rickyp wrote:fate

It's entirely reasonable to be concerned her symptoms could worsen while on the plane.

No really. She would have to progress through the stages of ebola faster than any one ever has... And all she ever showed was a low grade fever...

Usually flu like symptoms last for 3 days before vomitting and diaherra set in...
Which is the point you'd want someone isolated...

But then again maybe the flight from Cleveland to Dallas was going to take 3 days? I've heard of Jet Blue flights like that...

Good to know you know as much as the CDC. I mean, their performance has been flawless!

In fact, they've done so well, I understand their publishing new guidelines this week--because the old ones were, um, flawless.

You write as if Ebola is static, cannot and will not change, everything that can be known about it is known, etc. That's exactly the sort of hubris that led to three cases in the US.

rickyp wrote:Good Lord. The case history of Ebola in Africa is well documented. . . .

How "well-documented" are the cases in the US? Do we know how the NBC cameraman got the disease? How specifically did the nurses in Houston get it?

meanwhile all of Duncan's contacts have under gone their 21 day isolation periods and are Ebola free.... .

Hmm, except for the two nurses, right?

fate

Do we know how the NBC cameraman got the disease?

In Liberia.

3:25 p.m. ET: Nebraska Med: 2, Ebola: 0. Physicians at Nebraska Medical Center announced Monday that Ashoka Mukpo, the Rhode Island cameraman who contracted Ebola while covering the outbreak in Liberia, could be released from the hospital’s isolation unit by the end of the week.
Mukpo has been receiving treatment for two weeks in the hospital’s isolation unit in Omaha with a combination of treatments including a blood transfusion from Dr. Kent Brantly and the same experimental drug that was administered to Thomas Eric Duncan.
Dr. Mark Rupp, who is leading Mukpo’s care team, also addressed some of the irrational fears spreading across the country about Ebola.
“Children of parents who are working in our Biocontainment Unit are being shunned. This isn’t helpful or appropriate,” Dr. Rupp said at the press briefing. He also announced that hundreds of thousands of doses of a possible Ebola vaccine might be available in the next few months.

http://www.boston.com/health/2014/10/20 ... story.html

Fate

How specifically did the nurses in Houston get it?

They cared for Duncan when he was particularly ill, and infectious... and somehow managed to contract fluids .... most likely when disrobing their protective clothing...
But what we do know

Amid the panic and fear about Ebola sweeping the US, let's be clear about one fact: as far as we know, two nurses who cared for Duncan got the virus — but no one else. Not the passengers who sat next to Duncan on his flights or touched the same surfaces as him in airports. Not the school kids and friends he met in Dallas. Not the Texas Presbyterian hospital staff who met him on his first visit, when he was misdiagnosed and sent home. Not the ambulance drivers who brought him to the hospital on his second visit, when he was vomiting with a high fever.

Most importantly, his fiance, Louise Troh, didn't catch the virus either. She shared a cramped apartment with him and several other family members while he was already contagious, and then stayed in the same contaminated space, cooped up for days in a quarantine, after Duncan was admitted to hospital.

So far, all these people have been declared virus free. And the dozens of suspected cases of Ebola across the US have turned out to be negative, except for three — Duncan and his two nurses, Amber Vinson and Nina Pham. The fact that they got sick while caring for Duncan should also remind us of the science of this virus: that fits what we know of the science of the virus, which is that people are most contagious late in the infection.

rickyp wrote:fate

Do we know how the NBC cameraman got the disease?

In Liberia.

3:25 p.m. ET: Nebraska Med: 2, Ebola: 0. Physicians at Nebraska Medical Center announced Monday that Ashoka Mukpo, the Rhode Island cameraman who contracted Ebola while covering the outbreak in Liberia, could be released from the hospital’s isolation unit by the end of the week.
Mukpo has been receiving treatment for two weeks in the hospital’s isolation unit in Omaha with a combination of treatments including a blood transfusion from Dr. Kent Brantly and the same experimental drug that was administered to Thomas Eric Duncan.
Dr. Mark Rupp, who is leading Mukpo’s care team, also addressed some of the irrational fears spreading across the country about Ebola.
“Children of parents who are working in our Biocontainment Unit are being shunned. This isn’t helpful or appropriate,” Dr. Rupp said at the press briefing. He also announced that hundreds of thousands of doses of a possible Ebola vaccine might be available in the next few months.

http://www.boston.com/health/2014/10/20 ... story.html

Great job of proving what I said! Read your post very carefully and explain IN YOUR OWN WORDS how Mr. Mukpo became ill.

