Have you touched an Ebola Patient’s Puke, Sweat, Sh*t, or Blood? If Not, You Don’t Have Ebola.

[riqster]

Last edited Fri Oct 17, 2014, 01:38 PM - Edit history (3)

Hopefully, everybody will calm the f*** down now.
And stop blaming nurses, too, PLEASE.

That’s because there has been no evidence that Ebola spreads between people through the air. Health experts repeatedly emphasize that human-to-human transmission requires direct contact with infected bodily fluids, including blood, vomit and feces.

And to infect, those fluids have to reach a break in the skin or the mucous membranes found around your eyes, mouth and nose.

Source info at the link. Enough with the [IMG][/IMG], already.

http://bluntandcranky.wordpress.com/2014/10/17/have-you-touched-an-ebola-patients-puke-sht-or-blood-if-not-you-dont-have-ebola/

On edit: yes, other bodily fluids can also carry the virus, such as sputum or breast milk. I excluded them from the title because they are not typically spread by Ebola patients. Typically, the patients vomit, defecate, sweat, or bleed, or some combinations thereof.
It is of course wise to be mindful of contact with other people's bodily fluids in any case: influenza, for example, is a risk to millions of people. So too are HIV, Hep C, the common cold, and so on.

Mindfulness is, however, not panic. We need to calm down and deal with this in a rational manner.

[grahamhgreen]

1. Or sweat.

[riqster]

4. I'll add that.

I also left out breast milk and saliva, but they require very close contact.

[hfojvt]

92. what about tears?

I mean, we have blood and sweat ...

[grahamhgreen]

97. And tears

[riqster]

112. Interesting article:

http://commonhealth.wbur.org/2014/10/reality-check-how-catch-ebola

Different fluids become infectious at different times as the disease progresses.

[cali]

2. while that may be true, the virus can live

on surfaces for a period of time. It's not like you have to stick your hand in a puddle of puke or piss.

[riqster]

3. The period of time and quantity are open questions, so I left that out.

My point is that people are panicked and forgetting basic facts.

On edit: I just went to the CDC site, and although it is true that the virus can survive on surfaces for several hours, the bodily fluids are still required to be present in order to be transmissible to another person.

[cali]

5. The CDC hasn't been great on Ebola.

I'm not criticizing the agency really. I understand their perspective, but the fact remains that there is a great deal we don't know about Ebola still. Quite a few epidemiologists have stressed that point, including Peter Piot who discovered and named the virus.

Panic is decidedly dangerous. I don't believe we're in danger of a full blown epidemic like in West Africa, but if we don't get it under control there, all bets are off.

[riqster]

6. Their understanding of the virus seems in line with other agencies.

Where they are fucking up is how they are handling actual operations. And you are correct, they need to get it together.

[cali]

7. no, it is not entirely in line with other agencies and experts.

It really isn't. WHO, for instance, has/had stricter protocols.

[riqster]

10. Protocols, yes. Policies, yes. Procedures, yes.

Science of the virus's behavior, not so much. They don't have (at least according to what I have been able to find) evidence of non-direct-fluid-contact infection vectors.
I'd be interested in reading anything that demonstrates otherwise, of course.

[pnwmom]

24. The CDC says it can be caught through sneezing and coughing, if an Ebola patient is close enough

for it to land on someone.

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

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.

[riqster]

29. That is direct contact with bodily fluids.

Just edited the OP. Thanks!

[HereSince1628]

9. this is from the public health agency of Canada...

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

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°C and 25°C 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.

[riqster]

21. Very interesting! Thanks.

Again, no evidence of infection via such a source, but it certainly brings data to the discussion.

[Sivart]

8. immune?

Are some people immune to ebola? Is that possible?

Just curious...

[cali]

11. yes, some people appear to be immune to ebola. Just read an article

about that, but forget where.

Here it is:

http://www.medicalnewstoday.com/articles/284037.php

[riqster]

13. So far, no proof of it. Not enough cases.

Last edited Fri Oct 17, 2014, 02:00 PM - Edit history (1)

I understand that survivors are being followed to see if they have immunity, and that one patient has recently been transfused with plasma from a survivor. I haven't heard of any conclusive evidence of immunity as yet.

On edit: just read Cali's link. No proof yet, but possibilities do seem to exist. Here's hoping!

Further edit, "pajama". Ooops, missed that little autocorrect gem. Fixed.

[moriah]

38. Pajamas can give immunity? (grin)

I assume you meant plasma. Damn spell check!

[riqster]

39. That ducking autocorrect!

[Ykcutnek]

12. Irrational fear and finger pointing is how us Americans deal with crises.

That will probably never change, but it gets tiresome.

[riqster]

14. It's also how we are manipulated. The Propaganda of Panic.

[Savannahmann]

15. I've also read a bit about it.

Let me provide links and explanations.

The CDC says that there are methods of transmission, but they say there is no evidence that it can be transmitted by Mosquito's as an example. http://www.cdc.gov/vhf/ebola/transmission/index.html?s_cid=cs_3923

OK, so it can't be transmitted by mosquitos, but it can be transmitted by bats? You can get it from a needle, but you can't get it from the needle like aperture on a mosquito?

OK, fine. But you see why my level of doubt is starting to climb. Because the assertions are starting to sound a little illogical? The argument about the Mosquitos by the way, is that the Mosquitos can't catch the virus, and thus can't become symptomatic. OK, so a needle can catch the virus, and become symptomatic? No. The needle merely transfers the virus from the infected person, to the uninfected. The same way a mosquito does for a number of diseases, the mosquito doesn't catch malaria, it merely carries the malaria parasite to the soon to be infected person. So why is it impossible that the mosquito would not carry the Ebola virus from one person to another?

http://www.cdc.gov/ncidod/diseases/list_mosquitoborne.htm

I'm not saying it's likely, but that it is obviously possible. It is obviously possible, and ruled out by the list of things you've put out there. So we're safe. Somehow, through some sort of Dark Magic, or perhaps divine intervention, Mosquitos are magically sterile where Ebola comes in, but at the same time perfect transmission mediums for a couple dozen other diseases. I know, it's Witchcraft or something right?

