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  #21  
Old 01 October 2014, 11:45 PM
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Ordinary antibiotics and being sent home isn't how you'd treat tuberculosis either. I didn't say they should have "Ebola on the brain." I do think that it is information that should have been passed on to the doctor, and follow-up questions asked, like whether they had been around anyone who was sick--which would help diagnose tuberculosis, too.
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  #22  
Old 02 October 2014, 01:32 AM
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Doctors say they give out antibiotics for viruses to prevent secondary infections. At some subconscious level I bet they do it because it stops patients from complaining.

Back to the topic at hand, this particular strain of the Ebola virus appears to be relatively easy to spread. IIRC, an American doctor in an obstetrics ward in West Africa was infected with Ebola. Assuming he used universal precautions and wasn't infected by some other route, droplets from blood splatter, coughs, or touching his face or eyes after touching an infected individual likely caused the infection. The CDC recommends droplet safeguards (goggles, masks) as standard protocol now.
I'll have to check but I believe Ebola is able to survive on hard surfaces for up to 9 hours. Ebola cannot be spread across a room (it's not airborne) but you don't want to shake the hands of a person with symptomatic Ebola or have them get splatters of phlegm on your face. Any family members who directly cared for this individual when he arrived back from the hospital have a non-trivial chance of developing Ebola.
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  #23  
Old 02 October 2014, 01:50 AM
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That's what I've heard as well. It's tempering the whole, "it's not airborne" thing. It isn't airborne, but if someone with it coughs in your face, you'll very likely get it. One doctor mentioned feeling perfectly safe if she was standing six feet away from a symptomatic EVD patient. I do wonder about the OB ward doctor. His patients were also screened for fever on intake.
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  #24  
Old 02 October 2014, 03:55 AM
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Quote:
Originally Posted by erwins View Post
Ordinary antibiotics and being sent home isn't how you'd treat tuberculosis either.
Of course not. That's why I said:
Quote:
So I'm not so sure it should be handed out any more than antibiotics.
I don't think doctors in the US should waste any time asking questions that might relate to Ebola. Whatever they ask can be covered in the questions about dozens of other more dangerous and prevalent diseases.
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  #25  
Old 02 October 2014, 04:31 AM
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Little Pink Pill Little Pink Pill is offline
 
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Heavt breathing

Quote:
Originally Posted by erwins View Post
What kind of travel restrictions should there be, do you reckon?

Air travelers from the area are already screened for a fever before boarding. Other restrictions are not likely to be helpful. http://www.washingtonpost.com/news/t...ged-countries/.
I'm unconvinced by that link, which seems to be claiming air travel from countries where Ebola is an epidemic is safe based on 2 things: 1. Passengers are checked for fevers before a flight, and 2. Ebola is not airborne. But the article also talks about how quickly contagious symptoms can come on (like, say, in the middle of a long international flight) and you have addressed the contradiction of the airborne question in another post. And while screening passengers for a fever may help protect the people onboard that particular flight, it does nothing for the people who will be exposed at the destination by someone who is still in the incubation stage while traveling.

I don't disagree with you about nurses being aware and sharing info, but ER personnel should not be our first line of defense against the spread of an international epidemic, and rapid transit from countries "ravaged" with a rapid onset disease doesn't seem helpful.
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  #26  
Old 02 October 2014, 04:37 AM
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Quote:
Originally Posted by ganzfeld View Post
I don't think doctors in the US should waste any time asking questions that might relate to Ebola. Whatever they ask can be covered in the questions about dozens of other more dangerous and prevalent diseases.
I gave examples of questions that they should be asking, such as whether they have traveled recently, and then whether they have been around someone who was sick. Follow-up questions to that will depend on the answers to those questions. They should certainly ask those questions, and those questions do "relate to Ebola."

The CDC and the American College of Emergency Physicians agree, and I think I'll rely on their expertise in this area.

Quote:
The CDC reminded the nation’s health care providers to ask patients with symptoms if they've traveled recently. The American College of Emergency Physicians planned to alert its members as well.
http://www.boston.com/health/2014/10...aAL/story.html

Asking the questions I suggested might have revealed this important, and very relevant information.

