First diagnosed case of Ebola in the U.S. *Patient dies*

BlindFaith

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Yes, and airborne is extremely unlikely.

Your example would be like saying that AIDS can evolve and spread via the air.

The ebola virus requires direct contact, fluid to tissue.

The thing that makes containment difficult, is that in its acute and infective stage, the patient sheds billions of virons through profuse perspiration, projectile emesis, and explosive diarrhea. Those in direct contact have a distinct challenge just getting out of their protective suits.

The virus is not shed until the acute phase begins. Therefore, passengers on the plane with Mr. Duncan were not at risk; similarly, we don't need to fear public exposure with unknown "carriers"

http://www.wnd.com/2014/10/ebola-victims-without-symptoms-could-still-be-contagious/

The German physicians, led by Dr. Timm H. Westhoff of the Department of Nephrology at the Carité Campus Benjamin Franklin in Berlin, noted in a virology blog published Feb. 12, 2009, that acute viral infections such as Ebola hemorrhagic fever may cause little or no clinical symptoms in a so-called “inapparent infection” yet may be contagious.

“A well-known example is poliovirus: over 90% are without infections,” Westhoff and his colleagues continued. “During an inapparent infection, sufficient virus replication occurs in the host to induce antiviral antibodies, but not enough to cause disease. Such infections are important for the spread of infection, because they are not easily detected.”

Westhoff and his colleagues then made the key point that individuals with an inapparent infection, showing no symptoms, can yet spread diseases such as polio.

“During the height of the polio epidemic in the United States, the quarantine of paralyzed patients had no effect on the spread of the disease, because 99 percent of the infected individuals had no symptoms and were leading normal lives spreading infection.”

Westhoff and his colleagues also discussed the risk of spreading Ebola by sneezing or coughing.

“An example of a classic acute infection is uncomplicated influenza,” the medical doctors noted. “Virus particles are inhaled in droplets produced by sneezing or coughing, and begin replicating in ciliated columnar epithelial cells of the respiratory tract. As new infectious virions are produced, they spread to neighboring cells.”

The point was clear: “Inapparent infections probably are important features of pathogens that are well-adapted to their hosts. They replicate sufficiently to endure the spread to new hosts, but not enough to damage the host and prevent transmission.”

Westhoff and his associates conclude: “Acute viral infections are responsible for epidemics of disease involving millions of individuals each year, such as influenza and measles. When vaccines are not available, acute infections are difficult to control – most are complete by the time the patient feels ill, and the virus has already spread to another host.”

The German physicians published in 2008 the fundamental medical research that formed the basis for their blog comments, demonstrating kidney-transplant patients could carry the norovirus infection that is common in cases of acute gastroenteritis, even if the patient was asymptomatic.

Westhoff’s 2008 study provided “the first evidence” that norovirus, typically a self-limiting disease of short duration, can cause chronic infection in renal transplant recipients,” even when there are no symptoms of acute gastroenteritis evident in the patient.

Dr. Norman M. Balog, D.O., a board-certified family doctor practicing in Silver Spring, Maryland, brought the research of the German medical team to the attention of WND as evidence that the CDC’s Frieden could not prove his assertion air travel was safe as long as a person infected with Ebola were not showing symptoms. An infected person can go as long as 21 days in an incubation period before being infected.

“Dr. Freiden is either completely uninformed of this research,” Balog explained to WND in an exclusive telephone interview, “or he is deliberately lying because he does not want to panic the general public.”


Balog pointed out that asymptomatic carriers of diseases infecting others is a phenomenon that has been widely documented in virology studies for decades.

“There’s a good potential that on any given day a person you may shake hands with will have Strep Group A Streptococcus that causes sore throats,” he pointed out. “Shaking hands you take the risk you are going to get the Streptococcus virus, even if the person you shook hands with looked perfectly well.”

Balog explained to WND much of the fundamental research on Ebola, including the conditions under which asymptomatic carriers of the disease can infect others, has yet to be conducted and reported in peer-reviewed medical journals.

