a normal person in a public environment have if they touch surfaces where an infected person has been, not much in my opinion.
I still think that stuff is far more contageous than they are saying!
I don't think you understand ebola.
Okey Dokey. You're probably right. We're all gonna die. Go back and read post 62. The CDC was very up front in saying they expected additional health care workers to test positive.
It isn't even spreading like wildfire in Africa where people take patients back home to self treat then wash the bodies after they die. It's tough to catch it. It has an infection rate of R1-2. You have to come in direct contact with an infected person's body fluids. The virus can only live outside the body in body fluids that have dried (several hours) or in liquid body fluids (several days). I doubt any nurse is going to walk around with fluids on themselves and let them dry in place or stay wet for days.
From the Federation of American Scientists:
http://fas.org/programs/ssp/bio/fact...factsheet.htmlQuote:
Delivery: Person-to-person transmission requires close contact with an infected individual or items used by an infected individual. Ebola could be intentionally transmitted by an infected individual. Currently, it is not possible to aerosolize Ebola in dry form. The possibility of transmission via aerosolized liquid droplets (such as produced by sneezing) is speculated but unconfirmed.
WebMD:
http://www.webmd.com/a-to-z-guides/e...irus-infectionQuote:
Other ways to get Ebola include touching contaminated needles or surfaces.
CNN:
Quote:
…some of the nation's top infectious disease experts worry that this deadly virus could mutate and be transmitted just by a cough or a sneeze.
Quote:
Ebola is an RNA virus, which means every time it copies itself, it makes one or two mutations. Many of those mutations mean nothing, but some of them might be able to change the way the virus behaves inside the human body. (snip)
Dr. James Le Duc, the director of the Galveston National Laboratory at the University of Texas, said the problem is that no one is keeping track of the mutations happening across West Africa, so no one really knows what the virus has become. (snip)
This from the chief of UN Ebola Mission:
http://www.telegraph.co.uk/news/worl...to-the-US.htmlQuote:
There is a ‘nightmare’ chance that the Ebola virus could become airborne if the epidemic is not brought under control fast enough, the chief of the UN’s Ebola mission has warned.
Anthony Banbury, the Secretary General’s Special Representative, said that aid workers are racing against time to bring the epidemic under control, in case the Ebola virus mutates and becomes even harder to deal with.
“The longer it moves around in human hosts in the virulent melting pot that is West Africa, the more chances increase that it could mutate,” he told the Telegraph. “It is a nightmare scenario [that it could become airborne], and unlikely, but it can’t be ruled out.”
I don't think anyone really understands ebola.Quote:
Originally Posted by canid
Okay. I give. Ya'll can worry yourself silly over it. If you want to worry about maybes, might bes, could bes, and not about what's actually happening today go ahead. Yeah, it could become transmissible person to person but it's not. An asteroid could drop a ton of gold in my back yard but I don't think that's likely either.
Well, I already feel better now that you put it in the right context for me. :smartass:Quote:
Originally Posted by Rick
Who knew...?!
Right now my greatest concern is that last month Ebola was 5,000 miles away, last week Ebola was 950 miles from my home, and this week it has been brought to within 250 miles of the house.
At that rate within two more weeks I will not be answering the door when the bell rings.
My point is you are worried about something that might happen. HIV could become airborne but it hasn't. A whole lot more folks are infected with that than Ebola and no one is worried that HIV will mutate. Now THAT would be a disaster of epic proportions. All I'm trying to do is post current information and suggest that there are other more dangerous diseases that we should be preparing for (D68).