Showing posts with label Ebola. Show all posts
Showing posts with label Ebola. Show all posts

November 20, 2014

The People Against Ebola (Video taped live)

Published on Oct 21, 2014
The People vs Ebola Inside Sierra Leone BBC Documentary 2014
The ebola virus has claimed more than 4,000 lives in West Africa. This is the largest and most complex outbreak since ebola was first discovered in 1976. Global health correspondent Tulip Mazumdar travels to Sierra Leone, one of the countries worst affected. She meets some of those affected by the virus, as well as medical teams struggling to combat it.

November 12, 2014

Ebola Diaries: A team of Army Doctors Arrives in Sierra Leone

 Army Medical Team just arrived

If you had asked any of us about our plans for November 2014, it probably would not have included a tour to Sierra Leone to treat patients with Ebola. But here we are: eight British army and navy doctors, sweating in the heat and the humidity of a west African afternoon, waiting for the President to open our brand new Ebola treatment centre in Kerry Town, Sierra Leone.
Our Ebola Virus Disease Treatment Unit (EVDTU) is bespoke and comprises of an 80 bed facility run by Save the Children, and a 12 (expanding rapidly to 20) bed unit run by 22 Field Hospital. Our unit is specifically designed to treat healthcare workers who are suspected of contracting EVD.
Our journey to Sierra Leone began in mid September with some unexpected phone calls. The team consisted of intensivists and physicians specialising in infectious diseases, gastroenterology, and cardiology. Interestingly, this spirited group were to be led by an . . .  orthopaedic surgeon?
We reported for training at the Army Medical Services Training Centre in Yorkshire. We had all previously used this training centre in preparation for tours to Afghanistan, however, this time it had been reconfigured to represent our EVDTU.
At this juncture, you may wish to know the personalities of our team: Stuart, our fair skinned, Scottish infectious disease physician and intensivist, tries to avoid the sun almost as much as he does vegetables; “TNR,” our neuro intensivist, can sometimes be found wandering in the undergrowth in search of his next entomological specimen; Mark, our tropical medicine expert, has spent several months collaborating with other EVD experts to produce our training package and is now exasperated by our “electronic isolation;” Paul, our cardiologist from a “leading London teaching hospital,” can be found on www . . . ; Tom was recalled from his attachment to the World Health Organization in Guinea and Sierra Leone to become our subject matter expert—in keeping with local customs he is non conformist when it comes to dress policy; Dave is still wondering how an orthopaedic surgeon got lumbered with controlling a bunch of physicians.
Lastly, this entry is being written by Christian and Lucy. Christian is a gastroenterologist, normally found in the bowels of Paul’s “leading London teaching hospital,” and is trying to keep our patients out of the s*** by demonstrating how to use a diarrhoea management system. Lucy has just come back to clinical medicine after studying for a PhD and having two children—she is wondering if a third right now would get her back home.
We have now been in Sierra Leone for two weeks, and been exposed to the usual frustrations of an emerging humanitarian operation: reduced communication; supply line difficulties; acclimatising to 80% relative humidity; and learning the local dialect, which lies somewhere between Brixton and Peckham. However, these difficulties are ameliorated by a sea view and friendly nurses! We have been asked to produce a weekly blog, aiming to keep you abreast of our time spent treating Ebola in Sierra Leone.
Lt Colonel Christian Ardley is a consultant gastroenterologist and internal medicine consultant. Major Lucy Lamb is a specialist registrar in infectious diseases and general internal medicine.
This blog was obtained from BMJ blogs

