Read this and tell me again how Ebola in the environment/on fomites isn't anything to fuss about:

[kestrel91316]

http://www.washingtonpost.com/news/to-your-health/wp/2014/10/03/can-you-catch-ebola-from-an-infected-blanket/

"Hensley said the speed at which the virus will degrade depends on many variables. Is the virus contained within dried blood or some other fluid? Is it exposed to sunlight?

"Anyone dealing with the virus should be extremely careful, she said – because the consequences of a mistake are potentially so dire."

[BlindTiresias]

1. No!

You have to literally be eating vomit and corpses to catch it!!!!!!!! It is as hard to catch as HIV!!!!!!!!!!!!!!!!!!!!!!!!!!

[Whiskeytide]

28. And millions had been infected with HIV...

... before people started taking it seriously. CDC estimates 50,000 new HIV cases each year even to this day. Ebola may be hard to catch, and its epidemiology is very different from HIV. But blowing it off as no big deal is foolish. We don't need to panic, but we need to address it with serious urgency.

If you were being sarcastic - as I now see you were- never mind.

[Louisiana1976]

2. That's why it's so worrisome that the Ebola victim's family had to stay for three weeks in their

Ebola-contaminated apartment.

[kestrel91316]

8. They didn't have to stay 3 weeks. They stayed 5 days (since the exposure to the victim ended).

They are in another location now that is clean (and that is a good thing).

I am worried that they will count the 21 days from last Sunday and not from today, since some of that virus could still have been alive today, we simply do NOT know.

[BlindTiresias]

3. Look at how many people are drinking ebola blood in the Dark Continent

Clearly the Enlightened West is impervious to such things, being entirely devoid of human ignorance, gaps in healthcare coverage, and indifference to the lower classes and immigrants.

[Fred Sanders]

5. Not immune to hysteria and projections of doom. Your OP clearly implies it.

Last edited Fri Oct 3, 2014, 08:57 PM - Edit history (1)

[BlindTiresias]

7. Who said anything about doom?

My entire point throughout this whole thing has been that hysteria is just as bad as being cavalier. Hysteria breaks down society and downplaying threats exposes people and creates blindspots.

[Fred Sanders]

11. Your graphic screams doom.

[BlindTiresias]

20. ???

Doom=actual vetted projections? Strange, I thought that would be the pinnacle of keeping ones head straight and focused at the matter at hand.

ECDC: propagators of doom!!!!111

http://www.ecdc.europa.eu/en/press/news/_layouts/forms/News_DispForm.aspx?List=8db7286c-fe2d-476c-9133-18ff4cb1b568&ID=1073

[Caretha]

21. It's not "His" graphic

I think you are confused. Your issue should be with the scientist/graphic maker and not the lowly poster here at DU.

[Fred Sanders]

22. Ok. I blame both of them, one for making it and other for misrepresenting it to spread fear.

We good?

[Caretha]

23. We good?

You kid - right?

I'm willing to look at the science/facts - even delve into the details from other sources. But, pay attention to someone who has no credentials and sounds ...hmmm childish....well, not so much.

We Good?

[magical thyme]

47. right. How dare the European CDC publish facts showing the

trendline of Ebola and the predictions by the WHO, CDC, and other organizations. What a bunch of hysterics...

[Erich Bloodaxe BSN]

4. Ok, I read it, and now I'll tell ya. IT's not much to fuss about.

Basically, what they said is the only thing to possibly worry about is the refrigerator/freezer.

I'd read this one

http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php

specifically the 'survival outside host' part under Section IV - Stability and Viability.

Basically, it only survives for any extended period outside a host when kept refrigerated.

[Fred Sanders]

6. All the Ebola outbreak has taught me is that the reptilian part of the human brain has not evolved.

[kestrel91316]

9. Um, no. Dried blood still has live virus for variable periods of time, many factors come into play.

The point is YOU CANNOT BE TOO CAREFUL since that proteinaceous debris just might have the one live virus particle it takes to kill you.

Where did you get your microbiology degree or your medical degree? Where did you study virology and epidemiology?

People like you are the problem. West Africa is full of the corpses of people who underestimated this thing.