The flu is spread by sneezing or coughing, the virus particles are ejected with the spray of the sneeze.

Now if someone doesn't know they have it, if they are even suffering from two things, flu and ebola, or mistake the itchy nose for a seasonal allergy, unlikely or whatever, then this comes into play doesn't it?

But thankfully all these questions have been answered by you. I have to just about roll around in the infected bodily fluids of the person who is fully symptomatic. I could go swimming in the bile, blood, or nasal mucus of an infected person who is not symptomatic and be perfectly fine. Really, I have your word on it. And if it appears slightly illogical to those of us who aren't bobble head dolls, well that's because we're the idiots right? If the events turn out to actually prove your assertions wrong, you can't personally be held responsible for your assertions that anyone who disagrees with you is merely running about with their hair on fire.

Somebody let me know when the OP is advising everyone to have holes drilled in their heads to let the evil spirits out.

[riqster]

16. Actually, the opposite of your last paragraph is true.

All of these "coulds" and "possibles" and "maybes" are analogous to the ancient Germanic superstitions about evil spirits in our heads being responsible for illness, not my reliance on hard data.

Backwards, you have it. Ja.

[Savannahmann]

17. Great, so we can rule out Mosquito's as a method of transmission

Outstanding. You will excuse me if I don't jump for joy by the way. In fact, you'll excuse me if I reject that assertion out of hand as utterly illogical and asinine.

I've got some experience in engineering. The wise old Engineer who trained me taught me this way. Never build up, always cut down. What he meant was this. Start with the worst case scenario, and work down from there to best case. With a disease like Ebola, one that already has a 70% mortality rate, don't assume that the means of transmission is the best case, assume it is the worst case. Assume that droplets from a sneeze days before the patient became symptomatic are infectious. There had to be ebola strands in those droplets, the disease does not progress from one strand to a billion in the space of a few hours. It progresses in a logical logarithmic manner. From one you get two, then four, then eight, with a doubling on a predictable schedule. Some of those will be ejected before the patient is symptomatic. That is plain and simple logic. That is plain and simple common sense experience of everyone who has ever endured flu season. So a sneeze from an individual from a source as innocuous as dust could eject ebola strands into the air, where it is breathed in by another.

So the worst thing we can do is panic the population. That is a given. The second thing on the list of bad things that we could do is give the people a false sense of security. Don't worry, you can't get it unless you roll round in the blood, bile, or feces of the patient showing frank symptoms is that second worst thing.

Read some history, read about how diseases were stopped in history. Read about the Plague, the Spanish Flu, and many other diseases were tackled by science. The Bubonic Plague was not eliminated when we killed the rats. It was eliminated when we isolated all those who had come into contact with someone who had the plague. Plague Islands for ports where the disease showed up. They were used to quarantine anyone with any disease. The diseases did not spread, because the individuals with the diseases were unable to intact with and infect the public.

Widespread panic is a bad thing. I agree. However, false sense of security is just as bad. Because if Ebola continues to spread, than people will decide that the public health experts are fools and will ignore them and take matters into their own hands. Civil order is one of the major challenges facing the nations with widespread ebola outbreaks. Neighboring nations have closed their borders in order to protect their own populations.

We are using nonsensical statements in an effort to contain the panic, but those statements will be utterly rejected if things get worse. That is not hair on fire nonsense. That is an assessment from history. Deal with it.

[riqster]

19. As an engineer myself, I respond to evidence and facts.

When you have something verifiable, based in evidence, I will deal with that.

Frankly, your attempt at establishing intellectual superiority would ring less hollow if you knew how to use an apostrophe. That failure leads me to suspect sloppiness in your thinking as well.

Give me some facts instead of suppositions. Cali did so upthread, and I treated her posts with respect, even though we don't often agree on much of anything. Because she came equipped with sources.

You think mosquitoes can carry Ebola? Cite some research.

You think sneezes can carry Ebola? Cite some research.

Until then, such little hair as remains on my elderly noggin shall remain flame-free.

[pnwmom]

23. Sneezes and coughs carry bodily fluids in the form of spit and mucous.

Do you really need research proving that?

If you were sitting next to someone on an airplane and that person coughed, and the spray landed on you or something you touched, and then you touched your mucous membranes, yes, you could get sick.

http://www.ibtimes.com/can-you-get-ebola-sneeze-or-cough-facts-myths-about-viral-infection-1706565

Can you get Ebola through a sneeze or cough?

A person who was symptomatic would have to sneeze or cough on a person directly, and then the mucus or saliva would have to come into contact with the eyes, nose, mouth or open wound for an individual to be at risk. Sneezing and coughing are not symptoms of Ebola.

[riqster]

43. That's what I'm talking about. Thanks. Citations.

[Fred Sanders]

72. Strange how liberals who profess to love science abandon it instantly at the crack of the whip of

the mass media.

[SoCalDem]

106. Dengue is mosquito-borne.. People EAT bats

whomever butchers the bat, nicks themselves..blood mixes..and there you go..

If the governments would spend money on sewers/toilets/running water and ordinary food, people would not be walking through sewage in flip flops/barefoot and butchering bush-meat.. That's how you "stop" ebola..

[JoePhilly]

18. I only drive in the "Ebola Free" lane on the highways now.

So I should be safe.

[riqster]

20. Dang, I thought "HOV" meant "High Occupancy Vehicle".

Now you tell me it's "Healthy Only"? Shit, I've been missing out.

[pnwmom]

22. You left out spit and mucous from the nose, both of which could land on surfaces

if the person happened to cough or sneeze. And each tiny drop contains billions of viral particles.

[riqster]

32. Edited the OP. Thanks.

[former9thward]

25. Tell that to the NBC camera man who was infected.

[riqster]

30. And exactly how was that person infected?

I would bet that direct contact with bodily fluids was involved.

