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Ebola Transmission Discussion and More...
- Thread starter Nordica
- Start date
Re: Ebola Transmission Discussion
Re: Ebola Transmission Discussion
A few years could help get over this crisis: decrease the number of Healthcare Workers that die and increase the number of caregivers when many are withdrawing.
Re: Ebola Transmission Discussion
A few years could help get over this crisis: decrease the number of Healthcare Workers that die and increase the number of caregivers when many are withdrawing.
Re: Ebola Transmission Discussion
Re: Ebola Transmission Discussion
However, recent survivors should have some immunity and immunological memory, and as such would be ideally suited to become care givers. As with so many other aspects of this disease, there is much we still need to learn e.g for how long prior exposure confers immunity and to what degree. There are now survivors in sufficient numbers that it should be possible to test this, over time. Whether this can be done quickly enough to put them to good use is another good question.
Re: Ebola Transmission Discussion
However, recent survivors should have some immunity and immunological memory, and as such would be ideally suited to become care givers. As with so many other aspects of this disease, there is much we still need to learn e.g for how long prior exposure confers immunity and to what degree. There are now survivors in sufficient numbers that it should be possible to test this, over time. Whether this can be done quickly enough to put them to good use is another good question.
Re: Ebola Transmission Discussion
Re: Ebola Transmission Discussion
Some pertinent quotes:
http://www.theage.com.au/world/it-couldnt-be-ebola-could-it-20140804-3d49n.html#ixzz39VRUQ3qK
http://www.npr.org/blogs/goatsandso...ebola-out-so-how-can-a-health-worker-catch-it
www.macleans.ca/society/health/fron...gatic-on-the-worst-ebola-outbreak-in-history/
If it was significantly airborne, I'd expect many more cases in the urban areas - and the doctor behind the last quote would be among them.
I think that people are a little quick to attribute factors to the virus which are really down to human behaviour.
Medical treatment has unquestionably been more available than with most outbreaks, which affects the fatality rate. MSF had great results at their clinics.
Also, the level of community resistance and mobility here is unprecedented.
Re: Ebola Transmission Discussion
Some pertinent quotes:
http://www.theage.com.au/world/it-couldnt-be-ebola-could-it-20140804-3d49n.html#ixzz39VRUQ3qK
http://www.npr.org/blogs/goatsandso...ebola-out-so-how-can-a-health-worker-catch-it
www.macleans.ca/society/health/fron...gatic-on-the-worst-ebola-outbreak-in-history/
If it was significantly airborne, I'd expect many more cases in the urban areas - and the doctor behind the last quote would be among them.
I think that people are a little quick to attribute factors to the virus which are really down to human behaviour.
Medical treatment has unquestionably been more available than with most outbreaks, which affects the fatality rate. MSF had great results at their clinics.
Also, the level of community resistance and mobility here is unprecedented.
sharon sanders
Editor-in-Chief & President
Re: Ebola Transmission Discussion
Re: Ebola Transmission Discussion
I don't know. Good question. I will look tomorrow morning.
Re: Ebola Transmission Discussion
I don't know. Good question. I will look tomorrow morning.
Nordica
Well-known member
Re: Ebola Transmission Discussion
Re: Ebola Transmission Discussion
YES.....I have also wondered about the numbers in the WHO statistic.
We read about people hiding the ill, throwing dead into the rivers or out on the street. The government sends out teams to find Ebola cases and close areas. The news gives the picture of lack of control in many ways.
Ebola being so contagious and in a big area with such high density of people - I actually would expect much higher numbers of cases.
How is counting and reporting the cases to the authorities and are there cases that are not counted and shown in the WHO summary?
Re: Ebola Transmission Discussion
YES.....I have also wondered about the numbers in the WHO statistic.
We read about people hiding the ill, throwing dead into the rivers or out on the street. The government sends out teams to find Ebola cases and close areas. The news gives the picture of lack of control in many ways.
Ebola being so contagious and in a big area with such high density of people - I actually would expect much higher numbers of cases.
How is counting and reporting the cases to the authorities and are there cases that are not counted and shown in the WHO summary?
Re: Ebola Transmission Discussion
Re: Ebola Transmission Discussion
Well, the WHO updates say they come from the respective Ministries of Health. Goodness knows how they acquire the data.
I find the Sierra Leone figures particularly dubious. They are formally reporting that 161 have recovered and been discharged, which leaves a substantial gap between cases and deaths, even allowing for a couple of hundred active cases.