The nuances and unknowns of this virus's survival in the environment cannot be summed up in a freaking MSDS sheet. Jesus wept.

[Erich Bloodaxe BSN]

17. Well, let's see

I didn't get a microbiology degree or study virology more than as part of pathophysiology and microbiology courses. I got my medical (nursing) degrees from Miami University, which is where I also studied epidemiology.

I would feel perfectly comfortable doing the cleanup on that apartment, or working with isolation patients with ebola in a hospital, as I have done with various other non-ebola isolation patients.

Where'd you get your medical degree, microbiology degree, and study virology and epidemiology, since we're comparing qualifications?

[kestrel91316]

37. I got my BS in Microbiology at Colorado State University

And my doctorate in veterinary medicine at the same place. I had an upper level virology lecture and lab (two separate classes) as an undergrad, an upper level immunology lecture and lab (again two separate classes) as an undergrad, along with coverage of epidemiological aspects of pathogenic bacteriology in that upper level undergrad class. In vet school I got doctoral level coursework in the whole shebang, at great length. And I have spent the past 32 years continuing to learn all about veterinary zoonoses and their epidemiology without any professional requirement to do so - just for my own betterment so as to serve the public better.

And in the school of hard knocks I learned all about rabies and how the public health system handles that (or should) in private practice years ago. I diagnosed a rabid cat that had been missed by two other vets, and the owners fought tooth and nail to violate all health department recommendations in the case, endangering my life and 21 others. Los Angeles Veterinary Public Health has given me a letter of commendation and considers me a minor public health celebrity as a result of this case.

We veterinarians are widely acknowledged to be a vital part of the public health system, though we are unpaid.

I have found far too many physicians and RNs to be dangerously ignorant of veterinary matters and zoonoses on far too many occasions, BTW. And I have also found that they usually hold veterinarians in contempt - they see us as pretend doctors, not real doctors. Though it is FAR more difficult to get into veterinary school than medical school.

I got into the best one in the country on my first try, right out of my undergrad program.

Since you asked.

[Erich Bloodaxe BSN]

44. Congrats.

I'm glad to find out you're not just one of those freaking out with absolutely no experience at all. But I'm still going to guess that you're one of a very small number of doctors who are as worried as you are.

Yes, it's a highly infectious virus, and yes, this is the farthest spread we've seen, but I'm not ready to embrace the notion that we're headed for Spanish flu territory in the developed world.

(And I hold my vet in high regard. Known her since '77, and I would trust her medical knowledge and acumen before my family GP's, actually. While vets certainly can specialize, as you well know, your typical vet is GP, surgeon, dentist and a number of other specialties rolled into one. AND they have to work exclusively with nonverbal patients. So yeah, I don't look down on vets.)

[kestrel91316]

50. I've personally experienced (and been harmed by) too many incompetent boob physicians

to have much faith in our supposedly fabulous healthcare system's ability to address an ebola problem when you add to it the tendency for people to lie, withhold information, and not follow medical advice.

It's the perfect storm when you combine it with ebola's high infectivity.

[TorchTheWitch]

46. I've said more than once that if I ever need health care

I want my saintly vet to do it... and at their prices. Almost every doctor I've seen is an incompetent boob that doesn't check your chart to see what your taking before prescribing nor asks you what you're taking, is so rushed they cut you off from asking questions or even describing your symptoms and other stupidity.

One doctor I'd been seeing for decades prescribed me a dangerous contradictory medication because he didn't bother to look at my chart with the huge red magic marker lettering on the front cover that announced I took __ so to make sure that I wasn't given any contradictory medication. Thankfully, I don't blindly trust doctors and always check the PDR for any prescription I'm given to make sure I can take it before even buying it. I called him and said it was a contradictory drug with my __, and he YELLED AT ME why did I not tell him and My GOD I could have died! Asshole.

Same doctor killed my father by prescribing him a medication for high cholesterol without doing the necessary liver testing beforehand and not doing the necessary liver testing every month he was on it because it was so high risk for liver cancer, and guess what my dad died of? Liver cancer.

