Ebola and more or less related issues.

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Ebola and more or less related issues.

Postby portia » Sun Oct 19, 2014 8:55 am

One item I hear infrequently, and wonder about, is the source of the infection. I hear that there are several diseases that originate with eating or otherwise dealing with "bush meat" esp. in Africa. Apparently, there are diseases which have more or less reached an equilibrium in the non-humans, but flare up in humans. I do not criticize anyone for eating "bush meat", but is anyone researching whether there are other diseases that can pass the human/animal barrier and how? Such diseases seem to hold unusual dangers for people (AIDS, Ebola ).

These are not the first diseases that cross the barrier (Cow Pox?), so we need to be more aware of them.
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Re: Ebola and more or less related issues.

Postby Jnyusa » Sun Oct 19, 2014 8:54 pm

Theoretically any virus can cross the species barrier. All it has to do is mutate, and viruses mutate frequently because their life-cycles are so short. Trying to remember... must have been around 1994, our university introduced AIDS awareness to our orientation classes for incoming freshman, and the infected person who spoke in my classroom had 41 identified strains of HIV living inside of him at that point. He'd been infected for about ... 5 years? ... I don't recall all the details of his story now because it was so long ago but I'll never forget the number of mutations he was carrying around because it knocked all our socks off. Anyway. Mutation is the reason why last year's flu virus was ineffective in preventing flu for something like 96% of the people who were vaccinated (including me).

The university is a little freaked about ebola, and with good cause, I think. We have a really large Liberian population in Philadelphia, mostly employed in health care, the highest risk population imaginable. There are no travel quarantines in effect. We send students to Africa on health missions, which is insane right now in my opinion. So we're holding seminars to spread information, mainly about the difficulty of transmission. But you don't have to eat bush meat to get ebola, and the fact that the university is devoting resources to information, however anodyne it may be, tells me that they do consider us to be at some degree of risk. My nightmare scenario is a nursing student fresh off a health mission vomiting hot blood in my classroom.

There's nothing we can do to stop viruses from mutating, so I don't know what we could do about species-jumping beyond what we are doing now: deal with it when it hits us. But with ebola's mortality rate, I really feel travel quarantines should be in effect.
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Re: Ebola and more or less related issues.

Postby Frelga » Mon Oct 20, 2014 1:51 pm

My fear about quarantines is that people will sneak into county with, e.g., counterfeit documents. And then it will be much harder to monitor their movement if they do get sick. I don't think we can lock this one out forever.

Ebola pushes my phobia buttons, but logically, we are seeing a vast overreaction. So far in the US we had 4 resolved cases, of which 1 ended in death and 3 in recovery. The three people that shared Mr. Duncan's apartment for days after he became symptomatic have cleared quarantine. Of the 3 patients treated at the facility with experience in highly communicable diseases, all recovered, with zero reinfections, although it is too early to be sure with the latest case.

I am more concerned about the case of meningococcal meningitis at the university here.

Edit: wait, I forgot Mr. Sacra's case. So 4 recoveries and 1 death.
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Re: Ebola and more or less related issues.

Postby Jnyusa » Mon Oct 20, 2014 7:14 pm

Frelga, yes, people who want to get in to a country and circumvent a quarantine can probably find a way to do it, and the ones who are most highly motivated to do that are the ones who suspect they are sick. The ones who would be caught by a quarantine on entry are those who are sick without suspecting it and who are basically law-abiding. 21 days is a long time, though; a lot to ask people to put up with and ungodly expensive.

We had one case of meningococcal meningitis last year; the student died. They did quarantine everyone who'd had contact with her, like, the entire floor of her dorm, classmates, profs, friends ... they all had to get vaccinated. Luckily no one else was infected, as far as the reports I read.

I don't know ... to come back to portia's question ... infections are opportunistic. If they find their way into a dense human population, as our cities and campuses are, dinner is on the house from their point of view. I'm not confident that ebola will remain confined to Africa, not just because of people traveling but also because of illegal trade in wild animals.
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Re: Ebola and more or less related issues.