You can't.

Fate

How specifically did the nurses in Houston get it?

They cared for Duncan when he was particularly ill, and infectious... and somehow managed to contract fluids .... most likely when disrobing their protective clothing...

So, again, we don't know.

But, no one should worry because we know everything about it, except how the three Americans being treated became ill, says noted expert rickyp.

A grateful nation thanks you.

rickyp wrote:fate

Do we know how the NBC cameraman got the disease?

In Liberia.

You stated where he got Ebola. The questions that have been posed to you have been concerning transmission of the virus (i.e. HOW). Your statements have not answered that. I can see why Freeman gave up.

You say it was animal transmission. I agree that there are animal vectors. However, there was not an animal vector that caused both nurses to become infected, right?

freeman

bbauska

You stated where he got Ebola. The questions that have been posed to you have been concerning transmission of the virus (i.e. HOW). Your statements have not answered that. I can see why Freeman gave up.

You say it was animal transmission. I agree that there are animal vectors. However, there was not an animal vector that caused both nurses to become infected, right?

Try rereading... I've bolded the part where I think Freeman conflated what the expert said about zoonoses and transmission of the virus.

What he is saying is that there must be repeated animal to human transmissions because human to human transmission is so difficult and there are so many cases.

He saying that when a human ebola outbreak is controlled and ended....
that there won't be another unless there is animal human contact.
That is the case with all diseases called zoonoses.

And that is well understood by experts in infectious diseases.
You are conflating the transmission of a current outbreak, with recurring outbreaks.
The first is human to human. And with ebola requires transferance of bodily fluids in some manner.

The second human to animal. And the transmission method varies according to the virus. In the case of Ebola is generally, but not conclusively considered to be eating virulent bush meat. A practice which means a recurrence of an ebola outbreak is likely only in Africa.

Try re-reading what your expert said. I've quoted it, analyzed it, cut it up into bite size pieces for you to easily digest. The hypothesis is that an outbreak starts from an animal to human transmission. That is uncontroversial. Your expert, however, decides that since he believes that human to human transmission is so difficult then the explanation for the large number of cases in West Africa is REPEATED animal to human transmission. The inference is since we don't tend to eat infected bush meat, then we don't have to worry about Ebola
However... there is no proof that his contention is correct. We will assume that the original ground zero case was animal to human transmission, but after that it could have been all human to human are almost all human to human transmission. There is no evidence to support his theory that a lot of the cases are from animal to human transmission. And then his whole theory that an outbreak is not possible in Canada goes to pieces.

I said this a number of times and then keep coming back and talking about irrelevant stuff about recurrring outbreaks or zoonoses. Where has anyone expressed the opinion here that if the current Ebola outbreak ended we would still have to worry about it cropping up again? Everyone understands that when no person is still ill, then the outbreak will be done (it can only start again by another animal to human transmission). Please provide evidence for your expert's contention that the LARGE NUMBER OF CASES IN WEST AFRICA IS DUE TO ANIMAL TO HUMAN TRANSMISSION (NOT JUST THE FIRST CASE BUT REPEATED ANIMAL TO HUMAN TRANSMISSION DUE TO EATING BUSH MEAT)

freeman3 wrote:Try re-reading what your expert said. I've quoted it, analyzed it, cut it up into bite size pieces for you to easily digest. The hypothesis is that an outbreak starts from an animal to human transmission. That is uncontroversial. Your expert, however, decides that since he believes that human to human transmission is so difficult then the explanation for the large number of cases in West Africa is REPEATED animal to human transmission. The inference is since we don't tend to eat infected bush meat, then we don't have to worry about Ebola
However... there is no proof that his contention is correct. We will assume that the original ground zero case was animal to human transmission, but after that it could have been all human to human are almost all human to human transmission. There is no evidence to support his theory that a lot of the cases are from animal to human transmission. And then his whole theory that an outbreak is not possible in Canada goes to pieces.

I said this a number of times and then keep coming back and talking about irrelevant stuff about recurrring outbreaks or zoonoses. Where has anyone expressed the opinion here that if the current Ebola outbreak ended we would still have to worry about it cropping up again? Everyone understands that when no person is still ill, then the outbreak will be done (it can only start again by another animal to human transmission). Please provide evidence for your expert's contention that the LARGE NUMBER OF CASES IN WEST AFRICA IS DUE TO ANIMAL TO HUMAN TRANSMISSION (NOT JUST THE FIRST CASE BUT REPEATED ANIMAL TO HUMAN TRANSMISSION DUE TO EATING BUSH MEAT)

I tried to help. Truly I did...

