Well, all that is pretty conclusory with no scientific information provided in support. Here is what CDC is saying about transmission.http://www.cdc.gov/vhf/ebola/transmissi ... =nocontent

In fact, what scientific support is there for their assumption that there must be repeated animal to human transmission and that Ebola is only spread by severely Ill patients. I guess since I an a vegetarian I should be fine...guessing dressed up as science...

Oh boy. Rickyp has made freeman3 and me allies. Well done.

If the CDC is so wise and all-knowing, why did they tell the second nurse to catch Ebola she could fly with a fever--and then later admit that was a mistake?

How serious is our government about Ebola? Not very. They put a political hack in as "Ebola Czar." Furthermore, he will report to the pathological liar of the Administration, Susan Rice.

I don't really care that the Ebola Czar has no medical experience. However, shouldn't he be (at least) an efficiency expert rather than a political operative? The only thing we've been told he brings to the table is "communication skills."

Great. Maybe he can talk some sense into Ebola.

freeman

In fact, what scientific support is there for their assumption that there must be repeated animal to human transmission and that Ebola is only spread by severely Ill patients

I take it this is a rejoinder to the post from the Globe and Mail...If so than I have to ask,

Do you think this guy is making stuff up? he's the author.

Richard Schabas was Ontario’s chief medical officer of health from 1987 to 1997. Neil Rau is an infectious diseases specialist and medical microbiologist in private practice in Oakville, Ont., and a University of Toronto lecture.

He says no where in the article that there must be "repeated animal to human transmission".
Only that the virus resides in animals and is occasional transmitted to humans.
In Africa, Bush Meat is the usual culprit. This is called zoonoses.

Many serious epidemic diseases are zoonoses which originated in animals. These include rabies, Ebola virus disease and influenza. In a systematic review of 1,415 pathogens known to infect humans, 61% were zoonotic.[2] The emergence of a pathogen into a new host species is called disease invasion or "disease emergence".

There's nothing in the CDC article on the epidemiology that you linked that contradicts anything Schabas claims. About the only thing that wasn;t supported was the decreased death rate.
Your claim was that the death rate for Ebola is 80%.
Perhaps then you'd be surprised to find:

It's important to remember that roughly 50 percent of the patients in the current West Africa Ebola outbreak have survived.

http://www.vox.com/2014/9/30/6875325/eb ... agnosed-us

BY the way Freeman . Schabas has hands on experience in dealing with a perceived epidemic. SARS. Here's what he said about the experience in 2103,.

until 2005, Hastings and Prince Edward counties health unit medical officer of health Dr. Richard Schabas was York Central Hospital’s chief of staff.

His take on SARS is more benign than those of his colleagues.

Health leaders in Ontario and the GTA took some effective measures during the SARS outbreaks, he said, but was critical of many of the procedures implemented.

He identified several areas of concern, including reporting the daily tally of suspected and cumulative cases, which gave the impression the disease was out of control.

Instead, limiting the count to probable cases would have given a more accurate picture, he said.

Measures that needlessly placed thousands of residents in quarantine and closed York Central Hospital, now Mackenzie Health Richmond Hill, for 20 days were “draconian”, he said.

“There was a huge amount of uncertainty and anxiety,” he said. “The key lesson to remember is how important it is to keep perspective. The problem was in only a handful of hospitals around the world. SARS never caused significant problems outside hospitals and became very easy to manage.”

The real issue was the slow assessment of the situation and speculation, he said.

Quarantines, in his opinion, were a waste of time.

The province was obsessed with infectious disease containment and not the source, he said, adding, while practical lessons were learned, the medical community missed initial indicators about the virus.

“There were clues about a pandemic in the beginning and they were ignored,” he said. “It wasn’t what we thought it would be.”

http://www.yorkregion.com/news-story/25 ... ars-later/

Fate

If the CDC is so wise and all-knowing, why did they tell the second nurse to catch Ebola she could fly with a fever

You could look this stuff up. BUt here's what was reported:

It was later confirmed that the CDC gave Vinson permission to get on the plane because she was showing no other symptoms of the virus, and her temperature didn't reach the threshold of 100.4 degrees.

