Ebola virus outbreak

littlemac1980

I should add that the fingers and hands sweat all the time.

That's why when you place your hands on a pane of glass/table/laptop for a few seconds without removing them - you can see an outline of the hand where it was for a little while.

This happens even when the body is at rest - but is more evident when doing something which involves some physical exertion.

Creative Juices

http://www.forbes.com/sites/matthewherper/2014/10/23/why-you-wont-catch-ebola-on-the-new-york-city-subway/

Should people be worried that they might have been exposed to Ebola on a subway car?

No, says William Schaffner, chairman of the Department of Preventive Medicine at the Vanderbilt University School of Medicine and a top expert on infectious disease.


“I think the risk is close to zero. I would even say it’s zero because none of those people had any contact with his body fluids,” Schaffner says. “I would feel no concern had I been standing next to him on the subway.”
The reason, Schaffner says, is because when patients first become sick with Ebola, there simply isn’t that much virus in their bodies. “It’s very hard to transmit the virus in those first days of illness,” he says. “As the illness progresses, for sure the viral load in the body increases. It can get into the skin cells or onto the surface of your skin. That’s when people are near death.”

Grayson

WILL NEVER LOG OFF wrote: »

I get what people say about bodily fluids, but the threshold would appear very low, like coughing near an open soda-can. All those little virus-conveying acts we do without noticing

It's very hard to transmit via saliva. I remember reading an expert say you could french someone who was in the early stages and you probably wouldn't get it.

people are worried about bowling balls and stuff like that. It's like thinking you could get HIV from sitting on a toilet seat.

The biggest worry I can think of is the guys GF. It can be transmitted through semen. If they had unprotected sex, then she might be at risk. Poor girl is in a separate quarantine in the same hospital. Must be horrible for both of them including him. Besides having ebola he's probably also worried that he gave it to her.

littlemac1980

I really hope that the situation in Mali is caught and dealt with in time, as appears to have been the case in Nigeria.

The population of Mali is 14.5 million approx.

The combined population of Guinea, Sierra Leone and Liberia is 20.3 million approx. (all figures from Wiki)

As grim and hopeless as the situation is in the West African Countries of Guinea, Sierra Leone and Liberia now appears to be, were the Virus to get a foothold in Mali at this stage then the already grossly deficient response and resources would clearly have to be spread even thinner over a much much larger geographical area.

Creative Juices

littlemac1980 wrote: »

I really hope that the situation in Mali is caught and dealt with in time, as appears to have been the case in Nigeria.

The population of Mali is 14.5 million approx.

The combined population of Guinea, Sierra Leone and Liberia is 20.3 million approx. (all figures from Wiki)

As grim and hopeless as the situation is in the West African Countries of Guinea, Sierra Leone and Liberia now appears to be, were the Virus to get a foothold in Mali at this stage then the already grossly deficient response and resources would clearly have to be spread even thinner over a much much larger geographical area.

I doubt it, like Senegal and Nigeria and USA and Spain, it's an imported case. It should be containable, the lessons are there.

littlemac1980

http://www.theguardian.com/world/2014/oct/24/mali-first-ebola-case

The World Health Organisation is sending experts to help Mali fight Ebola, a day after the first case of the disease was confirmed there.

Authorities said on Thursday a two-year-old girl had been infected – making Mali the sixth west African country to report a case of Ebola. The child was brought to a hospital in the Malian town of Kayes on Wednesday, and her blood sample tested positive for the virus.

Nearly all cases of Ebola, and all deaths so far, have occurred in Liberia, Sierra Leone and Guinea. Senegal and Nigeria had imported cases, but both have since been declared Ebola-free.

WHO spokeswoman Fadela Chaib said a team of three experts had been in Mali evaluating its defences, and at least four more would set off over the next few days. The Malian authorities were monitoring 43 people who had been in contact with the girl, including 10 health workers, she told a news briefing.

European Union leaders agreed on Friday to double to €1bn their financial support for efforts to fight Ebola.

Contributions from the 28 nations currently stand at about €500m and there has been criticism that wealthy countries are not doing more.

According to the WHO, Ebola has killed at least 4,877 people and infected 9,936.