Another doctor after having me in my undies and paper dress tried to have me sit on the exam table where it was clearly seen that whoever sat on it last must have been sweating profusely because they left a big damp butt print on the paper covering the table. I told him to not only change the paper but swab down the table with disinfectant and wash his hands, put on gloves and a mask before he even came near me much less touched me or I'd pitch his bleeding ass out the window (we were 11 stories up and I had to translate what "bleeding" meant).

Another doctor I saw in the ER wanted to admit me to the hospital because having gotten food poisoning I hadn't eaten for nearly two days. When I asked what the hell he wanted to admit me for he said because I wasn't eating. He was such a rude asshole I ended up crying a bit and he YELLED AT ME "What are you crying for!" I would have told him he better run before I pitched him head first out the window but we were on the ground floor. Instead I told him if he didn't run I'd grab the nearest heavy blunt object and bash his head in if he couldn't act with respect and competancy... and to get the fuck out and send me another doctor (who was fortunately very nice and very thorough though he was probably warned by the previous Dr. Shithead). My sister-in-law still sees Dr. Shithead and thinks he's great... but he's also reduced her to tears more than once and my brother (her husband) hates his guts and refuses to even go to his office for fear he may deck him.

Don't even get me started about the shit that I witnessed doctors doing and saying when I was a nurses' aid for 8 months.

On the other hand, my saintly vet I've used for decades are extremely thorough, will crawl on their bellies on the floor because my dog is scared of the exam table that moves up and down, will draw diagrams to help explain stuff or get out books with pictures to show me, listen to every word I say no matter how long I ask questions, make sure I understand something and can tell when I don't and will better explain it without making me stupid for not understanding, clipped some fur and a few toenails from my dogs that where in to be put down after they passed so I'd have a keepsake of a part of them and admit they had similar shrines for every one of their pets, knock off most of the price of meds or other treatments even surgery if I say I'm having money problems and send me lovely cards after losing a pet with every bit of white space filled with a handwritten eulogy to the pet, etc., etc.

Plus they know what the hell they're doing, keep the cleanest clinic that you wouldn't know was a vet's office if you didn't see any people in the waiting room with their pets and are open 7 days a week though they had to stop doing the 24 hour service due to lack of clients in the wee hours, and only use all natural healthy bribe treats that they dole out liberally and keep in the pockets of their lab coats so the animals know their delicious smell makes them good people. I've even see them cry or tear up when a pet passes or has to be put down or is diagnosed with something terrible. When my vet came back in the room and had to tell me that Boo had bone cancer I already knew because he'd gotten all teary eyed and was struggling not to really cry (which is also what made me start to cry). They also are quick to hand over the tissue box that's in every exam room when bad news is given or you're already boo-hooing. And they have awesome staff from the techs to the woman that answers the phone. That's why I always call them my saintly vet and why I wish they could do my health care as well as my dogs.

I swear if I ever get really sick or have a bad accident I want to go to my saintly vet!

[kestrel91316]

39. If you haven't read and understood and agreed to comply with every last

word of this stuff, you are part of the problem and not part of the solution.

http://www.cdc.gov/vhf/ebola/hcp/index.html

Hubris kills, and most BSNs have that by the bucketful.

[Erich Bloodaxe BSN]

43. Well, I haven't read the one on 'healthcare workers going to west africa'

and I probably won't get around to it. I do try to read anything that actually applies in the settings in which I practice. I have no more desire to catch something from patients than anyone else.

I also understand the desire for an 'abundance of caution'. But I will still be extremely surprised if anyone gets infected off of anything that is more than a week away from original contact with the infected guy that hasn't been kept refrigerated. If the virus was surviving that well outside of him, we'll be seeing people coming down with it anywhere he'd been while showing signs and symptoms, since virtually nowhere he would have been during that time will have been decontaminating. If even any of the family members come down with it, I would expect them to have contracted it with direct contact to the original patient, or contact with dirty bedding or clothes in the first day or so.

[kestrel91316]

49. That's probably your problem. You refuse to read about how to deal with Ebola up close and personal,

so of course you would underestimate it.

For a supposed RN to do so is horrifying. I hope for your patients' sakes you aren't ever put to work in an epidemic.

