Opinions on the Ebola Outbreak

[Panderson]

I don't think there is a thread for this yet! But I was curious to know what you guys might think about this outbreak.

For those who may not know (which I feel most of you do) I just read an article about a Liberian man who had contracted the virus boarded a plane to Lagos, one of the most population-dense cities in the region. He only turned himself in to be quarantined AFTER he left the airport... Meaning there is potentially 100 other passengers on this plane who are hosting the virus.
As the areas of the outbreak have only been rural, this greatly increases the chance for a pandemic. I thought that ebola could only be transmitted through direct contact of bodily fluids, but correct me if I am wrong.
I've also read some reports that the outbreak may have started from hunting fruit bats. Just wanted to talk to someone about this that will actually engage in the conversation. I'm very interested to hear thoughts!

---

Members don't see this ad.

 

[derwent2052]

The CDC has a good information page about the current outbreak, if you're interested in perusing it. http://www.cdc.gov/vhf/ebola/outbreaks/guinea/
Ebola can indeed only be transmitted via bodily fluids. The disease causes a lot of bleeding, diarrhea, and vomiting, all of which can transmit the disease. I believe ebola reston showed potential to be transmitted via the air/respiratory, however that strain was not infective to humans.
They think bats may be the reservoir of the virus, though it's not completely certain yet. http://www.cdc.gov/vhf/ebola/resources/virus-ecology.html There's thought that raw bushmeat (from wild animals eg bats monkeys etc) may be a possible transmission point from animal to human populations. Handling the raw meat and blood.

With proper quarantine, disinfection, and containment protocols in place, ebola outbreaks can actually be contained and ended pretty well... one of the big problems in this outbreak is a combination of things like improper containment and quarantine, lack of information for the public and public fear (people not knowing what it is, how it's transmitted, how to take adequate preventive measures or how to disinfect things or protect themselves), fear of medical centres - a lot of people who are infected don't want to go to a hospital, as there's a fear that they will be taken from their families just to die. people aren't going immediately to a hospital if sick. there have been people who go to hospital then escape and go back home, potentially infecting their family and village, and in this outbreak at least one story of an ill person being abducted from hospital by their family and brought back home (the patient later returned to hospital herself, and later died). Anyone who handles the dead, eg family members, also risks exposure. it can also be transmitted via sex, and although some of the governments of countries affected currently have advised not to have sex, or kiss anyone, or even shake hands, people may not follow that. this outbreak has both rural and urban cases.

anyone who's played Plague Inc (highly recommend the game!) can see the potential pandemic quality of most any illness... anything is really just a plane- or boat-ride away. as ebola isn't a respiratory illness, it is harder to transmit, and in areas where it can be properly contained it's less of a risk (the ebola infected US staff that are being flown to atlanta are being very carefully transported and kept in negative air pressure quarantine hospital facilities - very unlikely that would get out). if someone is ill and starts vomiting blood all over their fellow passengers on a plane, well, that's not as good, though at least that would likely be noticed and the plane instantly quarantined when it landed...!

 

[Beth_W737]

Actually if I recall right people showed antibodies to Reston but did not have typical symptoms (no bleeding, more flu type sx).


Posted using SDN Mobile

 

[Panderson]

one of the big problems in this outbreak is a combination of things like improper containment and quarantine, lack of information for the public and public fear (people not knowing what it is, how it's transmitted, how to take adequate preventive measures or how to disinfect things or protect themselves),

This is what I was thinking. The news does such a great job of installing fear in you , and doesn't look at the facts! I want to tell everyone to calm down because they just don't know what they are talking about. From what I know, Lagos actually handled the plane incident pretty well by cold-calling every passenger they had contact info on and isolating them. Two ended up with fever (they had helped the Liberian man into a wheelchair), but their blood tests were negative. There could be a pandemic in those medically underserved areas, but I just never saw it spreading any further than that.

http://m.mic.com/articles/95214/the...licymicFB&utm_medium=main&utm_campaign=social

This is an article going around my Facebook friends that does a great job of that kind of fear mongering. Even better is when people tell me "they said HIV/AIDS would never be a problem in America too"

 

[pinkpuppy9]

I thought that ebola could only be transmitted through direct contact of bodily fluids, but correct me if I am wrong.

According to what I've been reading, this is correct. The article I just read actually said that any modern hospital can handle infected patients as long as extreme caution is used when it comes to preventing transmission, since the virus isn't airborne.