October 28, 2014

CDC Says Isolation Not Quarantine in Ebola


 Federal health officials on Monday revamped guidelines for doctors and nurses returning home to the United States from treating Ebola patients in West Africa, stopping well short of controversial mandatory quarantines being imposed by some U.S. states.
Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC), called for isolation of people at the highest risk for Ebola infection but said most medical workers returning from the three countries at the center of the epidemic would require daily monitoring without isolation.
New York and New Jersey are among a handful of states to impose mandatory quarantines on returning doctors and nurses amid fears of the virus spreading outside of West Africa, where it has killed nearly 5,000 people in the worst outbreak on record. 
The Obama administration's new guidelines are not mandatory, and states will have the right to put in place policies that are more strict. Some state officials, grappling with an unfamiliar public health threat, had called federal restrictions placed on people traveling from Ebola-affected countries insufficient to protect Americans and have imposed tougher measures.
With thousands already dead from Ebola in Liberia, Sierra Leone and Guinea, concerns are high in the United States about stopping its spread. 
Late on Monday, the University of Maryland Medical Center in Baltimore said it was assessing a potential Ebola patient, who was in isolation. The hospital, one of three designated Ebola treatment centers in the area, gave no further details.
Earlier in the day in New York City, a 5-year-old boy who arrived in the United States from Guinea and was in hospital for screening for fever, tested negative for Ebola.
The CDC's Frieden, on a conference call with reporters, 
warned against turning doctors and nurses who are striving to tackle Ebola in West Africa before it spreads more widely into "pariahs."
Under new CDC guidelines that spell out four risk categories, most healthcare workers returning from West Africa's Ebola hot zone would be considered to be at "some risk" for infection, while healthcare workers tending to Ebola patients at U.S. facilities would be seen as "low but non-zero" risk.
In other Ebola-related developments, the U.S. military said it was isolating troops returning from their mission to help West African countries curb Ebola even though they showed no sign of infection. And a nurse who treated patients in Sierra Leone was released to go to her home state of Maine after New Jersey had forced her into quarantine. The nurse had been kept in quarantine for two days after testing negative for the Ebola virus.
There has been a growing chorus of critics, including public health experts, the United Nations, medical charities and even the White House, denouncing mandatory quarantines as scientifically unjustified and an obstacle to fighting the disease at its source in West Africa.
"At CDC, we base our decisions on science and experience. We base our decisions on what we know and what we learn. And as the science and experience changes, we adopt and adapt our guidelines and recommendations," Frieden said.
Medical professionals say Ebola is difficult to catch and is spread through direct contact with bodily fluids from an infected person and not transmitted by asymptomatic people. Ebola is not airborne.
Frieden said high-risk people include healthcare workers who suffer a needle stick while caring for an Ebola patient or who tend to a patient without protective gear.
He said returning health workers at “some risk” would have their health monitored daily by a local health department official who would check their temperature, look for signs of fatigue and review their daily activity plans to determine what activity “makes sense for that individual, at that time.”
President Barack Obama's spokesman, Josh Earnest, made clear Monday that the White House was not thrilled that individual states had implemented quarantines viewed as unfair to returning healthcare workers, though he acknowledged the states' rights to set them.
"We want to make sure that whatever policies are put in place in this country to protect the American public do not serve as a disincentive to doctors and nurses from this country volunteering to travel to West Africa to treat Ebola patients," Earnest said.
The Pentagon move went well beyond previously established military protocols. The U.S. Army has already isolated about a dozen soldiers at part of a U.S. base in Vicenza, Italy, including Major General Darryl Williams, who oversaw the initial response to the Ebola outbreak, the worst on record with nearly 5,000 dead.
Dozens more will be isolated in the coming days as they rotate out of West Africa, where the military has been building infrastructure to help health authorities treat Ebola victims, the Pentagon said.
"We are billeted in a separate area (on the base). There's no contact with the general population or with family. No one will be walking around Vicenza," Williams told Reuters in a telephone interview.
"Nobody is symptomatic. No Army soldier came in contact with Ebola-stricken patients," Williams said, calling the move precautionary.
The case of nurse Kaci Hickox, put into quarantine on Friday under a New Jersey policy that exceeded precautions adopted by the U.S. government, underscored the dilemma that federal and state officials are facing.
New Jersey Governor Chris Christie, who has defended his state's policy of automatic quarantine for medical workers returning from treating patients in Liberia, Sierra Leone and Guinea, told reporters he did not reverse the policy in allowing her to be discharged from the hospital and to return to Maine.
"We're very happy that she has been released from the hospital," said Christie, who Hickox had criticized for making comments about her health that she said were untrue while calling her quarantine unjust.
"She hadn’t had any symptoms for 24 hours and she tested negative for Ebola so there’s no reason to keep her," said Christie, a potential Republican Party 2016 U.S. presidential candidate known for his combative style.
Christie said he sees no reason to talk to her and expressed "goodwill" toward Hickox, who had worked with the medical charity Doctors Without Borders in Sierra Leone. "But she needs to understand that the obligation of elected officials is to protect the public health of all the people," Christie said.
Christie said his state was providing transportation for her to Maine, whose health officials "will take over her care and monitoring from there" as she completes a 21-day quarantine at home. The quarantine matches the incubation period of the virus.
U.N. Secretary-General Ban Ki-moon on Monday became the latest to criticize quarantines, saying through his spokesman these create difficulties for medical workers risking their lives in the battle against the deadly disease.
"Returning health workers are exceptional people who are giving of themselves for humanity," said Ban's spokesman, Stephane Dujarric. "They should not be subjected to restrictions that are not based on science. Those who develop infections should be supported, not stigmatized."
Four people have been diagnosed with Ebola in the United States, with one death - a Liberian man visiting Texas. The only patient now being treated for Ebola in the country is a New York doctor, Craig Spencer, who was diagnosed last Thursday. He had worked with Doctors Without Borders treating Ebola patients in Guinea.
(Reuters) -
(Additional reporting by David Morgan, Jeff MasonSteve HollandPhil StewartDavid Alexander, Roberta Ramptom and Susan Heavey in Washington, Louis Charbonneau, Laila Kearney and Joseph Ax, Bill Berkrot in New York, and Steve Scherer in Rome; Writing by Will Dunham and Bill Rigby; Editing by Lisa Shumaker and Grant McCool)

