Ebola outbreak in US...unneccssary scare?

[Elite Engineer]

With the recent influx of illegal aliens, (via the president), and those with ebola and other fatal diseases, is it just over-hype and media scare with the looming possibility of ebola spreading across the country?

 

-I say this b/c ebola is only passed via contact with contaminated feces, and/or ingestion of contaminated bodily fluids..it's not as if it were airborne or transferred via respiratory droplets.

 

your thought...

 

~ee

[CaptainPanic]

I think that ebola is just the next media scare. It's new. It's exotic. It attracts viewers/readers. It's good quality news! All the reports about wars (Ukraine, Gaza, Syria) get boring, so they need something else. It's even front-page news here in the Netherlands, were we have zero confirmed cases.

But you are right, the disease doesn't pass easily from a sick person to a healthy one, so I cannot imagine that Ebola will be a big issue.

Ebola death count: perhaps around 1000 people (nearly all in Central / Western Africa).
Have a look at the top 10 causes of death to put that tiny number in perspective...

 

The media don't report what is important. They report what people want to read/view.

[swansont]

The media don't report what is important. They report what people want to read/view.

 

Yes. Most of the things the news reports are things you don't have to worry about. It's news because it's unusual, in (increasingly) because it can be sensationalized. The mundane causes of death, which are far more numerous, don't make the news.

 

You hear about it when planes crash, but not when cars crash.

[Ophiolite]

Ebola death count: perhaps around 1000 people (nearly all in Central / Western Africa).

At one point in time the 1918 flu epidemic had killed around 1,000 people.

[CaptainPanic]

At one point in time the 1918 flu epidemic had killed around 1,000 people.

 

Bringing up the flu of 1918 (which caused 50-100 million deaths) suggests you do think that the Ebola epidemic is a very serious and dangerous development? I'd be interested to hear your reason to write that post. You probably know more about the topic than me.

[Ophiolite]

Your argument, as presented, is that since there have only been around 1,000 deaths, then on a global basis this outbreak is insignificant.

 

I have demonstrated that taking a time-specific casualty rate does not provide any evidence whatsoever for the final number of deaths.

 

Therefore, while you may be correct in your assertion as to the eventual limited impact of the disease, you have not presented any meaningful evidence to support this assertion.

 

 

 

I am surprised that anyone would take an Ebola outbreak lightly. I quote from Leroy, E.M. et al Multiple Ebola Virus Transmission Events and Rapid Decline of Central African Wildlife Science Vol. 303 2004

 

"The recent high frequency of EBOV out-breaks in central Africa, associated with high lethality and serious social consequences, has made Ebola a major public health priority. Given the very rapid spread of the disease and the lack of a vaccine or effective therapy, the cornerstone of management remains the prevention and rapid control of outbreaks."

 

And further, from Feldman,H. and Geisbert, T.W. Ebola Haemorrhagic Fever Lancet 2011

 

"Ebola virus is regarded as the prototype pathogen of viral haemorrhagic fever, causing severe disease and high case-fatality rates.¹ This high fatality, combined with the absence of treatment and vaccination options, makes Ebola virus an important public health pathogen and biothreat pathogen of category A."

 

There are only six category A pathogens.

 

So, I do not think the Ebola outbreak is a very serious and dangerous development. I think it is potentially a very serious and dangerous development. Taking potential threats seriously is often an effective way of stopping them realising their potential.

[Endy0816]

There are some pratical concerns but the bulk of our illegal immigrants are not coming from regions we need to be concerned about. Just media trying to spin zenophobia. Even if we did role out with an Ebola Vaccine tomorrow how many of your own countrymen would you be willing to bet wouldn't take it?

 

For its high rate of mortality, Ebola's transmission rate is actually fairly poor. If it were an airborne disease I'd be more concerned.

 

I don't think it even technically qualifies as an outbreak. Only 2 infected and were initally infected in a different country. It hasn't spread any further as far as we can tell and it has certainly been within US borders(outside labs) in the past.

[CharonY]

I think ebola is of significant local concern, but much less on a global scale. The reasons being:

- it has a very aggressive progression which actually limits undetected spread

- it is not that easily transmissible and require quite some extensive contact with body fluids (transient contact does poses a very low risk)

 

On the opposite side influenza has a much higher spread, but lower fatality rate. Yet, due to the sheer amount of infections fatality estimates even in highly developed nations such as the USA have higher yearly fatalities. In other words, the very thing that currently makes Ebola so scary (high fatality rate, aggressive) is currently limiting its potential to spread. Due to its relatively low reservoir (in humans at least) there may be also a smaller potential to get nastier, but I would have to do some more reading to be able to evaluate that...