“Dr. Freiden and the CDC have been reassuring the American public from the beginning of the current outbreak that we can contain and control Ebola, no problem; but the first assurances were three continents ago,” he pointed out. “Now we have Ebola in the United States and in Spain. Where is Ebola going to show up next?”

Balog was critical of the steps taken so far by the CDC to contain the Ebola outbreak.

“Ebola is spreading a lot faster than anybody expected,” he said.

“But even today we are not stopping people from West Africa from boarding international air flights; health officials in Dallas did not put up a fence around Duncan’s apartment complex; and it took several days before Dallas health authorities found anyone qualified to clean up the vomit outside Duncan’s apartment. And then the workers just washed the vomit down into the town storm drains.”

Balog pointed out the medical literature on virology commonly says asymptomatic but infected individuals can spread a disease to others before showing any signs of being sick.

“We have medical models that say a person is capable of secreting a virus like Ebola in bodily fluids before the person displays symptoms of the disease,” he stressed, “and that medical evidence is simply being ignored by Dr. Frieden and the CDC when the public is told repeatedly it’s OK to let Ebola-infected people fly as long as they don’t have a fever.”
 

Doc50

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Hey Doc I have a question about the nurse who contracted it. You mention the protective gear, when she takes it off I assume there is a chronological routine in the undress of it, is that where the protocol was broken?
I haven't read up on any of it but there is also procedures for equipment etc. but my first thought was how she took off her protection would be the most likely way.

There was an interesting demonstration on one of the news channels last night.

A person gowned, gloved, and masked, and then placed gloved hands in chocolate or some other dark substance. The individual then systematically and carefully removed said protective gear, trying (of course) to prevent contamination. Unfortunately contact occurred on the skin of the forearm and neck.

This illustrates just how difficult it is to avoid contamination, even when fully protected.
 

BlindFaith

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There was an interesting demonstration on one of the news channels last night.

A person gowned, gloved, and masked, and then placed gloved hands in chocolate or some other dark substance. The individual then systematically and carefully removed said protective gear, trying (of course) to prevent contamination. Unfortunately contact occurred on the skin of the forearm and neck.

This illustrates just how difficult it is to avoid contamination, even when fully protected.

So why isn't it mandatory for a full body wash in bleach PRIOR to taking off the PPE?

  • Recommended PPE should be worn by HCP upon entry into patient rooms or care areas. Upon exit from the patient room or care area, PPE should be carefully removed without contaminating one’s eyes, mucous membranes, or clothing with potentially infectious materials, and either
    • Discarded, or
    • For re-useable PPE, cleaned and disinfected according to the manufacturer's reprocessing instructions and hospital policies.
  • Instructions for donning and removing PPE have been published
  • Hand hygiene should be performed immediately after removal of PPE

And here is the process to follow:
http://www.theverge.com/2014/10/13/6970529/ebola-prevention-removing-protective-gear-isnt-easy

I'm no expert, but its obvious to see how someone could get contaminated.
 

Doc50

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http://www.wnd.com/2014/10/ebola-victims-without-symptoms-could-still-be-contagious/

The German physicians, led by Dr. Timm H. Westhoff of the Department of Nephrology at the Carité Campus Benjamin Franklin in Berlin, noted in a virology blog published Feb. 12, 2009, that acute viral infections such as Ebola hemorrhagic fever may cause little or no clinical symptoms in a so-called “inapparent infection” yet may be contagious.

“A well-known example is poliovirus: over 90% are without infections,” Westhoff and his colleagues continued. “During an inapparent infection, sufficient virus replication occurs in the host to induce antiviral antibodies, but not enough to cause disease. Such infections are important for the spread of infection, because they are not easily detected.”

Westhoff and his colleagues then made the key point that individuals with an inapparent infection, showing no symptoms, can yet spread diseases such as polio.

“During the height of the polio epidemic in the United States, the quarantine of paralyzed patients had no effect on the spread of the disease, because 99 percent of the infected individuals had no symptoms and were leading normal lives spreading infection.”