October 25, 2014

A Liberian Slum Takes Ebola into their Hands


Pharmacist Doris Nyenkan takes money from a customer at her store in the West Point slum in Liberia's capital. She says that since the Ebola outbreak started she stands far back from her customers to avoid contact. HEIDI VOGT/THE WALL STREET JOURNAL

MONROVIA, Liberia—Two months after Liberia’s largest slum fought a government-imposed Ebola quarantine, residents are in a desperate push to conquer the deadly virus—with or without the government’s help.
It is a marked change from August, when many in West Point argued Ebola was a hoax and some residents even dumped the highly contagious corpses of Ebola victims into a nearby river to avoid handing them over to the government’s body-collection teams.
 Ebola is still spreading through West Point, but so are changes to habits and traditional practices that offer a glimmer of hope in an impoverished country’s fight against the deadly virus. The shift is also key to the international effort to contain the disease. 
West Point isn’t the only place where attitudes are shifting, but it is particularly remarkable because the slum—where more than 50,000 people live in closely packed tin-roofed shacks—is one of the poorest districts of the capital city and because the government almost gave it up for lost.
When President Ellen Johnson Sirleaf imposed the quarantine in mid-August, Ebola was threatening to consume the slum. Angry about being sealed off and abandoned by the government, residents of West Point rioted in anger and overran a school that was being used as an Ebola holding center.
Ebola is a highly contagious virus, but only if you come into contact with certain bodily fluids of those infected. What do scientists know about how it's transmitted? WSJ’s Jason Bellini has #TheShortAnswer.
Mrs. Johnson Sirleaf lifted the quarantine after 10 days, but the measure became a catalyst for the community. When the lockdown ended and international aid organizations poured into West Point with bleach, rubber boots and information, community leaders decided they needed to take action fast.
Prince Mambu, the head of a community group called Health Education, Sanitation and Sensitization Group, started going house to house talking with people who have had contact with victims. It is now routine. He reminds his neighbors to stay in their houses and asks about symptoms.
“I ask them, ‘Do you have a headache?’ But also I watch their eyes. Sometimes they say no but if I detect that they look weak, I will report it to the others. If they are willing, I will call for an ambulance,” Mr. Mambu said.
The group also spreads the sanitation message throughout the community: Wash your hands with a bleach solution. Don’t touch anyone who is sick.
Streets police once blocked off to pedestrians and cars now teem with local residents recruited as workers to distribute bleach and hand out advice. One recent afternoon, 22-year-old Mechie Seih told charcoal seller Mamie Kollie how to lower infection risk if a family member falls ill: “You put clean plastic bags on your hands. You wear a thick jacket with long trousers. You put shoes and socks on your feet.”
Ms. Kollie nodded. She is being careful: Already outside her shop is a bucket of chlorinated water for washing hands. A woman selling dried fish nearby said she had stopped eating meat from animals like monkeys and rodents—commonly called bush meat—a suspected source of infection. A few doors down, a barber said special body-collection teams are receiving calls from families when someone dies.