To me, it is not the disease that bothers me as much as the apparent incompetence, ad-hoc responses, and apparent laziness of Gov't in its desire to demonstrate its effectiveness in protecting us, The People. Local case in point (Mpls StarTribune for 10/23/14):

Here in the Twin Cities we have a sizable population of people from Liberia, Guinea and Sierra Leone (I'm excluding our very large Somali population, since their country is not within the infection zone). We get around 10 travelers a week from these countries. So what is the Gov't's Big Plan?

1. Local officials have asked the CDC for permission to monitor incoming travelers.

2. These travelers will get information kits with brochures and thermometers at various US Customs desks. Travelers voluntarily provide information on their destination and contact information.

3. State Health officials will receive that information and contact the travelers BY PHONE over a 21-day period, asking them if they have any symptoms and what their temp is, twice a day.They may have to call up to 30 people! But these travelers otherwise get to go their usual ways around town.

4. Dr. Tom Frieden, director the US CDC said "We have to keep up our guard".

5. A member of the Minnesota African Task Force Against Ebola noted that people may be hesitant to comply because their participation might be discovered and stigmatize their families. The Gov't says that privacy is an important part of this plan. (Maybe they's why don't bother to actually SEE these people. Don't want to make them feel insecure.)

6. Kris Ehresmann, director of infection control for the MN Dept of Health believes people will want to participate in case they get sick or threaten to infect others. "There's definitely a motivation for people to participate", she said. Of course. (May be that's why that Texas nurse took a plane trip and why those media people decided to voluntarily break their isolation to go out for burgers. Meanwhile these travelers get to live with family, travel around town, go to work, the movies, etc.

Officials keep saying people are not contagious until they show symptoms. I suppose then that if they call one of the monitored travelers on the afternoon of day 25 and that person declares symptoms after they take their temp at the Mega Mall while having lunch, then...what? Now that the CDC has admitted that the disease can be transmitted by objects/surfaces contaminated with the person's "bodily fluids", such as sweat and spit, what's the plan if somebody is infected?

7. Apparently, nothing. Well, the StarTribune's crack reporting staff couldn't be bothered to ask. What happens IF somebody gets sick in a public or private place was not mentioned. Maybe State officials don't know, themselves, or don't care about letting us know.

georgeatkins wrote:To me, it is not the disease that bothers me as much as the apparent incompetence, ad-hoc responses, and apparent laziness of Gov't in its desire to demonstrate its effectiveness in protecting us, The People. Local case in point (Mpls StarTribune for 10/23/14):

Here in the Twin Cities we have a sizable population of people from Liberia, Guinea and Sierra Leone (I'm excluding our very large Somali population, since their country is not within the infection zone). We get around 10 travelers a week from these countries. So what is the Gov't's Big Plan?

1. Local officials have asked the CDC for permission to monitor incoming travelers.

2. These travelers will get information kits with brochures and thermometers at various US Customs desks. Travelers voluntarily provide information on their destination and contact information.

3. State Health officials will receive that information and contact the travelers BY PHONE over a 21-day period, asking them if they have any symptoms and what their temp is, twice a day.They may have to call up to 30 people! But these travelers otherwise get to go their usual ways around town.

4. Dr. Tom Frieden, director the US CDC said "We have to keep up our guard".

5. A member of the Minnesota African Task Force Against Ebola noted that people may be hesitant to comply because their participation might be discovered and stigmatize their families. The Gov't says that privacy is an important part of this plan. (Maybe they's why don't bother to actually SEE these people. Don't want to make them feel insecure.)

6. Kris Ehresmann, director of infection control for the MN Dept of Health believes people will want to participate in case they get sick or threaten to infect others. "There's definitely a motivation for people to participate", she said. Of course. (May be that's why that Texas nurse took a plane trip and why those media people decided to voluntarily break their isolation to go out for burgers. Meanwhile these travelers get to live with family, travel around town, go to work, the movies, etc.

Officials keep saying people are not contagious until they show symptoms. I suppose then that if they call one of the monitored travelers on the afternoon of day 25 and that person declares symptoms after they take their temp at the Mega Mall while having lunch, then...what? Now that the CDC has admitted that the disease can be transmitted by objects/surfaces contaminated with the person's "bodily fluids", such as sweat and spit, what's the plan if somebody is infected?

