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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsWhat We’re Afraid to Say About Ebola
by Michael T. Osterholm (the director of the Center for Infectious Disease Research and Policy at the University of Minnesota.)
MINNEAPOLIS THE Ebola epidemic in West Africa has the potential to alter history as much as any plague has ever done.
There are two possible future chapters to this story that should keep us up at night.
The first possibility is that the Ebola virus spreads from West Africa to megacities in other regions of the developing world. This outbreak is very different from the 19 that have occurred in Africa over the past 40 years. It is much easier to control Ebola infections in isolated villages. But there has been a 300 percent increase in Africas population over the last four decades, much of it in large city slums. What happens when an infected person yet to become ill travels by plane to Lagos, Nairobi, Kinshasa or Mogadishu or even Karachi, Jakarta, Mexico City or Dhaka?
The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air. You can now get Ebola only through direct contact with bodily fluids. But viruses like Ebola are notoriously sloppy in replicating, meaning the virus entering one person may be genetically different from the virus entering the next. The current Ebola viruss hyper-evolution is unprecedented; there has been more human-to-human transmission in the past four months than most likely occurred in the last 500 to 1,000 years. Each new infection represents trillions of throws of the genetic dice.....
http://www.nytimes.com/2014/09/12/opinion/what-were-afraid-to-say-about-ebola.html?src=me&module=Ribbon&version=context®ion=Header&action=click&contentCollection=Most%20Emailed&pgtype=article
More at link. There is another possibility that he doesn't discuss, but I've seen raised elsewhere. It's possible that it has become more infectious, that is, that it requires less viral load to become transmissible, so transmits earlier on in the course of the disease. Iow, before symptoms are apparent...
hobbit709
(41,694 posts)laundry_queen
(8,646 posts)I simply can't believe western society has been so blasé about this outbreak.
LiberalArkie
(15,686 posts)I am afraid that has been the way people thought of it like it is only the Queers getting HIV. Nothing will really happen until it hits the white people in Europe or other places in the industrialized world.
jwirr
(39,215 posts)calimary
(80,693 posts)AWFUL. Just awful! Nobody cares. It's just Africa.
Sad. Disgraceful. Frickin' AWFUL!
laundry_queen
(8,646 posts)locdlib
(176 posts)Plano, Texas people became suddenly concerned when white kids started overdosing on drugs. The attitude prior to that had been that only black/brown kids used drugs. When it was finally figured out that there were more white kids using hard drugs (parent's prescriptions, meth, etc.), there was a sudden frenzy to do something. So yes, many an idiot out there sees Ebola as something that only affects those of us with dark skin. To them it's all good . . . until it isn't.
savalez
(3,517 posts)LiberalArkie
(15,686 posts)of older ladies talking.
1dogleft
(164 posts)delrem
(9,688 posts)and I can't say I've ever heard anyone comment like *that*! in a grocery or any kind of line.
Not even when visiting the 'burbs.
heaven05
(18,124 posts)heaven05
(18,124 posts)typical of amerikkkan culture at this time. A lot of people like those that commented about it being an outbreak only affecting n.......are foolish amerikkkan fux news cultural morons probably disguised as civilized human beings. People like those who commented makes me hope sometimes............that.........but, oh well, karma can be an equalizer. Such a hateful, hateful culture we live in.
Anansi1171
(793 posts)Is this often the language used and the sentiment expressed when blacks are not present, which I assume was the case?
LiberalArkie
(15,686 posts)Where else can a white man with a black wife, be sitting in a break room with co-workers and hear all the time about the welfare queens, and yes "the Nig**rs" causing all the problems and crimes and need to be shot at sight. And the guy with the black wife and children sitting back and agreeing with them. Everyone knows he has a black wife and children. Tea heads just repeat what everyone else say. I really think that is the problem in Police depth these days, you have a strong racist and everyone else follows and may not agree to start wife, but sooner or later they just blindly follow.
Anansi1171
(793 posts)I have an cousin in the Research Triangle area in North Carolina. She's black and her white husband would tell of these work sites he visits, where they know him we'll enough to be themselves quite comfortably. And who they are is 9-5am hate radio filled tirades, put downs and email chains about "N"s.
In 2014, as DU ably demonstrates, white racism is rampant and worse than it was 15-20 year ago.
Sorry, it does not work both ways. Blacks don't assemble and spend the days with other blacks making jokes about whites or poor whites or Rednecks or anything else having to do with white identity.
I wish you blessings and I thank you for telling the truth!
LiberalArkie
(15,686 posts)They thought I was to most anti-social person they ever knew because I never gave an inch. I would walk in and turn off the TV (it was always on Fox) and if any started on race or the Gays or anything red neck tea-head, I would tear into them and never give an inch. Al they ever had was what Rush and Fox told them, all I had was facts. God did they hate me.
But I worked with the Executives (CEO and down and on first name basis with them). I kept the executives off all the managers back like no one has done before or after I retired. 2 techs and 1 manager had to leave when they took over after I retired.