Postby Frelga » Wed Oct 22, 2014 8:23 pm

Jnyusa wrote:Frelga, yes, people who want to get in to a country and circumvent a quarantine can probably find a way to do it, and the ones who are most highly motivated to do that are the ones who suspect they are sick.

In fact, that's how the Nigeria outbreak started. Eliminated now, thank goodness.

The ones who would be caught by a quarantine on entry are those who are sick without suspecting it and who are basically law-abiding. 21 days is a long time, though; a lot to ask people to put up with and ungodly expensive.

OIC. It may be a bit early to tell, but monitoring seems to be enough to prevent transmission, quarantine of people without symptoms does not seem to be necessary.

In the meantime, two more American patients were announced to be free of Ebola, as was the Spanish nurse. 1 death, 6 recoveries in the USA. The second nurse is said to be improving, too, and I sincerely hope she recovers as well.
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Re: Ebola and more or less related issues.

Postby Jnyusa » Thu Oct 23, 2014 7:58 pm

Our university announced their formal ebola policy to all faculty and students yesterday. We've stopped the missions to West Africa and are screening everyone who has been in Liberia, Sierra Leone, or Guinea during the past 21 days. Christmas travel was especially noted as something the university would be screening. There was a related article by one of our profs who is doing research on the outbreak, which said that 21 days is likely too short. I don't have the background to evaluate this, but if they're only screening and not quarantining people they might go to a longer screening period without much additional expense. In any event, I do feel safer in the upcoming winter classroom because we did have, until missions were cancelled, an unacceptably high risk population in our classrooms. I was not a happy camper over this outbreak.

No quarantines at this time. That would probably raise civil liberties issues that the uni doesn't want to deal with, and might ultimately be unnecessary.

Thanks for counting up the morbidity stats, Frelga. It could be that the historically high mortality associated with ebola is indeed because of the atrocious state of medical care in Africa and not necessarily because of the relative toxicity of the virus. If patients brought back to the US and treated here are mostly surviving, that's a very different picture from what we've seen so far. I'm guessing that early diagnosis plays a role too, which is more likely to happen now than it was from 1960-1990. I still don't want to catch it, though!
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Re: Ebola and more or less related issues.

Postby Griffon64 » Fri Oct 24, 2014 7:42 am

It could be that the historically high mortality associated with ebola is indeed because of the atrocious state of medical care in Africa and not necessarily because of the relative toxicity of the virus. If patients brought back to the US and treated here are mostly surviving, that's a very different picture from what we've seen so far. I'm guessing that early diagnosis plays a role too, which is more likely to happen now than it was from 1960-1990. I still don't want to catch it, though!

My thoughts exactly. I definitely don't want to catch it, but it does seem as if prompt, modern treatment of the illness vastly increase the odds of recovery. When the first two Westerners fell ill, there was relief that ZMapp seems to be "the only" thing that saved them ( conveniently ignoring the fact that infected Africans have been surviving this disease, albeit at low rates, all along ). Since, we've had more cases where, to my knowledge, the infected recovered without any ZMapp-type treatments.

Unless you've been there, it is hard to understand what medical care, not to mention day to day life, in Africa is like - and not in the thin first world-ish veneers that most tourists see. In the real third world. This makes it easy to read about the disease scything through African populations and become fearful that it will do the same in America. It is my belief that, although it is a dangerous disease, it is not nearly as dangerous in the first world as it is in the third. I doubt a real "outbreak" will occur in any of the first world nations. Not to say that extreme caution shouldn't be taken. It should, and health care workers falling ill is very concerning*. Likewise, anything like the missions your university has been doing, Jn, strikes me as foolhardy and should be stopped at once if they are still occurring. That is part of being cautious. But, I doubt that, with proper caution, this disease will be as devastating in the first world as it has been in the third.

