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Old 07-29-2014, 04:31 PM   #51
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Quote:
Originally Posted by andy View Post
I have a question: Have we ever seen a bug go "airborne"? Is the possibility totally hypothetical - or is there a precedent?

We have seen H5N1 change, but going airborne is a big leap?!
Smallpox is a variola virus and IIRC it has been documented to be transmittable via airborne infection.

While the clinical articles are enough for nightmares, Richard Preston's 'Demon in the Freezer' is a definite reason to wonder if / when ebola could develop into an airborne nightmare.




Since 1960, smallpox has been introduced into 10 European countries on 28 separate occasions. Most commonly, the index case was infected in Asia and returned to Europe by air during the period December-May. Subsequent cases have occurred mainly among persons exposed by direct, face-to-face, contact in the household or hospital. Medical and hospital personnel, patients and visitors constituted approximately half of all cases in these outbreaks.In a recent outbreak in Meschede, Federal Republic of Germany, detailed epidemiological studies have clearly indicated that 17 of the cases were infected by virus particles disseminated by air over a considerable distance within a single hospital building. Several features believed to be of importance in this unusual pattern of transmission were common to a similar outbreak in the Federal Republic of Germany in 1961 in which airborne transmission also occurred. These features include a source case with extensive rash and cough, low relative humidity in the hospital and air currents which caused rapid dissemination of the virus. While airborne transmission of this sort is rarely observed in smallpox outbreak, it is important to recognize that it may occur under certain circumstances.Proper vaccination of travellers prior to their departure from their native countries and a regular programme for vaccination of medical and hospital personnel could have prevented at least half of the cases which occurred in Europe during the past decade. Although progress in the global smallpox eradication programme has been accompanied by a decreased frequency of importations into Europe, no country should relax its vigilance until smallpox has been eliminated everywhere.

http://www.ncbi.nlm.nih.gov/pubmed/5313258

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Old 07-29-2014, 05:29 PM   #52
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Demon in the Freezer is such a fun read - not!

I'm shucking peas - are the little buggers breeding in the bowl? It just doesn't end.
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Old 07-29-2014, 06:10 PM   #53
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Could Ebola Virus Become A Threat In The U.S?



As the Ebola virus continues to spread throughout West Africa, with increasing concern among both health officials and the public alike, recent media reports about a death of a man who traveled to Lagos, Nigeria having been in an area rife with Ebola Virus, recently caught the world’s attention–and for good reason.

As we live in an interconnected world–and not just by the internet- we have to come to grips with the fact that hopping on a plane may potentially spread any virus–not just Ebola–to another country.

Thus, the importance of enforcing proper infectious screening procedures of those who plan to board an aircraft in an endemic area such as West Africa becomes critical to containing the spread of the Ebola virus. Enforcing a “Do Not Board List” would be critical to preventing any spread of such a virus.

While the Ebola virus could potentially be transported by travelers to another country by a plane ride, according to officials at the CDC, the actual chance of this developing in a serious public health risk to those living in the US is small.

One of the main reasons, officials believe, that the virus has a low public health risk is related to the conditions which would be favorable to allow spread of the virus. Poor and crowded living conditions, along with improper sanitation seem to be an important element that contribute to the spread of the virus. Such are not the living conditions, in general, throughout most modernized countries in the Western world



Ebola, comprised of 5 strains, was first identified in 1976 in the Western Democratic Congo along the Ebola river. Four of the strains can be spread to humans. The fifth resides only in primates. The fruit bat, considered a delicacy in West Africa, is typically considered a natural reservoir of the Ebola virus.

Ebola is spread directly, human-to-human, by secretions such as saliva, sweat, but also by blood and feces. It can be spread directly by a break in the skin or mucous membranes or indirectly after touching your nose, mouth or eyes after having contact with the virus. It is not transmitting by coughing or sneezing (droplet spread)- as would be the case for someone with influenza or measles.