This is a google map link to the area in Mali where the town (Kayes) is located where the little girl was admitted to hospital:

https://maps.google.ie/maps?client=safari&oe=UTF-8&ie=UTF-8&fb=1&gl=ie&q=Kayes,+Mali&ei=9TNKVKPFN6Hj7QaFmIDADQ&ved=0CBMQ8gEoATAA&output=classic&dg=brw

Good to see the EU have doubled their aid to the cause as of this morning (apparently).

ectoraige

littlemac1980 wrote: »

The Doctor in New York went bowling the day before he was admitted to hospital.

I've been bowling a good few times.

When you put your fingers in the holes in the Bowling Ball they always sweat a little each time due to the close contact with the ball and weight of the ball.

Typically I'd use about 5 - 10 different balls during a session, depending on circumstances.

The balls are thrown down the lane, and return, and unless you have your own personal ball, they all are used by other people sharing your lane, and sharing the pair of lanes serviced by the same return mechanism.

After you finish other groups take over and use the same balls.

There is no direct sunlight in Bowling Alleys - nor any UV light I'm aware of.

We know from scientific reports (previously linked on this thread many time) that the virus has been recovered on plastic/metal surfaces not exposed to Sunlight (in ambient humidity - I think I recall 60% - 70% and temperature 20-220 degrees after 15 hours).

The bowling alley visit should be a massive concern to those disease investigators trying to trace the Doctor's possible contacts.

If sweat were a vector in early-stage patients then this would be significant. However live virus hasn't been isolated in sweat to date that I'm aware of. Of sweat does price to be a vector it is expected to only occur in very late stage patients with huge vital loading.

littlemac1980

This report's description of the health system in Mali (if accurate) raises concerns about that Country's ability to handle a situation themselves were things to escalate, although its reassuring at this stage that they appear to have taken a proactive approach as soon as possible with quarantining relatives and closing schools.

Thankfully it also appears that the WHO are mobilised to assist immediately with Experts and aid, although I do hope the details in the second-last paragraph doesn't represent the extent of aid that will be sent.

Hopefully all this will be shown to have been implemented in time.

http://www.dw.de/eu-to-boost-funding-ebola-case-in-mali/a-18018861

Arrival from Guinea

Mali's health ministry confirmed the vast former French colony's first case, saying a 2-year-old girl who had arrived from neighboring Guinea with relatives had tested positive for Ebola.

She had been placed in isolation in a clinic in the city of Kayes, which lies about 500 kilometers from Mali's capital Bamako. The relatives were in quarantine.

The governor of Kaye, Salif Traoré, closed all city schools on Friday and called on residents to strictly observe hygiene recommendations. Two other West Africa nations, Nigeria and Senegal, recently declared similar limited outbreaks to be ended.

Mali, where French troops intervenied in 2013 during uprisings by militant Islamists and Tuareg rebels, has a meager health system. It has only one clinic bed for every 10,000 citizens, and only one doctor for every 12,500 Malians.

The UN's Geneva-based World Health Organization (WHO) said it would send four more of its experts to join three who have already been evaluating Mali's defenses.

WHO spokeswoman said Malian authorities were monitoring 43 people, including 10 health workers, who had been in contact with the girl.

WILL NEVER LOG OFF

Grayson wrote: »

It's very hard to transmit via saliva. I remember reading an expert say you could french someone who was in the early stages and you probably wouldn't get it.

do we know the scientific basis for that claim ?

I meam mucus is basically the body's built-in disinfectant. It contains proteins that act as a barrier to infection. I get that. But what is the evidence in support of the hypothesis that salivary glycosolated protein, or whatever , stops the transmission of Ebola?

I mean, take these health workers contracting ebola. I doubt they have been contracting the disease per rectum or vaginally, or open wounds. So how's it getting in there, if it isn't crossing the oral-respiratory mucosa?

If so, it's not like HIV or related disorders. It's more transmissible than that.

Canis Lupus

WILL NEVER LOG OFF wrote: »

do we know the scientific basis for that claim ?

I meam mucus is basically the body's built-in disinfectant. It contains proteins that act as a barrier to infection. I get that. But what is the evidence in support of the hypothesis that salivary glycosolated protein, or whatever , stops the transmission of Ebola?

I mean, take these health workers contracting ebola. I doubt they have been contracting the disease per rectum or vaginally, or open wounds. So how's it getting in there, if it isn't crossing the oral-respiratory mucosa?

