Ebola virus outbreak

Joe Doe · 15-10-2014 11:00PM

Aerosoled - yes.
Airborne - nope.

One tricky thing is the 21 day quarantine for all suspected cases, which could multiply fairly quickly to a lot of folks out of action, from each suspected multiplier, even if none are actual cases. Again, bring in the robots

wexie · 15-10-2014 11:00PM

ceadaoin. wrote: »

It droplet borne so it can only survive and travel for a limited distance in droplets created when someone sneezes or vomits. I agree though, to you and me, that means airborne. If it really was able to travel in the air then it would spread a lot quicker than it does now.

That's a bit of a difference indeed, still pretty scary stuff but not as scary as 'proper' airborne so.

InTheTrees · 15-10-2014 11:05PM

My name is URL wrote: »

What an absolute clusterfuck

If that's the situation in the world's most advanced healthcare system, and in the most developed nation on Earth, you can only imagine how bad things must be in the likes of Liberia.

Its not the "most developed" at all. Its based on how much someone can pay.

If you've spent any time in the USA you wouldn't be surprised that a dark skinned african man without health insurance, (in texas too!), was sent home with antibiotics and tylenol.

Today there was a story in the Dallas Daily News, from Duncan's nephew:

"On Friday, Sept. 25, 2014, my uncle Thomas Eric Duncan went to Texas Health Presbyterian Hospital Dallas. He had a high fever and stomach pains. He told the nurse he had recently been in Liberia. But he was a man of color with no health insurance and no means to pay for treatment, so within hours he was released with some antibiotics and Tylenol.
Two days later, he returned to the hospital in an ambulance. Two days after that, he was finally diagnosed with Ebola. "

http://www.dallasnews.com/opinion/latest-columns/20141014-exclusive-ebola-didnt-have-to-kill-thomas-eric-duncan-nephew-says.ece

gozunda · 15-10-2014 11:35PM

Canis Lupus wrote: »

It could, I'm not a doctor just going on what I read and from what I read the above scenarios are considered low risk.

I would have some comments to make though.

1: A person isn't infectious until they start showing symptoms and are quickly bedridden there after. Therefore whilst they are mobile they're not infectious and afterwards they won't be walking about much.

2: A person from the 1st world with confirmed Ebola or even suspected Ebola isn't likely to be allowed to wander about touching stuff like some kind of Ebola fairy and would generally be conscientious enough to not smear their bodily fluids around in the first place.

And in the case of those individuals who are infectious and in transit / 'wandering about' as in this case in the 1st world?

http://news.yahoo.com/traveler-liberia-first-ebola-patient-diagnosed-u-003007621--finance.html

15-10-2014 11:45PM

Did you know that the majority of Irish hospitals currently do not have the correct protective gear for staff in the event a suspected case of Ebola presents itself.

EoghanIRL · 15-10-2014 11:53PM

[Deleted User] wrote: »

Did you know that the majority of Irish hospitals currently do not have the correct protective gear for staff in the event a suspected case of Ebola presents itself.

You need to look further back though.
A person suspected with Ebola should be checked before getting on their flight .
And Ireland should be regulating people entering the country from at risk areas .

testicle · 16-10-2014 12:02AM

String wrote: »

Nigeria seemed to have done amazingly well to contain it considering they are located so close to the source.

So close? When was the last time you looked at a map? It's about 1000 miles!

5 countries in Africa have Ebola at the moment, not 4 as mentioned above. DRC also has an active strain, unrelated, but still Ebola.

Canis Lupus · 16-10-2014 12:30AM

gozunda wrote: »

And in the case of those individuals who are infectious and in transit / 'wandering about' as in this case in the 1st world?

I would imagine they'd fall Ill quickly and the people they were in close contact with then quarantined in the event they get sick (which I believe unlikely unless they were sitting right next to the infected person who started vomit on them like a scene out of 28 Days Later). Bear in mind that anyone infected on the flight isn't infectious themselves for a few weeks.

WakeUp · 16-10-2014 12:31AM

FullblownRose wrote: »

Among the nurses’ allegations was that the Ebola patient’s lab samples were allowed to travel through the hospital’s pneumatic tubes, opening the possibility of contaminating the specimen delivery system. The nurses also alleged that hazardous waste was allowed to pile up to the ceiling

the nurses have had a few choice words for the powers that be alright.

“We’ve been told a lot of things that have been wrong. We’ve been lied to, in terms of the preparation and the hospitals, and we know this because the nurses are telling us this and the nurses are the ones taking care of the patients.”

though fear not, the bureaucrats with their politically correct bullsh1t have this one hand. they are on it.