Pharmacist Doris Nyenkan says she now tells customers complaining of fever to get tested for Ebola. She also now stays a few feet away from customers and washes her hands at least once an hour.
“People clean their homes every day now. Now they are washing their hands, buying this gel,” Ms. Nyenkan said, pointing to a bottle of hand sanitizer. “Before Ebola you didn’t see people doing such things.”
Such steps are important: The Liberian man who brought Ebola to the U.S. contracted it in Monrovia when he tried—without proper protection—to help a pregnant neighbor who had fallen sick.
The Liberian government isn’t absent from West Point: The clinic here is helping triage patients and government workers are among those handing out information and collecting bodies. 
Tolbert Nyenswah, the head of the Liberian government’s Ebola response, applauded West Point as one of a few Monrovia neighborhoods where residents have taken charge of the effort.
“They have their own active case finding, and they are quarantining households and checking for strangers. If people are sick, they report that to the call center,” Mr. Nyenswah said.
But many in West Point say they are taking responsibility because the government deserted them. Even now, they would be much worse off had they depended on the government.
“During the quarantine, medical teams were not coming here. There were no ambulances, things were just terrible here,” Mr. Mambu said. It is better now, but the government is still too slow to respond: Ambulances sometimes take a day to arrive, he said. 
Now, when West Point residents need an ambulance, many call Kenneth Martu —who works for a U.S.-funded charity that hired a private ambulance. Mr. Martu’s ambulance team averages about 10 calls a day and gets to people within about 30 minutes of the call, he said.
The charity, called More Than Me, ran a school for girls from West Point before the Ebola outbreak. Now, it is paying for nurses to do rounds in West Point and providing lunch for Ebola response workers, in addition to sponsoring the ambulance service.
The sad reality is that it still may not be enough. Mr. Mambu has tracked Ebola deaths in the community and says that although the numbers have gone down in recent weeks, bodies are still being carried away every day. Even though those who have had contact with Ebola patients are told to stay home, Mr. Mambu said no one is dropping off provisions, so many still go out in the evening to buy food.
And some are still treating their sick at home because of fear or lack of beds at centers.
Paris-based Doctors Without Borders is distributing home-care kits in West Point and other neighborhoods so those who are treating their sick at home don’t have to resort to covering their hands with plastic bags. That is itself an acknowledgment of failure to get people into treatment centers.
“The key is—in addition to the community being aware of how you get the disease and what the symptoms are—is find the sick person as fast as possible and put them in isolation in a treatment center,” said Laurence Sailly, the emergency coordinator for Doctors Without Borders in Liberia. 
With Ebola, she said, “one case is an epidemic.”

October 20, 2014

What Happen if Ebola Lands at JFK?