"She wasn't bleeding or vomiting," Frieden said. "The level of risk around her would be extremely low, but because of the extra margin of safety, we will be contacting [all those who were on the flight].

fate

and then later admit that was a mistake?

That is a good question.
If it was safe for her to fly, and based on the way we know Ebola is transmitted, any risk to other passengers would have been very low, by not being consistent they undermined the message they were correctly communicating.
I'll guess its because someone told them it was politically expedient to do so...

And your right Fate, the Czar is BS. Just politics. Let the health care professionals manage the situation calmly, and they'll get it right. They are humans after all, and not perfect and its obvious the Dallas Hospital made some mistakes. But it the US health care system is as good as Bbauska says it is, things will be fine.

rickyp wrote:Fate

If the CDC is so wise and all-knowing, why did they tell the second nurse to catch Ebola she could fly with a fever

You could look this stuff up. BUt here's what was reported:

It was later confirmed that the CDC gave Vinson permission to get on the plane because she was showing no other symptoms of the virus, and her temperature didn't reach the threshold of 100.4 degrees.

"She wasn't bleeding or vomiting," Frieden said. "The level of risk around her would be extremely low, but because of the extra margin of safety, we will be contacting [all those who were on the flight].

Actually, I knew that. I should have been more explicit. What this shows is the arrogance with which the CDC is approaching this. She, more than anyone else, should have been quarantined. She had contact with Mr. Duncan. She called with a fever. Caution, a notably lacking characteristic of the CDC, would dictate telling her to stay home.

While it's true she did not meet the threshold, she had to go through TSA and then spend a couple of hours on a plane. It's entirely reasonable to be concerned her symptoms could worsen while on the plane. So, again . . . WHY tell her to get on the plane? Why risk the spread of the disease?

That is dumber than a box of rocks.

fate

and then later admit that was a mistake?

That is a good question.
If it was safe for her to fly, and based on the way we know Ebola is transmitted, any risk to other passengers would have been very low, by not being consistent they undermined the message they were correctly communicating.
I'll guess its because someone told them it was politically expedient to do so...

"Very low" is not "zero."

Again, these are the same morons who told us Ebola would not come to the US. They told us every hospital in America was ready. They told us if it did pop up, it would not spread.

Wrong. Wrong. Wrong.

And your right Fate, the Czar is BS. Just politics. Let the health care professionals manage the situation calmly, and they'll get it right. They are humans after all, and not perfect and its obvious the Dallas Hospital made some mistakes. But it the US health care system is as good as Bbauska says it is, things will be fine.

We'll see. So far, Abbott and Costello would be a step up.

"The driving force is new infections acquired from animals". "The large number of cases in West Africa must be the result of more human contact with affected animals". Gee, Ricky, where could I have gotten the idea that he is saying that transmission is at least significantly (if not primarily) from animals to humans so that we don't have to worry about an outbreak here (along with the fact, according to him and no one else that transmission is only from seriously ill patients). So where is your "expert" getting this stuff from? I don't know but no one else is saying this so I would think his opinions are outliers. If he is going to make such claims, you would think he would cite to some evidence or scientific study in support but, no, he cites nothing.
After that, I could care less what he said about a quarantine but again he provides us nothing to support his contention that quarantines are ineffective.

freeman3

. Gee, Ricky, where could I have gotten the idea that he is saying that transmission is at least significantly (if not primarily) from animals to humans so that we don't have to worry about an outbreak here (along with the fact, according to him and no one else that transmission is only from seriously ill patients).

He says the source of any new virus infection is animals. And it is...
If all the victims of Ebola are isolated until they are symptom free, Ebola will be gone quickly as there is no way for the virus to reserve itself in humans.
But, since Ebola is not easily transmitted, the need to isolate all contacts of Ebola victims, is not so urgent. Monitoring heir health and isolating them when they show symptoms is best.

In 2007 in Uganda, an Ebola outbreak was traced to “a couple of kids playing with fruit bats in a cave. They came home with two dead fruit bats and the mothers cooked them,” said Dr. Estrella Lasry, a tropical medicine advisor to Doctors Without Borders.