It is my hope that, now that their attention is caught, the first world will render more assistance to help snuff it out at its sources, and develop vaccines and treatments if possible. Ebola was easy to ignore while it was a "those poor black Africans" problem. However, I'm cynical enough to know that the modern news-cycle will take care of any focus on Ebola soon enough. All those conservative news outlets working up a good ol' fear froth will move on to something else as soon as the infections taper off, and their constituents have been trained to follow along smoothly. Yesterday's frightful thing that will destroy America is so passe now, what is the new thing that will destroy America? Likewise, mainstream and liberal outlets will return to their hand-wringing over how the conservative newswar machines and their zombie followers who can't think for themselves are destroying the nation. And we'll go on as we have before, because humans have this strange duality where they both survive by adapting and are incapable of learning from the past.

*EDIT: In a way, it is both concerning and reassuring, actually. Concerning because we believe that health care workers know what they're doing, and if THEY fall ill, what chance do the rest of us have? But that ignores the fact that health care workers are in much more direct, constant contact with the disease than anybody else. Therefore, their odds of contracting it is vastly elevated, and we should almost expect that there would be some infections. No-one is perfect all the time. I believe I read somewhere that the nurse who fell ill touched her face with her hand while disrobing, and this is probably how she became infected. If she followed protocol, she probably would not have fallen ill.
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Re: Ebola and more or less related issues.

Postby Frelga » Fri Oct 24, 2014 8:25 am

Jn wrote:Thanks for counting up the morbidity stats, Frelga. It could be that the historically high mortality associated with ebola is indeed because of the atrocious state of medical care in Africa and not necessarily because of the relative toxicity of the virus. If patients brought back to the US and treated here are mostly surviving, that's a very different picture from what we've seen so far. I'm guessing that early diagnosis plays a role too, which is more likely to happen now than it was from 1960-1990. I still don't want to catch it, though!


As Griffy said, the quality of life and care almost certainly account for much of the mortality. Still, we have a very small sample here, thank goodness. Not enough to draw conclusions. The final score in the Nigerian outbreak was 20 cases and 8 deaths, about 40% , although their index patient was already very sick when he flew into the country. Without, BTW, infecting any other passengers.

There's also an argument that the death toll in Africa only counts the most serious cases that had to be hospitalized. In the US, the new patients were taken to the hospital the moment first symptoms occurred.

Griffy, while it is true that the West has generally ignored African problems, it is also true that until now, Ebola was simply not a major problem in the big scheme of things. It is difficult to transmit and kills quickly, so that on average each patient infects only 2 other people. While the virus was confined to remote areas, the outbreaks burned out fast. The WHO website shows that the total number of deaths in every previous outbreak since 1976 was 1, 590, out of 2,387 known cases. That's less than 45 deaths per year on the entire continent. By comparison, CDC estimates that flu kills between 3,000 and just under 49K every season in the US alone, depending on the strain.

Apologies for not posting links. It's a pain on mobile, and I have every confidence in your Google skills if you don't want to take my word. ;)

Edited because I did the math wrong.
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Re: Ebola and more or less related issues.

Postby Griffon64 » Fri Oct 24, 2014 9:07 am

Frelga wrote:Griffy, while it is true that the West has generally ignored African problems, it is also true that until now, Ebola was simply not a major problem in the big scheme of things. It is difficult to transmit and kills quickly, so that on average each patient infects only 2 other people. While the virus was confined to remote areas, the outbreaks burned out fast. The WHO website shows that the total number of deaths in every previous outbreak since 1976 was 1, 590, out of 2,387 known cases. That's less than 45 deaths per year on the entire continent. By comparison, CDC estimates that flu kills between 3,000 and just under 49K every season in the US alone, depending on the strain.


Absolutely. Even in Africa, Ebola is not a major problem in the big scheme of things. It really isn't, for precisely the reasons you mention. It doesn't easily transmit casually ( transmitting to someone actively caring for an infected person is a different issue ) and it kills pretty quickly when poorly treated. Which is why many African opinion pieces and news articles I have read are baffled at the American response. "An epidemic of fear, not Ebola, in America", one of them called it.

While I hope that this episode would improve Ebola treatment in Africa, from a pure numbers point of view, there are many other diseases that, if focused on instead, will save more lives.

