CDC: Ebola patient may have had symptoms on Frontier flight from Cleveland to Dallas

[Divernan]

Source: ABC Channel 7 Denver

DENVER - A Dallas nurse who has Ebola may have had symptoms while on a public flight from Cleveland to Dallas.

That startling development was announced Wednesday night from Frontier Airlines CEO Dave Siegel who sent the following message to airline employees: "At 1:55 p.m. MDT (Wednesday) Frontier was notified by the CDC that the passenger may have been symptomatic earlier than initially suspected; including the possibility of possessing symptoms while onboard the flight.

"In light of the new information, Frontier determines that the aircraft will remain out of service and ferries it back to Denver from Cleveland without customers. The flight departs at 6:20 p.m. EDT and arrives in Denver at 7:20 p.m. MDT. In an abundance of caution, it is determined that the aircraft will receive a fourth cleaning since the infected customer was onboard. Though not required, this cleaning will consist of the removal of seat covers and carpets in the immediate vicinity of the passenger seat. The airline will also change the environmental filters onboard.

"NOTE: These extraordinary actions went beyond CDC recommendations. These steps were taken out of concern for the safety of our customers and employees. Steps such as removing the aircraft from service, removing aircraft seat covers and carpet and replacing environmental filters as well as placing the crew on paid leave were not requested nor mandated by the CDC. Frontier expects that the aircraft will return to service in a few days."

The plane, which had been grounded in Cleveland, flew empty to Denver International Airport to undergo the additional These steps were taken out of concern for the safety of our customers and employees. Steps such as removing the aircraft from service, removing aircraft seat covers and carpet and replacing environmental filters as well as placing the crew on paid leave were not requested nor mandated by the CDC. Frontier expects that the aircraft will return to service in a few days."



Read more: http://www.thedenverchannel.com/news/health/ebola/frontier-plane-that-carried-ebola-patient-made-5-additional-trips10152014

---

It is quite significant that the airline felt compelled to "go beyond CDC recommendations". Someone at that airline is smart enough to realize that the CDC is flying blind when it comes to whether the Ebola virus has mutated such that it is more contagious than thought in the past. The farther this virus spreads, and the more people it infects, the greater the opportunity the virus has to mutate as to (1) whether a victim is infectious BEFORE they are symptomatic; and (2) whether the disease becomes airborne.

According to Flight Aware, after Vinson flew from Cleveland to Dallas, the same Frontier Airlines plane made five additional trips:

Frontier Flight 2042 departed to Dallas on Oct. 14 at 8:11 a.m. CDT and arrived in Cleveland at 11:14 a.m. EDT
Frontier Flight 1104 departed Cleveland on Oct. 14 at 12:24 p.m. EDT and arrived in Fort Lauderdale at 3 p.m. EDT
Frontier Flight 1105 departed Fort Lauderdale on Oct. 14 at 4:02 p.m. EDT and arrived in Cleveland at 6:16 p.m. EDT
Frontier Flight 1101 departed Cleveland on Oct. 14 7:24 p.m. EDT and arrived in Atlanta at 9:03 p.m. EDT
Frontier Flight 1100 departed Atlanta o An Oct. 14 at 10:12 p.m. EDT and arrived in Cleveland at 11:19 p.m. EDT
Frontier jet lands in Denver Wednesday afternoon and is taken to a Frontier maintenance hanger for further decontamination cleanup procedures.
http://flightaware.com/live/flight/N220FR/history/20141014/2215Z/KCLE/KATL

Siegel ended his letter to Frontier employees by saying, "We take today’s events seriously as your safety and that of our customers is always at the forefront of everything we do. Since we were notified by the CDC, we’ve proactively placed six crew members (two pilots; four flight attendants) on paid leave for 21 days out of an abundance of caution as the safety and security of our employees is our number one priority. This was over and above CDC guidance that stated that our flight crews were safe to fly."

Customers who may have traveled on the Frontier flights the nurse was on should contact CDC at 1-800-CDC-INFO.

FlightAware shows the plane was scheduled for flights Thursday from Atlanta to Washington Dulles and then on to Chicago.

[Downwinder]

1. No radiation like the mail got for anthrax?

[Justice]

2. Best response yet - taking measures out of an abundance of caution - that is what is needed.

[Baitball Blogger]

22. That is what is lacking with this CDC.

"taking measures out of an abundance of caution."

[Darb]

34. "this CDC"?

Curious wording, what do you mean by this CDC?

[Baitball Blogger]

36. There's nothing peculiar about the wording.

But it is peculiar that you think it is.

[Darb]

55. "This" CDC implies it is different than other CDCs,

I would think. Are there more than one? Is there a great deal of turnover in the CDC so that one could imply that "this" CDC is different from past CDCs?

Is it like a sports team with completely different players?

It is peculiar that you cannot see the distinction I'd say.

The proper wording would be "the" CDC, in case you were wondering.