If so, it's not like HIV or related disorders. It's more transmissible than that.

Those healthworkers are dealing with very very sick individuals at their most infectious and dealing with the vomit, faeces and blood. I don't think you'll be dealing with these situations so you should be okay.

Beano

WILL NEVER LOG OFF wrote: »

do we know the scientific basis for that claim ?

I meam mucus is basically the body's built-in disinfectant. It contains proteins that act as a barrier to infection. I get that. But what is the evidence in support of the hypothesis that salivary glycosolated protein, or whatever , stops the transmission of Ebola?

I mean, take these health workers contracting ebola. I doubt they have been contracting the disease per rectum or vaginally, or open wounds. So how's it getting in there, if it isn't crossing the oral-respiratory mucosa?

If so, it's not like HIV or related disorders. It's more transmissible than that.

Because in the early stages the viral load is very low. By the time the viral load is high enough to be transmitted by a kiss neither party would be very interested.

Foggy Jew

littlemac1980 wrote: »

The Doctor in New York went bowling the day before he was admitted to hospital.



I wonder if he was ebowling....

littlemac1980

Canis Lupus wrote: »

Those healthworkers are dealing with very very sick individuals at their most infectious and dealing with the vomit, faeces and blood. I don't think you'll be dealing with these situations so you should be okay.

That's not particularly scientific - which is what was requested in relation to the earlier response. But nevertheless you're entitled to your opinion and I think your comment is largely sensible despite its speculative rather that scientific nature.

There is always value in speculation. I'd hope to see more of it in this thread. Science by its nature is always a step behind speculation, though scientific proof is obviously more determinative once completed.

Incidentally here's some details from the CDC website - although all this has been posted on this thread previously - so apologies to those posters who have been reading this thread for some time now:

http://www.cdc.gov/vhf/ebola/transmission/qas.html

I believe its worth reading all this with the benefit of personal common-sense and experience.

For instance, though getting infected fluid directly on the skin might not lead to infection - were it to get on someones hands, then given our typical practices of rubbing our eyes, and mouths - or even picking your nose perhaps - infection can be very possible in everyday circumstances.

What are body fluids?

Ebola has been detected in blood and many body fluids. Body fluids include saliva, mucus, vomit, feces, sweat, tears, breast milk, urine, and semen.

Can Ebola spread by coughing? By sneezing?

Unlike respiratory illnesses like measles or chickenpox, which can be transmitted by virus particles that remain suspended in the air after an infected person coughs or sneezes, Ebola is transmitted by direct contact with body fluids of a person who has symptoms of Ebola disease. Although coughing and sneezing are not common symptoms of Ebola, if a symptomatic patient with Ebola coughs or sneezes on someone, and saliva or mucus come into contact with that person’s eyes, nose or mouth, these fluids may transmit the disease.

What does “direct contact” mean?

Direct contact means that body fluids (blood, saliva, mucus, vomit, urine, or feces) from an infected person (alive or dead) have touched someone’s eyes, nose, or mouth or an open cut, wound, or abrasion.

How long does Ebola live outside the body?

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.

WILL NEVER LOG OFF

Beano wrote: »

Because in the early stages the viral load is very low. By the time the viral load is high enough to be transmitted by a kiss neither party would be very interested.

no, i'm not saying the virus is present in saliva early-on, i'm doubting the suggestion that ebola is hard to acquire via the O-R mucusa/ saliva. I suspect that's the major form of transmission. Hence the whole not wanting to share a subway carriage with an infected person.

wildefalcon

Interesting research:

http://www.sciencedaily.com/releases/2014/10/141023193539.htm

http://www.sciencedaily.com/releases/2014/10/141023193539.htm

Summary - it's going to keep spreading unless the ROTW gets it's aid program together it will hit 1/4 million before Christmas and that the " possibility of averting calamitous repercussions from an initially delayed and insufficient response is quickly eroding".

- Alison Galvani, professor of epidemiology at Yale School of Public Health and Medicine

Beano

WILL NEVER LOG OFF wrote: »

no, i'm not saying the virus is present in saliva early-on, i'm doubting the suggestion that ebola is hard to acquire via the O-R mucusa/ saliva. I suspect that's the major form of transmission. Hence the whole not wanting to share a subway carriage with an infected person.