[former9thward]

31. He says not.

Some people claimed he got it from washing his car.

[riqster]

33. Ummhmmm. "Some people". Yup.

Let's wait for something with scientific rigor attached.

[trotsky]

35. Hey - "some people say" is enough to run an entire news network on.

If it's good enough for FOX, it should be good enough for us to panic over!

[riqster]

37. It's right up there with "I know a guy".

[former9thward]

56. Yeah, like the CDC Director sitting in his comfortable office in Atlanta

blaming the nurses for "not following protocol" when he didn't know a single fact about the matter.

[riqster]

58. Exactly. We need facts.

When that CDC putz got caught bullshitting, it was a wonder to behold.

And I daresay the "washing his car" folk will look equally silly when trained professionals find out how this brave cameraman did in fact contract Ebola.

[valerief]

26. Off to Ignore for you!

[riqster]

44. Poor me.

[Logical]

49. LOL, add me too if that offended you. nt

[riqster]

50. Let's start an organization: I. O. I. D.

Kind of like the Odd Fellows, but we'd be the International Organization of Ignored DUers.

[LostInAnomie]

27. Or, have been within three feet of someone with it...

... or maybe accidentally touch the skin of someone with it.

http://www.cdc.gov/vhf/ebola/hcp/case-definition.html

Ride any public bus or subway and tell me how many people you bump into or are within three feet of.

[riqster]

36. Point, although remember symptoms and transmission.

Last edited Fri Oct 17, 2014, 02:43 PM - Edit history (1)

I would have to inhale airborne liquid from a patient, or touch bodily fluid on the skin with an open wound on my finger to contract the disease.

Not impossible, but not terrifying either.

[LostInAnomie]

40. Or, they could cough, sneeze, wipe vomit from their mouth, wipe poorly, etc.

Resulting in biological material on their hands which they then use to touch doorknobs, light switches, writing implements, ATM buttons, etc.

How often do you touch something public and then touch your face before you wash your hands?

[riqster]

41. Again, possible. But it is still contact with bodily fluids. If I see puke on a doorknob, do I grab?

Hell no. I wipe it off first. Same with liquids or smears of any source.

There are lots of things to watch out for like flu and colds, ya know. The same precautions work here too.

[LostInAnomie]

46. It takes as few as 10 virions to successfully infect someone with Ebola.

How confident are you in your ability to spot 10 virions worth of biological material?

[riqster]

47. From all I have been able to find, the virus has to be in suspension.

No information exists on an Ebola infection being transmitted without it still being carried by bodily fluid. And I feel pretty good about my ability to see liquid on a surface, and to be mindful of any open wounds on my hands when touching surfaces.

When and if science documents Ebola transmission without bodily fluid, I'll worry. For now, I'll go with what the data shows.

[LostInAnomie]

65. Let's increase the volume then: One drop.

One drop of any bodily fluid you choose. More than enough to carry the critical mass to infect you. How sure are you that you could spot one drop of biological material on all the surfaces you touch throughout the course of your day? Every door knob, pen, key pad, toilet, telephone, piece of fabric, skin, etc., could be a hiding spot.

Are you absolutely sure you could see the threat before you rub you eyes, bite your nails, pick your nose, or accidently touch a scratch you don't know about?

It might not be much of a threat now, but it wasn't much of a threat a year ago in Liberia either.

[riqster]

69. This is different from other diseases, how?

One breath could give me the flu. Because it is Ebola, we should all go lizard shit insane?

No. Take reasonable precautions. Treat it like it is: a risk to be managed with awareness and science,

[LostInAnomie]

73. A few ways...

Most regular diseases like the flu have effective, readily available vaccines and treatments.

Most regular diseases like the flu are only deadly to people with health conditions or because of age may not be able to fight it off.

Most regular diseases like the flu don't have a +70% mortality rate.

It's easy to manage risk currently because only 2-3 Americans are infected by it. That could easily be subject to change.

[hedgehog]

71. I don't think anyone deathly ill with Ebola is going to be taking a subway any time soon.

[LostInAnomie]

74. Amber Vinson took a plane from Ohio to Texas while infected and feverish.

Why would it be any harder for an infected person who is feverish and vomiting to take the bus or subway to the hospital?

[hedgehog]

75. A mild fever is something a lot of people go to work with -

explosive diarrhea and projectile vomiting, not so much.

[hedgehog]

28. Ebola has been bouncing around in West Africa almost a year now -

in places with no running water and no toilets. Truth to tell, I'm not certain there are latrines. This is not to denigrate the people of West Africa, it's just to bring home to First Worlders what "Third World" means. These are countries where tens of thousands of children die from diarrhea each year. These are countries with fewer doctors and nurses than most major American cities. If Ebola was that easy to catch, we'd all be dead by now.

[riqster]

34. Poverty is a huge factor. And local customs.

[trotsky]

42. And where burial rituals involve direct contact with the deceased...

http://www.voanews.com/content/traditional-burial-practices-hamper-efforts-to-fight-ebola/1970353.html

[hedgehog]

45. Again, proof that while it is contagious and deadly, it's not that easy to contract Ebola.

Last edited Fri Oct 17, 2014, 03:58 PM - Edit history (1)

[riqster]

48. Not in America, at least.

[Eugene Stoner]

51. this

let me know when healthcare workers stop wearing hazmat suits and building special isolation rooms for the sick. I wonder what the CDC requirements are for working with Ebola. Probably t-shirts, shorts and flip flops since its a low risk of transmission? The cognitive dissonance is unbelievable. On one hand you have people saying something to the effect of "nothing to worry about, we have it under control, it does not spread easily" contrasting with photos and video of wash down areas, people wearing protective clothing. Images of special containment and isolation areas and positive pressure suits, that are normally used for the containment of highly infectious airborne diseases.

[riqster]

52. Our infrastructure is poorly equipped for Ebola.

Poor in equipment, budget, materials, protocols, policies and procedures. So lots of stupid things are being said and lots of people are cobbling together gear meant for other purposes. It'll get sorted out eventually, as soon as Repubs can find a way to profit from it.