Ebola virus, a member of the family of filoviruses, is one of the most deadly viruses known to man, owing to its ability to constantly undergo changes or mutations in its viral proteins. Symptoms begin suddenly–often with an intense headache and fatigue, sore throat and chills–followed by vomiting, and diarrhea with onset of a hemorrhagic rash in the upper roof of the mouth and the skin that appears to be blister-like. The virus attacks the immune system, releasing inflammatory mediators, which lead to collapse of the coagulation pathway, ending in massive external and internal bleeding.

While the virus incubates from 2-21 days, its important to know that only those who are symptomatic–generally after 8-9 days–having fever along with diarrhea, vomiting and potentially a hemorrhagic rash can transmit the virus to others.

As a result, if someone on a plane with active symptoms–including vomiting and diarrhea –soils a restroom, another person who is not aware could theoretically touch a contaminated area, and then acquire the virus.

That said, its important to know that the majority of those who have become infected with the Ebola virus have been primarily healthcare workers in close contact with patients as well as family members caring for sick family members. In addition, the risk of transmission from family members touching an infected corpse prior to burial represents another potential mode of transmission.

As a caveat, its also important to know that early on its course, persons with Ebola may have symptoms that are nonspecific (headache, chills fever) making identification of the virus nearly impossible. It could be easily be mistaken for other illnesses including malaria, cholera or even typhoid fever. Only many days into the illness–after the onset of profuse vomiting and diarrhea–will a patient exhibit the telltale signs of Ebola with bleeding from the mouth and nose along with rectal bleeding concurrent with shock, liver and renal failure, followed by [entity display="DIC" type="organization" subtype="company" active="true" key="dic" exchange="Tokyo" natural_id="fred/company/1218"]DIC[/entity] and fulminant cardiovascular collapse.

As a result, a heightened awareness, proper education, and a recent travel history from West Africa are vital for for healthcare providers who are on the front lines.

The public should be assured that medical providers in all US emergency departments are on high alert for persons with active symptoms and who have a concerning travel history. Prompt isolation using universal precautions, (gown, gloves, mask, eye protection) by providers is essential to preventing spread of the virus.

At this time, there is no vaccine or antiviral medication available to treat the disease. Only supportive care, with intravenous fluids, platelet and blood transfusions are available to patients. While there have been some promising experimental treatments in animal models,(monoclonal antibodies), there are no treatments that are currently available for humans.

With obvious technical issues regarding the high mutability of the virus–related to the proteins on its surface—preventing researchers from being able to produce a vaccine or viable antiviral medication, larger issues such as the danger of handling the virus (Biosafety Level 4) often have prevented more intense efforts to aggressively pursue research. With few patients having the disease and far fewer surviving, research efforts have likely been compromised.

However, one recently discovered compound, BCX 4430, reported by researchers in a paper in Nature (April, 2014), may hold promise for not only treating Ebola, but other deadly viruses such as Marburg, as well as MERS, SARS, dengue and measles.

Developed by US Army’s highly specialized biolaboratory in Fort Detrick, Maryland, the compound is a RNA dependent RNA polymerase that has shown promise in nonhuman primate models, as well as some in vitro activity against the virus in human cells. In their experiment, 18 Macaque monkeys who were exposed to the deadly Marburg virus, but then given post exposure treatment (1, 24, and 48 hrs) with BCX4430 exhibited near complete survival. 17 of the 18 treated monkeys survived based on results of the trial. There have been no human trials reported to date.








http://www.forbes.com/sites/robertgl...at-in-the-u-s/

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Old 07-29-2014, 06:21 PM   #54
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http://www.huffingtonpost.com/2014/0...n_5630878.html







By Umaru Fofana and Adam Bailes

FREETOWN, July 29 (Reuters) - The doctor leading Sierra Leone's fight against the worst Ebola outbreak on record died from the virus on Tuesday, the country's chief medical officer said.

The death of Sheik Umar Khan, who was credited with treating more than 100 patients, follows the deaths of dozens of local health workers and the infection of two American medics in neighboring Liberia, highlighting the dangers faced by staff trying to halt the disease's spread across West Africa.

---------- Post added at 11:21 PM ---------- Previous post was at 11:16 PM ----------

Public health experts have issued urgent warnings to British doctors and border officials to watch for signs of the Ebola virus arriving in the UK.