Just in Africa, there are many more immediate and deadly illnesses. Cholera, for instance. It kills less than 1% of the infected if proper treatment is given. What is proper treatment? Re-hydration with electrolytes. That's all. Yet, it kills tens of thousands in Africa each year. ( 53,000 - 130,000 world-wide a year, Google tells me ). The mortality rate for untreated individuals is 50-60%. For want of something as simple, to first world eyes, as clean drinking water, and oral or IV treatment for the infected. Malaria is another terrible disease with its own sobering statistics. Those are just two examples.

And of course, the same comparison you made to the flu jumped to mind for me, too. Thousands die from influenza in the US every year, yet we do not panic and insist everybody with a fever or a relative with the flu be quarantined. In fact, some people still pride themselves on going to work sick, and few people bats an eyelid. The flu is something known, so the titillating fear of the unknown is absent and it just becomes mundane, the deaths accepted in the same way automobile accident deaths are acceptable.
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Re: Ebola and more or less related issues.

Postby Frelga » Fri Oct 24, 2014 11:02 am

Griffy, that's exactly what I meant - it was not a major problem in Africa. And as you said, there are much bigger problems there even today.

I think it's the part about bleeding from eyeballs that makes Ebola so scary.

Meanwhile, the second Texas nurse was declared virus-free today. 1 death, 7 recoveries, 1 new patient in New York.
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Re: Ebola and more or less related issues.

Postby Minardil » Fri Oct 24, 2014 12:40 pm

Why do I get the sense that those who sought to politicize Ebola, and to benefit from the fear they worked so hard to create, are feeling terribly disappointed that the "outbreak" here in the US has stubbornly refused to turn into a pandemic?
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Re: Ebola and more or less related issues.

Postby Griffon64 » Fri Oct 24, 2014 12:58 pm

Frelga - I think you're exactly right on the bleeding from the eyeballs thing.

And I'm a bit disturbed that typing in 'ebola symptoms' into Google Search brings up "ebola symptom pictures" as the second most searched for thing.
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Re: Ebola and more or less related issues.

Postby Storyteller » Fri Oct 24, 2014 1:00 pm

Minardil wrote:Why do I get the sense that those who sought to politicize Ebola, and to benefit from the fear they worked so hard to create, are feeling terribly disappointed that the "outbreak" here in the US has stubbornly refused to turn into a pandemic?

Because you're seeking to politicize Ebola.
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Re: Ebola and more or less related issues.

Postby Minardil » Fri Oct 24, 2014 1:10 pm

Storyteller wrote:
Minardil wrote:Why do I get the sense that those who sought to politicize Ebola, and to benefit from the fear they worked so hard to create, are feeling terribly disappointed that the "outbreak" here in the US has stubbornly refused to turn into a pandemic?

Because you're seeking to politicize Ebola.


Hmm, I am registering my disgust with those who have sought to politicize Ebola. I suppose that is a "political" comment which is obliquely related to Ebola, but it I'm not the one saying "Politician X isn't protecting you from Ebola. Vote for me or you'll all die". That is pretty much what some pols are saying, which I think is disgusting.
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Re: Ebola and more or less related issues.

Postby Frelga » Sun Oct 26, 2014 8:19 pm

From Scientific American, there's a good article about the realities of the epidemic in Sierra Leone. The author is a Medical Director for Adult Vaccines at Merck, who went to West Africa as part of an international effort to contain the epidemic.

The Ebola Outbreak: Hopeful News from the Front Lines

The system to control the outbreak is growing and strengthening. People are told to call a toll-free number if they have symptoms, and a patient-transport vehicle comes to ferry them to an Ebola care center, where they are tested for the virus. Those who test positive are then moved to an Ebola treatment center. The burial rituals that helped fuel the outbreak initially are now not permitted. Support tools for those who must remain at home until beds are available are being developed. Constant and fastidious attention to infection control in every one of these steps is the key to success. To be sure, there are still not nearly enough beds, lab services are inadequate, there are not enough transport vehicles, some still handle the dead as they have traditionally, and infection control is too often spotty. But efforts to address these shortcomings are vigorously underway.