[CaptainPanic]

Your argument, as presented, is that since there have only been around 1,000 deaths, then on a global basis this outbreak is insignificant.

 

I have demonstrated that taking a time-specific casualty rate does not provide any evidence whatsoever for the final number of deaths.

 

Therefore, while you may be correct in your assertion as to the eventual limited impact of the disease, you have not presented any meaningful evidence to support this assertion.

 

 

 

I am surprised that anyone would take an Ebola outbreak lightly. I quote from Leroy, E.M. et al Multiple Ebola Virus Transmission Events and Rapid Decline of Central African Wildlife Science Vol. 303 2004

 

"The recent high frequency of EBOV out-breaks in central Africa, associated with high lethality and serious social consequences, has made Ebola a major public health priority. Given the very rapid spread of the disease and the lack of a vaccine or effective therapy, the cornerstone of management remains the prevention and rapid control of outbreaks."

 

And further, from Feldman,H. and Geisbert, T.W. Ebola Haemorrhagic Fever Lancet 2011

 

"Ebola virus is regarded as the prototype pathogen of viral haemorrhagic fever, causing severe disease and high case-fatality rates.¹ This high fatality, combined with the absence of treatment and vaccination options, makes Ebola virus an important public health pathogen and biothreat pathogen of category A."

 

There are only six category A pathogens.

 

So, I do not think the Ebola outbreak is a very serious and dangerous development. I think it is potentially a very serious and dangerous development. Taking potential threats seriously is often an effective way of stopping them realising their potential.

 

Ok, so, to people in disease control and the medical sector, Ebola is important and they should learn about it, develop vaccins, and possibly take further actions and precautions. Institutions and corporations who have business in the most-affected areas may have to take precautions as well (such as British Airways, who cancelled some flights to Africa). I agree that these people make this a top-priority.

 

But here's me, living in the Netherlands. Zero casualties in my country so far. I have no direct links to any affected areas. Ebola is just very unlikely to affect me in the near future. What am I supposed to do? Should I take Ebola as a potential serious thread to my life, at this moment in time? Should I take any precautions? Should I be afraid? I think the answer is no. I might as well ignore it. In the Western world, there are institutes with people who professionally keep an eye on diseases, and our government will issue official warnings when stuff gets serious. Until then, I choose to ignore this media scare, because I know that the right people are not ignoring it.

[Ophiolite]

Clearly your response and my response to the situation reflect particulars of character that are not readily susceptible to scientific analysis on a discussion forum. I'll just note that if you ever run out of sand then I can sell you some at a discount.

[StringJunky]

I think ebola is of significant local concern, but much less on a global scale. The reasons being:

- it has a very aggressive progression which actually limits undetected spread

- it is not that easily transmissible and require quite some extensive contact with body fluids (transient contact does poses a very low risk)

 

On the opposite side influenza has a much higher spread, but lower fatality rate. Yet, due to the sheer amount of infections fatality estimates even in highly developed nations such as the USA have higher yearly fatalities. In other words, the very thing that currently makes Ebola so scary (high fatality rate, aggressive) is currently limiting its potential to spread. Due to its relatively low reservoir (in humans at least) there may be also a smaller potential to get nastier, but I would have to do some more reading to be able to evaluate that...

What characteristics should a pathogen have to maximise global infection and ultimately the most fatalities? I ask so I can compare those parameters with that of the Ebola virus. I think the incubation period is 2 to 21 days ...this is too short isn't it?

Edited August 7, 2014 by StringJunky

[CaptainPanic]

I'll just note that if you ever run out of sand then I can sell you some at a discount.

 

Living in a country below sea level, we can always use some! I believe we're currently building more beach and dunes on our coast, and that will take roughly 20 million m3 of sand. What's your price?

 

(Please note that this is just a joke, and also off-topic, and if anyone wishes to discuss this topic, I'd be happy to respond in a separate thread).