Joe Doe · 16-10-2014 12:36AM

Deleted User wrote: »

Did you know that the majority of Irish hospitals currently do not have the correct protective gear for staff in the event a suspected case of Ebola presents itself.

I'd wonder also what percentage of staff would opt in for full time & direct line of care duties for confirmed cases, even with e.g. triple pay or other incentives. Even if suitable protective gear was acquired.

All the more reason to order a couple of Xenex Bots, and custom upgrade with 360 Oculus VR® headsets using upgraded stereoscopic full-hd cams, 2-way comms and real-time tactile kinetic hydraulic motion abilities.

InTheTrees · 16-10-2014 12:40AM

WakeUp wrote: »

the nurses have had a few choice words for the powers that be alright.

Suddenly a "healthcare" system that is geared to cater for the wealthy and insured is faced with a quandary, it seems they cant just turn these people away at the door after all.

WakeUp · 16-10-2014 12:48AM

InTheTrees wrote: »

Suddenly a "healthcare" system that is geared to cater for the wealthy and insured is faced with a quandary, it seems they cant just turn these people away at the door after all.

well actually, no. I dont think its that I think that might be unfair. the powers that be would never tell lies or willfully misinform some of the more naive among us would have you believe. yet here we have these nurses claiming such a thing. shock phukin horror. there is a statement on the national nurses united website this is some of it. make of it what you will.
__________________________________________________________

Statement by RN’s at Texas Health Presbyterian Hospital as provided to National Nurses United:

This is an inside story from some registered nurses at Texas Health Presbyterian Hospital in Dallas who have familiarity with what occurred at the hospital following the positive Ebola infection of first the late Thomas Eric Duncan and then a registered nurse who cared for him Nina Pham.

The RNs contacted National Nurses United out of frustration with a lack of training and preparation. They are choosing to remain anonymous out of fear of retaliation.

The RNs who have spoken to us from Texas Health Presbyterian are listening in on this call and this is their report based on their experiences and what other nurses are sharing with them. When we have finished with our statement, we will have time for several questions. The nurses will have the opportunity to respond to your questions via email that they will send to us, that we will read to you.

We are not identifying the nurses for their protection, but they work at Texas Health Presbyterian and have knowledge of what occurred at the hospital.

They feel a duty to speak out about the concerns that they say are shared by many in the hospital who are concerned about the protocols that were followed and what they view were confusion and frequently changing policies and protocols that are of concern to them, and to our organization as well.

When Thomas Eric Duncan first came into the hospital, he arrived with an elevated temperature, but was sent home.

On his return visit to the hospital, he was brought in by ambulance under the suspicion from him and family members that he may have Ebola.

Mr. Duncan was left for several hours, not in isolation, in an area where other patients were present.

No one knew what the protocols were or were able to verify what kind of personal protective equipment should be worn and there was no training.

Subsequently a nurse supervisor arrived and demanded that he be moved to an isolation unit– yet faced resistance from other hospital authorities.

Lab specimens from Mr. Duncan were sent through the hospital tube system without being specially sealed and hand delivered. The result is that the entire tube system by which all lab specimens are sent was potentially contaminated.

There was no advance preparedness on what to do with the patient, there was no protocol, there was no system. The nurses were asked to call the Infectious Disease Department. The Infectious Disease Department did not have clear policies to provide either.

Initial nurses who interacted with Mr. Duncan nurses wore a non-impermeable gown front and back, three pairs of gloves, with no taping around wrists, surgical masks, with the option of N-95s, and face shields. Some supervisors said that even the N-95 masks were not necessary.

The suits they were given still exposed their necks, the part closest to their face and mouth. They had suits with booties and hoods, three pairs of gloves, no tape.

For their necks, nurses had to use medical tape, that is not impermeable and has permeable seams, to wrap around their necks in order to protect themselves, and had to put on the tape and take it off on their own.

Nurses had to interact with Mr. Duncan with whatever protective equipment was available, at a time when he had copious amounts of diarrhea and vomiting which produces a lot of contagious fluids.

Hospital officials allowed nurses who had interacted with Mr. Duncan to then continue normal patient care duties, taking care of other patients, even though they had not had the proper personal protective equipment while caring for Mr. Duncan.

Patients who may have been exposed were one day kept in strict isolation units. On the next day were ordered to be transferred out of strict isolation into areas where there were other patients, even those with low-grade fevers who could potentially be contagious.

Were protocols breached? The nurses say there were no protocols.