Researchers still don’t know the exact cause of this particular outbreak, but it might have to do with the local practice of eating bats for food, according to Jonathan Epstein, an epidemiologist at EcoHealth Alliance. “It's unclear whether it occurred due to butchering a bat, exposure to bat bodily fluids, or eating some food or fruit that was contaminated by saliva, urine, or feces from the bat, which may contain Ebola virus,” he said. Pig farms in Africa also often attract bats, which also may have been a cause

.

And yes he does say that transmission is by seriously ill patients and difficult. Which is what every expert I've read says...
Compared to easily transmitted viruses like flu or common colds...

A person who is severely ill with Ebola can spread the infection to other humans by close contact with blood and body fluids. This puts caregivers at risk – both in households and in resource-poor hospitals. But crucially, Ebola cannot spread efficiently between humans and cannot cause sustained human-to-human outbreaks, even to the limited extent that SARS could.

If you want to compare to an actually easily transmitted flu, look at the history of H1N1.
59 million Americans contracted the H1N1 virus, 265,000 were hospitalized as a result, and 12,000 died
And H1N1 was also a zoonoses, with its origins with pigs.
I suspect that Americans don't remember this so much, or worry so much about death from Flu as much as Ebola because Ebola is a messy death compared to the pneumonia that eventually kills flu victims... Or maybe its just because media reports aren't rationale about the relative risks?

Ebola is not H1N1 again. Its Lassa Fever... And it will be isolated and gone in the US as quickly as Lassa fever.

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...

You cannot just assume what you need to prove. You have to prove that Ebola transmission is difficult. CDC does not think that airborne transmission is possible (airborne transmission is when particles remain viable in the air for extended period whereas droplet transmission occurs when people sneeze on you.) The CDC is recommending droplet transmission precautions which means there is concern that if someone sneezes directly on to another person then that person can be infected. See CDC's current thinking on transmission. http://www.cdc.gov/vhf/ebola/transmissi ... =nocontent

What your guy does is assume that transmission is very difficult. He then struggles to adapt his facts to his unproven theory. He then decides that the only way for there to be that many cases is that the outbreak did not just start from animal to human transmission (other researchers agree with this) but takes the unwarranted assumption that there are that many cases because many of the cases must come from animal to human rather than human to human transmission. Given that we just had two nurses taking safety precautions get infected in Dallas the assumption that human to human transmission is very difficult seems ridiculous.

It is logical to assume that as viral levels rise and the illness gets worse transmission will be more likely but that does not mean that the virus cannot be transmitted before a patient gets severely ill. I have not seen any scientific evidence for the contention that transmission only occurs in severely ill patients; I don't believe it exists.

Medical professionals have a tendency to give opinions indicating they know something is true when in fact they are not certain. There are also seems to be this perceived need to calm the public, even when the facts are not clear. The problem is that there is a loss of credibility when this is done and facts come to light that contradict the certainty of these claims. Just give us the facts (which are given by the CDC but you have to go to the website, look for the science on transmission, find out the scientific community is not certain that airborne transmission is ruled out, and the CDC is recommending precautions against droplet transmission, meaning a concern about sneezing on to nearby people).

So, Ricky, go back and look at the science on transmission--it is not clear as you think. Again, a common-sense reaction to what happened in Dallas is that transmission is not that difficult, at least not nearly as difficult as you seem to think. The CDC's droplet transmission precautions also indicates that transmission is not extraordinarily difficult.

By the way, it seems questionable and inconsistent (if not outrageous) for the CDC to be on the one hand telling the public transmission is by physical contact with the bodily fluids of the infected person (and not by air) but telling health care professionals to use droplet precautions. It seems to me the CDC is reluctant to tell the public they could get Ebola by someone sneezing on them. They are telling medical professionals this. Their website is careful to say a person cannot get it in the air (meaning airborne transmission), but they don't want to tell us that a sneeze could transmit it. Just give us the facts, please.

freeman3

What your guy does is assume that transmission is very difficult. He then struggles to adapt his facts to his unproven theory

.