This news you can read at adamfoxie and VillageVoice

Last Saturday, New York's John F. Kennedy International Airport started conducting the U.S. Centers for Disease Control's enhanced Ebola screening. JFK became the first out of five U.S. airports, including Washington-Dulles, Newark Liberty, Chicago-O'Hare, and Hartsfield-Jackson Atlanta international airports, to begin the special screening exercise. The discovery that Amber Vinson -- the second Texas nurse who contracted Ebola -- was allowed to board a commercial airliner from Ohio to Texas while running a fever begs an obvious question for New Yorkers: What happens if an infected passenger arrives at JFK?
If someone starts showing Ebola-like symptoms while their plane is close to JFK, the pilot, according to the CDC's Ebola Guidance for Airlines, will first notify the agency that they have an ill traveler on board. Then, cabin crew members are trained to act quickly: separating the sick passenger from others and handling him or her with disposable, waterproof gloves, while wearing surgical masks, protective aprons and goggles. 
Other Passengers
If the infected passenger becomes symptomatic while en route to the U.S., other passengers on the plane are at risk of contracting the virus. Once a contagious case is confirmed upon arrival at JFK, the CDC is required to reach out to the airline for the manifest to determine the radius of exposure -- the at-risk area surrounding the passenger -- a strategy that the CDC has used in the past to assess exposure to infectious diseases like measles, rubella, or tuberculosis. (Although their contact investigations information has not yet been updated to be more Ebola-specific, it would appear that this is the same protocol the CDC would use to track passengers in danger of exposure to Ebola.) 
Passengers, or "contacts," whose assigned seats fell within a certain radius around the patient will be contacted
Centers for Disease Control and Prevention.
Seating diagram with the area of exposure in green and the infected persons in red.
by the CDC once they've disembarked. The zone of exposure can be up to 40-50 seats outward from the Ebola patient, according to the CDC's website. Frank Rhame, an infectious-disease physician at the Abbott Northwestern Hospital in Minneapolis, is not convinced that the CDC's estimation of who is likely to be infected aboard a plane is accurate. 
"This management scheme is of dubious relevance to Ebola," he says, as it has typically been used for airborne and droplet-spread pathogens. Ebola, on the other hand, is a virulent pathogen that can only be transmitted through direct contact with the body fluids of an infected person. There is no evidence to suggest that it can be spread through the air, hence weakening the argument that infectious aerosols in sneezes and coughs are contagious. "Sometimes the more highly exposed folks are investigated first -- that may be the rationale" behind the attention given by the CDC to the plane's seating chart, Rhame adds. But "if one of the nearby exposed persons is found to have suffered a transmission, they can expand the scope of the investigation," he says. 
The CDC did not respond to several calls and emails from the Voice seeking comment.
There are exceptions, however, to the 40- to 50-passenger radius. The infected traveler's companions will also be deemed exposed and will be contacted by the CDC. More official protocols grant the CDC leeway to flex its authority, while tracking down and containing infected persons and suspected cases:
Under 42 Code of Federal Regulations parts 70 and 71,CDC is authorized to detain, medically examine, and release persons arriving into the United States and traveling between states who are suspected of carrying these communicable diseases.... When alerted about an ill passenger or crew member by the pilot of a plane or captain of a ship, CDC may detain passengers and crew as necessary to investigate whether the cause of the illness on board is a communicable disease.
State, local, and tribal authorities also have the legal latitude to enforce the implementation of isolation and quarantine within their borders.
Exposed passengers and crew members will be monitored closely for 21 days (the incubation period of the Ebola Virus Disease).
Patient Zero
What becomes of the infected patient? The infected person will most likely be transferred from JFK to one of the four New York City hospitals that have been designated as Ebola treatment centers (there are eight overall in New York State). There, he or she will be quarantined. 
Jennifer Bender, a spokeswoman for the NYC Health and Hospitals Corporation, says the city's four Ebola treatment centers -- Manhattan's Bellevue, Mount Sinai, and New York Presbyterian hospitals and Montefiore Medical Center in the Bronx -- will also be able to receive transfers from other city hospitals, "after consultation with [the New York City Department of Health and Mental Hygiene]."
After arriving at one of the Ebola treatment centers, the passenger's fate lies amid a cocktail of blood transfusions, experimental drugs, rehydration therapies, and quality medical care.
According to the CDC, nearly 50 percent of travelers from the three affected West African nations — Guinea, Sierra Leone, and Liberia -- arrived in the U.S. through JFK in the year ending July 2014.