Some hospital personnel were coming in and out of those isolation areas in the Emergency Department without having worn the proper protective equipment.

CDC officials who are in the hospital and Infectious Disease personnel have not kept hallways clean; they were going back and forth between the Isolation Pod and back into the hallways that were not properly cleaned, even after CDC, infectious control personnel, and doctors who exited into those hallways after being in the isolation pods.
http://www.nationalnursesunited.org/blog/entry/statement-by-registered-nurses-at-texas-health-presbyterian-hospital-in-dal/

Egginacup · 16-10-2014 01:23AM

InTheTrees wrote: »

Suddenly a "healthcare" system that is geared to cater for the wealthy and insured is faced with a quandary, it seems they cant just turn these people away at the door after all.

I understand that they're is no Surgeon General in the US right now because a bunch of simpletons in Congress blocked his assignment on the grounds that he spoke out against the proliferation of firearms and espoused the need to control weapons in order to "imporve" the health (read: life expectancy) of many whose health he is charged to consider.

So now that America needs a "Top Doctor" to explain the issues behind this entire Ebola scare....they don't have one, thanks to **** who couldn't tell the difference between Socialism, Capitalism and Botulism.

But it gets even more hysterically laughable. There is now an American Military ex-Captain who has stated that ISIS could infect themselves with Ebola and then just be 'carriers'....or something?

“The individual exposed to the Ebola virus would be the carrier,” he said. “In the context of terrorist activity, it doesn’t take much sophistication to go to that next step to use a human being as a carrier.”

http://www.forbes.com/sites/brucedorminey/2014/10/05/ebola-as-isis-bio-weapon/

...and they actually PAY people like this.
:pac:

gozunda · 16-10-2014 06:09AM

Canis Lupus wrote: »

I would imagine they'd fall Ill quickly and the people they were in close contact with then quarantined in the event they get sick (which I believe unlikely unless they were sitting right next to the infected person who started vomit on them like a scene out of 28 Days Later). Bear in mind that anyone infected on the flight isn't infectious themselves for a few weeks.

As in this example?

http://news.yahoo.com/traveler-liberia-first-ebola-patient-diagnosed-u-003007621--finance.html

wexie · 16-10-2014 07:24AM

WakeUp wrote: »

well actually, no. I dont think its that I think that might be unfair. the powers that be would never tell lies or willfully misinform some of the more naive among us would have you believe. yet here we have these nurses claiming such a thing. shock phukin horror. there is a statement on the national nurses united website this is some of it. make of it what you will.
__________________________________________________________

Statement by RN’s at Texas Health Presbyterian Hospital as provided to National Nurses United:

This is an inside story from some registered nurses at Texas Health Presbyterian Hospital in Dallas who have familiarity with what occurred at the hospital following the positive Ebola infection of first the late Thomas Eric Duncan and then a registered nurse who cared for him Nina Pham.

The RNs contacted National Nurses United out of frustration with a lack of training and preparation. They are choosing to remain anonymous out of fear of retaliation.

The RNs who have spoken to us from Texas Health Presbyterian are listening in on this call and this is their report based on their experiences and what other nurses are sharing with them. When we have finished with our statement, we will have time for several questions. The nurses will have the opportunity to respond to your questions via email that they will send to us, that we will read to you.

We are not identifying the nurses for their protection, but they work at Texas Health Presbyterian and have knowledge of what occurred at the hospital.

They feel a duty to speak out about the concerns that they say are shared by many in the hospital who are concerned about the protocols that were followed and what they view were confusion and frequently changing policies and protocols that are of concern to them, and to our organization as well.

When Thomas Eric Duncan first came into the hospital, he arrived with an elevated temperature, but was sent home.

On his return visit to the hospital, he was brought in by ambulance under the suspicion from him and family members that he may have Ebola.

Mr. Duncan was left for several hours, not in isolation, in an area where other patients were present.

No one knew what the protocols were or were able to verify what kind of personal protective equipment should be worn and there was no training.

Subsequently a nurse supervisor arrived and demanded that he be moved to an isolation unit– yet faced resistance from other hospital authorities.

Lab specimens from Mr. Duncan were sent through the hospital tube system without being specially sealed and hand delivered. The result is that the entire tube system by which all lab specimens are sent was potentially contaminated.

There was no advance preparedness on what to do with the patient, there was no protocol, there was no system. The nurses were asked to call the Infectious Disease Department. The Infectious Disease Department did not have clear policies to provide either.