It emphasizes once again that this is not a problem that is awaiting a medical miracle, although a treatment and a vaccine wold be great right about now. At the core, though, this is a problem that requires, simply, decent infrastructure, strong public health and healthcare system, and education to combat ignorance and superstition. (OK, maybe we in the US do have a cause to panic)

If there is one cause for hope, it is that the international efforts to stop the epidemic will leave the stricken countries with better ability to combat other diseases and problems that take a great toll without grabbing headlines.
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Re: Ebola and more or less related issues.

Postby Griffon64 » Mon Oct 27, 2014 8:41 am

Frelga wrote:It emphasizes once again that this is not a problem that is awaiting a medical miracle, although a treatment and a vaccine wold be great right about now. At the core, though, this is a problem that requires, simply, decent infrastructure, strong public health and healthcare system, and education to combat ignorance and superstition.

Yes to the n-th degree. Developed nations know about disease vectors and how infections work. Or, they should.

I have to agree with your postscript too. The amount of panicked fear-mongering I've seen from people who, as members of a nation with access to science and knowledge really should know better, is disheartening. If an epidemic takes hold in the US, it will be because personal freedom, to some, means that they can freely put others at risk because of assumptions based on falsehoods. *coughvaccinescough* It won't be ( shouldn't be!! ) because people do not know the ins and outs of infectious diseases, which is one of the reasons Ebola spreads in third world nations.

In the US, with its strong infrastructure and its ability to give support to the symptoms of the disease, Ebola would have a much harder time spreading, and the infected can be treated much more easily. The article states that aggressive re-hydration is one of the ways to provide the patient support - of course it is, you lose important fluids through vomiting and diarrhea. The bleeding eyeballs thing is the most sensational aspect of this disease, but don't lose sight of the fact that vomiting and diarrhea are also symptoms, and are very effective killers if improperly treated. To an American mind, you immediately think Ebola makes you bleed out and that's why you die, because you mostly read about the bleeding - that is the exceptional symptom to us, the sensational headline grabber to the media. And to an American mind, dying because of an upset stomach is not even on the charts, because we can easily treat those symptoms with oral electrolyte solutions, or an IV in dire cases, and because we have flush toilets that wash the infectious fluids away before it can contaminate others. That is not the reality in those parts of the world where this disease rages. And that is why Ebola seems to spread so quickly. It is important to understand that, with what we currently know of it, it spreads that quickly in the third world because it has transmission vectors available there that is crippled or absent in the first world.

Make no mistake, Ebola is dangerous. But it is unlikely to be as dangerous in the first world as it is in the third.
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Re: Ebola and more or less related issues.

Postby oldtoby » Mon Oct 27, 2014 7:41 pm

The amount of panicked fear-mongering I've seen from people who, as members of a nation with access to science and knowledge really should know better, is disheartening


well its mostly cause our "leaders" are all bad clones of this guy:

http://www.bing.com/videos/search?q=youtube+blazing+saddles+harrumph&FORM=VIRE1#view=detail&mid=B96CF42B0B935AC25010B96CF42B0B935AC25010
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Re: Ebola and more or less related issues.

Postby Minardil » Tue Oct 28, 2014 6:40 am

And it seems as if the Ebola pandemic that FOX was telling us was sure to sweep across the US just hasn't happened. . .
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Re: Ebola and more or less related issues.

Postby Griffon64 » Tue Oct 28, 2014 8:21 am

oldtoby wrote:well its mostly cause our "leaders" are all bad clones of this guy:

I think you're mostly right. Most politicians want to win - they don't want to solve people's problems, improve people's lives, whatever. They want to win at whatever cost it takes. And they learn that "winning" means appearing as if you "take charge" in any situation, quickly and immediately. Even if you don't know your head from your foundation in this case. Also that "winning" means you have to exploit every single thing to rip your opponents for "doing nothing" and showing that you alone can "do something". So that ends up being all they do: blow hot air, and if we're unlucky, stupid policies and decisions, all around them. It ends up playing out just like that video clip from where I'm standing. It is stupid.

Last night I was pondering this for a while, and I decided one of the reasons I loathe and deeply mistrust these "do something" politicians who will exploit every little thing - besides whatever obvious reasons there are - is that you absolutely cannot trust them to be on any other side but their own. If they think they can gain leverage and votes by destroying people ( more personally, by destroying you, even if you have supported them faithfully up to now ) they will. They don't care about people, they only care about winning.