October 17, 2014

Ebola Crisis: Hospital Says Sorry


The top doctor at the Texas hospital where an Ebola patient infected two nurses before dying has apologised for its failure to diagnose him promptly.
Dr Daniel Varga of Texas Health Presbyterian Hospital told a congressional panel it remained unclear how the nurses caught the disease.
Congressmen are questioning public health officials about the threat of an Ebola outbreak in the US.
The epidemic has killed more than 4,000 people, almost all in West Africa.
The World Health Organization (WHO) has said it will "ramp up" efforts to prevent Ebola spreading beyond the three countries most affected by the deadly virus - Guinea, Liberia and Sierra Leone.
Fifteen African countries are being prioritised, top WHO official Isabelle Nuttall told a news conference in Geneva. They will receive more help in areas including prevention and protection. 
Also on Thursday, US President Barack Obama authorised the calling-up of National Guard troops and reserves, if necessary, to fight the spread of Ebola. 
Nearly 4,000 US troops are being sent to West Africa to assist in containing the virus, mainly by building treatment units.
Hazmat workers help each other put on protective clothing before entering The Village Bend East apartment complex where a second health care worker who has tested positive for the Ebola virus resides on October 16, 2014 in Dallas, Texas.Hazmat workers prepare to clean the apartment of the second nurse infected
At the sceneLaura Trevelyan, Dallas, Texas
At Dallas-Fort Worth Airport, a young couple embrace in arrivals and leave for the city centre discussing the case of Nina Pham, the Dallas nurse infected with Ebola who cared for Thomas Eric Duncan. How could it happen here, they ask in wonder. 
There's a pervasive sense of unease about the Ebola virus in the midst of this prosperous city. Three schools have closed temporarily because two of the pupils were on the same flight as nurse Amber Vinson on Monday night - she has become the second nurse to contract Ebola from Duncan and the CDC want to trace all 132 people on the plane.
And faith in Texas Health Presbyterian Hospital Dallas has been shaken - this prestigious institution, favoured by the wealthy of Dallas for their healthcare, has had to apologise for failing to diagnose Ebola symptoms in Mr Duncan.
A hospital nurse told NBC News this morning she could no longer defend the hospital at all.
In Washington DC on Thursday, a panel of the House of Representatives energy and commerce committee questioned senior public health officials about the threat of Ebola to the US.
Witnesses included Centers for Disease Control and Prevention (CDC) director Dr Thomas Frieden, Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and Dr Varga, chief clinical officer at Texas Health Resources, the parent company of Texas Health Presbyterian Hospital in Dallas.
In prepared testimony, Dr Varga acknowledged medical staff at Texas Health Presbyterian Hospital erred in sending Duncan home after he arrived on 25 September with a fever, despite him telling them he had come from Liberia.
Duncan returned to hospital on 28 September, was officially diagnosed with Ebola two days later, and died on 8 October.
Dr Varga said: "We did not correctly diagnose his symptoms as those of Ebola. We are deeply sorry."
The hearing came a day after a second nurse who treated Liberian national Thomas Eric Duncan, Amber Vinson, was diagnosed with Ebola. 
It's unclear how her and the other nurse, Nina Pham, contracted the virus while using protective clothing. Ebola.
The House panel questioned health officials over protection for health workers
Centers for Disease Control and Prevention (CDC) Director Dr Tom Frieden, left, prepares to testify on Capitol Hill in Washington 16 October 2014
A national nurses' union has suggested infection control procedures were lacking and the nurses were not sufficiently trained.
Dr Varga admitted under questioning his hospital's staff had received information about Ebola response but had no training before Duncan's arrival.
The CDC has come under fire for allowing Ms Vinson to fly on a commercial aeroplane to Dallas from Cleveland, Ohio, the day before she fell ill with Ebola.
Dr Frieden on Thursday said, "My understanding is she reported no symptoms."
Amber Vinson -undated photoAmber Vinson travelled on an aeroplane before showing symptoms
Nina Pham is reportedly in a good condition and is being transferred to the National Institutes of Health in the US state of Maryland.
Senior Republican congressmen on the panel called for a travel ban from what one described as the Ebola "hot zones".
They rejected public health officials' insistence that such a move would only isolate the affected countries and hinder efforts to stanch the outbreak there.
New US Ebola control measures
  • A "site manager" will supervise how workers at the Texas Health Presbyterian Hospital put on and take off protective clothing
  • Two nurses from Emory University Hospital in Atlanta will offer "enhanced training" in Dallas
  • An immediate response team will travel to the site of any future Ebola diagnoses to hit the ground "within hours"
  • New guidelines for testing at hospitals throughout the US, with special emphasis on asking questions about travel history 
Duncan was not symptomatic when he arrived in Dallas from Liberia in September, but reportedly failed to tell authorities prior to his departure that he had had contact with an Ebola patient.
  Can it Spread to US?
The US is now screening passengers arriving from the three countries most affected - Liberia, Sierra Leone and Guinea - at multiple airports.
On Wednesday, Mr Obama said the risk of Americans getting the virus was still "extremely low", but ordered "much more aggressive response", including increased CDC involvement.
In other developments on Thursday:
  • A Spanish healthcare worker, who came into contact with a nurse already infected, is being tested for the virus
  • An Air France passenger with a high fever, reportedly from Nigeria, is to be examined in hospital for Ebola symptoms after arriving in Madrid from Paris
  • UN Secretary-General Ban Ki-moon said just $100,000 dollars had been given to a UN Ebola trust fund which needed $1bn
  • World Bank President Jim Yong Kim warned against imposing “travel restrictions on the whole world”