Quote:
The New York Times said that Duncan, in his mid-40s, helped transport a pregnant woman suffering from Ebola to a hospital in Liberia, where she was turned away for lack of space. Duncan helped bring the woman back to her family's home and carried her into the house, where she later died, the newspaper reported. Four days later Duncan left for the United States, the Times said, citing the woman's parents and neighbors.
http://news.yahoo.com/traveler-liber...--finance.html

Also, he presented with a fever and abdominal pain, so tuberculosis would be a strange thing to focus on.

LPP: The experts have consistently said that quarantines and travel restrictions do more harm than good. Cutting off the ways that aid workers and supplies can get into the country is a problem. And it's not like there's a bustling tourist industry there right now. There is a travel advisory in effect to the area warning people not to travel there unless it's necessary. There are reasonable screening procedures in place. Yes, there may be a small chance that a person's immediate seatmates could be exposed if someone gets ill during the flight. But it isn't the nightmare scenario that many people imagine of a whole plane full of people unknowingly being exposed and then dispersing around the country. If someone gets vomited on, or has blood coughed in their face on the way out of the area, I think they'll probably have a good idea that they may have been exposed to something serious. From a public health perspective, the risk is pretty low. Monrovia is a city of around a million people, and there are maybe (generously) a few thousand people symptomatic with Ebola right now. It doesn't make sense to cut off all travel to the area.

Last edited by erwins; 02 October 2014 at 04:53 AM.
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  #27  
Old 02 October 2014, 06:00 AM
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I wasn't advocating for a complete cut off. I think emergency personnel and compassion missions should have access. But what is the harm in temporarily suspending things like tourist visas from epidemic stricken areas? From what I'm reading, it sounds like Duncan was just in the States on a casual visit to family, a family who has now been potentially exposed to a life threatening pathogen.

I understand that this is not the kind of threat you see hyped in Hollywood movies, but I still don't think a man who just carried a woman dying from Ebola away from an overloaded hospital in Liberia should have been hopping international flights and visiting Dallas ER's a few days later on vacation.
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  #28  
Old 02 October 2014, 06:56 AM
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United isn't going to keep flying if hardly anyone can travel from here to there or vice versa. And while I don't think it was a one in a billion chance, I mentioned the numbers because they illustrate that it's a pretty low chance that a visitor has had any contact with someone symptomatic with EVD. People should be cut off from visiting friends and family because of a tiny chance of not just having contact with a person with symptomatic EVD, but also having the timing work out perfectly to hide the disease before boarding the flight? And if the airlines stop flying then it doesn't matter that all travel wasn't cut off by law--it will happen anyway.
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  #29  
Old 02 October 2014, 02:41 PM
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Quote:
DALLAS, Oct 2 (Reuters) - More than 80 people had direct or indirect contact with the first person to be diagnosed with the deadly Ebola virus in the United States, health officials said Thursday, as four members of the patient's family were quarantined as a precaution.
This is 2 miles away from my house. Now I'm feeling pretty absurdly paranoid...

http://www.huffingtonpost.com/2014/1...n_5919522.html
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  #30  
Old 02 October 2014, 10:50 PM
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Perhaps this will put your mind at ease, LLO:

Quote:
"I have no doubt that we will control this importation, or case, of Ebola so that it does not spread widely in this country," said the director of the CDC, Dr. Tom Frieden.
Why is Frieden so sure this virus won't spread beyond a handful of cases?
It boils down to something called "R0."
http://www.npr.org/blogs/health/2014...gious-is-ebola
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  #31  
Old 03 October 2014, 12:56 AM
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Quote:
Originally Posted by erwins View Post
People should be cut off from visiting friends and family because of a tiny chance of not just having contact with a person with symptomatic EVD, but also having the timing work out perfectly to hide the disease before boarding the flight?
I guess as someone who lived for years separated from friends and family (with occasional visits, as the case usually is when there are oceans between you), I don't find the notion particularly outrageous. It's certainly a bummer, but you Skype and plan around it, like you do the other events in your lives (pregnancies, illnesses, money issues, etc). And it's not the kind of bummer that, say, exposing your family to Ebola is, like the man in the OP did.

But I understand your point, that the actual risk doesn't currently demand that kind of action.