But I am so damn tired all the crap, Thank God I am retired and don't have to listen to anyone but the redneck fox-heads I over hear at stores. Where is the race riots that the NRA promised all the gun nuts. I would have to buy a gun and join the blacks and minorities.
morningfog
(18,115 posts)AverageJoe90
(10,745 posts)It won't turn into the next Black Death.
hobbit709
(41,694 posts)The pneumonic form of the plague was way more infectious and deadly than the other form.
And Ebola is a virus-much more capable of a rapid change in its DNA structure.
AverageJoe90
(10,745 posts)hobbit709
(41,694 posts)Better hope you have a Class A Prime immune system if it gets loose.
Warren DeMontague
(80,708 posts)RNA, yes.
However in the viral world it would be pretty unprecedented for it to change to an airborne transmission mode. As others have noted, AIDS never did that, and it certainly would have been advantageous to it to do so.
I will say that I am not either "dont worry, be happy" or "we're doomed, game over"
On this one I am somewhere in between those two points.
CoffeeCat
(24,411 posts)The article outlines a situation in which piglets with Ebola were caged and in the same room with
monkeys. No contact between the animals happened. Ebola jumped from the piglets to the monkeys
and the researchers never did conclude why. However, they acknowledge that airborne transmission is
definitely a possibility.
It's possible that it was transmitted via the air. Researchers can't definitely conclude how animals--that
never had direct contact with infected animals--contracted Ebola.
Another point: The American doctors who came down with Ebola were following CDC guidelines to the letter.
They were suited up and gloved and following strict procedures. They got it. How did that happen?
It's possible that this virus is mutating. With so many victims, it is possible that the virus is getting smarter.
Maybe it's not airborne in all cases, but maybe some of the cases.
I'm not a virologist. I don't know. However, there is something different this time. We've had Ebola outbreaks
in Africa before, but this one is spreading like wildfire, with no end in sight. 2000+ people are dead and a recent
WSJ article quoted a WHO official as saying that they expect 20,000 to die before this is over. If that holds true, how
in the world could it *possibly* be contained to one continent?
This is a volatile, unprecedented situation with many unknowns. Viruses are unpredictable. Given the possibilities, it's
astounding to me that more isn't being done.
Warren DeMontague
(80,708 posts)messy fashion. Which includes hacking and coughing a lot of spit and snot into the air.
Saying "ebola isn't currently airborne" does not mean I would think it'd be a good idea to hang around an ebola patient who is hacking and coughing big droplets of spit.
As for how the doctors got sick- they're all working crazy shifts in 100 degree heat, down there. Mistakes happen. The infected doctors themselves acknowledged this. If it were being spread, regularly, above and beyond how they know it is transmitted, we would probably see greater numbers than we are now. The rate of spread would be even higher than it is.
I don't think it can be contained on the continent, not totally, obviously- as I said downthread a lot will depend on how well additional outbreaks are contained. Fortunately, despite some setbacks, it appears Nigeria is getting a handle on their situation. I don't think there's any great mystery as to why this epidemic is worse than prior ones- it cropped up in a region which is highly traveled between 3 countries (the 3 countries where, 9 months later, the disease is still primarily situated) and some pretty big mistakes were made early on, between people not recognizing it, the relevant authorities not taking it seriously enough, etc. by the time it reached major cities (Conkary, and later Monrovia) which also happened to be densely populated AND with poor health care infrastructure, a disaster was practically inevitable.
I agree with your last sentence, totally.
so on top of work, money, family, day to day crap I have to worry about Ebola turning my neighborhood into an episode of "The Walking Dead"
Before last month I never thought about Ebola and now...
adigal
(7,581 posts)Able to,spread through the air from lung droplets. That is what I have been dreading hearing. That's when I go to the supermarket and buy all the cans and rice and beans I can afford.
JDPriestly
(57,936 posts)The history of the spread of the plague demonstrates that it occurred at times of increased international trade and travel.
The spread of disease is a side-effect of increased international travel and trade.
Ebola could become an international disease. It is just a fact borne out by history. It is not necessarily such a threat. But it could well become such a threat.
This should be treated as a national security issue in every country in the world. Travel may have to be discouraged in certain areas or even in general. That is for others to decide, not me. But travel bans or warnings may be a wise course. We should not shy away from that idea. It could be one aspect of policies that prevent the further spread of the disease. I do not know to what extent climate and other environmental factors play a role in the spread of the disease.
homegirl
(1,419 posts)I suspect that the next area to be hit with the Ebola virus will be the Middle East. Sanitary and health conditions are inadequate and war torn districts are vulnerable and face the double whammy of increased threat to health workers.
grahamhgreen
(15,741 posts)jtuck004
(15,882 posts)grahamhgreen
(15,741 posts)http://contagions.wordpress.com/2012/06/28/plague-at-the-siege-of-caffa-1346/
jtuck004
(15,882 posts)between us leaving the brains, arms, and guts of innocent children and others strewn along the road as any of their actions, by the people who brought smallpox and other death to wipe out the populations on this continent.