Initial nurses who interacted with Mr. Duncan nurses wore a non-impermeable gown front and back, three pairs of gloves, with no taping around wrists, surgical masks, with the option of N-95s, and face shields. Some supervisors said that even the N-95 masks were not necessary.

The suits they were given still exposed their necks, the part closest to their face and mouth. They had suits with booties and hoods, three pairs of gloves, no tape.

For their necks, nurses had to use medical tape, that is not impermeable and has permeable seams, to wrap around their necks in order to protect themselves, and had to put on the tape and take it off on their own.

Nurses had to interact with Mr. Duncan with whatever protective equipment was available, at a time when he had copious amounts of diarrhea and vomiting which produces a lot of contagious fluids.

Hospital officials allowed nurses who had interacted with Mr. Duncan to then continue normal patient care duties, taking care of other patients, even though they had not had the proper personal protective equipment while caring for Mr. Duncan.

Patients who may have been exposed were one day kept in strict isolation units. On the next day were ordered to be transferred out of strict isolation into areas where there were other patients, even those with low-grade fevers who could potentially be contagious.

Were protocols breached? The nurses say there were no protocols.

Some hospital personnel were coming in and out of those isolation areas in the Emergency Department without having worn the proper protective equipment.

CDC officials who are in the hospital and Infectious Disease personnel have not kept hallways clean; they were going back and forth between the Isolation Pod and back into the hallways that were not properly cleaned, even after CDC, infectious control personnel, and doctors who exited into those hallways after being in the isolation pods.
http://www.nationalnursesunited.org/blog/entry/statement-by-registered-nurses-at-texas-health-presbyterian-hospital-in-dal/

Or, as it's called in the US : one helluva lawsuit

ProfessorPlum · 16-10-2014 10:48AM

WakeUp wrote: »

well actually, no. I dont think its that I think that might be unfair. the powers that be would never tell lies or willfully misinform some of the more naive among us would have you believe. yet here we have these nurses claiming such a thing. shock phukin horror. there is a statement on the national nurses united website this is some of it. make of it what you will.

I hope that's not a little dig at me after out conversation yesterday - that was about misinformation regarding modes of transmission, remember?

Now it would only be the very naive among us who would believe that a hospital administration (or almost any organisation run almost exclusively by bean counters) would not be capable of getting involved in serious amount of arse covering in a situation like this. It's almost even more amazing that people think that hospitals are kitted out with the 'proper gear' for this kind of disease. They are not. My first reaction when I heard the nurses' 'breach of protocol', both in Texas and Spain was ' well, that's a little convenient, isn't it'. There's understandably a lot of 'learning as we go' here. I think the hospitals in question would be better served if they were a little more honest. At this rate they are loosing the confidence of their communities rapidly, and that will only lead to panic and hysteria.

As a point of information, although I think it's a technicality at this point, Nigeria and Senegal are not officially Ebola free yet. The WHO will declare them free after 42 days (Senegal tomorrow and Nigeria Monday), so including those two, we have 5 African countries affected with this outbreak, and a separate outbreak in DRC.

wexie · 16-10-2014 10:53AM

ProfessorPlum wrote: »

I think the hospitals in question would be better served if they were a little more honest. At this rate they are loosing the confidence of their communities rapidly, and that will only lead to panic and hysteria.

The problem with that is that being more honest would pretty much entail informing the public that 'we're not actually in any way equipped, trained or experienced to deal with this ****, we're trying our best though'

I don't really think that will help confidence much either.

ProfessorPlum · 16-10-2014 10:56AM

wexie wrote: »

The problem with that is that being more honest would pretty much entail informing the public that 'we're not actually in any way equipped, trained or experienced to deal with this ****, we're trying our best though'

I don't really think that will help confidence much either.

I think the secret is out, don't you?

I was thinking more along the lines of 'we've made some mistakes, but we've learned a lot, and in cooperation and with the help of the CDC, this is what we're going to do now. We're confident that these measures will be effective in containing this disease'

youtube! · 16-10-2014 10:58AM

So the 2nd nurse who became infected had flew on a plane with 132 on board, this is gonna be interesting to see how many (if any) get the disease, if nothing else it will tell us a lot about transmission chances.

http://www.bbc.com/news/world-us-canada-29632433

Creative Juices · 16-10-2014 11:14AM

testicle wrote: »

So close? When was the last time you looked at a map? It's about 1000 miles!

5 countries in Africa have Ebola at the moment, not 4 as mentioned above. DRC also has an active strain, unrelated, but still Ebola.