October 7, 2014

Ebola, Get the facts and KNOW

No longer Just in Africa

None of the 10 people who were in close contact with Ebola patient Thomas Eric Duncan has shown any sign of being infected with Ebola, health officials said Monday. The next few days will be the most important — Ebola’s usual incubation period is eight to 10 days and Duncan was isolated Sept. 28.
Many Americans are worried that the virus could spread because Duncan was sick and had gone back home for two days when the hospital mistakenly failed to recognize the risk of Ebola. In fact, a Pew poll out Monday found 11 percent of Americans were "very worried" that they themselves or a family member will be exposed to Ebola, while 21 percent are somewhat worried.
How could the infection spread?

How likely is it that you will catch Ebola?


Think close contact, think wet and think warm.

The virus doesn’t live for long outside the body. Ultraviolet rays from sunlight destroy it, as does heat. Bleach kills it and plain soap and water can wash it away. Warm body fluids such as blood, vomit and feces carry the virus. And it has to get into the body to infect you — it doesn’t soak in through the skin, for instance. It must get in through the nose, mouth, eyes, through a cut or by a needle stick.

Delivering medical care.

Doctors say close contact is the usual way for people to become infected with Ebola virus. That includes caring for patients — health care workers are among those most likely to become infected as they examine patients, draw blood, clean them and clean up bodily fluids such as vomit. That’s why seven of the 10 people on the state of Texas and CDC’s close contact list for Duncan are health professionals.

Home care.

Experts say one reason Ebola is spreading so badly in Sierra Leone, Guinea and Liberia is that patients have nowhere to run. They’re being treated at home, or left to die in the streets. A single sick patient can infect his or her whole family. Anyone who's treated a loved one with a stomach virus knows how messy, and infectious, it can be.

Cleaning up a mess.

The virus lives in vomit, diarrhea, blood and sweat. The sicker a patient is, the more virus there is in the bodily fluids. Thomas Geisbert, who tests Ebola drugs and vaccines at the University of Texas Medical Branch, says using high-pressure sprays to clean animal cages can splash the virus into the air. “If you blast it, you can create a manmade aerosol,” Geisbert said. But that is not the same as the virus being airborne. It’s not. And the mess, in general, should be fresh. “I don’t think there’s a whole lot of evidence that there is going to be virus on door handles,” says Geisbert. Ashoka Mukpo, the freelance NBC camera operator who’s infected, said he believes he got infected while helping to disinfect a car used to transport a sick Ebola patient in Liberia.

Burying a body.

People who have just died of Ebola are the most infectious. One healer who died in Sierra Leone infected 14 other people who prepared her body. CDC says people who have just died of Ebola should be placed in not one, but two sealed plastic bags and then a hermetically sealed casket.

You won’t get it from casual contact.

Some people have expressed worry that Texas state officials walked unprotected into an apartment where Duncan stayed when he was sick. But there is no evidence at all the virus could be suspended in the air somehow, or even on the walls or floors. It’s important to clean an area where someone’s been sick with Ebola but that’s just to make sure no fluids that could contains the virus could remain. Forty years of studying Ebola outbreaks show the danger comes from being close to sick people. “Most times, when people get it, there’s some kind of defining moment when they have been in close contact with the body fluids of somebody who had it,” Geisbert said.
So why do crews cleaning the apartment wear hazmat suits? Because they may be handling wet or damp soiled sheets or towels, and because cleaning may cause splashes that could carry virus-laden fluids into the eyes, nose or mouth, or if the virus splashed onto someone's skin and they later touched it, they could carry it into their own eyes, nose or mouth.

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