 

[derwent2052]

http://m.mic.com/articles/95214/the...licymicFB&utm_medium=main&utm_campaign=social

This is an article going around my Facebook friends that does a great job of that kind of fear mongering. Even better is when people tell me "they said HIV/AIDS would never be a problem in America too"

I'd start by linking those friends to good, factual pages like the CDC site to combat articles like that BBCnews has had some good articles keeping up to date about the outbreak without being particularly fear mongering. http://www.bbc.co.uk/news/magazine-28583051 is an interesting read
hiv/aids was completely unknown when it first started spreading around the US. ebola is very well known, and there are samples at the CDC for study (in biosafety level 4 labs). probably the main issue in places like the US is it's such an incredibly rare thing to see in the US, that if a single person had it and went to hospital (NOT at the same time as a major outbreak) the symptoms probably wouldn't be recognised as ebola right away (the, if you hear hoofbeats think horses, not zebras). With the current outbreak I think most places, at least afaik in the US and UK, are on high alert to be mindful of ebola symptoms. A few athletes at the Commonwealth Games in Glasgow were tested for Ebola recently after they fell ill (tested negative).

 

[pinkpuppy9]

I'd start by linking those friends to good, factual pages like the CDC site to combat articles like that BBCnews has had some good articles keeping up to date about the outbreak without being particularly fear mongering. http://www.bbc.co.uk/news/magazine-28583051 is an interesting read
hiv/aids was completely unknown when it first started spreading around the US. ebola is very well known, and there are samples at the CDC for study (in biosafety level 4 labs). probably the main issue in places like the US is it's such an incredibly rare thing to see in the US, that if a single person had it and went to hospital (NOT at the same time as a major outbreak) the symptoms probably wouldn't be recognised as ebola right away (the, if you hear hoofbeats think horses, not zebras). With the current outbreak I think most places, at least afaik in the US and UK, are on high alert to be mindful of ebola symptoms. A few athletes at the Commonwealth Games in Glasgow were tested for Ebola recently after they fell ill (tested negative).

That's what I've been reading...that the early stages of ebola match with other, more common viruses. "fever, headache, muscle aches and sore throat." So in other words, every virus that runs rampant on college campuses

 

[Kyoht]

From what I have read about ebola most outbreaks occur because of the way certain people live and their cultural practices- like in west Africa. After a person dies they all gather around and wash the person, potentially exposing themselves to the virus. Ive also heard doctors say that the people most at risk are healthcare workers because they are more likely to come into contact with bodily fluids. Researchers also say that it is a more "stable" virus that has not mutated or changed since it was discovered - only transferred through bodily fluids, the most common way being through the diarrhea. I'm not too worried IMO.

 

[Kyoht]

Also, correct me if im wrong, I believe that people aren't contagious until they exhibit symptoms and usually by that time they aren't moving around on their own too much.

 

[that redhead]

http://boingboing.net/2014/08/02/how-much-should-you-be-worried.html

(Disclaimer: I know it's a serious thing, but I had to laugh.)

 

[Panderson]

I put this on my Facebook yesterday... Still no regrets.

http://boingboing.net/2014/08/02/how-much-should-you-be-worried.html

(Disclaimer: I know it's a serious thing, but I had to laugh.)

 

[bbeventer]

Actually, both Ebola and Marburg have been shown experimentally to spread through aerosol transmission and there was actually an outbreak in the US in Reston, VA that showed strong evidence towards aerosol transmission. Experimentally only 500 infectious virus particles were required to cause a lethal airborne dose.

Source
"There is considerable misunderstanding concerning the potential for aerosol transmission of filoviruses. The data on formal aerosol experiments leave no doubt that Ebola and Marburg viruses are stable and infectious in small-particle aerosols, and experience of transmission between experimental animals in the laboratory supports this [49, 56–63]. Indeed, during the 1989–1990 epizootic of the Reston subtype of Ebola, there was circumstantial evidence of airborne spread of the virus, and supporting observations included suggestive epidemiology in patterns of spread within rooms and between rooms in the quarantine facility, high concentrations of virus in nasal and oropharyngeal secretions, and ultrastructural visualization of abundant virus particles in alveoli [17, 50]. However, this is far from saying that Ebola viruses are transmitted in the clinical setting by small-particle aerosols generated from an index patient [64]. Indeed patients without any direct exposure to a known EHF case were carefully sought but uncommonly found [65]. The conclusion is that if this mode of spread occurred, it was very minor."

So I would say its incorrect to state that the virus can't be transmitted by air, but it would be correct in saying aerosol transmission is not the viruses primary route of transmission.

 

[Panderson]

Actually, both Ebola and Marburg have been shown experimentally to spread through aerosol transmission and there was actually an outbreak in the US in Reston, VA that showed strong evidence towards aerosol transmission. Experimentally only 500 infectious virus particles were required to cause a lethal airborne dose.

Source
"There is considerable misunderstanding concerning the potential for aerosol transmission of filoviruses. The data on formal aerosol experiments leave no doubt that Ebola and Marburg viruses are stable and infectious in small-particle aerosols, and experience of transmission between experimental animals in the laboratory supports this [49, 56–63]. Indeed, during the 1989–1990 epizootic of the Reston subtype of Ebola, there was circumstantial evidence of airborne spread of the virus, and supporting observations included suggestive epidemiology in patterns of spread within rooms and between rooms in the quarantine facility, high concentrations of virus in nasal and oropharyngeal secretions, and ultrastructural visualization of abundant virus particles in alveoli [17, 50]. However, this is far from saying that Ebola viruses are transmitted in the clinical setting by small-particle aerosols generated from an index patient [64]. Indeed patients without any direct exposure to a known EHF case were carefully sought but uncommonly found [65]. The conclusion is that if this mode of spread occurred, it was very minor."