It comes after an infected man in Liberia was allowed to fly from disease-affected West African country to the major international travel hub of Lagos, Nigeria.

Experts from Public Health England (PHE) are meeting with representatives from the UK Border Agency and individual airports to make sure they are aware of the signs to look for and what to do if "the worst happens".


http://www.independent.co.uk/life-st...w-9634779.html
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Old 07-29-2014, 06:33 PM   #55
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With such a potentially long incubation period, |I'm grateful it's not transmissible until a patient breaks with symptoms. Clearly at this time especially, NOBODY leaving the known affected & possibly affected countries as well as neighbouring nations, should be allowed to board any plane going anywhere if they're showing any of the symptoms. For that matter, they shouldn't be allowed on any mode of transport heading to any other country - trains, ferries, bus...

These methods of transport, in case someone breaks with symptoms while in transit, should establish procedures in regards to how to deal with them. And get that set up quickly - a basic set if gloves, masks, disposable gown & shoe covers, etc. at the very least should be available. If at all possible, ways of distancing the sick person from others should be thought through & trialed. To whom does one communicate the info that someone sick, possibly with a HF is on board?

That needs to be done because it will happen again - someone get on a flight well & getting sick in transit.

The media is doing a good job warning people; informing them about the symptoms of Ebola. But that needs to be ramped up a bit & most especially, what to do if you or someone in your household just back from an affected area breaks with symptoms.

Back inn the spring, we had a scare in Canada with an individual returning from Guinea - think it was Guinea - with symptoms. Luckily, it proved to be 'only' malaria & just as importantly, it wasn't hidden.

Transparency is key to handling the terrifying event any case of Ebola on our shores would be.
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Old 07-29-2014, 07:11 PM   #56
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Some, maybe all, of the July info is cached on Google. Is is possible to capture it and merge it?

page 6 http://webcache.googleusercontent.co...ient=firefox-a

page 7 http://webcache.googleusercontent.co...ient=firefox-a
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Old 07-29-2014, 07:42 PM   #57
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I don't know if we can merge that into this page. That's a question for our resident database expert who is presently outside in the rain messing with something electrical. If he lives I'll have him take a look.

I'm saving each page's source, so at the very least we can cut and paste it into one post in another thread. (from #1 to end, then link to this thread)
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Old 07-29-2014, 07:49 PM   #58
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I hope there is a easy way to do it.
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Old 07-29-2014, 07:49 PM   #59
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He says to just copy and paste, it's such a small amount of info that would be the quickest way.

Working on that now.
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Old 07-29-2014, 09:28 PM   #60
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Thanx for your work in salvaging those posts - a lot me of people put a lot of effort into collecting that info& I couldn't begin to imagine finding it all again - not the articles linked to posts anyway.

I'm listening to a CNN report now - CDC has a team on the way to contact trace, as best they can, anyone Patrick Sawyer came into contact with. For those who may not be aware - CDC simply can't swan into another country - they must be asked or obtain permission to do so. Right now, we can't have enough experienced agencies on the ground with all the resources they can bring to bear.

Just considering the KNOWN scope of the outbreak, I'm of the opinion we're in for the long haul here. In all past outbreaks - this was the scenario everyone worked frantically to prevent - a widespread outbreak crossing a border or more. It was hard enough battling the illness, contact tracing, educating local populations in a small area - the nightmare was always going to be having to fight that battle on many fronts.

Opinion only here - it's going to spread throughout more of west Africa & perhaps 'hop' over a few countries to a different region. And - opinion again - it's not if but WHEN this turns up in the west.

And how might that play out? An aid worker, business person, tourist - someone is exposed & at some point in their incubation period, flies home... wherever that may be. It's easy to see how someone in a relationship could spread it to at least one other person. Or they could take ill while out with friends & infect someone else that way. A LIMITED outbreak may result, limited in terms of cases but certainly not in terms of fear among those in that community, local health care settings...