But the backstabbing cowards of today have taken lying, deception, treachery and murder to an art form that the Mongols would have been proud of.
heaven05
(18,124 posts)the brutality of human beings knows no depth. I read about that very thing years ago. Said no....people wouldn't do something as heinous as that, yet given the last 15 years or so in world history............I expect anything from human beings with a racial, political, religious or ethnic agenda. As Pope Francis say, "piecemeal third world war" is happening. If it gets cohesive any weapon WILL be used.
AverageJoe90
(10,745 posts)Which I doubt would happen under the Obama administration. And frankly, I don't think Steve Harper's that foolish, either.
JDPriestly
(57,936 posts)We come in contact with the bodily fluids of others all the time.
sendero
(28,552 posts).... but it is thought that the mortality in Africa being around 50% is a result of people having been exposed to a less virulent strain in the past, and that if it breaks out of Africa the mortality will be much higher because the rest of the world has not had that exposure.
I think the likelihood of a serious outbreak in, for example, the USA is pretty low but people who claim it is impossible annoy the piss out of me. It's very freaking possible.
greatlaurel
(2,004 posts)Last edited Sat Sep 13, 2014, 12:05 PM - Edit history (1)
The White House had requested $88 million to combat the Ebola epidemic for the 2015 budget. That nitwit, Rogers, in his infinite wisdom, slashes the budget to less than half what was requested. This should be a national scandal and it is getting no attention.
Great OP. Thanks!
magical thyme
(14,881 posts)...seriously. I posted this in another thread that isn't getting any traction (maybe because my title focuses on our response to ISIS), but the paucity of response from this and other countries is so pathetic that I can't help but think there is a reason for it.
The fact is that Europe has already been buying land in Africa to grow food for their own countries. And China has built a huge, empty city for its own surplus population to move to at some point. I can't help but think that some people are thinking that a de-populated Africa will open up land for their countries, and other people are thinking better that the surplus population move to an emptied out Africa than additional resource wars.
dumbcat
(2,120 posts)I'd like to learn more about that.
Thanks.
LiberalArkie
(15,686 posts)magical thyme
(14,881 posts)...Perched in an isolated spot some 30km (18 miles) outside Angola's capital, Luanda, Nova Cidade de Kilamba is a brand-new mixed residential development of 750 eight-storey apartment buildings, a dozen schools and more than 100 retail units.
Designed to house up to half a million people when complete, Kilamba has been built by the state-owned China International Trust and Investment Corporation (CITIC) in under three years at a reported cost of $3.5bn (£2.2bn).
Spanning 5,000 hectares (12,355 acres), the development is the largest of several new "satellite cities" being constructed by Chinese firms around Angola, and it is believed to be one of the largest new-build projects on the continent.
dumbcat
(2,120 posts)Now that you mentioned it, I vaguely remember hearing about it a couple of years ago. I'll re-look. Thanks again.
VanillaRhapsody
(21,115 posts)just curious....
heaven05
(18,124 posts)sound curiously like how the upper egypt dynasty(black) was finally subjugated by the asian/european influx from lower egypt around 3000bc--2040 bc. History has a long memory.
IDemo
(16,926 posts)Developers there have gone on an insane building boom, with multiple massive construction projects and no tenants. This has been featured on 60 Minutes and several other places. One of the richest developers chuckled to Diane Sawyer that yes, a bubble burst is very possible shortly.
http://www.zerohedge.com/news/2013-09-21/chinas-ghost-cities-are-multiplying
tblue37
(64,979 posts)heaven05
(18,124 posts)yet, they are in place, bubble bursting or not.
silverweb
(16,402 posts)[font color="navy" face="Verdana"]The industrialized world is interested only in natural resources... and Africa has them aplenty.
Turbineguy
(37,206 posts)people will gladly give up their freedom to not get sick.
Iliyah
(25,111 posts)and Benghazi happened where the corporate media barely if any made referrence to it. The Dems did and the GOP ignored it. Same will happen here if "God" forbid it spreads to other nations, especially the USA but of course they will blame Pres O.
greatlaurel
(2,004 posts)Thanks!
caraher
(6,276 posts)I don't think we spend $40 billion total on all research for all diseases.
I don't know if this is the latest word on the story but it looks like the figures are indeed in the tens of millions, and that Rogers' cut has been reversed. Maybe.
greatlaurel
(2,004 posts)Thanks for the catch!
caraher
(6,276 posts)I just hope it's true that full funding will happen.
grahamhgreen
(15,741 posts)Moostache
(9,895 posts)We are dealing with something that could change the course of history in very, very bad ways. Yet, to date, there is no official plan, no government or world agency that is setting up defenses for civilization. Its an existential threat orders of magnitude more likely to destroy America than ISIS/ISIL could dream of achieving in a 1,000 years....yet we are going to predictably focus on the lesser threat.
Republican or Democrat, doesn't matter when it comes to focusing on the truly important, they are equally worthless...just goes to show you that while money can buy politicians and power, it cannot make the stupid more intelligent. Its too bad that there is no disease that attacks people who are driven by money more than they are by compassion or community...a financial AIDS or Ebola to thin the ranks of the amoral bankers maybe?
magical thyme
(14,881 posts)TeeYiYi
(8,028 posts)What if the virus was carried on the mushroom cloud?...