So I would say its incorrect to state that the virus can't be transmitted by air, but it would be correct in saying aerosol transmission is not the viruses primary route of transmission.

Interesting! This would validate the panic of the virus found on a plane. Does your source say just how uncommon these cases were?

 

[that redhead]

Interesting! This would validate the panic of the virus found on a plane. Does your source say just how uncommon these cases were?

In the link she gave, it makes it pretty clear that these cases are extremely rare. It's important to keep in mind that heavily controlled research experiments are not equivalent to the real world, nor are non-human primates perfect indicators of human response. I get as excited as any other science geek about breakthroughs in research but things that can be made to happen in a lab don't always translate to the "real world". I can see the point with Reston, but even then the evidence is not strong, only "circumstantial" (as described by the source).

 

[bbeventer]

Interesting! This would validate the panic of the virus found on a plane. Does your source say just how uncommon these cases were?

I am not sure about the actual number of reported airborne transmission cases. This one paper does put it this way though "Due to the low frequency of secondary infected cases, airborne transmission involving humans is considered a possibility only in rare instances from persons with advanced stages of disease." Source

 

[bbeventer]

In the link she gave, it makes it pretty clear that these cases are extremely rare. It's important to keep in mind that heavily controlled research experiments are not equivalent to the real world, nor are non-human primates perfect indicators of human response. I get as excited as any other science geek about breakthroughs in research but things that can be made to happen in a lab don't always translate to the "real world". I can see the point with Reston, but even then the evidence is not strong, only "circumstantial" (as described by the source).

I agree that the cases are rare, but for the CDC to say that airborne transmission does not occur I think is obscuring the facts and may be putting people at risk.

 

[DVMDream]

Actually, both Ebola and Marburg have been shown experimentally to spread through aerosol transmission and there was actually an outbreak in the US in Reston, VA that showed strong evidence towards aerosol transmission. Experimentally only 500 infectious virus particles were required to cause a lethal airborne dose.

Source
"There is considerable misunderstanding concerning the potential for aerosol transmission of filoviruses. The data on formal aerosol experiments leave no doubt that Ebola and Marburg viruses are stable and infectious in small-particle aerosols, and experience of transmission between experimental animals in the laboratory supports this [49, 56–63]. Indeed, during the 1989–1990 epizootic of the Reston subtype of Ebola, there was circumstantial evidence of airborne spread of the virus, and supporting observations included suggestive epidemiology in patterns of spread within rooms and between rooms in the quarantine facility, high concentrations of virus in nasal and oropharyngeal secretions, and ultrastructural visualization of abundant virus particles in alveoli [17, 50]. However, this is far from saying that Ebola viruses are transmitted in the clinical setting by small-particle aerosols generated from an index patient [64]. Indeed patients without any direct exposure to a known EHF case were carefully sought but uncommonly found [65]. The conclusion is that if this mode of spread occurred, it was very minor."

So I would say its incorrect to state that the virus can't be transmitted by air, but it would be correct in saying aerosol transmission is not the viruses primary route of transmission.

EBO-R (the one in the VA outbreak) is different than EBO-Z, the virus that is being discussed now. Also, the VA outbreak of 1989 (note the date) was via monkeys shipped from the Philippines, two rooms of monkeys were euthanized. Also, a different virus was originally thought to be causing the disease. One person was infected because he cut his finger while doing necropsy, all others found to be positive for the virus had contact with the monkeys.

Also, lab setting is highly different than real life. There is no reason to claim that Ebola can be spread as an airborne virus due to one experiment in a lab that shows the risk is very, very small. Not only that, health standards and handling of tissues back in 1989 is not the same as it is now. The only thing people effectively do by saying there is a minute chance of airborne transmission is cause panic, much like H1N1 panic. People have a greater chance of being hit by a car.

 

[that redhead]

Re-reading The Stand while this all is unfolding does not help anything. FYI.

 

[dyachei]

Re-reading The Stand while this all is unfolding does not help anything. FYI.

hahaha, I'm doing the same thing.

My thing is this - although the risk is VERY small, there is still some risk and it makes me uneasy when we introduce any virus to a region that does not already have it.

 

[Panderson]

My thing is this - although the risk is VERY small, there is still some risk and it makes me uneasy when we introduce any virus to a region that does not already have it.

Especially when there is no vaccine. I have to admit that the thought of the outbreak is making my current sinus infection a little scarier than it should be...

It just drives me up a wall when an editorial journalist turns a virus into some type of Hollywood horror to get hits and shares with no actual research on his info, and people who read nothing but their Facebook feeds outright take it for fact.