Dr Ricky you have previously testified that a 21 day quarantine is unnecessary for persons who have been exposed to the virus but who don't show any symptoms, correct?
Yes. I've quoted the authorities who state this as known fact.
"And you indicated such persons should be allowed to go into public because the risk is almost non-existent?
yes. They aren't infectious. You'll note that none of the people exposed to Michael Duncan became infected excepting two nurses. And his familiy was exposed to him in close quarters after he began vomitting and diarrea.
" And would you say that it was ok for them to work in a pre-school and work in close contact with children? Would it ok for them to work in a nursing home and work in close contact with the the elderly?"
Sure. As long as they monitor their temperature a couple of times a day and isolate themselves if they achieve a fever.
"You say that Ebola can only be transmitted when a person has symptoms, right? How is that been established scientifically?
I understand that Ebola is transmitted by bodily fluids and that Ebola only is detectable in bodily fluids when a person has symptoms, but I am asking who has done the testing to establish this
?
If i say it, its because i'm quoting medical experts.
From the new England Journal of Medicine.
Health care professionals treating patients with this illness have learned that transmission arises from contact with bodily fluids of a person who is symptomatic — that is, has a fever, vomiting, diarrhea, and malaise. We have very strong reason to believe that transmission occurs when the viral load in bodily fluids is high, on the order of millions of virions per microliter. This recognition has led to the dictum that an asymptomatic person is not contagious; field experience in West Africa has shown that conclusion to be valid. Therefore, an asymptomatic health care worker returning from treating patients with Ebola, even if he or she were infected, would not be contagious. Furthermore, we now know that fever precedes the contagious stage, allowing workers who are unknowingly infected to identify themselves before they become a threat to their community. This understanding is based on more than clinical observation: the sensitive blood polymerase-chain-reaction (PCR) test for Ebola is often negative on the day when fever or other symptoms begin and only becomes reliably positive 2 to 3 days after symptom onset. This point is supported by the fact that of the nurses caring for Thomas Eric Duncan, the man who died from Ebola virus disease in Texas in October, only those who cared for him at the end of his life, when the number of virions he was shedding was likely to be very high, became infected. Notably, Duncan's family members who were living in the same household for days as he was at the start of his illness did not become infected.
How has it been established, by rigorous scientific testing, that a person cannot be contagious until they exhibit symptoms? Is it possible that there are small amounts of Ebola in bodily fluids prior to there being any symptoms?
See above. PCR tests are very accurate.
"Is a high fever a symptom of Ebola? So a person with high fever could be infectious?f a person is voluntary quarantining we have to rely on them to take their temperature? How do we know they will do that? How do we know that if a person is starting to get symptoms they will not be in denial about and go into public, anyway?"
Someone coming from West Africa who is a medical professional would be very capable of self monitoring and would well know the benefit of early treatment of ebola. Preserving one life.
The only ebola patients in the US who came from Africa without being symptomatic already both went to hospitals to seek care. One, Michael Duncan was misdiagnosed at a privately run hospital. But even he didn't infect any of his family even though he'd reached the stage at home where he was vomitting and had diarrea.
I
t's true that a cough or sneeze could transmit Ebola
, right?
Ebola does not cause one to cough or sneeze. Before reaching the point where the disease is contagious, a person would become feverish, weak and feel very poorly. But they wouldn't be coughing or sneezing.
And it's true that Ebola virus can survive for several days outside of the body?
from cdc
Ebola is killed with hospital-grade disinfectants (such as household bleach). Ebola on dry surfaces, such as doorknobs and countertops, can survive for several hours; however, virus in body fluids (such as blood) can survive up to several days at room temperature.
Thats why, ebola spreads in places like liberia where there is poor sanitation. Where people die whilst being cared for at home, at home and where their bodies are handled for funerals.. Or the vomit and feces from a dieing person infects someone treating them.
It doesn't spread because someone who is asymptomatic sneezes in a bus. See the rest of your scenario....
So someone could catch the virus from a sneeze if the person did not cover their mouth and hit people nearby, ought? And if someone with Ebola sneezed and wiped their hand on a surface someone else could get the disease if they put their hand on the surface? But you would say it would be fine for a person exposed to Ebola to take public transportation?
Really, you're getting into the "bats could fly out of your ass " scenario here...
"Would you feel comfortable sitting next to a person on a bus who had been recently exposed to Ebola? Would you feel comfortable with your child sitting next to someone recently exposed to Ebola?"
If i knew they were feeling fine, had no fever, sure. If they were sneezing or coughing it would more likely be flu or a cold. And that could be lethal ... but you aren't worried about that are you?
"You are asking us to rely on a person who has been exposed to the virus to immediately go to an ER when they have symptoms, right? But of course they may go into public and they are unaware of symptoms? They may go into public even if they have symptoms but they are in denial about them?"
Again, most are medical workers who understand the need for early treatment. But as you've already seen, anyone who has become sick did go to the hospital.... Some went who weren't stricken with ebola but had fevers... So, human nature being what it is, i think anyone coming from west africa would seek help when they begin to feel sick.
This is about self preservation... and people like to live.
"What is the chance that a person quarantined in their home will transmit the disease to the general public? And there is a chance that said person could infect someone if they were allowed to roam freely? Given that why would public health authorities allow persons with recent exposure to go into public when Ebola is such a deadly disease? "
But its not a contagious disease until someone is really sick...
And people who are really sick with ebola aren't walking around. Its debilitating.
You can imagine all the scenarios you want, but the real life experience of doctors treating ebola is what I'll trust, and I won't worry about implausible scenarios until someone who knows how to measure PCRs tells me to...
MODE OF TRANSMISSION: In an outbreak, it is hypothesized that the first patient becomes infected as a result of contact with an infected animal Footnote 22. Person-to-person transmission occurs via close personal contact with an infected individual or their body fluids during the late stages of infection or after death Footnote 1 Footnote 2 Footnote 22 Footnote 42. Nosocomial infections can occur through contact with infected body fluids for example due to the reuse of unsterilized syringes, needles, or other medical equipment contaminated with these fluids Footnote 1 Footnote 2. Humans may be infected by handling sick or dead non-human primates and are also at risk when handling the bodies of deceased humans in preparation for funerals Footnote 2 Footnote 10 Footnote 43.
http://www.phac-aspc.gc.ca/lab-bio/res/ ... la-eng.php
29 Oct 2014, 1:55 pm 