Anyway, we're not going to bomb anything that we think we may have quasi contained.
TYY
Jerry442
(1,265 posts)There was a brilliant column a while back, possibly by Krugman, although I don't recall for sure, which explained that while it's a problem that the corrupt leech resources from the society that they infest, the biggest problem is that while they're doing it, they damage crucial parts of society. You know, things like public health services, the CDC, and the sense of community that makes those things work.
Or to put it more bluntly, the 0.01% are not only parasites, but stupid ones -- not even evolved enough to avoid killing their hosts.
greatlaurel
(2,004 posts)Very good post. History teaches us that rich people are stupid, but few pick up on it. Just read "The Guns of August" by Barbara Tuchman. What a bunch of idiotic loons the aristocracy of Europe were (and still are).
hifiguy
(33,688 posts)no one ever learns the plain lessons of history, especially the elites.
Ex Lurker
(3,808 posts)BANGKOK, 11 September 2014 (NNT) - A Danish man is the second person suspected of having Ebola in Thailand. His blood sample is being tested for the virus with the results expected this Friday.
The Ministry of Public Health on Thursday announced that the 52-year-old Danish man was suspected of contracting Ebola after he traveled back from the Ebola-affected Nigeria on 10 September 2014. He had 38 degrees fever with sore throat and cough and later received treatment in a private hospital. Since he traveled from an affected country, he was sent to Rajavithi Hospital for treatment in an isolation room, said the ministry.
The patient is now closely monitored by a medical team who gives him symptomatic treatment. His fever has been lower.
Six people who have been exposed to close contact with the patient are also being watched by physicians. - See more at: http://thainews.prd.go.th/centerweb/newsen/NewsDetail?NT01_NewsID=WNSOC5709110010012#sthash.VfwKMRuS.dpuf
magical thyme
(14,881 posts)There are people all over the world right now, including in the US, who have been quarantined and tested after traveling from infected areas and then showing symptoms.
So far, they have been testing negative. Sooner or later, it will happen, but it hasn't happened yet.
37C is normal temp, so 38 would be 1.8 higher than normal in fahrenheit, or ~100.4F. From what I've read, it starts with a high fever spike.
Warren DeMontague
(80,708 posts)As opposed to sierra leone/guinea/liberia-
Then the Nigerians aren't telling the truth.
Because "ebola-affected nigeria" is not the same thing as those other countries. In theory Nigeria is paying close attention to the contacts of everyone who is infected there, so far, and that is a limited number all traceable to the first case there.
DippyDem
(658 posts)All those suicide Middle East bombers...they could go to North Africa..infect themselves with Ebola..then come here to the USA while incubating Ebola...there aren't any bomb detectors to catch Ebola...perfect bomb..and leave dirty traces of themselves wherever they go and/or blow themselves up spewing blood all over...or get into fights with police and police beating the crap out of them splattering blood over themselves as police are wont to do. You know where Ebola goes next..... Eek
ReRe
(10,597 posts)I can't remember where I heard it... maybe on AJ America, I think it was somewhere in Europe, where the UN reps were meeting with the different groups who were helping work the outbreak. The speaker said in one country, they had no more surgical/plastic gloves! that the world response was abysmal. They said they need everything and more than anything workers, i.e. Doctors and nurses & medical workers. And now we get this report (thank you magical thyme).
Someone in this thread mentioned that Rep Hal Rogers (KY) had cut the request of $88 mil down to $40 mil? Ignorant asshole.
Let me tell you what's going to happen: E-bola is going to eventually travel east in the direction of north eastern Africa, and guess what that is next to? Right. Israel. When that finally dawns on the nitwits running this country (the Republicans in the House), believe you me, they will get their asses in gear.
This is the 21st effing century, and yet ignorance may do us ALL in. Ignorance that is running this country. I swear, avarice and ignorance is going to kill us all!
greatlaurel
(2,004 posts)The lack of simple supplies, like disposable gloves, disposable bed sheets and chlorine bleach for disinfection is so shocking. The pictures of the decontamination areas for the health workers are shocking to me. They do not have concrete/hard surfaces to stand on. That alone would make it so much easier to have proper decontamination. How much would 10 or 20 bags of quickrete cost? A lot less than replacing dead doctors and nurses.
I called Hal Rogers' office. I would suggest everyone call his office and tell him what an ignorant act that slashing of the ebola epidemic funds was. I called my local US rep, too, even though he is not on the Appropriation Committee. Hal Rogers telephone number is (202)225-4601.
ReRe
(10,597 posts)greatlaurel
(2,004 posts)I cannot believe that the slashing of the Ebola budget is not the number 1 news story. It shows how ignorant the media class is.
Hugin
(32,778 posts)LiberalArkie
(15,686 posts)at most of Africa. Usually the leader of the country and his cronies have everything and society has nothing. All death centered at the top. No public health, no public sanitation in fact no public services at all. Rand Pauls idea of heaven I guess.