7. Apparently, nothing. Well, the StarTribune's crack reporting staff couldn't be bothered to ask. What happens IF somebody gets sick in a public or private place was not mentioned. Maybe State officials don't know, themselves, or don't care about letting us know.

Great post.

As far as I can tell, the main priorities seem to be 1) containing** the virus***; 2) treating the virus.

**As long as it's done in a way that doesn't embarrass any potential carrier of the virus. Ultimately, his/her self-esteem is more important than the people he/she may infect.

***Well, the virus is the problem, not the countries it is thriving in. So, we can't restrict travel to/from those countries--that would stigmatize them and hurt their feelings. If some Americans have to get Ebola, well, we deserve it.

Yeah, we now have this extensive tracking system instead of just banning travel to those countries...
I thought this chart of Ebola's infectiousness compared to other diseases is interesting.http://www.theguardian.com/news/datablo ... s-diseases

Preface: I really doubt I'll get Ebola. I'm not stopping life.

Now, do doctors know what they're doing? Apparently not.

First, consider it is doctors and nurses who are getting this. If they know how it is communicated and are so expert in it, why are they getting sick?

Now, we read this about the NYC doctor recently returned from West Africa:

“We know that he left his apartment and so that he — self-quarantine would have meant he never left his apartment. But he did self-isolate in the sense that … he limited his contact with people and saw friends. He did leave his apartment, so I don’t want to give the impression that he was in his apartment the entire time.”

The same health commissioner went on to later note that the Ebola patient took the subway (the A train, L train, and the 1 train), went to a bowling ally, took an Uber, later went to the High Line, and “may have stopped and gone to a restaurant along the way.” He also went for a 3-mile run around the city.

I'm not buying a hazmat suit, but I don't think they know what they are doing.

Doctor Fate wrote:First, consider it is doctors and nurses who are getting this. If they know how it is communicated and are so expert in it, why are they getting sick?

Because they make mistakes, or someone else does. It's not actually that easy to be both hermetically sealed and at the same time providing medical care to an ebola patient.

danivon wrote:

Doctor Fate wrote:First, consider it is doctors and nurses who are getting this. If they know how it is communicated and are so expert in it, why are they getting sick?

Because they make mistakes, or someone else does. It's not actually that easy to be both hermetically sealed and at the same time providing medical care to an ebola patient.

So, they are making mistakes, even though their lives are potentially at risk, yet we trust that people without that training will do the right thing, etc.?

For the 300th time, I do not live in fear of Ebola. However, I do think common sense would mandate a more stringent set of restrictions than the CDC has devised.

A doctor gets back from West Africa, goes to a bar, goes bowling, etc. If this virus mutates, we're in a world of hurt.

Here's bipartisanship disagreement with Obama. http://time.com/3537755/ebola-new-york-new-jersey/

Fate

However, I do think common sense would mandate a more stringent set of restrictions than the CDC has devised.

There you go. Common sense versus evidence based science...
You might want to look stuff up, but the virus has mutated lots.

The virus amassed 50 mutations during its first month, the researchers found. They say there is no sign that any of these mutations have contributed to the unprecedented size of the outbreak by changing the characteristics of the Ebola virus — for instance, its ability to spread from person to person or to kill infected patients

.
http://www.nature.com/news/ebola-virus- ... ds-1.15777

When no one else in New York gets sick, will that cure the hysteria?
The benefits of "quarantine" are not supported by the leading infectious disease specialists anywhere. But they all agree it may impact the one thing required to end the ebola outbreak in Africa.

In the meantime, doctors and researchers say that the only way to end the outbreak is to send more health workers and supplies to affected regions, and to train Africans to diagnose, trace and treat Ebola.

The inability of politicians, the media and the populace at large to readily accept the best scientific information, but instead question it, is reflected in many other aspects of public health.
The anti-vaccination crowd has meant that whooping couch and measles are at the highest levels in 70 years.

http://www.forbes.com/sites/stevensalzb ... -70-years/

One in 4 Americans believe vaccines cause autism. With no evidence whatsoever..
http://www.fromhopetocures.org/1-in-4-a ... -children/

and lets add to that the faact that a third of Americans don't accept evolution as fact,
http://www.livescience.com/42251-politi ... elief.html

And a quarter don't believe climate change is happening..
http://www.livescience.com/42633-climat ... rises.html

Add to that a perpetually hysterical and iresponsible media and politicians seeking sheen, and what chance do public health professionals and infectious disease specialists have?