[uppityperson]

51. "I do try to read anything that actually applies in the settings in which I practice."

Maybe you missed reading that.

[Erich Bloodaxe BSN]

52. You sure like to hurl insults.

I indicated that I read up on what I'm going to encounter in my clinical settings, you interpret that as 'you refuse to read'...

If I ever go to west africa, i'll read up on west africa. It's not a matter of 'up close and personal', it's a matter of a totally different environmental setting with a totally different level of available healthcare options.

[magical thyme]

48. the NBC cameraman had his face splashed while helping to de-contaminate a chair

What I would note is that they are looking at samples that have *dried* outside the host. A glob of mucus takes a while to dry. Even a relatively thin glob smeared onto a slide and left in an micro incubator (very dry air, 37C) can take an hour to dry. Also, "thick" blood smears (thickness being relative, I would guess <1/32" thick looking at a ruler) in the incubator take an hour+ to dry. Same with urine smears.

The study was intended for researchers, but seems useful for anybody with the potential for direct contact either caring for or cleaning up after a patient.

Also for people who live in areas that get well below 4C (refrig temp).

"SURVIVAL OUTSIDE HOST: Filoviruses have been reported capable to survive for weeks in blood and can also survive on contaminated surfaces, particularly at low temperatures (4°C) Footnote 52 Footnote 61. One study could not recover any Ebolavirus from experimentally contaminated surfaces (plastic, metal or glass) at room temperature Footnote 61. In another study, Ebolavirus dried onto glass, polymeric silicone rubber, or painted aluminum alloy is able to survive in the dark for several hours under ambient conditions (between 20 and 250C and 30–40% relative humidity) (amount of virus reduced to 37% after 15.4 hours), but is less stable than some other viral hemorrhagic fevers (Lassa) Footnote 53. When dried in tissue culture media onto glass and stored at 4 °C, Zaire ebolavirus survived for over 50 days Footnote 61. This information is based on experimental findings only and not based on observations in nature. This information is intended to be used to support local risk assessments in a laboratory setting.

A study on transmission of ebolavirus from fomites in an isolation ward concludes that the risk of transmission is low when recommended infection control guidelines for viral hemorrhagic fevers are followed Footnote 64. Infection control protocols included decontamination of floors with 0.5% bleach daily and decontamination of visibly contaminated surfaces with 0.05% bleach as necessary."

[kestrel91316]

10. Gawd. Teh stoopit. It almost makes me wish we would have a serious ebola outbreak just to cull the

dimwits who refuse to take it seriously.

[Fred Sanders]

12. Everyone is taking it seriously, some are taking it hysterically and outraged at those not joining

in their hysteria.

[kestrel91316]

15. I'm not hysterical. But the blithe attitudes around here are really appalling.

Blithe attitudes around ebola will get you and your family killed.

[PCIntern]

18. What is bothering me is the way they're phrasing stuff:

I have two favorites already, though I'm keeping track and probably going to have new ones daily.

1. "There is a zero percent probability that…" Uh-oh…no such thing exists when it comes to epidemiology.

2. "Even if people show Ebola signs and symptoms who have come into contact with the Dallas victim, it's not an outbreak"

It would be riotous if it weren't so seriously frightening...

[kestrel91316]

24. Yep. People with zero epidemiology education need to not

make epidemiologic proclamations.

[uppityperson]

13. Thank you kestrel, that is very reassuring.

How long will it remain infectious? Hard to say, exactly, though there have been scientific studies on just that question.

In one laboratory experiment, scientists couldn’t recover Ebola virus that had contaminated a surface kept at room temperature. In another study, Ebola virus kept at cold temperature was recovered from plastic and glass surfaces after more than three weeks.

But Peter Jahrling, director of the Integrated Research Facility of the National Institute of Allergy and Infectious Diseases in Frederick, Md., doubts that in the real world the virus would survive nearly that long.
(clip)

“This stuff isn’t volatile, it’s not floating around the air,” Jahrling said. “You go in there with rubber gloves and a pail full of disinfectant, and have at it.” He suggested other protective equipment as well, including a face mask and goggles. Jahling isn’t fazed by Ebola because he studies the virus, and other dangerous pathogens, in a BSL-4 (biosafety level 4) laboratory. So does his colleague Lisa Hensley, a virologist and Associate Director for Science.