Good Lord. The case history of Ebola in Africa is well documented. The notion that transmission is not well understood, and that an infectious diseases specialist is working on an unfounded theory is ridiculous.The CDC abstract you post, does list some tests of airborne transmission but imnmediately criticizes their field conditions. (Monkeys fling poop...) And in summary concludes that transmisssion is difficult. (Airborne is easy ...)

The need to protect from air borne transmission isn't being followed by Medicines Sans Frontiere. And they are dealing with the genuine epidemic. I'm certain that the extra caution in the US is really just a political response to the media over reaction.... not the reality that airborne transmission is a genuine risk.

meanwhile all of Duncan's contacts have under gone their 21 day isolation periods and are Ebola free....
A few more days without a new case and Ebola is done for in the US...
Nigeria was declared Ebola free yesterday...


Freeman3

He then decides that the only way for there to be that many cases is that the outbreak did not just start from animal to human transmission (other researchers agree with this) but takes the unwarranted assumption that there are that many cases because many of the cases must come from animal to human rather than human to human transmission

I think you miusunderstand.
The reason ebola and other viruses only have "outbreaks" is because the human body is not a resevoir of the vuirus. It cannot be carried without the body reacting. And therefore when a outbreak has been beaten, the virus is gone from the populace. It re-enters only when there is another human/animal interaction that provides a new introduction.
The key is that in some animals, ebola resides without ill effect to the animal, and therefore can "incubate" ...

I did not misunderstand. Just because someone is a so-called expert does not mean they cannot spout non-sense. 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. You keep making the point that human being cannot keep the virus in them in a dormant state . This is a completely irrelevant point in an outbreak where infected people can transmit it. So his point that there must be many animal to human transmissions is a complete guess. It's completely unscientific.
Ebola transmission is not well- understood. It 's only been around for less than 40 years. They "hypothesize" that outbreaks began with an animal to human tranmission ( hypothesize-- meaning that actually has never been proven). In an Ebola outbreak in 1995
the CDC first says that 16 percent of household contacts with the 27 primary cases got Ebola. Another way to look at it is that 27 primary patients spread it to 28 family members. On average for every person who got the disease they spread it to one family member. So it's not that tough to spread it. As for the science, the CDC is heavily weighted towards their pre-existing view that it is not airborne transmission; they discounted science that weighed against it and certainly did not show any conclusive proof that Ebola is not an airborne transmitted disease. But one would think there would be a lot more cases if it were an airborne transmitted disease so their skepticism does make sense. But the idea that Ebola is a well-understood disease is ridiculous .
I note that you did not respond to the fact that the CDC recommends droplet precautions. Again, this indicates easier transmission ( not airborne but easier)
I note also that you did not provide any scientific foundation for the claim that only severely ill people can transmit the disease.

freeman

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.

freeman

n 1995
the CDC first says that 16 percent of household contacts with the 27 primary cases got Ebola. Another way to look at it is that 27 primary patients spread it to 28 family members.

in Kikwit, Democratic Republic of the Congo

What do you think the living conditions are like in the average family home in Kikwit? Running Water? Nope. Seperate bedrooms? Nope. People in close quarters, without modern plumbing or sanitation are far more likely to get Ebola than those with ...
And it doesn't have to be airborne.

freeman

As for the science, the CDC is heavily weighted towards their pre-existing view that it is not airborne transmission; they discounted science that weighed against it and certainly did not show any conclusive proof that Ebola is not an airborne transmitted disease

welll, they actually quoted the two studies that claimed there was airborne potential. even if they did note the failings of the field work.
If you can find anywhere else a scientiific or epidemological study beyond the two mentioned in the CDC, maybe that would be meaningful. But two noted but dismissed studies don't mean much.
Doctors Without Borders discount airborne transmission in their field work, and they are generally considered the hands on experts at caring for Ebola.

The difference between dealing with an ebola break out in Africa and the US is vast. Both in terms of the environment, and culture.
Here's a good read:
http://www.doctorswithoutborders.org/ne ... est-africa

I give up. Believe what you want to.