If there is no virus present in saliva early on then how be it be transmitted? Somebody with an advanced enough case for their saliva to be a significant carrier of the virus is not going out to spend the evening bowling.

WILL NEVER LOG OFF

Beano wrote: »

If there is no virus present in saliva early on then how be it be transmitted?

define "early on"?

if it's crossing the oro-respiratory membranes and the mucosal defences, I doubt there is literally "no virus present" in the mucosa and associated fluid, even in early symptomatic stage. The risk may be lower, but i wouldn't go french kissing a medic with direct ebola exposure, now running a temperature.

You would , would you?

Beano

WILL NEVER LOG OFF wrote: »

define "early on"?

Before they become symptomatic.

WILL NEVER LOG OFF wrote: »

if it's crossing the oro-respiratory membranes and the mucosal defences, I doubt there is literally "no virus present" in the mucosa and associated fluid, even in early symptomatic stage. The risk may be lower, but i wouldn't go french kissing a medic with direct ebola exposure, now running a temperature.

"no virus present" = not enough to be transmitted.

WILL NEVER LOG OFF wrote: »

You would , would you?

I am not free and easy with my affections. Nobody is advocating that you go around sticking your tongue down peoples throats. It was hyperbole to illustrate the fact that the risk of catching it from being in the same subway car is so low as to be non-existant.

WILL NEVER LOG OFF

Beano wrote: »

"no virus present" = not enough to be transmitted. .

eh, no. those are two completely different statements . that equals sign is misplaced. anyway it seems you're reading into my posts things i haven't written.

Beano

WILL NEVER LOG OFF wrote: »

eh, no. those are two completely different statements . that equals sign is misplaced. anyway it seems you're reading into my posts things i haven't written.

For practical purposes they are not. The viral load needs to reach a threshold before it can be transmitted. Below that the viral load is irrelevant.

WILL NEVER LOG OFF wrote: »

no, i'm not saying the virus is present in saliva early-on, i'm doubting the suggestion that ebola is hard to acquire via the O-R mucusa/ saliva. I suspect that's the major form of transmission. Hence the whole not wanting to share a subway carriage with an infected person.

So if you are not saying the virus is present early on then what are you saying?

Grayson

WILL NEVER LOG OFF wrote: »

do we know the scientific basis for that claim ?

I meam mucus is basically the body's built-in disinfectant. It contains proteins that act as a barrier to infection. I get that. But what is the evidence in support of the hypothesis that salivary glycosolated protein, or whatever , stops the transmission of Ebola?

I mean, take these health workers contracting ebola. I doubt they have been contracting the disease per rectum or vaginally, or open wounds. So how's it getting in there, if it isn't crossing the oral-respiratory mucosa?

If so, it's not like HIV or related disorders. It's more transmissible than that.

In one case they found that the virus transmitted from one person to another with no physical contact. It was to the person was in the next bed in the hospital. the original person was also very sick at the time. They hypothesised that it may have been transmitted in saliva if the person had managed to cough directly at the other person and it went directly into their mouth. That's the only ever recorded case of Ebola being transmitted by saliva and they're not even sure that it happened.

The health workers are getting it from bodily fluids. Tears, vomiting, blood and diarrhoea. When the victims are really sick they are producing fluid out of every possible orifice. And they're producing a lot of it. The further the disease progresses, the worse it gets.
The guy in New York is just symptomatic. He's not getting the whole vomiting etc yet. And he has a low viral payload.

WILL NEVER LOG OFF

Beano wrote: »

So if you are not saying the virus is present early on then what are you saying?

that we shouldn't exaggerate the risk, but i certainly wouldn't want to sit near an ebola victim in a bowling alley or on a subway.

because once symptoms present (fever, fatigue, git disturbance ) it is foolish to pontificate on risk via mucous transmission along the lines of dismissing the risk of sharing enclosed spaces. I have not mentioned pre-symptom situations.

ectoraige

Ebola has been detected in blood and many body fluids. Body fluids include saliva, mucus, vomit, feces, sweat, tears, breast milk, urine, and semen.

I think it's important to point out that "detected" does not mean they found live virus, just that they found fragments of the virus.
That list of body fluids does not indicate that viral loads are the same in each.

