Dallas Ebola incubation timeline

[morningfog]

Days since Duncan showed symptoms (Sept. 24)......20 days.


Days since Duncan was isolated (Sept. 28).....16 days -- 48 people are being observed in this group, including his family and the first responders. No one from this group has shown any symptoms as of yet.


Days since Duncan's death (Oct. 8)......6 days -- around 70 people provided care to Duncan before his death. As of today, one nurse, Nina Pham, has shown symptoms and infection has been confirmed. Pham was in his room often, from the day of his admission until the day before he died, which is when he would have been the most infectious and his bodily fluids contain the highest viral load.


Days since Pham showed symptoms (Oct. 10).....4 days -- One person is being observed as having direct contact with Pham after she showed symptoms.

______________________________________________________


The class of people exposed to Duncan pre-isolation have not shown symptoms and likely will not. The incubation period of this strain is 7-10 days in most people who become infected. It will be a very good thing when the official 21 days expire with no infections in the 48.

Pham's infection is troubling for all the reasons that have been discussed. Hopefully she will recover and no one will be infected while giving her care. Her one direct contact outside of isolation, was very early, when her viral load was low and when her symptoms relatively minor.

The 70 people in the same class/timeline as Pham are now in the critical period. If more were infected, they will most likely show symptoms in the next 1-4 days, with just over two weeks to go until the 21 days.

Of course, the clock has just started (and will restart) for those treating Pham.

If and when Duncan's pre-isolation class are cleared this coming Sunday, while the virus has spread to at least Pham, it will still have been contained within the hospital.

[Demit]

1. Are the 70 people in the 2nd group being quarantined, do you know?

I guess I could look that up, but you've done such a nice clearheaded summing up...

[morningfog]

3. Not that I have read. As of now the entire groups have not even been identified.

It is only "about 70."

[Demit]

9. I think I read elsewhere that people (maybe not this group?) are self-monitoring...

Taking their own temps twice a day. I guess because fever is the agreed-upon first sign of ebola. And I guess people would be scrupulous about this, as it's in their own interest to discover it early...

[morningfog]

10. Right. And that is how Pham, as part or this group,

Caught her infection so early.

[Yo_Mama]

15. No, but the second positive may cause a reassessment of that.

Because it's still early on in that exposure pipeline.

[YarnAddict]

2. One thing I don't understand--

How can she have had contact with only one person? If she was working, her co-workers and all of her patients would have had direct contact with her. If she stopped at a store to buy milk or dog food, a clerk would have had contact, and so would other shoppers. The virus can live on surfaces for varying degrees of time, so anyone who may have touched a doorknob she touched, or any number of other things could have been exposed. I just don't understand how they can definitively determine that there was only one person who may have been exposed.

[morningfog]

4. Only one contact, after showing symptoms.

She was taking her temperature twice daily. I assume she was at home with her one contact when her fever registered the first time. From there, she had no other contact with anyone else.

[YarnAddict]

5. I see. n/t

[LisaL]

8. She didn't go to work last two days before getting sick.

I guess we were lucky in that regard.

[Avalux]

12. Ebola isn't contagious until symptoms are present.

All of those things you've said are irrelevant if she was asymptomatic at the time. Apparently, after she noticed symptoms, she was in contact with one other person only.

[KurtNYC]

6. just a thought, you might correct "now" to "no" as some skimming readers

may get the wrong idea there.

[morningfog]

7. Got it. Thank you.

[morningfog]

11. The 48 are all healthy and Frieden says it's "unlikely" they will get the virus. -- CDC.

About 75 other health care workers came into contact with Duncan, and they are being monitored closely. Another 48 people who came into contact with Duncan outside of the hospital are still being monitored, but Frieden says they have passed two-thirds of the risk period for showing symptoms.

They are all healthy and Frieden says it's "unlikely" they will get the virus.

http://www.wfaa.com/story/news/health/2014/10/14/cdc-monitoring-125-people-for-ebola-symptoms-dallas-health/17257739/

[morningfog]

13. 2nd healthcare worker infected. (10/15/14).

[Yo_Mama]

14. Nice update, but overtaken by events. Several points of fact

According to WHO, 95% of cases fall within the 2-21 day incubation. 98% of cases fall in the 1-42 days, which is why WHO uses the 42 day range. Source for this:
http://www.who.int/mediacentre/news/ebola/14-october-2014/en/

Recent studies conducted in West Africa have demonstrated that 95% of confirmed cases have an incubation period in the range of 1 to 21 days; 98% have an incubation period that falls within the 1 to 42 day interval. WHO is therefore confident that detection of no new cases, with active surveillance in place, throughout this 42-day period means that an Ebola outbreak is indeed over.

So now we have the second Dallas HCW.

Also, WHO recently calculated an average incubation period for this outbreak at 11.4 days. WHO's standard for clearing a suspected case is two negative RT-PCR tests at least 48 hours apart.

After the second HCW positive, it may be time to segregate these people.

[morningfog]

17. Thanks. That is good to know.

[TBF]

16. CDC website for monitoring purposes -

they are still claiming Ebola is not an airborne disease. We shall see. http://www.cdc.gov/

2nd case in Dallas announced.

[morningfog]

18. Nothing suggests it is airborne.

[TBF]

19. Not yet. And I completely

understand that the democratic party does not need this at the time of midterms.

I get that.

But we also needn't stick our heads in the sand.

[morningfog]

20. Not sure how the Democratic party influences

a virus's inability to mutate to become airborne. If it were airborne, the infection rates for Duncan's pre-isolation contacts would be well over zero. Don't you think?

[TBF]

21. I will clarify -

I think there is a concerted effort on this website by certain posters to downplay Ebola due to the midterms. It's frustrating because people want to talk about what may or may not be happening with Ebola and what we get is "don't worry, be happy" in response.


I don't think we're as prepared to handle it as some would assert, and I place that squarely on the republicans who have cut funding for research at every opportunity.

I do think you make a good point re Duncan's pre-isolation contacts and that gives me hope you are correct and it really is a training issue (or an issue with that particular hospital in Dallas not being prepared).