But the other matters remain true. Most Americans do not live with open sewers, filthy water and primitive conditions. And those who do tend to be isolated and thus not a large risk from an epidemiological standpoint.

[Eugene Stoner]

53. but

1 imported case turns into 1 death and 2 ill health workers who did not go anywhere near a sewer or any of the other straw men you tossed down. You argument is disingenuous

[riqster]

54. No, the health care workers treated him.

While he sweated, bled, puked and shat. And they did so while wearing improvised protective gear due to institutional ineptitude.

Read the OP. They did in fact contact those bodily fluids. Repeatedly.

[Eugene Stoner]

55. I've read it and I disagree with your premise and your source

Ebola Zaire is a level 4 bio-hazard and should not be down played. EOM

[riqster]

57. Nor should it be sensationalized.

[Eugene Stoner]

59. here's an authoritative source

on how to deal with infectious agents. pay close attention to the BSL-4 sections.

http://www.cdc.gov/training/quicklearns/biosafety/

[riqster]

60. There is something from the same source in the OP.

It says how you can catch Ebola.

Via contact between infected bodily fluids and your mucus membranes and/or open wounds.

Period.

[Eugene Stoner]

62. Wrong absolutely Wrong

Filoviridae has 5 ebolavirus species and one Marbugrvirus species

Zaire
Sudan
Reston
Tai Forest
Bundibugto

Marburg

Of these at least one (maybe 2) has been tested and confirmed in laboratory tests to be aerosol or airborne transmitted. The origin of none of the ebolavirus species has been specifically identified but has been traced to the same river valley in Uganda/Kenya. It is believed and supported by scientific theory that they all originate from the same or very similar source and have spread world wide through mutations in both animal and human vectors.

If they are all mutations of a single origin then it not sensationalism but common sense to be aware of the hazards.

you my friend are in need of some better sources. Google is your friend

[Marrah_G]

94. Reston is the airborne version that kills monkeys but does not create illness in humans

They believe that fruit bats are the host species but are not absolutely sure yet.

Also, unlike the other Ebola strains, Reston came from monkeys in the Philippines.

[elias49]

79. Yes. This! If ebola was easy to contract

western Africa would be a wasteland by now. Not 4,000 but 400,000 dead.
Thanks for saying what I've been wanting to say.

[riqster]

80. Indeed. All the people who are dead from Ebola deserve to be alive.

And we can best honor their memories by facing reality, eschewing panic, and demanding action from the bastard Repubes who sacrificed those innocents in the name of budget cuts that filled the pockets of the rich as the same time as the morgues of West Africa.

And freaking out over a non-contagious nurse gets in the way of more constructive action.

[hedgehog]

61. I was referring to the general public. Health care workers here and in Africa

take much greater risks of exposure to bodily fluids than the average person walking down the street. While i would agree that health care workers need to wear protective clothing, and that hospital procedures need to be adjusted to isolate patients properly, there is no need for the rest of us to run around with our hair on fire.

[riqster]

63. Quite true. The same precautions we take against other bugs serve us well.

[Eugene Stoner]

64. Wrong Again

None of the other bugs are BLS-4. influenza is BSL-2 and BSL-3 for some of the more deadly like H5N1

Biosafety Level 3. The inner sanctum is supermax, or BSL-4. Researchers can study bubonic plague at level 3; Ebola and other killers that are transmissible and currently incurable must be quarantined at level 4. The institute is so security-conscious that it asked Popular Mechanics not to identify the floor on which the BSL-3 and BSL-4 labs are located.

Again I urge you to take some time out and do some reading on the subject

http://www.popularmechanics.com/science/health/med-tech/4315093

[Ms. Toad]

66. The problem with that premise is that you don't know.

Nurse Vinson was experiencing symptoms as early as Friday, four days before her Monday diagnosis.

She was in close contact, with a fever, at least with her seatmate in two flights. I typically sweat when I run a fever - so during that ~ two hour flight, there could have been sweat and saliva (as service items were passed across the row) among those seated in closest proximity to her.

Her sweat, potentially mucous, saliva, and fecal matter (depending on her cleanliness habits) could have been deposited on her seat and tray. Given the quick turn-around before the next flight, the next person sitting in her seat - or row - could easily have come into contact with those three bodily fluids and transferred them to their eyes or mouth by rubbing their eyes or eating during the flight.

The same scenario can be played out with the contact in the bridal shop, where the fitter would have almost certainly come into contact with her skin - and definitely the fabric of the gown - in the process of fitting her. Depending on what stage of the gown selection this was, others that same day may have tried on the same gown - potentially transferring the sweat to their skin for transmission to mucous membranes, or through any breaks in the skin.

No - hair on fire panic is not appropriate. I work about 4 miles from where she lives in Akron. I am keeping an eye on any new information about where she visited to make sure I was not there while or shortly after her visit - but beyond that I am not doing anything I don't already do during flu season to protect myself. The contact pool is still relatively small, and given her viral load was likely pretty low in the first few days of the disease, the chances she transmitted it to anyone in that direct or indirect contact pool are pretty slim.

But those chances are not zero, and the cost of pretending that they are could well mean death. Stop trivializing the screw-ups that got us to this place - and the risks that people need to pay attention to in order to stop this before it becomes appropriately a hair on fire nightmare.

As I recall, you were johnny on the spot with outrage when anyone dared suggest anything Nurse Vinson did was wrong. We now know that (1) she was definitely symptomatic on Saturday when she was out and about trying on wedding gowns, (2) potentially symptomatic on Friday as well before her first flight, (3) didn't directly call the CDC to ask about flying, and (3) flew at least once - potentially twice - with symptoms that someone (a) who had directly treated an Ebola patient and (b) was trained in medicine and (c) knew a co-worker had contracted Ebola should know were consistent with the early stages of Ebola.