When that happens, the transmission of timely, accurate information is going to be crucial to prevent raw panic, people possibly hiding or denying symptoms & 'social manifestations'. There MUST be the right balance between providing accurate information & instructions as to what to do under various circumstances while maintaining as much privacy as possible for patient(s), family & care givers. It's a tough balance to strike.

I'm not a publicity/public perceptions type nor do I play one on TV but here's how I'd like to see it play out if a case is confirmed in a location. Make sure well known, LOCAL media people are given the point on reporting. Start by giving the news about a case & explain what is being done for that person, family & other known contacts.

Detail what arrangements are being made for care - where is this person being treated. Don't lie or be evasive - it's better out in the open. If a special ward or other setting has been designated - film it; discretely of course. SHOW the piles of PPE supplies & other needed stuff available. Explain what else is in the works should more cases emerge. Outline what other agencies are playing a role & what they're doing. Offer a schedule of regular media updates & STICK TO IT.

Give people practical advice including symptoms to watch for, how to report if you suspect you may be infected. In cities with many cultural/ethnic groups, make SURE the info gets to them in the languages with which they're most comfortable. Stress the importance of barrier care, isolation/quarantine.

Don't lie about how bad a course of disease can be - best that's out front because rumours can make it even worse than it is.

Not fun stuff to think about but I think we're at the point where we have to be realistic. We're going to see this here; the questions remaining are where & when?
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Old 07-29-2014, 10:04 PM   #61
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An interesting, brief & well laid out set of simple maps & charts giving the known total case & fatality numbers since the first outbreak, countries affected, symptoms & a few other tid bits:

http://www.cbc.ca/news2/interactives/map-ebola/
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Old 07-30-2014, 12:59 AM   #62
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Question; has there ever been an Ebola patient suffering frank symptoms who's been treated in a good European/ North American hospital? I know many years back the Germans had Marburg, but I don't know if anyone suffering Ebola has gotten everything a modern hospital in a developed nation has to offer?
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Old 07-30-2014, 08:25 AM   #63
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Some information coming ... more when confirmed source (if possible) but looks like time is running out. Did not really want to post this without saying anything so maybe worth removing this post at some point in the next 24 hours.
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Old 07-30-2014, 08:29 AM   #64
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mordan - time is running out for what?
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Old 07-30-2014, 08:38 AM   #65
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Dr. Ian Malcolm: John, the kind of control you're attempting simply is... it's not possible. If there is one thing the history of evolution has taught us it's that life will not be contained. Life breaks free, it expands to new territories and crashes through barriers, painfully, maybe even dangerously, but, uh... well, there it is.

Quote:
Body of 'African' stowaway found on US military plane prompts fears over Ebola virus containment

Jul 30, 2014 09:18 By Steve Robson

The young boy's body was found in a cargo plane which landed in Germany following stops near West African hotspots

Fears over the ability to contain the spread of the Ebola virus have been heightened after the body of a young stowaway was found hidden on a US military plane.

The Pentagon says the young boy, believed to be of African origin, was found near the wheel well of a US cargo plane which landed in Germany.

The plane which was on a routine mission in Africa and had made stops in Senegal, Mali, Chad, Tunisia and Naval Air Station Sigonella in Sicily before arriving at Ramstein.

It is believe the boy climbed aboard in Mali.
http://www.mirror.co.uk/news/world-n...litary-3933989
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Old 07-30-2014, 08:45 AM   #66
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All the info and articles I've seen have focused on the sickness itself, transmission and the very high fatality rates.

This is the first article I've seen that talks about the ongoing health issues of those that beat the odds and manage to survive the virus.

http://www.cbsnews.com/news/survivin...at-lies-ahead/
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Old 07-30-2014, 09:44 AM   #67
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Samaritan's Purse and SIM USA have ordered non-medical staff and volunteers, spouses and children to evacuate Liberia immediately

http://www.mirror.co.uk/news/world-n...#ixzz38xX5QFlE
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Old 07-30-2014, 09:56 AM   #68
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Dead Liberian official was a naturalized American citizen, with family in Minnesota.