BlindTiresias
(1,563 posts)paleotn
(17,778 posts)Some points irritate the hell out of me though. If only news types and the chattering class in general had spent more time in the Science building and less in English building at the ole alma mater, I'd have a hell of a lot less irritation.
In 2012, a team of Canadian researchers proved that Ebola Zaire, the same virus that is causing the West Africa outbreak, could be transmitted by the respiratory route from pigs to monkeys, both of whose lungs are very similar to those of humans.
Kobinger and his teams 2012 paper in no way "proved" anything. I hate that word "proved" in this context. It just shows the incredible lack of science education in this country. It was not the same strain responsible for the current epidemic. Their study suggests that in certain circumstances, one particular strain of Ebola with no documented evidence of infecting humans but is deadly to other primates, might be transmitted airborne from pigs to macaques. To date there have been no corroborating findings that have replicated this particular route of infection, swine to primate. Could there have been some yet unknown cross contamination? Who knows? In further research, Kobinger hasn't been able to show any potential airborne transmission macaque to macaque. Is it something about pigs that makes this particular Ebola strain prone to possible airborne transmission? Again, no one currently knows.
http://www.nature.com/srep/2012/121115/srep00811/full/srep00811.html
https://www.sciencenews.org/article/ebola-may-go-airborne
https://www.sciencenews.org/article/airborne-transmission-ebola-unlikely-monkey-study-shows
The rest of the article is good. This is one very novel and damn scary scenario when it comes to Ebola infection in humans. Could the particular strains involved in this epidemic mutate to some airborne form, easily passed human to human? Possibly, but who knows? For all practical purposes, it's out of control in West Africa and we're at the mercy of probability. This could have been stopped in its tracks, but our powers that be in the West either quibbled or ignored it.
Can it still be brought under control? Who knows? But some pretty draconian solutions come to mind. I doubt seriously if any of our leaders have the political will to implement anything the least bit repressive, so again, we're at the mercy of probabilities with respect to viral evolution.
magical thyme
(14,881 posts)at the University of Minnesota. So he's not your ordinary "news type" or "chattering class."
"It was not the same strain responsible for the current epidemic....
"...Their study suggests that in certain circumstances, one particular strain of Ebola with no documented evidence of infecting humans but is deadly to other primates, might be transmitted airborne from pigs to macaques."
The current pandemic is most likely Ebola Zaire. The first 2 of your links state the Canadian study was Ebola Zaire; the 3rd article doesn't state which strain was used in the study. So it is the same strain, and the study suggests that in certain circumstances the Ebola Zaire strain might be transmitted airborne from pigs to macaques.
That said, I prefer a softer word to "prove" with such a limited study as well. It appears to have been aerosolized, but it's also possible that contaminated water was splashed into the macaque pen.
paleotn
(17,778 posts)the study "PROVES" nothing and said director should chose her words more carefully, instead of sounding like Geraldo Rivera. Such a style certain gets more eyeballs on her article, which may be her sole purpose or may not, but does little else except spread unnecessary hysteria among those who know no better. This situation is bad enough without the hyperbolic bullshit from those who damn sure should know better.
magical thyme
(14,881 posts)until it didn't. And "she" is named Michael. Which leaves me wondering exactly how closely you read the posted article or your linked articles.
Here is what the CDC has to say about it:
Although in the laboratory the viruses display some capability of infection through small-particle aerosols, airborne spread among humans has not been clearly demonstrated.
http://www.cdc.gov/vhf/virus-families/filoviridae.html
"Has not been clearly demonstrated" is not the same as "Is not transmitted."
The pig-monkey experiment is not the only one demonstrating the potential for airborne transmission. In the laboratory situation it has been demonstrated that it can be aerosolized:
"One hundred percent mortality was observed in all groups of KO mice that were administered with a range of challenge doses of MARV and ZEBOV by either IP or aerosol routes."
http://jmm.sgmjournals.org/content/61/1/8.full
Right now it likely doesn't transmit airborne because it doesn't directly attack the upper respiratory system or the upper digestive system; it specifically attacks the liver. So the viral load is heaviest in blood and feces.
It also didn't mutate much (or at all) for its first few decades. Now it is mutating rapidly, which potentially can change everything, including its transmission and the ability to develop a reliable vaccine.
defacto7
(13,485 posts)When did the Ebola outbreak definition change to "pandemic"? Last I heard it was still being called an epidemic. Big difference.
djean111
(14,255 posts)that list.
Iliyah
(25,111 posts)hifiguy
(33,688 posts)Ultimately, Mother Nature will not be denied. Plagues have ever been a part of human history.
grahamhgreen
(15,741 posts)AverageJoe90
(10,745 posts)and lack of medical knowledge. We don't really have that problem today, in any Western country.
hobbit709
(41,694 posts)AverageJoe90
(10,745 posts)Why it did so much damage. Let's be thankful that we've learned our lessons.
hobbit709
(41,694 posts)SheilaT
(23,156 posts)had lived through a previous type A flu epidemic and so were immune.