[Eugene Stoner]

67. Hear Hear, sanity prevails

NT

[riqster]

68. Link please.

[Ms. Toad]

70. I've posted links (as have many others) in multiple threads already.

Instead of continuing to vulgarity laced crap that you have to correct when people provide you here with links they have repeatedly provided elsewhere, you might want to spend some time reading the threads or doing your own direct research in a way that doesn't just reinforce your preconceptions.

But Thursday, Dr. Chris Braden of the CDC told reporters in Ohio that Vinson may have had started feeling general malaise October 11, and that investigators couldn't rule out the possibility that her illness started October 10, the day she flew to Ohio.
"So this new information now is saying we need to go back now to the flight that she took on Friday the 10th and include them in our investigation of contacts," he said.

http://www.cnn.com/2014/10/17/health/us-ebola/index.html

But a federal official with direct knowledge of the case told CNN's Elizabeth Cohen that Vinson said she felt fatigue, muscle ache and malaise while she was in Ohio and on the flight home. The prospect that she might have felt sick during her time there has led health authorities to reach out to more people, from those on her initial Dallas-to-Cleveland flight to those she interacted with in Ohio.

http://www.cnn.com/2014/10/16/us/amber-vinson/index.html

In fact, he said a CDC official -- through an intermediary in Texas -- gave his niece the go-ahead to fly, even after learning that she had an elevated temperature of 99.5 Fahrenheit. Officials confirmed that she got the OK to fly, although there were questions about who contacted whom.

http://www.cnn.com/2014/10/16/us/amber-vinson/index.html

Vinson did not directly call federal health officials for permission to board a passenger flight Monday, instead talking to a team of Texas health officials who relayed her symptoms to the Centers for Disease Control and Prevention, her uncle told ABC News.

http://abcnews.go.com/Health/ebola-nurse-called-texas-health-officials-flight/story?id=26266763

Only one laboratory study, which was done under environmental conditions that favor virus persistence, has been reported. This study found that under these ideal conditions Ebola virus could remain active for up to six days. In a follow up study, Ebolavirus was found, relative to other enveloped viruses, to be quite sensitive to inactivation by ultraviolet light and drying; yet sub-populations did persist in organic debris.

http://www.cdc.gov/vhf/ebola/hcp/environmental-infection-control-in-hospitals.html

[riqster]

77. So, she may have felt this, and somebody told somebody that.

There is no evidence that she exhibited any of the symptoms that are required to transmit the virus. None.

Let me know when the huge outbreak happens a dozen or so miles from my hometown, won't you? I'm betting it won't.

All the panic fetishests really need to calm down.

[Ms. Toad]

78. Anyone trained in medicine,

who has treated someone with Ebola, and who has symptoms matching the early states of a viral infection should assume it is Ebola until proven otherwise. She chose to treat it like a common cold and hop on a plane even though she had a fever, was fatigued, feeling malaise and potentially muscle aches (all but the last are statements from the CDC; the last is attributed to an unknown Federal official close to the case).

Had she acted responsibly (or had the CDC and Texas Presbyterian acted responsibly), there would not be a couple dozen nurses on paid leave from Metro Health & the Cleveland Clinic, a dozen or so people quarantined at home, and up to 250 who were on the plane with her on either of the two flights being self monitored, the additional cost to staff the Summit County (and perhaps Cuyahoga County) tracking hotline - extended a day because of the volume of the response, not to mention several schools and one business closed temporarily.

That does not mean there will be a huge outbreak. If you've been paying attention at all, you know I have said no such thing. The average person with Ebola only infects two other people. With any luck she was early enough in her infection that she was not infectious at the level of contact she had with others. But the irresponsibility shown by Ms Vinson, the CDC, and Texas Presbyterian has resulted in a significant financial and emotional cost even if we are lucky and it does not result in any additional Ebola infections and deaths.

[riqster]

81. Most of the emotional cost has been inflicted by the panic fetishests.

While you bash Ms. Vinson, you let the real culprits off the hook: Repubs who have for years blocked progress towards vaccines, treatments, infrastructure, supplies, and protocols.

Panic fetishests are helping the Repubs do their dirty work. Please stop encouraging the pillorying of nurses: instead we need to agitate for funding and prioritizing a better world, one in which science is utilized and hysterical nonsense is marginalized.

[Ms. Toad]

82. It is not hysterical nonsense

to encourage people who have medical training to actually use their training when it comes to Ebola, which we don't do when we let any of them (including Ms Vinson) off the hook. I am not letting the real culprits - which, in this case, include all three of Ms Vinson, the CDC, and Texas Presbyterian - off the hook. All three made stupid mistakes.

All of those mistakes that each of them made needs to be publicly acknowledged so we know what they were, and to discourage people from making them in the future.

The message that it is fine and dandy to ignore your medical training because someone else said it was OK is a potentially deadly message - and I think it is important to stop that message cold. As mobile as we are in this country, everyone needs to start using common sense to avoid transmission of Ebola or we risk an epidemic that is potentially worse than Africa. If you know have been exposed - and you experience flu-like symptoms or any temperature - assume you have Ebola until it is confirmed you don't. Period.

[riqster]

83. "Exposed" is the key here.

You are defining it in an hysterical fashion, in which every space a potentially symptomatic person might possibly have occupied is a den of death. Note the "potentially"-for all your efforts to imbue "possibles" and "maybes" with an aura of certainty, no one has proven Ms. Vinson was contagious. No one has proven anything of the sort.

Meanwhile, people around the world die in droves from diseases far more easily transmissible than the phantom menace you so loudly shout about.

Hysteria. Never helpful, except to those who profit from it. We need to go to the root cause if we are to solve the problem, not heap abuse on professionals who have worked to help others.

[Ms. Toad]

85. When did I define it that way?

Stop putting words in my mouth. I have not said a single word to indicate that I thought every space a potentially symptomatic person might possibly have occupied is a den of death.