It is beyond ugly.

Minardil wrote:And it seems as if the Ebola pandemic that FOX was telling us was sure to sweep across the US just hasn't happened. . .

I was thinking about this this morning, actually. From my understanding, Ebola's incubation period can be up to 21 days. Therefore, in all fairness, we have to say that we don't yet know whether the doctor in New York infected anyone. I don't believe he did, in part because I understand he moved about before he ran a fever and you do not become contagious until you start showing symptoms. But, we don't know yet.
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Re: Ebola and more or less related issues.

Postby Minardil » Wed Oct 29, 2014 7:33 am

Griffon64 wrote:
Minardil wrote:And it seems as if the Ebola pandemic that FOX was telling us was sure to sweep across the US just hasn't happened. . .

I was thinking about this this morning, actually. From my understanding, Ebola's incubation period can be up to 21 days. Therefore, in all fairness, we have to say that we don't yet know whether the doctor in New York infected anyone. I don't believe he did, in part because I understand he moved about before he ran a fever and you do not become contagious until you start showing symptoms. But, we don't know yet.


And Fox News continues to beat the drum of fear:


http://www.foxnews.com/health/2014/10/29/new-york-city-doctor-with-ebola-reportedly-lied-about-his-movements-in-city/

Unless this doctor was spraying his bodily fluids all over his fellow strap hangers, and vomiting into the mouths of other strollers on the High Line, I'm pretty sure that we can rule out the possibility of any wide spread infection. His FIANCE might have some cause for worry, but again, Ebola takes root in the internal organs like the spleen and liver, and then spreads to the blood and other bodily fluids, upon which the victim begins to notice that they are feeling ill. It isn't contagious as long as the victim is asymptomatic, so anything he did before his fever started etc, wouldn't spread the virus about.

So I'll agree that this doctor's behavior was appalling from a PUBLIC RELATIONS standpoint, I don't see it as a serious threat from a public health perspective.
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Re: Ebola and more or less related issues.

Postby Griffon64 » Wed Oct 29, 2014 8:01 am

This article adds facts to the fire:

http://www.cnn.com/2014/10/29/health/ebola-us-recovery/index.html?hpt=hp_t2

This may seem obvious. But sometimes it's the basics -- namely, the ability to pump ample fluids through patients with severe diarrhea and vomiting -- that can mean the difference between life and death.

"The most important care of patients with Ebola is to manage their fluids and electrolytes, to make sure that they don't get dehydrated," said Dr. Tom Frieden, director of the Centers for Disease Control and Prevention. "And that requires some meticulous attention to detail and aggressive rehydration in many cases."
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Re: Ebola and more or less related issues.

Postby Minardil » Wed Oct 29, 2014 9:56 am

I've been following Ebola for years now, since Preston's great book "The Hot Zone" came out back in the 90's.

Even so, I'm still learning about it. I heard that same bit about the importance of fluids the other day, and it was surprising to me, the description I'd had before of Ebola as a hemorrhagic fever seemed to indicate that the virus replicated so rapidly within infected cells, that the cells would burst open and be destroyed, essentially turning the victim's insides to goo. So, the successful treatment of patients with fluids and electrolytes etc wasn't something I'd expected. Good news, and hey, I always like learning something new. Also heard a description earlier today on NPR, where the doctor said that the only "real cure" for Ebola was keeping the patient alive long enough to let their own immune system kill of the virus. Seems we have the ability to do that here in the States at a fairly high rate of success. Another point which argues against the fear that we'll have a large scale epidemic with widespread fatalities.
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Re: Ebola and more or less related issues.

Postby portia » Wed Oct 29, 2014 5:33 pm

I agree that the Public Relations issue is getting s lot of play these days, but I also feel that those who are upset by this are not recalling the very low level of scientific sophistication of the US Public. Generaly, we are pancicable by illusions--especially when they are fed by some parts of the Media.
I think I would come down on Christie's side, not because his concern is supported by science, but because it takes into account people's fears, and because--since it goes beyond what is actually necessary-- it is likely to be successful.
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Re: Ebola and more or less related issues.

