ProMED calls an Ebola pandemic...

[alert]

ProMED released a post on the ongoing Ebola outbreak in West Africa:

Published Date: 2014-07-16 20:20:03
Subject: PRO/AH/EDR> Ebola virus disease - West Africa (90): Sierra Leone, Ghana meeting, history
Archive Number: 20140716.2615640

in which they end with the comment:

If the particular ebolavirus strain causing the current epidemic (actually pandemic, because it has crossed international borders) has been in West Africa at least since 2006, why haven't cases been seen before? Well, they have; they were viral hemorrhagic fever patients coming to the Lassa ward of Kenema General Hospital, where they were treated with the proper precautions and did not spread either in hospital or to the community. But since fatal cases were presumably buried with traditional rites, why didn't the carers and mourners get massively infected in past years as they are being now? It's looks as though we have a strain that is more virulent than the Zaire strain has been in the past in West Africa yet not as virulent as it is in the Congo, where up to 90 percent of victims died.

I have to object to the bold text. Ebola has not yet caused a pandemic, and hopefully never will. Just because an outbreak is in more than one country doesn't make it a pandemic. Is malaria a pandemic? Cholera? Measles? The root "pan" in pandemic is EVERYWHERE. Ebola isn't everywhere; it is in 3 countries that share a border.

I fear that the authority of ProMED may cause this quote to get taken out of context and cause unnecessary global alarm...

 

[Vibrant62]

Re: ProMED calls an Ebola pandemic...

West African regional epidemic would be a better descriptor at this stage. I think for the term pandemic to truly apply it needs to be epidemic in more than one continent.

 

[alert]

Re: ProMED calls an Ebola pandemic...

They just did it again, but deliberately this time:

Published Date: 2014-09-06 16:46:24
Subject: PRO/AH/EDR> Ebola virus disease - West Africa (153): hospital ships
Archive Number: 20140906.2754003

[snip]

I believe ProMED should make an exception and start a discussion on rapid response to the EVD pandemic (still euphemistically referred to as just an "outbreak" in some places). Many health authorities worldwide are subscribed to ProMED, and maybe we could hear all the reasons why field hospitals and hospital ships haven't been deployed weeks ago, besides "We haven't been asked". It would be valuable training for biodefense responders. - Mod.JW (My personal view, not necessarily that of all the ProMED team)

[snip]

 

[sharon sanders]

Re: ProMED calls an Ebola pandemic...

Mod JW is posting anonymously. I would like to know what is his/her definition of "pandemic". Mod JW specifically says he/she is not speaking on behalf of ProMED.

 

[alert]

Re: ProMED calls an Ebola pandemic...

Moderator JW continues to vent. Today's post ended in:

Published Date: 2014-09-07 22:26:29
Subject: PRO/AH/EDR> Ebola virus disease - West Africa (154): hospital ships, military logistics
Archive Number: 20140907.2755900

EBOLA VIRUS DISEASE - WEST AFRICA (154): HOSPITAL SHIPS, MILITARY LOGISTICS
***************************************************************************

[snip]

When the 1st few cases slip past quarantine into communities in the USA or Europe, the outpouring of huge amounts of money to take care of the situation, if spent earlier on more beds and health workers (and paying their salaries to avoid the current strikes) in West Africa, might have turned the situation there around (my personal view, not necessarily that of all the ProMED team). - Mod.JW

 

[sharon sanders]

Re: ProMED calls an Ebola pandemic...

I guess JW is essentially turning ProMED into a comment site. lol

It is always easier to look back at what should have been done. Not really insightful.

 

[Gert van der Hoek]

Re: ProMED calls an Ebola pandemic...

Talking about preparing: other African countries like Gabon, Cameroon, Central African Republic, Ghana and some more are at risk for an outbreak of Ebola.

See map in this post: http://www.flutrackers.com/forum/showthread.php?t=227133

Also see the latest blog of Mike Coston: http://afludiary.blogspot.be/2014/09/mapping-zoonotic-range-of-ebola-virus.html

.

 

[JJackson]

Re: ProMED calls an Ebola pandemic...

I do not know who JW is but I think it is just a combination of frustration and trying to get someone, anyone, to 'get it'.

Successful containment of all previous outbreaks has been achieved by containment and contact tracing but this is only practical with small numbers of cases.

He/she must have been watching what we were and realised that sufficient resources were not being applied early enough to achieve this. Now it looks like those with the potential to do so are trying to move in the right direction but what could have been solved with a plane load of medics and equipment is now going to need a massive airlift and cost more than a billion dollars. It is looking increasingly likely at even that is no-longer going to cut it.

Try this little experiment. Get a bit of paper and pencil and put it in your pocket and carry it around with you for 3 days. Every time you touch someone or interact in anyway that you think could possibly count as a potential transmission event make a mark on your paper. How many marks were on your paper? How many people would be needed to contact trace, test, quarantine, monitor and feed those contacts bearing in mind they must all be found within 3 days lest they become infectious and need the whole contact tracing process to be repeated for them? If you became ill for how many of those marks would you be able to give a name and location?

Multiply those numbers by a thousand and that is what will need to be achieved per week very shortly. It would be a nightmare in the US where you have the IRS database and most people can be found in a phone database. In Liberia - poof.

 

[Nika]

Re: ProMED calls an Ebola pandemic...

JJackson I love that thought experiment. Excellent way to bring the discussion back to the human scale.