When evaluating the R value, which is quite high, one has to understand that at early stages, it has very low potential to spread, only increasing as the patient worsens. The main vector is through handling items soiled by vomit, blood, and diarrhoea, and handling the virus-ridden corpses of the decreased. Worrying about subways isn't a priority, worrying about protocols for care workers is of far more significance.

Grayson

WILL NEVER LOG OFF wrote: »

define "early on"?

if it's crossing the oro-respiratory membranes and the mucosal defences, I doubt there is literally "no virus present" in the mucosa and associated fluid, even in early symptomatic stage. The risk may be lower, but i wouldn't go french kissing a medic with direct ebola exposure, now running a temperature.

You would , would you?

How hot is she?

WILL NEVER LOG OFF

Grayson wrote: »

The health workers are getting it from bodily fluids. Tears, vomiting, blood and diarrhoea.

Think about those 2 sentences . they don't correspond to my point.

i asked how are health-workers getting the virus? i.e. through what mode.
well presumably, via OR mucosa, including passing through saliva.

littlemac1980

A politician has publicly announced he has no problem riding the subway and that it is safe.

http://www.koat.com/politics/ny-gov-ill-ride-the-subway-today/29314666

New York Gov. Andrew Cuomo said Friday he'll ride one of the three subway lines taken by the latest Ebola patient in the United States.

That settles it - if a politician is saying the Subway is safe, then it is clearly unsafe.

Grayson

WILL NEVER LOG OFF wrote: »

Think about those 2 sentences . they don't correspond to my point.

i asked how are health-workers getting the virus? i.e. through what mode.
well presumably, via OR mucosa, including passing through saliva.

they're not different. You can get HIV through blood and semen, but not through kissing (Unless their gums are bleeding and you have cuts in your mouth. And even then it's a lower risk unless there's lots of blood). Different fluids can transmit a virus in different ways. Sometimes you can even detect a virus in a particular excretion/fluid and yet still not be at risk.

Ebola can be transmitted through saliva. but it has to be at later stages when it's virus laden and there has to be direct physical contact. In other words someone who is very sick has to cough on you and their saliva has to go into your eyes, mouth (or say a shaving cut)

here's a nice snippet on it.

http://www.usatoday.com/story/news/nation/2014/10/06/how-ebola-spreads/16802063/

While it's theoretically possible for someone to become infected through coughing, the WHO's new statement explains why this is highly unlikely.

"Theoretically, wet and bigger droplets from a heavily infected individual, who has respiratory symptoms caused by other conditions or who vomits violently, could transmit the virus – over a short distance – to another nearby person. This could happen when virus-laden heavy droplets are directly propelled by coughing or sneezing (which does not mean airborne transmission) onto the mucus membranes or skin with cuts or abrasions of another person."

Again, while spreading Ebola this way is theoretically possible, the WHO statement says there are no documented cases of Ebola spreading this way. When doctors and disease detectives interview people who have had Ebola, "all cases were infected by direct close contact with symptomatic patients."

While the Ebola virus has been detected in bodily fluids other than blood — including breast milk, urine, semen, saliva and tears — there's no conclusive evidence showing that the virus really spreads this way.

Although scientists have found the Ebola virus in saliva, it was most frequently found in the saliva of patients at a very late stage of illness, when the virus has had the chance to reproduce extensively. And while the DNA of an Ebola virus has been found in sweat, a "whole, live virus" — one that could infect someone — has never been found in sweat, the WHO says. the WHO says.

Maximus Alexander

Grayson wrote: »

How hot is she?

About 38°C. :pac:

WILL NEVER LOG OFF

Grayson wrote: »

they're not different...

aand after this statement, you completely contradicted yourself.

i am not making any claim about the scale of probability regarding OR transmission.

I am simply saying Oral-resp mucosal entry is likely the most common site of entry, unlike, say HIV, where this site is less implicated. HIV is probably less contagious on the whole (excluding direct blood-blood contact in both viruses).

Beano

WILL NEVER LOG OFF wrote: »

aand after this statement, you completely contradicted yourself.

i am not making any claim about the scale of probability regarding OR transmission.

I am simply saying Oral-resp mucosal entry is likely the most common site of entry, unlike, say HIV, where this site is less implicated. HIV is probably less contagious on the whole (excluding direct blood-blood contact in both viruses).

what are you basing this on?