Re: Ebola Transmission Discussion
Well, the WHO updates say they come from the respective Ministries of Health. Goodness knows how they acquire the data.
I find the Sierra Leone figures particularly dubious. They are formally reporting that 161 have recovered and been discharged, which leaves a substantial gap between cases and deaths, even allowing for a couple of hundred active cases.
Re: Ebola Transmission Discussion
Re: Ebola Transmission Discussion
It is believed by experts on the ground that the WHO numbers are the tip of the iceberg (see Ebola news threads) and that there are many more cases than officially reported, i.e many more people are infected or have died than have been confirmed through testing. People have been hiding and burying their dead in secret, and some communities have still not permitted access to medics, but with the official declaration of a 'state of emergency' in Liberia and Sierra Leone, and house to house searches, we may begin to get a better picture of the real situation over the course of the coming weeks.
With regard to official numbers it is also worth noting that there is a long incubation period in many cases (up to 21 days after exposure), so even with officially monitored cases, if you take account of incubation time and time for testing and positive confirmation, we are probably running between 2 - 4 weeks in arrears before people become symptomatic.
What we are looking for is a stabilation (not growth) in new case numbers followed by falls in new case numbers that are maintained for at least one month, without any resurgence. This would indicate that the situation may be starting to be brought under control. It will take many months before this outbreak will be declared over, if current actions are successful.
Re: Ebola Transmission Discussion
It is believed by experts on the ground that the WHO numbers are the tip of the iceberg (see Ebola news threads) and that there are many more cases than officially reported, i.e many more people are infected or have died than have been confirmed through testing. People have been hiding and burying their dead in secret, and some communities have still not permitted access to medics, but with the official declaration of a 'state of emergency' in Liberia and Sierra Leone, and house to house searches, we may begin to get a better picture of the real situation over the course of the coming weeks.
With regard to official numbers it is also worth noting that there is a long incubation period in many cases (up to 21 days after exposure), so even with officially monitored cases, if you take account of incubation time and time for testing and positive confirmation, we are probably running between 2 - 4 weeks in arrears before people become symptomatic.
What we are looking for is a stabilation (not growth) in new case numbers followed by falls in new case numbers that are maintained for at least one month, without any resurgence. This would indicate that the situation may be starting to be brought under control. It will take many months before this outbreak will be declared over, if current actions are successful.
sharon sanders
Editor-in-Chief & President
Re: Ebola Transmission Discussion
Re: Ebola Transmission Discussion
I agree with the last several comments. The official ebola numbers tabulated by all parties are only a view into the problem. It gives us an idea.
All government reports are similar in nature for large scale outbreaks. The numbers tabulated are a window into the situation and not necessarily the absolute. (Except the Saudi MoH who insists they have ALL of the coronavirus MERS cases accounted for.
)
Re: Ebola Transmission Discussion
I agree with the last several comments. The official ebola numbers tabulated by all parties are only a view into the problem. It gives us an idea.
All government reports are similar in nature for large scale outbreaks. The numbers tabulated are a window into the situation and not necessarily the absolute. (Except the Saudi MoH who insists they have ALL of the coronavirus MERS cases accounted for.
)
Nordica
Well-known member
Re: Ebola Transmission Discussion
Re: Ebola Transmission Discussion
http://www.who.int/csr/disease/ebola/evd-outbreak.jpg
The iceberg is spread over an area of 500 * 500 km, as big as Poland in Europe or Arizona in the US!
A big challenge ahead!
Re: Ebola Transmission Discussion
http://www.who.int/csr/disease/ebola/evd-outbreak.jpg
The iceberg is spread over an area of 500 * 500 km, as big as Poland in Europe or Arizona in the US!
A big challenge ahead!
Last edited:
JimO
Well-known member
Re: Ebola Transmission Discussion
Re: Ebola Transmission Discussion
I have serious doubts that the cases where bodies are abandoned are counted as either cases or deaths. If the MoH was aware of a death, I can't imagine they would lose track of the body such that it could be abandoned in the street or dumped in the river. The known cases and deaths in Liberia, in particular, could be a fraction of actual cases/deaths.
Re: Ebola Transmission Discussion
I have serious doubts that the cases where bodies are abandoned are counted as either cases or deaths. If the MoH was aware of a death, I can't imagine they would lose track of the body such that it could be abandoned in the street or dumped in the river. The known cases and deaths in Liberia, in particular, could be a fraction of actual cases/deaths.