Amber Vinson did expose everyone she came in direct contact with once she started having symptoms - which was either Friday or Saturday, based on the interviews the CDC had with her. That includes her family, the party at the bridal shop, and at least her seatmates and people she interacted with on the one, possibly 2, flights. The risk that anyone was infected from that exposure is small, but non-zero. My point, which you know if you are reading with any integrity, is that because of her known exposure to someone with a very active Ebola infection, the minute she experienced symptoms she needed to assume she had Ebola and treat it as Ebola until proven otherwise. That would have prevented - or at least minimized - exposing others.

It turns out that Thomas Duncan was very careful about limiting known exposure to Ebola, and the story about his helping a pregnant woman who died from Eboal is an urban myth. So he apparently contracted it from someone who was not blatantly symptomatic - or from contact with a surface he touched that he was unaware someone who was blatantly symptomatic had touched recently enough to have active virus.

Tearing out the seat covers and carpet where Vinson sat on the plane was overkill. Outside the body the virus is relatively weak and can be destroyed by thorough cleaning with standard cleaning products. Cleaning sufficient to kill any potential virus on places she was likely to have touched did need to be done - including cleaning the bridal shop Amber Vinson was actually in.

Closing and cleaning any place that anyone who was on the plane with Amber Vinson is overkill. People who were on the plane with Amber Vinson and who came in contact with her were exposed (and if they begin to feel flu-like symptoms within 21 days after exposure they need to assume it is Ebola until proven otherwise). Because. in the first two days after exposure (unless they became symptomatic that early), you are not contagious there is no danger that those individuals transmitted their own version Ebola to any surface in the buildings they were in. Any transmission would have had to be of the virus they picked up by contact with a surface touched by Amber Vinson (or by touching Amber Vinson herself). It would have had to persist on their skin or clothing through whatever other contacts they had with anyone or anything else between the plane and their buildings, not to mention changes of clothing, showers, hand washing, etc. Whoever touched a contaminated surface would then have needed to transfer whatever virus they picked up to a cut or mucous membrane. Not to mention that because Vinson was in the early stages of Ebola, her viral load was low, so there would have been minimal viral shedding to create virus laden surfaces. So the chance that anyone does not have Ebola would have transferred active virus by physical contact with virus left by another person to a separate building, in most cases at least a day later, is small. Given how poor most cleaning services are, there was probably a greater chance that cleaning crews would have missed it even if it was somehow present.

But - the fact that the risk of people she exposed are unlikely to come down with Ebola doesn't excuse her failure to treat the early stages of Ebola as Ebola. We will probably get lucky this time - but if we excuse that kind of behavior (and continue to minimize the risk it poses to zero), the next time we may not be so lucky. Ebola is an extremely dangerous virus - and we must treat it that way - which means if you have had direct contact with someone with Ebola, and you develop flu-like symptoms, you should assume it is Ebola until proven otherwise, and stop exposing others.

[riqster]

86. One example of hysteria was treating the wedding dress she tried on as a possible Ebola source.

Last edited Mon Oct 20, 2014, 10:54 AM - Edit history (1)

Not sure if that was you or somebody else of like mind, but it is a good example of hysteria.

You'd do better to look up the results of the very professional and non- hysterical work in Dallas and Nigeria. They applied science and good communication, and look at the results.

We'll see the same results in NE Ohio, in spite of all the panic fetishests.

How about focusing on real issues? There are a lot of things that NEED working on.

[Ms. Toad]

87. If she was sweating while she tried it on, for at least a short time it is a possible Ebola source.

It should be decontaminated. Thinking that other dresses in the store, with which she had no contact with other than the air she breathed, are sources of Ebola would be hysteria.

I am applying science and good communication. Being cautious about direct contact or direct contact with surfaces on which she may have deposited sweat or saliva, is not hysterical. It is the difference between the two extremes: "There is absolutely no risk" & "Everything three or four generations of contact out is a risk."

Risk is not binary, and in your vigorous defense of Vinson's actions, you (and others) are ignoring the real (albeit small) risk which she created by not staying put once she was symptomatic. And - creating a false sense of security that may encourage others to ignore early signs of Ebola (and do stupid things like hang out with large crowds of people in a small space) because they were told (as the workers who cared for Mr. Duncan were) that they were not at risk.

[riqster]

88. I trust the epidemiology teams on the ground.

I have friends in that line of work. If they think the gown needs decontaminated, it will be done. If they think other measures need taken, it will be done. Please note that their efforts are why outbreaks are contained.

And if it has not been done, it does not need to be done, never mind the panic fetishests. If you go on results, the Chicken Littles have accomplished bupkis, and public health professionals have accomplished a lot.

[Eugene Stoner]

93. I call BS on your whole premise and agument

You have nothing on the subject and you refuse to learn anything on the subject.

I have debunked everything you have said and all you do is move on to others. You are not interested in the facts, just the argument.

[riqster]

95. You have debunked nothing. Your links did not disprove my thesis.

They were tangential, albeit interesting. For example, the precautions taken during viral research efforts are not meant to apply to clinical care environments or mass transit. Other citations you provided were similarly inapplicable.

I am reminded of Inigo's comment to Vizzini: "You keep using that word. I do not think it means what you think it means."

[Eugene Stoner]

96. Ding Ding we have a winner.

For example, the precautions taken during viral research efforts are not meant to apply to clinical care environments

hence the spread in clinical environments when inappropriately equipped. BECAUSE it spreads more easily than expected.


And talk about tangential and non germane

I am reminded of Inigo's comment to Vizzini: "You keep using that word. I do not think it means what you think it means."

[Ms. Toad]

98. Really? Contained like two new infections

when there was theoretically no risk of exposure? 153 new people being monitored in Summit and Cuyahoga Counties?

All those new costly infections and monitoring are the result of public health officials, at one level or another, who have failed to do their jobs - and medical staff who has failed to use their medical training to fill in the gaps left by the public health officials.