They are saying that the problem is not that it is easy to catch, which it isn't, but if you do the consequences are high.

Thanks for this article, it helps.

[cwydro]

14. You gotta wonder

how, if it is not that contagious...why the hell are they wearing all those biohazard suits?

[kestrel91316]

16. Because it is highly INFECTIOUS. Only 1-10 virus particles are necessary to infect and kill.

[PCIntern]

19. Didn't you know that it's safer than eating a banana?

You know…those Fukushima-banana comparisons...

[morningfog]

25. Has that been proven in humans?

I've only seen the 1-10 number cited from a study of non-humans.

[kestrel91316]

29. I'm pretty sure the research to "prove" that would be highly unethical.

Are you presuming to contradict the best medical evidence??

[flamingdem]

26. How did the NBC cameraman in Liberia get it?

They were all following protocol carefully.

[JI7]

31. from what i understand the camera man was in the country for a few years already

and only recently got the nbc job . i could be wrong.

but if this was the case he could have gotten it just going about his daily life and before whatever nbc would have provided to keep safe.

[uppityperson]

33. He lived there for the last 3 years, before recently getting the NBC job.

[Aerows]

32. Which is what scares the shit out of me.

There seems to be more at play here than we are being told.

[Zorra]

27. No problem. Make sure to keep on shopping. nt

[Aerows]

30. Here is the thing that I think about

"The foremost Ebola researcher in the world" died of it.

I think there is a lot of uncertainty and assumptions regarding this outbreak. We'll see as it develops. I'm heartened by the fact that there are many negative results to suspected cases. Let's hope that is a trend and it can continue to be contained.

[kestrel91316]

34. I REALLY hope that this Dallas case gets contained and limited to the one,

AND that it serves as a huge effing WAKE UP CALL to all the medical slackers and do-nothings.

[Aerows]

35. Precisely

This should serve as the canary in the coal mine that we aren't ready for a widespread public health emergency and we need to have a serious conversation about it and devote some revenue and resources towards being prepared.

[Duer 157099]

36. There's at least one thing I really, really appreciate about that article

the author never talks about the virus dying. He consistently uses the correct terminology, like: "remains infectious" (not "alive&quot and "disintegrates" or "degrades" rather than "dying".

Honestly I can't recall if the debate about whether a virus is a living thing has been settled or not. My opinion is that it is not.

Just a pet peeve thing.

[Aerows]

38. It's still debated n/t

[kestrel91316]

40. I look at them as more like machines.

Tiny malevolent machines. Though they have no intent, in reality. They simply exist, and do their thing as their chemical makeup dictates.

[Duer 157099]

41. Yes

They function as a mirror to show us the vulnerabilities we as a species have. That's it.

[kestrel91316]

42. They serve to keep all their host species on their toes, so to speak,

honing our immune systems and eliminating those of us with flawed genetics.

They actually aid in every species' evolution, as such.

[Sancho]

45. Thanks Kestrel...

I think what the CDC is saying about the transmission is correct, but it's obviously possible to catch ebola from "non-obvious" contact. What I mean is that a number of health care workers, the NBC camera man, etc. have contracted the disease even though they were taking all precautions.

It seems likely that either an airborne sneeze, or sweat on a faucet, or something similar was enough. The doctors are washing and spraying, avoiding touching their face, wearing suits, etc. Maybe an insect could transmit ebola in rare cases.

The two questions that are a problem for me are these....

1.) Exactly how long does ebola live on surfaces, skin (as sweat, etc.), and even in the air in droplets of saliva? It seems likely that the health care professionals who are infected likely caught it from a surface or as inhaled even though they thought they were safe. Maybe ebola is living longer on surfaces than previously thought, or else they simply don't know.

2.) Exactly when does an infected person transmit the disease? The CDC expert said symptoms occur from "2 to 20 days". I wonder if an infected person could be pre symptomatic, maybe an hour or two before it's obvious, could still transmit ebola? That may be part of the reason for the continuing spread of the disease.