Another reason that flu spread so viciously was that the United States, in the midst of WWI, was shipping soldiers who'd been exposed to the flu, overseas without waiting to see if they'd get sick. Another issue was that sanitation wasn't what it's like now. Even simple hand-washing wasn't as common then, and far, far fewer people had access to running water. As careless as many people are today about washing their hands, especially after using the toilet, it's not like it was back then, when it often wasn't possible to wash hands.
The Great Influenza by John Barry is beyond excellent, and should be required reading.
Generic Brad
(14,270 posts)Imagine if a mutated air born strain is strategically and intentionally introduced in heavily populated areas elsewhere. The horrors befalling West Africa could be replicated many times over throughout the world.
locks
(2,012 posts)Most of the news about the ebola outbreak has been late, copied from AP, or very limited. Just like the response to this crisis by the developed countries. Some of the media (NYTimes, Wash Post, VOA, Al Jazeera, Foreign Policy), have recently printed harsh editorials about the coverage and response of the developed countries, including the US. But generally it has been only WHO (budget drastically cut), CDC, Unicef, and the great NGOs like MSF (Doctors Without Borders) showing and telling the sad stories of the suffering, lack of coordination of agencies, the slowness of the response, and the pitiful amount of money, equipment and numbers of health workers compared to the need. We can understand the fears of risk of journalists, airlines, professionals, politicians and corporations, but wars, serial killers, wildfires, hurricanes, tsunamis, and earthquakes never seemed to stop them from reporting.
Obama has spoken out a number of times and will visit the CDC next Tuesday for a report, but the House has been holding up even the small amount of money he requested to send workers, equipment and research for a vaccine. And the US has approved the severe cuts to the UN World Health Organization and USAID. This week Obama said he would order the military into West Africa to build "hospitals" and guard workers but the affected countries soon learned they would build 25-bed stations for foreign health workers, not for African ebola patients. Bill Gates is contributing almost as much money as the US; Cuba has trained and sent more doctors and nurses than the wealthy countries.
One other note: the largest oil, silver, gold, rare earth mineral and lumber companies in the US and the world have been looting Africa's rich resources for years, exploiting African workers, polluting the air, water and land, and taking their billions in profit home to shareholders and executives. Have we heard yet what they are going to contribute toward containing this plague and caring for the workers it is affecting?
Maybe our only hope is that when the 1%ers, the politicians, big pharma, big oil and big gold notice that ebola might effect their families, their bottom line, their wall street stocks, or cheap labor they will decide to do the right thing.
valerief
(53,235 posts)NaturalHigh
(12,778 posts)I just said to my best friend last week that if ebola ever goes airborne we're all in trouble. The language might have been a bit more graphic, but that was the gist.
magical thyme
(14,881 posts)First, an infected diplomat violated quarantine and traveled to Lagos, where he was secretly treated by a doctor. The doctor contracted ebola, and continued to treat patients at his hospital and to socialie while symptomatic. That has added a few hundred people for them to track down and monitor.
Then yesterday a woman from either from Casablanca, Morocco or Liberia, just 2 days ago flew to Lagos, arrived symptomatic and tested positive. She was immediately arrested and quarantined. I expect everybody on that flight, plus any who contacted her on arrival, will now have to be monitored.
http://dailypost.ng/2014/09/11/breaking-liberian-ebola-patient-arrested-lagos-airport/
Warren DeMontague
(80,708 posts)The Nigerian index case, Patrick Sawyer, is a downright bizarre story but suffice it to say whatever he did once arriving in Lagos- reports vary, including some pretty weird stuff at the hospital- he managed to infect a bunch of people before they realized what was going on.
The person who escaped quarantine actually escaped to port harcourt, FROM lagos, and yes he was treated by a doctor who (not doctor who) then became sick, but not before he himself managed to expose a whole bunch of other people, potentially.
Interestingly enough, the doctor died but the quarantine-escaping diplomat recovered, and now may face charges.
Nevertheless, the time window on the port harcourt exposures has been long enough now that we should know pretty soon whether there is another cluster of cases coming in, or not.
This is all assuming that the nigerian authorities are being totally up front, but so far they seem to have done a pretty good job of keeping it contained, despite the above issues.
AverageJoe90
(10,745 posts)Unless someone has gotten a hold of a sample and weaponized it, or something truly bizarre like that, this isn't going to turn into the next Black Death. Let's be reasonable....we can at least try, right? SMFH.
Iliyah
(25,111 posts)a vaccine will be available for mandatory use. That said, some of the regions that are affected have low to none vaccinations policies. I'm glad I live in a country that requires, mandatory (although some refuse) vaccinations.
It cost lots of money tho and you would figure that companies that produce such vaccinations would, at this time, freely give it to them so that Ebola won't spread, but alas - greed.
This kinda reminds of the "black death" whereas the so called religious leaders were so frighten of what they could not or would not understand and duly claims that cats were evil (Europe). Subsequently, majority of the cats were killed leaving rodents, especially rats to run free. Ya know what happen thereafter.