They public health officials now, finally, seem to be getting their act together - after their failures resulted in someone with Ebola flying at least once, possibly twice. Their new guidelines mirror almost exactly what I have been saying should have been the protocol from the day Nurse Pham was diagnosed with Ebola and the inadequate prior protocols become public knowledge.

[riqster]

99. There is a huge difference between clinical care and the general environment.

The nurses were inadequately equipped and in frequent contact with copious amounts of Mr. Duncan's infected bodily fluids. People in Akron, Kent, etc. were NOT in such contact.

Apples and oranges.

As to the monitoring: that is SOP for public health work in such circumstances. You'll note that the same steps were taken in Dallas, Nigeria, and elsewhere. The monitoring does NOT mean our state or region are at risk of an imminent outbreak.

Stop with the hysteria. It helps no one, and hurts the uninformed.

[Ms. Toad]

100. There is a difference,

which is why the risk to anyone here is low. But the risk is not zero, and the low risk - and cost of monitoring in Northeast Ohio - would not have existed but for the folks you currently place so much trust in failing to do their job in the first place. Had their current protocols been in place in Dallas, Amber Vinson and Nina Pham would almost certainly not have contracted Ebola in the first place, and Amber Vinson would not have traveled to NE Ohio. Period.

The CDC has now acknowledged that, even followed perfectly, its protocol was inadequate. Beyond the inadequate clinical protocol, the same monitoring steps were not taken in Dallas. Summit and Cuyahoga counties are monitoring 153 people (up 11 from the monitoring chart linked to at the end of the sentence) as Dallas should have been monitoring them: http://www.odh.ohio.gov/~/media/ODH/ASSETS/Files/ebola/Daily%20Contact.ashx

No one in Dallas was doing more than Tier 3 monitoring, despite the fact that all of the staff who cared for Mr. Duncan should have been at level 1. Had they been monitoring that way, no one in Northeastern Ohio would currently be being monitored at all, since Amber Vinson would not have left Texas. The kind of tight restrictions there were in Nigeria, and are currently in place in Ohio, were completely absent in Texas.

When there is a gap in protocols, as there clearly was here, people with medical training need to use their medical knowledge to fill in the gaps - and that where I fault Amber Vinson. As someone with medical training - at a minimum - when she started having flu-like symptoms and running even a low grade fever while still in the incubation period, she should have assumed it was Ebola until proven otherwise and not gotten on a plane. We are lucky she was only in the early stages of Ebola - which keeps the risk low. Since I am related to a member of one of the Boards of Health involved, I know what is being done here and I know that the monitoring screw-ups which happened in Dallas are not happening here - BUT we should never have been put in this position (in this particular infection chain) to have to prove that we can get it right in the first place.

[riqster]

101. Hysteria is hysteria. And that is what you are peddling.

Show me a case in which Ebola was transmitted in any manner other than what is described in my OP. Show me. Come on.

Oh wait, there aren't any. And never have been, either.

Stop with the hysteria.

[Ms. Toad]

102. Try again.

1. Uganda 2000-2001

Indirect exposure to blood and body fluids (via fomites) has also been implicated in EVD transmission but is not common. In the 2000 – 2001 Ebola outbreak in Gulu, Uganda, one EVD patient had no direct exposure to another known EVD patient; this patient slept with a blanket that had been used by another patient who died of EVD.

Francesconi P, Yoti Z, Declich S, et al. Ebola hemorrhagic fever transmission and risk factors of contacts, Uganda. Emerging Infectious Diseases. Nov 2003;9(11):1430-1437.

2. Thomas Duncan, the first case diagnosed in the US.

Thomas Eric Duncan was cautious. Among the most offensive errors in the media during my uncle’s illness are the accusations that he knew he was exposed to Ebola — that is just not true. Eric lived in a careful manner, as he understood the dangers of living in Liberia amid this outbreak. He limited guests in his home, he did not share drinking cups or eating utensils.

And while the stories of my uncle helping a pregnant woman with Ebola are courageous, Thomas Eric personally told me that never happened. Like hundreds of thousands of West Africans, carefully avoiding Ebola was part of my uncle’s daily life.

http://www.dallasnews.com/opinion/latest-columns/20141014-josephus-weeks-ebola-didnt-have-to-kill-my-uncle.ece

3-14. Several in outbreak investigations (for whom no known direct contacts could be identified):

In 1995, another large epidemic occurred in Kikwit, in the Democratic Republic of Congo, with 315 cases and 244 deaths. The primary mode of transmission was person-to-person transmission to household members who had had direct contact with sick persons or their body fluids, especially during the late stage of the disease. However, the source of infection remained unknown for 12 case-patients, which led to the suspicion that the virus was transmitted by airborne particles or fomites.

http://wwwnc.cdc.gov/eid/article/9/11/03-0339_article

Transmission through contaminated fomites is apparently possible. In fact, the association found for having slept on the same mat or having shared meals with a sick person or with funeral participants remained after controlling for direct contact. However, having washed the clothes of a sick person and having participated in the ritual handwashing during the funeral ceremony were not significant risk factors.

http://wwwnc.cdc.gov/eid/article/9/11/03-0339_article

[riqster]

103. Look up "confirmation bias" in a dictionary.

None of the cases you cite prove a different transmission method.

You are so determined to spread panic, now it's down to cherry- picked citation of anecdotal accounts.

One example: the blanket. Do you think the blanket of a person who died of Ebola was miraculously free of their infectious bodily fluids? And did you notice that no time frame is given between death and contact by the other party?

No, of course not. Panic is the way, the truth and the light.

[Ms. Toad]

104. You asked me to provide a single case, and stated flat out that there were none.

Show me a case in which Ebola was transmitted in any manner other than what is described in my OP. Show me. Come on.

Oh wait, there aren't any. And never have been, either.

I provided one confirmed case - a case which is recited in most formal studies on transmission which explore whether transmission without direct contact occurs.