Postby Frelga » Wed Oct 29, 2014 8:52 pm

The problem with that policy is that it attacks the very people who are at the frontlines of fighting Ebola in Africa. So let's not discourage them, because then we will have to fight it here.
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Re: Ebola and more or less related issues.

Postby Minardil » Thu Oct 30, 2014 6:11 am

portia wrote:I agree that the Public Relations issue is getting s lot of play these days, but I also feel that those who are upset by this are not recalling the very low level of scientific sophistication of the US Public. Generaly, we are pancicable by illusions--especially when they are fed by some parts of the Media.
I think I would come down on Christie's side, not because his concern is supported by science, but because it takes into account people's fears, and because--since it goes beyond what is actually necessary-- it is likely to be successful.


Or, rather than stoke fears and terrifying the uneducated public in order to serve their own personal political goals, politicians like Gov. Christie can use their bully pulpits to INFORM the public about the REAL level of threat from Ebola, and work to develop SCIENCE BASED policies whereby government can really do things that will help medical professionals do their jobs. But hey, that's me. . .
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Re: Ebola and more or less related issues.

Postby Griffon64 » Thu Oct 30, 2014 8:06 am

Minardil wrote: I heard that same bit about the importance of fluids the other day, and it was surprising to me, the description I'd had before of Ebola as a hemorrhagic fever seemed to indicate that the virus replicated so rapidly within infected cells, that the cells would burst open and be destroyed, essentially turning the victim's insides to goo. So, the successful treatment of patients with fluids and electrolytes etc wasn't something I'd expected. Good news, and hey, I always like learning something new. Also heard a description earlier today on NPR, where the doctor said that the only "real cure" for Ebola was keeping the patient alive long enough to let their own immune system kill of the virus. Seems we have the ability to do that here in the States at a fairly high rate of success. Another point which argues against the fear that we'll have a large scale epidemic with widespread fatalities.

If I were to speculate about it, as a complete layman, I'd say perhaps maintaining hydration levels leave the cells more flexible - and thus better able to survive the rapidly increasing viral load.

Isn't the immune system fighting off the viral infection generally how we survive viral infections? Ebola would be no different, then.

Minardil wrote:Or, rather than stoke fears and terrifying the uneducated public in order to serve their own personal political goals, politicians like Gov. Christie can use their bully pulpits to INFORM the public about the REAL level of threat from Ebola, and work to develop SCIENCE BASED policies whereby government can really do things that will help medical professionals do their jobs. But hey, that's me. . .

It's me, too. I agree completely. If we decide it is OK to implement policies based on fear-mongering instead of fact, what do we do next, portia? Take into account ( some ) people's fears that black men are violent criminals? You know there are plenty of white people who view black men that way. It isn't based on fact, but should we take their low sophistication to carry more weight than the truth? I say no. I deliberately picked a strong, emotional example there because I think this kind of thinking is absolute nonsense.

The solution to the US Public's low levels of scientific sophistication isn't to cater to it. We're trying to be a first world country, not some superstitious, fearful mass.
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Re: Ebola and more or less related issues.

Postby Minardil » Thu Oct 30, 2014 8:13 am

If I were to speculate about it, as a complete layman, I'd say perhaps maintaining hydration levels leave the cells more flexible - and thus better able to survive the rapidly increasing viral load.


I suppose that's as good an explanation as any. Or maybe the real issue with Ebola is loss of fluids through hemorrhaging? And if we keep the patient well hydrated etc, the body can heal from whatever cell damage it suffers? I dunno. Either way, it makes it seem as if the disease is far more treatable than I originally thought, based on my earlier reading, which more or less indicated that infection was equal to a death sentence.


Isn't the immune system fighting off the viral infection generally how we survive viral infections? Ebola would be no different, then.


True, for the most part. There are some antiviral medications now, which are supposed to attack viral infections the same way antibiotics attack bacterial infections, but yes, human antibodies are still the only real defense against a virus.
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Re: Ebola and more or less related issues.