Westhoff and his colleagues also discussed the risk of spreading Ebola by sneezing or coughing.

“An example of a classic acute infection is uncomplicated influenza,” the medical doctors noted. “Virus particles are inhaled in droplets produced by sneezing or coughing, and begin replicating in ciliated columnar epithelial cells of the respiratory tract. As new infectious virions are produced, they spread to neighboring cells.”

The point was clear: “Inapparent infections probably are important features of pathogens that are well-adapted to their hosts. They replicate sufficiently to endure the spread to new hosts, but not enough to damage the host and prevent transmission.”

Westhoff and his associates conclude: “Acute viral infections are responsible for epidemics of disease involving millions of individuals each year, such as influenza and measles. When vaccines are not available, acute infections are difficult to control – most are complete by the time the patient feels ill, and the virus has already spread to another host.”

The German physicians published in 2008 the fundamental medical research that formed the basis for their blog comments, demonstrating kidney-transplant patients could carry the norovirus infection that is common in cases of acute gastroenteritis, even if the patient was asymptomatic.

Westhoff’s 2008 study provided “the first evidence” that norovirus, typically a self-limiting disease of short duration, can cause chronic infection in renal transplant recipients,” even when there are no symptoms of acute gastroenteritis evident in the patient.

Dr. Norman M. Balog, D.O., a board-certified family doctor practicing in Silver Spring, Maryland, brought the research of the German medical team to the attention of WND as evidence that the CDC’s Frieden could not prove his assertion air travel was safe as long as a person infected with Ebola were not showing symptoms. An infected person can go as long as 21 days in an incubation period before being infected.

“Dr. Freiden is either completely uninformed of this research,” Balog explained to WND in an exclusive telephone interview, “or he is deliberately lying because he does not want to panic the general public.”


Balog pointed out that asymptomatic carriers of diseases infecting others is a phenomenon that has been widely documented in virology studies for decades.

“There’s a good potential that on any given day a person you may shake hands with will have Strep Group A Streptococcus that causes sore throats,” he pointed out. “Shaking hands you take the risk you are going to get the Streptococcus virus, even if the person you shook hands with looked perfectly well.”

Balog explained to WND much of the fundamental research on Ebola, including the conditions under which asymptomatic carriers of the disease can infect others, has yet to be conducted and reported in peer-reviewed medical journals.

“Dr. Freiden and the CDC have been reassuring the American public from the beginning of the current outbreak that we can contain and control Ebola, no problem; but the first assurances were three continents ago,” he pointed out. “Now we have Ebola in the United States and in Spain. Where is Ebola going to show up next?”

Balog was critical of the steps taken so far by the CDC to contain the Ebola outbreak.

“Ebola is spreading a lot faster than anybody expected,” he said.

“But even today we are not stopping people from West Africa from boarding international air flights; health officials in Dallas did not put up a fence around Duncan’s apartment complex; and it took several days before Dallas health authorities found anyone qualified to clean up the vomit outside Duncan’s apartment. And then the workers just washed the vomit down into the town storm drains.”

Balog pointed out the medical literature on virology commonly says asymptomatic but infected individuals can spread a disease to others before showing any signs of being sick.

“We have medical models that say a person is capable of secreting a virus like Ebola in bodily fluids before the person displays symptoms of the disease,” he stressed, “and that medical evidence is simply being ignored by Dr. Frieden and the CDC when the public is told repeatedly it’s OK to let Ebola-infected people fly as long as they don’t have a fever.”

The definition of "contagious" should be revisited.

For the purposes of public health, a non-acute patient who is incubating the virus has only small amounts, many of which are not virulent, and could most likely only be transmitted in direct blood to blood contact, such as sticking one's self with the needle that was just used draw blood from the patient. While contagion is present, it is difficult to transmit in this case.