Many Africans, especially their leaders have been influenced by so called Christians, some that do not believe in vaccinations.
magical thyme
(14,881 posts)They are being fast tracked as we type, but are months away from production.
magical thyme
(14,881 posts)P.M NEWS reports that the patient, who was brought into the hospital in the morning, was bleeding all over his body and as a result, nurses, doctors and other patients in the hospital fled from him.
A source in the hospital, who did not want her name published because she was authorised to speak on the matter, informed that the patient had come to the hospital last week complaining of fever, but re-appeared on Tuesday with blood coming out from his body.
The source added that everybody in the hospital fled from the patient in order not to contract the deadly Ebola Virus.
Mojorabbit
(16,020 posts)this closely through the infectious disease
Doc list serve, promed. The situation seems to be out of control in many countries.
suffragette
(12,232 posts)Between the start of his symptoms and the diagnosis?
From different reports, for example the person who took the plane then was diagnosed, it's seeming to me that there's a period between when it first starts affecting people and it being diagnosed. I keep wondering if that is part of the reason why it is spreading so much more, that it has a longer period of transmission while symptoms are milder or unclear?
magical thyme
(14,881 posts)Iirc, he had been in with a fever earlier and was sent home. So he was already symptomatic.
Also, the "not infectious until symptomatic" strikes me as squirrelly. As if an hour before you're symptomatic, you're not infectious, and then suddenly you are. I think there is a continuum, rather than symptoms on = infectious. What makes you infectious is largely the viral load in your system.
As far as Patrick Sawyer, there were mixed reports, but at least a few that I read said he was actually symptomatic during his flight, and even was allowed to switch planes. They had a lot of people to track down and monitor as a result.
suffragette
(12,232 posts)That does seem more how things in life operate.
7962
(11,841 posts)its getting a lot of viewers.
SheilaT
(23,156 posts)I'm racing off to see if I can watch that show. Thanks for mentioning it.
I don't have a TV, which means I watch what I can on the internet, and fortunately almost everything is available that way. But it does mean that I sometimes have no clue what shows are out there until I stumble across a mention like this, so thank you.
7962
(11,841 posts)It did well in the ratings and has been renewed for a 2nd 13 episode season (first was 10). It was on TNT.
SheilaT
(23,156 posts)and unfortunately the commercials were as many and as long as if I were watching on broadcast TV, and there's a reason I don't own a TV. I have put in the request for the DVDs on Netflix, once they become available.
Warren DeMontague
(80,708 posts)When there were little or no indications that it was going to be any different, substantially, than previous outbreaks, which have all been fairly quickly contained.
I claim no special insight; rather, like a character in a star wars flick, I've just had a bad feeling about this.
And, by even the most conservative estimations, it is set to be a catastrophe- hitting precisely the poorest, most ill equipped countries and health systems it possibly could.
Simply by spreading how it normally does, this outbreak is likely to take a simply horrific toll on the populations of Guinea, Sierra leone, and particularly Liberia. And make no mistake, it could spread elsewhere- it has, and it likely will again. Much will depend on how well those further outbreaks are contained, and how quickly.
There has been talk, like the osterholm piece, of the potential of ebola to mutate into an airborne mode of transmission- and likewise other prominent voices have come forth to calm the alarm by suggesting it is not terribly likely. I am not a virologoist so I don't really know, but I have done some reading and try to stay well-informed about the science. I'll say a couple things- one, ebola scares the fuck out of me, as it should any human, since the zaire strain at least has traditionally had up to a 90% lethality rate- although in this epidemic it has been running around 50-55%. Which indicates, perhaps, that it already HAS mutated, mutated in such a way to lessen the "burn-out" of previous outbreaks, perhaps by not killing as quickly, or effectively. Word on the ground is that the ebola currently infecting west Africans does not produce, at least as often, the gruesome "bleed-out" hemorrhagic end stage that is so horribly described in books like The Hot Zone.
Edited to add- as for evolving in a way that would require less viral load for infection- according to some accounts of the virus, it already is incredibly infectious, at least in terms of viral load. It would be hard for me to imagine how it could get any moreso, since as it is I dont believe it takes much virus exposure to produce infection anyway.
So a few things-
One, if it does have the potential to become airborne, it does not seem to have done so yet. If it had, i believe we would know. And fairly quickly.
Two, as others have noted in response to the Osterholm piece- ebola mutating to an entirely different mode of transport would be fairly unprecedented in the viral world. Early in the AIDS crisis there was fear of that virus doing the same. As we can see, that never happened. The ebola virus is big, in virus terms- and it is a strange, if particularly lethal, fucker. Basically a strand of RNA in a protein tube, that steals the lipid cell lining of its host for its own outer coat- which explains why the hosts cells burst so spectacularly, and nastily, in large numbers when the virus really takes hold. But what this means is that, design wise, it is fundamentally unlike a spherical flu virus wrapped in an ever-changing protein ball. Evolving to be able to survive in the air as a flu virus does, would likely require more than just a series of random mutations. At least, I hope.
Three, yes, as was extensively detailed in the Hot Zone, there has been evidence of the Reston strain of ebola being transmitted by air, by animals, in closed situations. This may be relevant to the human experience with ebola, it may not.