Postby Frelga » Thu Oct 30, 2014 9:23 am

I think fluids and enzymes can keep a patient strong enough to fight off the bug BEFORE it gets to the organs turn to goo stage. I read somewhere in passing that one of the patients survived after being put on dialysis, although conventional wisdom was that once it gets to that point, it's all over.

It also seems likely that "recovery" here means being alive and free of the virus. I don't know what lasting damage may be left.

Also, what Griffy said. Ignorant fear is a very poor guide to lawmaking.
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Re: Ebola and more or less related issues.

Postby portia » Fri Oct 31, 2014 10:34 am

Griffon64 wrote:
Minardil wrote: I heard that same bit about the importance of fluids the other day, and it was surprising to me, the description I'd had before of Ebola as a hemorrhagic fever seemed to indicate that the virus replicated so rapidly within infected cells, that the cells would burst open and be destroyed, essentially turning the victim's insides to goo. So, the successful treatment of patients with fluids and electrolytes etc wasn't something I'd expected. Good news, and hey, I always like learning something new. Also heard a description earlier today on NPR, where the doctor said that the only "real cure" for Ebola was keeping the patient alive long enough to let their own immune system kill of the virus. Seems we have the ability to do that here in the States at a fairly high rate of success. Another point which argues against the fear that we'll have a large scale epidemic with widespread fatalities.

If I were to speculate about it, as a complete layman, I'd say perhaps maintaining hydration levels leave the cells more flexible - and thus better able to survive the rapidly increasing viral load.

Isn't the immune system fighting off the viral infection generally how we survive viral infections? Ebola would be no different, then.

Minardil wrote:Or, rather than stoke fears and terrifying the uneducated public in order to serve their own personal political goals, politicians like Gov. Christie can use their bully pulpits to INFORM the public about the REAL level of threat from Ebola, and work to develop SCIENCE BASED policies whereby government can really do things that will help medical professionals do their jobs. But hey, that's me. . .

It's me, too. I agree completely. If we decide it is OK to implement policies based on fear-mongering instead of fact, what do we do next, portia? Take into account ( some ) people's fears that black men are violent criminals? You know there are plenty of white people who view black men that way. It isn't based on fact, but should we take their low sophistication to carry more weight than the truth? I say no. I deliberately picked a strong, emotional example there because I think this kind of thinking is absolute nonsense.

The solution to the US Public's low levels of scientific sophistication isn't to cater to it. We're trying to be a first world country, not some superstitious, fearful mass.


That would be a good long term goal, but one announcement from Christie will make no difference.
Will a person test negative for Ebola but, later, develop symptoms? If so, then testing negative is not any assurance that Ebola will not develop. I have heard people say that one cannot pass on Ebola if one is not negative, but I have not heard that one test that is negative is all that is necessary. How many such tests will be definite? Is it possible that a 21 day quarantine is necessary, as testing negative on day 2 or 3 will not mean that the disease cannot develop on day 18?
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Re: Ebola and more or less related issues.

Postby Minardil » Fri Oct 31, 2014 5:32 pm

One announcement? Probably not. How about we just have ALL of the announcements based on solid science rather than fear mongering demagoguery?

To answer your questions though, you are correct in your suspicion that one blood test alone can not determine whether or not a person is infected. This is because in the early stages of infection, the virus takes root in the internal organs, like the spleen, and doesn't spread to the blood until later, at which time the patient WOULD test positive. But at this time the patient would also be symptomatic, and this is the point at which they also become contagious. As long as the patient is non-symptomatic, they are not contagious, and even when they DO become symptomatic and contagious, it still isn't possible to catch the disease through casual contact, the way you get the flu.

So this nurse in Maine that is actually quite correct, scientifically speaking, when she says she does not feel that an involuntary quarantine is called for since she has both tested negative and remains asymptomatic. She isn't contagious, and poses no danger. But she is being horribly vilified by Fox and Conservative politicians because she refuses to submit to house arrest just to assuage or mollify the hysterical baseless fear that Fox and Republicans have worked to hard to create.
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