JimO
Well-known member
Re: Ebola Transmission Discussion
Re: Ebola Transmission Discussion
Based on the preparations being made, they either know more than they are revealing or they like to be incredibly well prepared. I base this on the following information:
1) There has been one imported case/death.
2) Several cases and one death were primary contacts.
3) No secondary cases have been identified.
4) Primary contacts were quarantened before becoming symptomatic.
And yet:
1) Nigeria has declared a state of emergency.
2) Certain hospitals have been designated as ebola treatment centers.
3) The government is scrambling to acquire and set up isolation tents for victims.
4) At least one Nigerian state has begun setting up dedicated cremation sites for ebola victims.
Maybe Nigeria is just trying to be extremely well prepared, but the actions seem excessive when compared with the available information about cases in Nigeria.
Re: Ebola Transmission Discussion
Based on the preparations being made, they either know more than they are revealing or they like to be incredibly well prepared. I base this on the following information:
1) There has been one imported case/death.
2) Several cases and one death were primary contacts.
3) No secondary cases have been identified.
4) Primary contacts were quarantened before becoming symptomatic.
And yet:
1) Nigeria has declared a state of emergency.
2) Certain hospitals have been designated as ebola treatment centers.
3) The government is scrambling to acquire and set up isolation tents for victims.
4) At least one Nigerian state has begun setting up dedicated cremation sites for ebola victims.
Maybe Nigeria is just trying to be extremely well prepared, but the actions seem excessive when compared with the available information about cases in Nigeria.
Re: Ebola Transmission Discussion
Re: Ebola Transmission Discussion
I have a couple of possible explanations: (1) their protection and equipment is substandard, (2) they wore their gowns and gloves longer than they are intended to endure protection, (3) the virus transmits via droplet transmission, (4) we are now dealing with a mutation, (5) doctors and nurses got infected by someone not following proper protocol in the scrub room.
I read that half the deaths from Ebola have been from medical personnel.
Re: Ebola Transmission Discussion
While reading all the news about the current Ebola outbreak I can?t help wondering how Ebola educated, medical professionals with full protection equipment can get infected with Ebola?
We are told that Ebola is only transmitted via direct contact, actually by touching an infected area, then it can go into your body via a wound or if you put your contaminated finger into your mouth, nose or eye.
But...is it the only way of transmission?
I have a couple of possible explanations: (1) their protection and equipment is substandard, (2) they wore their gowns and gloves longer than they are intended to endure protection, (3) the virus transmits via droplet transmission, (4) we are now dealing with a mutation, (5) doctors and nurses got infected by someone not following proper protocol in the scrub room.
I read that half the deaths from Ebola have been from medical personnel.
Nordica
Well-known member
Re: Ebola Transmission Discussion
Re: Ebola Transmission Discussion
I guess WHO analyses the virus from the different places and that they will tell if they see it changing.
The WHO statistic shows that;
Guinea, the first country hit by Ebola 2014 has 495 cases and a mortality of 73 %,
Sierra Leone, 691 cases and a mortality of 41%,
Liberia, 516 cases and a mortality of 55%.
Why is the mortality number so very different? Can it be explained with different way of counting, social behaviour or healthcare standard?
... or is it a difference in the Ebola virus?
Re: Ebola Transmission Discussion
I guess WHO analyses the virus from the different places and that they will tell if they see it changing.
The WHO statistic shows that;
Guinea, the first country hit by Ebola 2014 has 495 cases and a mortality of 73 %,
Sierra Leone, 691 cases and a mortality of 41%,
Liberia, 516 cases and a mortality of 55%.
Why is the mortality number so very different? Can it be explained with different way of counting, social behaviour or healthcare standard?
... or is it a difference in the Ebola virus?
Re: Ebola Transmission Discussion
Re: Ebola Transmission Discussion
Some will still be ill, and may yet die. The overall estimate for CFR is currently running at @60% when people who are sick are taken out of the equation.
However see
http://www.haaretz.com/life/science-medicine/.premium-1.609526
The Ebola epidemic in West Africa is worsening as bodies lie in city streets and entire villages are wiped out, an Israeli doctor based in Guinea says.
“I’ve been working with humanitarian-aid groups for 12 years and have been in Ebola-stricken areas four times, three of them in Guinea, but the current outbreak is the worst,” said Dr. Eyal Reinich of the Swiss branch of Doctors without Borders.
The disease, currently spreading across Guinea, Liberia and Sierra Leone, has a 90-percent mortality rate and no cure. Reinich isn’t optimistic about contaning the outbreak of the illness, marked by diarrhea, bleeding and vomiting.