"He could have brought Ebola here."

http://www.thedailybeast.com/article...=Cheat%20Sheet
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Old 07-30-2014, 10:06 AM   #69
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Samaritan's Purse and SIM USA have ordered non-medical staff and volunteers, spouses and children to evacuate Liberia immediately
I think we will see more of this. Rather than folks rushing in to West Africa/Nigeria to help, I suspect western organizations will do the opposite and flee, now that the outbreak is totally out of control. And that will only increase the risks of spreading the disease to the west.
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Old 07-30-2014, 10:13 AM   #70
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Acceleration: According to WHO, 108 new cases reported in West Africa between 21st and 23rd of July.

http://www.mirror.co.uk/news/world-n...#ixzz38xdxzOtV
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Old 07-30-2014, 10:49 AM   #71
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Had a really bad night & am still stumbling around all muzzy headed, needing sleep, needing food.

It was almost easier when this was just a 'filler' story - you could more easily keep up to date. Now, it's become one of the top 5 international stories but it's hard to properly sort out new information from rumour & speculation not noted as such.

Going to slap myself awake, ingest some caffeine & start looking up a few things - including if anyone has had care in a modern hospital in the west. Theoretically, that would improve their odds a bit but more importantly, would certainly make it easier to contain.
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Old 07-30-2014, 11:14 AM   #72
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Been reading up on this stuff and learn it takes 2 to 21 days for symptoms to develop after infection. It occurs to me that this would be an undetectable 'body bomb'. How long before it happens?
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Old 07-30-2014, 11:16 AM   #73
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Quote:
Originally Posted by Brihard View Post
Question; has there ever been an Ebola patient suffering frank symptoms who's been treated in a good European/ North American hospital? I know many years back the Germans had Marburg, but I don't know if anyone suffering Ebola has gotten everything a modern hospital in a developed nation has to offer?

According to the latest CDC HAN Advisory, "...While no EVD cases have been reported in the United States, a human case, caused by a related virus, Marburg virus, occurred in Denver, Colorado in 2008."

(EVD = Ebola Virus Disease)
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Old 07-30-2014, 11:29 AM   #74
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I can't find any cases of Ebola that have been evacuated to the west for treatment. If anyone, one of the Belgian nuns infected in the original Bumba zone outbreak in Zaire might have been a candidate for such a transfer - can't find anything on that though.

Be it in a hot zone or whizz bang modern hospital, treatment options are pretty limited. Clinicians try to keep a patient hydrated... if you can an IV in & keep it in without hemorrhage - great! If it's a bad enough infection & abdominal hemorrhaging has started & the gut lining starting to be destroyed... not so great. With skin sloughing off & other fun manifestations, infection control certainly helps. Not sure what you can do for any type of nutritional support - this virus attacks most of the important systems & while you're eventually no longer able to properly clot blood, various blood cells are jamming up vital organs.

I'm looking for any sort of analysis of survivors - any studies that have been done on them? Did you have better luck as a male or female, certain age group, etc. Nothing yet but I've just started.

I do know this much - a needle stick shortens incubation to between 5-7 days, contact with body fluids other than a needle stick can mean up to 21 days before breaking with symptoms - although that's rare.

Still looking...
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Old 07-30-2014, 12:01 PM   #75
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Just had a truly scary thought...

IF (or maybe when, the way this virus is going) Ebola makes its first appearance in the USA/CANADA, will anybody be able to spot it early? The initial symptoms are very similar to a flu bug, and there's been some sort of bug running around here lately-friend of mine just posted on FB about being in the doc's office, PACKED to the gills with this flu bug whose symptoms match the early symptoms of Ebola... wonder if any docs would ask about recent travel?

On another thought... Ebola might not be highly contagious, but with all the reports coming in over the past few days, something has definitely changed about the virus-it seems to be moving more easily (100+ cases in 2 days! ) wonder if maybe another vector has come into play? Longer life on surfaces, more viral load in mucus/sputum/saliva? Another mutation? From what I've gathered, Ebola is not as well understood as H1N1 (or even H5N1!)... is anyone even able to collect samples for testing, or has Ebola become "too hot" for that?

Niman's still stuck on MERS... pain that he can be at times, he could certainly provide some good timely info occasionally...

Franc (penguinzee)
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