[CharonY]

What characteristics should a pathogen have to maximise global infection and ultimately the most fatalities? I ask so I can compare those parameters with that of the Ebola virus. I think the incubation period is 2 to 21 days ...this is too short isn't it?

 

There are many things. Incubation period is typically not critical per se, but the thing about Ebola is that during that time people are not infectious. Spread can be facilitated if people are contagious while being presymptomatic. This is e.g. the case for many STDs but also a number of (often bacterial) infections including Bordetella pertussis. Another aspect would be slow progression, so that people do not die quickly after being symptomatic, for example. Then there is the transmission rate (which is also fairly low for Ebola) and also the specificity of symptoms.

[Dianna1234]

Well, I think we should concern about it but not to feel frightened. After all, all we can do is to try our best to keep us away from it. Hope every country has strict security measures to protect the people. Waiting for new methods to cure diseases like Ebola.

[Delbert]

According to media reports they are checking passengers arriving at airports for possible Ebola by checking their temperature in the arrival lounge. I'm baffled by this on the grounds that apparently Ebola is so infectious that, even with an isolation gown, a nurse caught Ebola from a patient - in fact I understand there has been a second nurse so infected. And yet they are allowing the possibility of an infected person to walk through an arrival lounge prior to checking. Not to mention that the possible infected passenger has travelled on a plane with other passengers.

 

It seems to me what they should be doing is sending testers, suitably gowned in isolation suits, to enter the plane upon landing and test all passengers before they disembark.

[Endy0816]

Symptoms won't show up immediately.

 

Month long quarantines would be the only certain way.

[Robittybob1]

Well, I think we should concern about it but not to feel frightened. After all, all we can do is to try our best to keep us away from it. Hope every country has strict security measures to protect the people. Waiting for new methods to cure diseases like Ebola.

They have to take the cures to the areas infected otherwise they will all want to migrate to the places where there are decent medical facilities.

The essential thing still being missed is the resource of the recovered patients. Once you have recovered you are immune. No one has caught it twice. So use them as much as practical in the treatment centers.

[Externet]

Me being ignorant in the subject, I wonder if the infected body fluids from ebola patients anywhere including US hospitals that get into the sewage can survive there, taking in account the great difficulty to kill the ebola virus.

Patients have to defecate and urinate too. Does it end in public sewer ?

[Robittybob1]

Me being ignorant in the subject, I wonder if the infected body fluids from ebola patients anywhere including US hospitals that get into the sewage can survive there, taking in account the great difficulty to kill the ebola virus.

Patients have to defecate and urinate too. Does it end in public sewer ?

I wouldn't want to put my hands in there to find out. I think the virus only survives a short time in the environment.

[CharonY]

The virus is actually somewhat resilient, samples were active for several days at low temps, but maybe only a day or so at room temperature (though I am not 100% certain). However, ebola is not terribly infectious and typically requires direct contact with body fluids. I.e. sewage or similar would be too diluted (even if they remain active) to be a likely source of infection. In addition, typical sewage treatment should be more than enough to inactivate the virus in any case.

[Delbert]

Symptoms won't show up immediately.

It still seems weird to me that on the one hand one can have a potential individual infected with Ebola walking through an arrival lounge and having temperature checked by someone in more or less normal dress, and on the other hand, someone is only considered as infectious after they've had their temperature checked.

 

For example: the individual that reportedly informed aircraft passengers that he had Ebola was then dealt with by people in isolation gowns. But if he hadn't so informed everybody, he would presumably have walked off the aircraft as normal whether he actually had Ebola or not!

 

Perhaps it's the case that Ebola is only infectious - to the extent of having to be biologically isolated - after an individual has had their temperature measured and found abnormal.

 

One learns a little every day.

[Delta1212]

It still seems weird to me that on the one hand one can have a potential individual infected with Ebola walking through an arrival lounge and having temperature checked by someone in more or less normal dress, and on the other hand, someone is only considered as infectious after they've had their temperature checked.

 

For example: the individual that reportedly informed aircraft passengers that he had Ebola was then dealt with by people in isolation gowns. But if he hadn't so informed everybody, he would presumably have walked off the aircraft as normal whether he actually had Ebola or not!

 

Perhaps it's the case that Ebola is only infectious - to the extent of having to be biologically isolated - after an individual has had their temperature measured and found abnormal.

 

One learns a little every day.