To further elicit the relative risk of non-airborne infections, I have some personal input from one of the world's foremost epidemiologists, Dr Nathan Wolfe. I attended his lecture on pandemics back in April, and talked with him for a bit afterwards. He is founder and CEO of Global Viral research institute, and has spent his entire career studying deadly viruses. His training has been at Stanford and Harvard, and he is currently a professor at Stanford, and has taught at Johns Hopkins. He's spent 10 years living in SE Asia and sub-Saharan Africa, just doing research.

His discussion of pandemics and public danger was centered around the several deadly strains of influenza virus. You may not know that these have become more difficult to vaccinate against, due to their mutation into variant strains, and that they have caused millions of deaths worldwide.
You may have heard of the pandemic of 1918, upon which approximately 30% of the world's population was afflicted, and approximately 50 million died. Even though medical care is much better 100 years later, the new virus strains are just as elusive. So, this represents the greatest worldwide risk.

I specifically asked and talked with Dr. Wolfe about Avian Flu and Ebola. He assured me that these have been thoroughly studied, and that their contagion could be controlled much more easily, while of course being deadly nonetheless. The problem with local spread in western Africa is their poor hygiene and medical system; there have been grossly inadequate quarantine procedures and lack of education and access to treatment.
 

BlindFaith

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A person that interacted with Duncan is now showing symptoms of Ebola. This is not public knowledge at the moment.

This person spent time working at a day care after interacting with Duncan. My girlfriend is close friends with a women who also spent time helping at the day care. Needless to say, they are very concerned at the moment.
 

Doc50

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A person that interacted with Duncan is now showing symptoms of Ebola. This is not public knowledge at the moment.

This person spent time working at a day care after interacting with Duncan. My girlfriend is close friends with a women who also spent time helping at the day care. Needless to say, they are very concerned at the moment.

Tested negative.
 

burmafrd

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alarmists are always with us like the tinfoil hat types. Ebola is a 3rd world disease; very dangerous there but not particularly in a MODERN country.
 

Doomsday101

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alarmists are always with us like the tinfoil hat types. Ebola is a 3rd world disease; very dangerous there but not particularly in a MODERN country.

as of yet, never was in the US before and now it is. Duncan died from it, the nurse treating him has it and now another has it. I don't believe in creating panic I also do not think acting like this is no big deal is smart. There is no know cure and mortality rate is high. No doubt I would rather be treated in the US than a hell holes like Sierra Leone, Liberia and Guinea.
 

CashMan

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alarmists are always with us like the tinfoil hat types. Ebola is a 3rd world disease; very dangerous there but not particularly in a MODERN country.

I 100% agree, but 2 posters on this board, told me I was crazy when I said that.

A blind man kept posting articles that said "Might" or "Maybe", and a Counting man told me, "3rd world" was an incorrect term.

Hmmm.....


A nurse contracts it, in Texas, and then we find out, they were not taking it serious. I hope the nurse lives, and they take it serious now.
 

CashMan

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as of yet, never was in the US before and now it is. Duncan died from it, the nurse treating him has it and now another has it. I don't believe in creating panic I also do not think acting like this is no big deal is smart. There is no know cure and mortality rate is high. No doubt I would rather be treated in the US than a hell holes like Sierra Leone, Liberia and Guinea.

I am pretty sure, that Hospital sent him home, after he told them he had multiple symptoms.
 

Doomsday101

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I 100% agree, but 2 posters on this board, told me I was crazy when I said that.

A blind man kept posting articles that said "Might" or "Maybe", and a Counting man told me, "3rd world" was an incorrect term.

Hmmm.....


A nurse contracts it, in Texas, and then we find out, they were not taking it serious. I hope the nurse lives, and they take it serious now.

To me that is the concerning issue, mistakes being made that could lead to a more serious issue for all. I think being going into a panic state is a waste of energy but I do think there should be healthy concern for a virus that can get out of hand before you know it.
 

Doomsday101

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I am pretty sure, that Hospital sent him home, after he told them he had multiple symptoms.

I know, how many people did he come in contact with? how many people did the 1st nurse come in contact with? and now another nurse has tested positive and is now in isolation, but how many did she come in contact with? To act as if this is no big deal I think would be foolish, virus do not care where you live or how much money you have and there is no known cure. Some do recover so it is not a 100 percent death sentence but the virus has a very high rate of mortality.
 