The bottom line is that at best this is a massive humanitarian crisis for west africa and it is the responsibility of the rest of the species and planet to come to their immediate aid, and when and if this is all over, not leave them with the shamefully inadequate health systems they went into this with. Because as we see, it is all our problem.
magical thyme
(14,881 posts)In the past, entire villages were wiped out before the could obtain any supportive treatment. So the 90% mortality was more likely untreated cases. They've also tested and discovered that 10-13% of the population in the region has antibodies without ever having become ill -- suggesting that some people were able to mount an immune response to low dose exposure quickly enough to prevent actual infection. That, too, would fit with the 90% mortality.
Remember the the infection and survival rates being reported right now are for *reported* cases, which also tend to be the treated cases. They really don't know how many people have been infected and died already, due to the levels of mistrust. WHO has stated that there could be as many as 2-4 times the cases as they've reported.
It is not uncommon for viruses to wrap themselves in host cells. What that explains, really, is why it is so difficult for the immune system to mount an effective defense once an infection is started -- it doesn't recognize the virions as "non-self" when they are wrapped in cell membrane.
Multiple studies have demonstrated aerolization and infection from animal to animal -- mouse to mouse and the recent pig to macqaque study. So it's not a matter of being wrapped in cell membrane.
It's more likely not to happen because in humans it attacks the liver, which is why the viral levels are highest in blood, feces and urine. It's more likely that the levels aren't as high in other body fluids.
Warren DeMontague
(80,708 posts)I also have to believe the size of the virus itself plays a part.
But yes, since it's not going straight to the lungs that is a crucial factor.
I'm not, as I said, a virologist. Still, I thought the outer coat of most viruses- like Flu, the common cold, AIDS etc- was a protein sphere, not a lipid membrane. Always open to learn.
magical thyme
(14,881 posts)very small versus versus large droplet. It's the ability of sufficient virion to survive and infect via very small particles, in the lab mimicing exposure to sneezes and coughs. So, for example, TB has aerosolized transmission in the real world.
In the pig to macacque study, it may have been have been snorting pigs sending larger droplets, and some have argued that it could have been splashed water. But necropsies showed that the transmission was via the monkey's lungs.
There are two basic types of viruses: the kind the are wrapped in a protein coat, and the kind that have spikes that enable them to fuse with the host cell membrane. Many viruses are able to wrap themselves in the host membrane when they leave the cell, including herpes and Hep A (which persists in the environment with just its protein coat, but is wrapped after infecting. They honestly aren't sure how the vaccine works for it).
Warren DeMontague
(80,708 posts)I find viruses fascinating, I mean despite the fact that they make people sick. The way they sit right on the border between life and non-life (prions, of course, even moreso) ... I know scientists believe now that the first life was RNA based, quite likely. Whatever eventually became ebola and these other RNA viruses could be very, very, very old.
Well let's hope ebola hasn't- or doesn't- become any easier to spread among humans than it traditionally has been.
It's an extremely important story for all of us, and really there's no way to overreact in terms of the governments and people of the world throwing resources and assistance at it.
After this is all over, assuming it doesn't kill us all (or most of us) It is incumbent upon all of us to not leave these countries with these inadequate health systems. Leaving aside the humanitarian imperative, this situation highlights how dilapidated or nonexistent health infrastructure in poor countries can easily become ALL our problem.
SheilaT
(23,156 posts)And while I can't begin to guess if the virus could become airborne, it would only have to become just a little more easily transmissible for the proverbial all hell to break loose.
While many other viruses have the virtue of, if you've gotten the disease you're now permanently immune (think smallpox), I understand that recovering from Ebola does not transfer permanent immunity, that it's more like flu in that if you've gotten a flu, you're somewhat resistant to similar flu viruses, but not perfectly immune to all of them.
magical thyme
(14,881 posts)so containment happened naturally. It burned out before it could reach densely populated areas.
This one started in a densely populated area, making it very difficult to contain.
I haven't seen anything stating length of immunity. In the earlier decades since its discovery, it didn't mutate much or at all. What has been very different this time is the speed with which it is mutating. That is likely due to the very large number of cases, giving it more opportunities as time goes on.
McCamy Taylor
(19,240 posts)...what if its lethal immune system suppression only works on some people, most of whom live in Africa and it turns out to be much less virulent on people in the rest of the world who happen to have inherited and retained Neanderthal HLA? Without the two week period of immune suppression, ebola is just a virus and it does not even kill all folks in Africa. Some clusters of people there are "immune" to the lethal effects.
....what if Russia engineered it in a lab and gave it to one of its allies and that is why is popped up during a war and why a Russian lab worker has been one of the fatalities? Maybe the Russians already have a cure. They owe us one.
...what if the US government has spent a bunch of our money investing in vaccines and drugs---as the news said a month ago---and now the patents are all being turned over to private companies which plan to make a killing off the investment made by US taxpayers? Oh, wait. That last one is not speculation. That is business as usual in the US.
Spitfire of ATJ
(32,723 posts)They might want to spread it to bring back Jesus and see the efforts by scientists to stop it as being against the will of God.