From the first article noted in my preceding post, published in the peer reviewed, Emerging Infectious Diseases Journal:

The patterns of exposure of 24 case-patients and 65 healthy contacts were defined, and crude and adjusted prevalence proportion ratios (PPR) were estimated for different types of exposure. Contact with the patient’s body fluids (PPR = 4.61%, 95% confidence interval 1.73 to 12.29) was the strongest risk factor, although transmission through fomites also seems possible.

. . .
All but one (95%) had had direct physical contact with the patient who was the likely source of their disease; the remaining person (case-patient 7) had slept wrapped up in a blanket left by his brother, who had just died of EHF.

So - out of 24 patients in which contacts were traced, one case was, in fact, transmitted without the direct contact you noted in your OP. And if you are now claiming that transmission is possible not by direct contact with fluid, but by indirect contact via things which someone with Ebola has touched, that is exactly the panic you are accusing me of trying to incite.

By insisting that there is NO risk of transmission by Amber Vinson, you are insisting on a reality that does not match with the little scientific research there is on the subject, which has documented the presence of Ebola virus on environmental surfaces where no fluid was visibly present, which has documented the presence of Ebola virus in a variety of bodily fluids other than blood or vomit, which has documented 13 cases where the transmission appears to have been by indirect contact, and which has been unable to make the flat, unqualified statements you have been making.

Things touched by Amber Vinson (fomites) may contain Ebola virus. Things such as the plane seat she was sitting in where she may have sweated, cups she was drinking from on the plane (and passed across the aisle) which may contain her saliva, wedding dresses she may have tried on (into which she may have sweated) are not miraculously free of her bodily fluids, either. They are likely much smaller quantities - both because the quantities are likely low and because the viral load was likely low, but they are not miraculously free. As such, these may be capable of spreading the disease as well. The risk is low, but it is not zero, which is my entire point.

That reality is not inciting panic - it is emphasizing the importance that people exposed to Ebola who develop flu-like symptoms assume it is Ebola (and quarantine themselves) until it is proven NOT to be Ebola. The same position the CDC now takes, the same position the monitoring Summit and Cuyahoga Counties are taking via their enforced monitoring protocols, and that WHO has previously had. Insisting Amber Vinson's actions created NO risk (which encourages others to act in a similar manner) is foolish.

[riqster]

109. Bullshit. Bodily fluid contact is NOT absent per your sources.

Using a blanket from a recently deceased person does NOT mean there was no contact with infectious bodily fluids.

[Ms. Toad]

114. Tell it to the researchers who reported it in the peer reviewed article. n/t

[riqster]

111. Read the facts:

http://commonhealth.wbur.org/2014/10/reality-check-how-catch-ebola

[Ms. Toad]

113. I prefer peer reviewed articles.

They are closer to real science, which you say you is your position.

The few peer reviewed articles which specifically explored transmission of Ebola in the absence of direct contact (1) have documented 1 case definitively, and (2) documented 12 additional suspected cases. Articles of that caliber have also documented the presence of Ebola on surfaces with no visible bodily fluids, and none rule out the possibility of transmission. They do rate it as low (as I have repeatedly said), and they rate it as still low - but potentially higher - in public areas which are not as rigorously cleaned as the isolation wards in which they ran the tests than. Public areas like, for example, planes or bridal shops.

You asked me to come up with a single case that was not contracted by direct contact with fluids - and I provided you with one confirmed case, and 13 additional cases where it could not be ruled out.

You say you are touting science, not panic - yet I am the one linking to scientific peer reviewed articles, and you are the one posting a conversation engaged in and transcribed for the mass market.

You have insisted that the CDC acted properly - yet they have admitted their earlier protocol was inadequate, and have implemented essentially the protocol I have said they should have been following from the first contact with Mr. Duncan. Feel free to go back and search my posts if you don't believe me.

You are the one who has repeatedly made vulgarity filled, hair on fire posts demanding that everyone accept that the CDC and Amber Vinson are perfect, that no one is at risk, and that anyone who believes otherwise is a complete idiot - while my responsive posts have logically and systemically countered every claim you have made. And once I counter each claim, you change the demand and engage in more name calling.

I don't think I'm the one with the problem with science here.

[ljm2002]

76. A few years ago I flew on a commercial airline...

...and when I reached into the seat pocket to retrieve the magazine put out by the airline company, the bottom of the magazine was soggy with puke.

I don't know if any of it got on me -- and I did of course wash my hands right away -- but if it had happened to me in the middle of this Ebola scare I would be very concerned.

My point is that it isn't really that unheard-of to encounter bodily fluids, even some of the gross ones. It also puts into question how well the airlines clean their airplanes after each flight. Remember Frontier saying they clean their planes "according to CDC guidelines" after each flight? Well obviously, sometimes things are missed.

You cannot be mindful without being aware, and people need to be aware of this thing. Of course this is not the only dangerous infectious disease out there, nor is it at all prevalent at the moment. Thank goodness for that -- let's keep it that way.

[riqster]

84. Another way of putting it:

[IMG][/IMG]

[librechik]

89. I'm not afraid of getting ebola

I'm terrified about what the ebola affair reveals about our healthcare system. And our political inability to address the problems through a national health service. A concept WE invented post WWII and passed on to England, Japan and France at least. A system we could never get passed here, and i quote Harvey Kaye, because of Southern racism.

So of course the first case is in a former slave-holding state, Texas. And all those states have the worst health "systems" if you can call them that, in the country.

[riqster]

90. Very true. Our "system" is the worst in the developed world.

[riqster]

91. The Rude Pundit on the subject:

http://rudepundit.blogspot.com/2014/10/gop-were-not-scientists-except-when-we.html?m=0

[kairos12]

105. I watched the movie Out of Africa, I feel a fever coming on.

[riqster]

107. Quick! What is your address? We need to quarantine you! Alert the media!

[IMG][/IMG] [IMG][/IMG] [IMG][/IMG] [IMG][/IMG]

[kairos12]

108. Ted Cruz with his fear promoting remarks on Ebola slanders Africa-he is the Lying King.

[riqster]

110. He has forgotten who he is.