It makes more sense when you realize that the temperature checks are pretty much worthless as far as a counter-measure to Ebola (since an infected person is far more likely to be presymptomatic when leaving a plane than they are to be running a fever) and that it is most likely just an attempt to calm people's fears.

 

You also need to realize that, unless you expect everyone in the airline industry to wear biohazard suits at all times and quarantine all passengers for a month upon disembarking, there isn't a much better system than "check for symptoms and treat as infectious if any show up."

 

It's not a great system, or even really a very good one, but screening people as they get off airplanes isn't exactly a particularly effective measure in this case no matter how you do it.

[Delbert]

It makes more sense when you realize that the temperature checks are pretty much worthless as far as a counter-measure to Ebola (since an infected person is far more likely to be presymptomatic when leaving a plane than they are to be running a fever) and that it is most likely just an attempt to calm people's fears.

That's one of the aspects that baffles me. Ebola is apparently so infectious that a nurse reportedly caught it by touching her face with her glove whilst disrobing, and yet the authorities seem quite prepared to have possible infected individuals walking through an airport arrival lounge. And direct airport staff to deal with them by taking their temperature. Looking at the pictures on the media, testing is done by someone wearing a bog standard while coat and mouth mask and pointing an object at the passenger! And noticed a media report that a UN medical worker has just died after coming into contact with an infected individual.

 

You also need to realize that, unless you expect everyone in the airline industry to wear biohazard suits at all times and quarantine all passengers for a month upon disembarking, there isn't a much better system than "check for symptoms and treat as infectious if any show up."

We're talking about a highly infectious and incurable infection with death being the almost certain outcome. As I see it, perhaps a better way is testing at departure - nay, upon approaching the airport building before departure!

 

It's not a great system, or even really a very good one, but screening people as they get off airplanes isn't exactly a particularly effective measure in this case no matter how you do it.

I would say a dangerous system likely to expose airport staff to possibly infected people - not to mention passengers and flight crew on the plane.

 

[CharonY]

Actually it is not terribly infectious. Typically the patient has to be symptomatic and you have to get into direct contact with body fluids. It is not even close to flu in that regard, for example (nor has it spread that much or caused as many deaths, for that matter). How the nurse got infected is, to my knowledge not clear (or at least not reported) yet. But you have to recall that the nurse got into contact with a patient who was ejecting a lot of contaminated fluids. That is a massive exposure to an infectious source. Someone being able to walk through an airport would typically not be at that stage (unless he/she is already vomiting or bleeding, obviously). While ebola is quite deadly, its spread is much more limited than, say, measles or HIV. The former because it is so contagious, the latter because patients can be infectious, but asymptomatic otherwise. These factors make ebola one of the more manageable infectious diseases. It appears that Nigeria and Senegal managed to contain the outbreak, but mainly for structural reasons Liberia, Guinea and Sierra Leone still report cases.

 

As others have noted, presymptomatic patients would not be detected, nor are they infectious. But to put it into perspective, the Dallas patient got into contact with quite a few people while being symptomatic and so far it appears that only the nurse (by unknown route) got infected.

 

To provide some numbers and perspective this year's outbreak has a total of 8400 worldwide (though mostly localized to West Africa) cases, which makes it the biggest ebola outbreak ever, although only 4633 have been actually confirmed, mostly due to issues in in Liberia.

If I limit the cases to pediatric reports (as these cases are actually reported) the ordinary flu results in about 100 children deaths per year in the USA alone (the range is from 35 in 2011-12 to 348, which was during the H1N1 pandemic 2009-10). The worldwide estimates of yearly deaths (including adults) of flu ranges between 250,000 to 500,000 each year. It is the case of an intense outbreak being scarier than something that we deal with each year. However the actual health burden is, at this point not that high.

 

I should also point out that ebola vaccines have now been submitted to trials. There have been successful animal studies around for some time, but I presume that the economic need was so low that they have not been pushed forward much.

Edited October 14, 2014 by CharonY

[Delbert]

Actually it is not terribly infectious. Typically the patient has to be symptomatic and you have to get into direct contact with body fluids.

Well, from what I understand from media reports, it can last some time outside the body on items touched.

 

As for your remark about it not being clear how the nurse became infected, I think it can be said that notwithstanding all precautions and wearing isolation clothing she became infected. And according to reports she isn't the only member of medical staff to be so infected. If that's not seriously infectious, I don't know what is.