This site is very good (but I cant post full links yet)

...internationalsos.com/ebola/index.cfm?content_id=421&language_id=ENG

1. Guinea: Major problems all over the country.
2. Liberia: Major problems all over the country.
3. Senegal: 1 case in August. WHO to declare country ebola free on Oct 17th.
4. Nigeria: Has been successfully contained after 20 cases. No new cases since early September. WHO to declare country ebola free on Oct 20th.
5. Sierra Leone: Major problems all over the country.
6. Congo: Only a problem in one part of one province (Equateur)

By Monday it is very likely that only 4 countries will have ebola with the Congo outbreak being very localised.

Maximus Alexander · 16-10-2014 11:18AM

Creative Juices wrote: »

This site is very good (but I cant post full links yet)

...internationalsos.com/ebola/index.cfm?content_id=421&language_id=ENG

1. Guinea: Major problems all over the country.
2. Liberia: Major problems all over the country.
3. Senegal: 1 case in August. WHO to declare country ebola free on Oct 17th.
4. Nigeria: Has been successfully contained after 20 cases. No new cases since early September. WHO to declare country ebola free on Oct 20th.
5. Sierra Leone: Major problems all over the country.
6. Congo: Only a problem in one part of one province (Equateur)

By Monday it is very likely that only 4 countries will have ebola with the Congo outbreak being very localised.

Shouldn't the US be in there at the moment?

MadYaker · 16-10-2014 11:19AM

Congo is a failed state and not safe for western aid agencies to enter.

Creative Juices · 16-10-2014 11:22AM

Maximus Alexander wrote: »

Shouldn't the US be in there at the moment?

It is but I was replying to a post about African countries. Follow the link for all countries.

ProfessorPlum · 16-10-2014 11:26AM

MadYaker wrote: »

Congo is a failed state and not safe for western aid agencies to enter.

True, but they are there none the less.

Creative Juices · 16-10-2014 11:35AM

MadYaker wrote: »

Congo is a failed state and not safe for western aid agencies to enter.

They seem to be able to handle it somehow nonetheless.

PREVIOUS OUTBREAKS
The Democratic Republic of Congo has had several deadly outbreaks of Ebola disease in the past. These include:

1976: the world's first Ebola outbreak, which killed 280 people
1977: 1 person died
1995: 254 people died
2007: 187 people died
2008: 14 people died
2012: 29 people died

Cantona's Collars · 16-10-2014 11:40AM

There's always an idiot with a clipboard somewhere:

http://i.dailymail.co.uk/i/pix/2014/10/16/1413418145946_wps_8_As_coverage_of_the_transp.jpg

http://i.dailymail.co.uk/i/pix/2014/10/16/1413418315034_wps_11_As_coverage_of_the_transp.jpg

So much for protocols.

Peist2007 · 16-10-2014 11:43AM

So how long will it be before it is known whether anyone on that nurse's flight was infected? As someone says above, that will tell us a lot about transmission. It will certainly test the "you can sit beside someone on a plane with Ebola and not be in danger" line that was being trotted out over the past couple of weeks.

Canis Lupus · 16-10-2014 11:52AM

gozunda wrote: »

As in this example?

http://news.yahoo.com/traveler-liberia-first-ebola-patient-diagnosed-u-003007621--finance.html

So the original case in the US back on the 1st Oct? I would hope lessons have been learned since he was brought in and treated. They are already in the process of tracking the contacts of the recent nurse who travelled.

ProfessorPlum · 16-10-2014 11:54AM

Peist2007 wrote: »

So how long will it be before it is known whether anyone on that nurse's flight was infected? As someone says above, that will tell us a lot about transmission. It will certainly test the "you can sit beside someone on a plane with Ebola and not be in danger" line that was being trotted out over the past couple of weeks.

95% of cases will have incubated by 21 days, 98% by 42 days. 42 days is where the WHO have drawn the line to declare regions Ebola free.

Akrasia · 16-10-2014 12:06PM

Peist2007 wrote: »

So how long will it be before it is known whether anyone on that nurse's flight was infected? As someone says above, that will tell us a lot about transmission. It will certainly test the "you can sit beside someone on a plane with Ebola and not be in danger" line that was being trotted out over the past couple of weeks.

If there are no symptoms and if test results come back negative after about 21 days, the passengers are in the clear. But We don't really need to wait 3 weeks. There won't be any infections from the nurse on the plane. Ebola is no more contagious than AIDS before the patient is severely symptomatic and the viral loads are high. Even when the nurse first started to feel feverish, she may still have shown up negative on an ebola test because viral loads would still have been low.

Ebola virus outbreak

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