“This is the most virulent Ebola virus I’ve encountered,” he said. “We don’t know how to assess the scope yet, but the actual numbers are higher than the published ones. The outbreak is coming from all diretcions.”
Reinich, who has been in Guinea since May, spoke to Haaretz by satellite phone from the town of Guéckédou near the border with Sierra Leone and Liberia — the outbreak’s center.
“Entire villages have been wiped out,” he said. “You come to villages and only find bodies. You don’t know if all the inhabitants died or if some simply fled. It’s a virus with a 90-percent death risk in these regions and we don’t know what condition the people who have fled are in.”
The panic in the afflicted countries is making it hard to contain the epidemic, even before considering other scourges like the Lassa virus and malaria, which are also spreading.
“Villagers are fleeing as if it were a civil war, which increases the spread of Ebola,” Reinich said. “They disappear into jungles and other places and become vagrants. So we’re constantly finding the virus in places we didn’t know about.” In some cases, aid workers like local Red Cross people also panic and run, Reinich says.
snip
In Liberia’s capital Monrovia, bodies are lying in the street. “The fear in the street is terrible,” Reinich said. “If an epileptic person falls, everyone reacts hysterically and nobody helps him.”
In the villages, residents have lost faith in Western aid organizations. “I’m in a very tribal area and in some cases they throw spears at us or wave machetes, warning us not to get near,” he said.
snip
Despite the fear of being infected, many people with symptoms don’t visit the aid organizations’ clinics. The doctors are trying to identify as many virus carriers as possible and treat the 10 percent of patients who survive — without being infected themselves.
snip
“The rainy season is delaying things. We’re stuck in the mud, the roads are impassable and the flowing water helps spread the virus,” Reinich said.
“There was a summit of presidents here that decided to close the borders, but actually the borders are wide open. All the conditions for letting Ebola spread further exist.”
Re: Ebola Transmission Discussion
Some will still be ill, and may yet die. The overall estimate for CFR is currently running at @60% when people who are sick are taken out of the equation.
However see
http://www.haaretz.com/life/science-medicine/.premium-1.609526
The Ebola epidemic in West Africa is worsening as bodies lie in city streets and entire villages are wiped out, an Israeli doctor based in Guinea says.
“I’ve been working with humanitarian-aid groups for 12 years and have been in Ebola-stricken areas four times, three of them in Guinea, but the current outbreak is the worst,” said Dr. Eyal Reinich of the Swiss branch of Doctors without Borders.
The disease, currently spreading across Guinea, Liberia and Sierra Leone, has a 90-percent mortality rate and no cure. Reinich isn’t optimistic about contaning the outbreak of the illness, marked by diarrhea, bleeding and vomiting.
“This is the most virulent Ebola virus I’ve encountered,” he said. “We don’t know how to assess the scope yet, but the actual numbers are higher than the published ones. The outbreak is coming from all diretcions.”
Reinich, who has been in Guinea since May, spoke to Haaretz by satellite phone from the town of Guéckédou near the border with Sierra Leone and Liberia — the outbreak’s center.
“Entire villages have been wiped out,” he said. “You come to villages and only find bodies. You don’t know if all the inhabitants died or if some simply fled. It’s a virus with a 90-percent death risk in these regions and we don’t know what condition the people who have fled are in.”
The panic in the afflicted countries is making it hard to contain the epidemic, even before considering other scourges like the Lassa virus and malaria, which are also spreading.
“Villagers are fleeing as if it were a civil war, which increases the spread of Ebola,” Reinich said. “They disappear into jungles and other places and become vagrants. So we’re constantly finding the virus in places we didn’t know about.” In some cases, aid workers like local Red Cross people also panic and run, Reinich says.
snip
In Liberia’s capital Monrovia, bodies are lying in the street. “The fear in the street is terrible,” Reinich said. “If an epileptic person falls, everyone reacts hysterically and nobody helps him.”
In the villages, residents have lost faith in Western aid organizations. “I’m in a very tribal area and in some cases they throw spears at us or wave machetes, warning us not to get near,” he said.
snip
Despite the fear of being infected, many people with symptoms don’t visit the aid organizations’ clinics. The doctors are trying to identify as many virus carriers as possible and treat the 10 percent of patients who survive — without being infected themselves.
snip
“The rainy season is delaying things. We’re stuck in the mud, the roads are impassable and the flowing water helps spread the virus,” Reinich said.
“There was a summit of presidents here that decided to close the borders, but actually the borders are wide open. All the conditions for letting Ebola spread further exist.”