Quote:
And if the airlines stop flying then it doesn't matter that all travel wasn't cut off by law--it will happen anyway.
True, relief agencies would have to charter private planes or work with governments, like they do in war torn areas.
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  #32  
Old 03 October 2014, 02:46 AM
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Quote:
Originally Posted by Little Pink Pill View Post
True, relief agencies would have to charter private planes or work with governments, like they do in war torn areas.
That would make it harder for the relief agencies. Relief agencies don't stop wars - but they can stop epidemics. Making it harder for them guarantees that the epidemic would get worse, rather than better.
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  #33  
Old 03 October 2014, 02:47 AM
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The (relatively) good news about this epidemic is that it seems to be a less lethal strain of the virus than has sometimes been encountered. I believe I read that it's been fatal to around 55% of those who contract it -- which is horrible, of course, but not as bad as the 80-90% rates seen in some outbreaks.
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  #34  
Old 03 October 2014, 02:56 AM
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Time corrected graphs show it is 80-90% fatal when untreated, 50-40% when treated.

In other news,
Quote:
Towels and sweat-ridden bedclothes remained for two days in the Dallas apartment where an undiagnosed Ebola sufferer was staying because health officials in Texas struggled to find a waste management company willing to accept them.
Jesus.
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  #35  
Old 03 October 2014, 03:30 AM
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Quote:
Health officials obtained an order to force the residents of the apartment to stay at home, after admitting they had not complied with a voluntary request to do so on Wednesday.
Jesus. WILL YOU STAY HOME.

Quote:
Local government officials said that the complex has 300 units and about 25,000 people live in the densely populated, multi-ethnic district known as Vickery Meadow.

At midday on Thursday, a child peeked out from behind a red diamond-pattered curtain in one of the apartments while at ground level a team of three contractors – none wearing any sort of protective clothing – power-washed the front porch. A stroller stood at the bottom of a staircase.

Earlier, a representative of one of the agencies who issued the control order said that arranging clean bedding was the responsibility of the family – despite the ban on them leaving their home. “The individuals, it’s up to them … to care for the household,” Erikka Neroes of Dallas County health and human services told the Guardian. “Our science tells us, according to CDC, that Ebola virus germs can be killed with soap and water … Dallas County has not been involved in a disinfection process.”
It is ludicrous to expect family members to wash Ebola-exposed bedding and clothing and possibly infect themselves. I had assumed that state or federal agencies, or the CDC, would be involved in any cleanup, not a private cleaning company.
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  #36  
Old 03 October 2014, 03:53 AM
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Some good questions and answers here: http://www.cnn.com/2014/10/01/health...ons/index.html
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  #37  
Old 03 October 2014, 06:19 AM
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Quote:
Originally Posted by Luka_the_Pooka View Post
Jesus. WILL YOU STAY HOME.
Isn't it kind of contradictory for authorities to ask them to, if they're not showing symptoms?
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  #38  
Old 03 October 2014, 06:45 AM
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No, not really. They are at high risk for having direct contact with a symptomatic person's bodily fluids. It should be enough to monitor them for a fever and other symptoms, but I imagine it is safer to ask them to stay in one place so that there isn't a chance that they would be out and about if symptoms do develop. I suspect that a major purpose of the request is to reassure the public.

I don't think making them stay in their home makes the most sense considering the cleanup issues there. And having made them stay there, it also doesn't make sense to not help them with the clean up.
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  #39  
Old 03 October 2014, 12:27 PM
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I must say it is rather amusing watching wing nuts mental gymnastics to reverse there position on Ebola. A few weeks ago the echo chamber message was "wish Obama cared as much about Isis as he does about Ebola." The message being that Ebola and his response to it was a overblown publicity stunt over nothing. Suddenly when one guy in Texas has it we should ban all flights from Africa and station every soldier we have on the US/Mexico boarder because apparently all foreigners are the same?
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  #40  
Old 03 October 2014, 01:53 PM
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i heard my first "that guy in Texas is an agent of ISIS sent here to infect us with Ebola" rant. A woman my wife works with.

I thought about countering with "that's stupid. Everybody knows that Ebola is a bio-weapon developed by the CIA," but thought she would just incorporate that into her conspiracy theory.

This woman is a professional, highly educated person. It just boggles the mind.
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