CashMan

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To me that is the concerning issue, mistakes being made that could lead to a more serious issue for all. I think being going into a panic state is a waste of energy but I do think there should be healthy concern for a virus that can get out of hand before you know it.

Agreed.


What I do not like, and I know it is for ratings, is half a story published.


We hear, a man has ebola, then dies. We all think, he went to the hospital, and died. Then we later learn, they sent him home.

I am not doctor, I just play one on TV, but I am sure, after a handful of cases, people will take it more serious, and will get it under control.
 

CashMan

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I know, how many people did he come in contact with? how many people did the 1st nurse come in contact with? and now another nurse has tested positive and is now in isolation, but how many did she come in contact with? To act as if this is no big deal I think would be foolish, virus do not care where you live or how much money you have and there is no known cure. Some do recover so it is not a 100 percent death sentence but the virus has a very high rate of mortality.

I know, but that mortality rate, is mostly from a 3rd work country(I think).

The problem might be, If I am correct, the signs are pretty close as the flu, so it might be hard initially to catch.
 

Doomsday101

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Agreed.


What I do not like, and I know it is for ratings, is half a story published.


We hear, a man has ebola, then dies. We all think, he went to the hospital, and died. Then we later learn, they sent him home.

I am not doctor, I just play one on TV, but I am sure, after a handful of cases, people will take it more serious, and will get it under control.

What bothers me is are we being given the full scoop? I understand that people at CDC do not want to create a panic but are they underselling the situation to avoid panic?
 

Doomsday101

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The second Dallas health care worker who contracted the Ebola virus was on a flight the day before her symptoms, the Centers for Disease Control and Prevention said Wednesday.
Now, the CDC wants to interview all 132 passengers who were on the plane with her.
The woman's name is Amber Vinson, the Reuters news agency reported.
"Because of the proximity in time between the evening flight and first report of illness the following morning, CDC is reaching out to passengers who flew on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth Oct. 13," the CDC said in a statement. The flight landed Monday at 8:16 p.m. CT.

http://www.cnn.com/2014/10/15/health/texas-ebola-outbreak/index.html?hpt=hp_t1
 

MonsterD

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The second Dallas health care worker who contracted the Ebola virus was on a flight the day before her symptoms, the Centers for Disease Control and Prevention said Wednesday.
Now, the CDC wants to interview all 132 passengers who were on the plane with her.
The woman's name is Amber Vinson, the Reuters news agency reported.
"Because of the proximity in time between the evening flight and first report of illness the following morning, CDC is reaching out to passengers who flew on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth Oct. 13," the CDC said in a statement. The flight landed Monday at 8:16 p.m. CT.

http://www.cnn.com/2014/10/15/health/texas-ebola-outbreak/index.html?hpt=hp_t1

Ok that is really not good, why would someone be in direct contact with an Ebola patient then hop on planes all around after that? We have video conferencing no need to do anything that can potentially spread the contagion. Presbyterian really screwed this they had him for a second time and did not have any plan or carry out procedures correctly.
 

Doomsday101

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Ok that is really not good, why would someone be in direct contact with an Ebola patient then hop on planes all around after that? We have video conferencing no need to do anything that can potentially spread the contagion. Presbyterian really screwed this they had him for a second time and did not have any plan or carry out procedures correctly.

True, it is not good but people make mistakes and that is the big fear. Carelessness and mistakes and this can get out of hand. This is virus is serious stuff
 

BlindFaith

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True, it is not good but people make mistakes and that is the big fear. Carelessness and mistakes and this can get out of hand. This is virus is serious stuff

And that is exactly why I started posting the articles that I did. I sensed that most were not seeing this as dangerous as it is. I didn't post them to be a chicken little.

And now we find that three nurses, counting the one in Spain, have contracted this while taking all the documented precautions. So transmission precautions absolutely have to be taken, and taken with the highest degree of caution.
 
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