[Baitball Blogger]

58. Each team has its own challenges.

I was referring to the team that was facing the Ebola virus.

Don't try to create meanings which aren't there. Your inferences are not welcome.

[kestrel91316]

59. He probably means "the black man's CDC". Just a wild-assed guess.

[Baitball Blogger]

61. Shame on you kestrel.

You know better than that.

[Diclotican]

3. Divernan

Divernan

Better safe - than sorry - specially with a ilness like Ebola... CDC looks like they are way out of experience without his type of illnesses
. And I suspect Frontier Airline on this have reason to cation... Even if it will cost money..

Diclotican

[Android3.14]

4. "whether the Ebola virus has mutated"

Thank you for mongering more fear.

[mnhtnbb]

5. Those who don't believe in evolution think this is fear mongering.

Anyone who has worked in a lab with strains of anything, knows mutation can and does happen.




Researchers have identified more than 300 new viral mutations in the latest strain of Ebola, according to research published in the journal Science last month. They are rushing to investigate if this strain of the disease produces higher virus levels -- which could increase its infectiousness.


http://www.bloomberg.com/news/2014-10-15/ebola-outbreak-boosts-odds-of-mutation-helping-it-spread.html

[Divernan]

11. Thank you for an informed & factual contribution to the discussion.

[Bluenorthwest]

39. Citations please for viruses that mutated to different forms of transmission.

Extra points for one that made such a mutation while retaining all the fearsome attributes of the pre-mutation virus.

[Android3.14]

45. Stick to the issue

We are not talking about belief in evolution, straw boy.

The OP originally said it has mutated to spread through the air. He or she changed that statement, thank goodness. This is fear mongering and reckless. You should not be spreading this fear without proof that it is now airborne.

Put on your big boy discussion pants and play like an adult.

[mnhtnbb]

50. I am sticking to the issue.

The Ebola virus is mutating at a rapid speed. See the Science article I cited.
Five of the co-authors died from Ebola before it was published.

http://www.sciencemag.org/content/345/6202/1369.full

Nobody knows what the hell is going on with this thing. There have already been
admissions that droplets from sneezing or coughing could transmit the virus--through
the air. It is known that sputum and nasal emissions can carry the virus.

If you want to quibble over whether that qualifies as "airborne", go right ahead.
Personally, I would not want to test the theory.

http://www.latimes.com/nation/la-na-ebola-questions-20141007-story.html#page=1

On a personal note, my husband is an MD who did an elective in Samoa studying tropical
medicine while he was in med school. Yes, that was years ago, and no, he didn't become
a tropical medicine specialist. But he has maintained an interest, and he reads every issue of Science
cover to cover. He also, as is required, maintains his license with appropriate hours of continuing
medical education.

That said, he is VERY worried about this outbreak. I agree with him, nobody knows what the hell
is going on with this disease--and it is not one you want to get. I am not ready to agree that it's
beyond the realm of possibility for it to become transmitted through the air.

[NickB79]

66. ALL viruses mutate. It's what viruses do.

But there's a HUGE gap between saying "viruses mutate" and "Ebola will mutate into an airborne strain."

Are you worried the latest flu virus will mutate and turn you into a fucking 28 Days Later rage monster?

[kestrel91316]

60. Ebola mutates all the time. And VIROLOGISTS are pretty fucking sure that it's physically impossible

for it or any other virus to "mutate" from one that spreads via droplets and contact to one that spreads via aerosol.

Those words all have precise meanings in epidemiology, BTW.

Go listen to This Week in Virology's podcasts covering Ebola and come back here to post with a little better background.

http://www.twiv.tv/tag/ebola/

[mnhtnbb]

67. self delete

[Divernan]

73. Your model & terminology are overly simplistic & out of date.

Here's the "better background" you requested.

http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola
How are infectious diseases transmitted via aerosols?

Medical and infection control professionals have relied for years on a paradigm for aerosol transmission of infectious diseases based on very outmoded research and an overly simplistic interpretation of the data. In the 1940s and 50s, William F. Wells and other "aerobiologists" employed now significantly out-of-date sampling methods (eg, settling plates) and very blunt analytic approaches (eg, cell culturing) to understand the movement of bacterial aerosols in healthcare and other settings. Their work, though groundbreaking at the time, provides a very incomplete picture.

Early aerobiologists were not able to measure small particles near an infectious person and thus assumed such particles existed only far from the source. They concluded that organisms capable of aerosol transmission (termed "airborne&quot can only do so at around 3 feet or more from the source. Because they thought that only larger particles would be present near the source, they believed people would be exposed only via large "droplets" on their face, eyes, or nose.

Modern research, using more sensitive instruments and analytic methods, has shown that aerosols emitted from the respiratory tract contain a wide distribution of particle sizes—including many that are small enough to be inhaled.5,6 Thus, both small and large particles will be present near an infectious person.

The chance of large droplets reaching the facial mucous membranes is quite small, as the nasal openings are small and shielded by their external and internal structure. Although close contact may permit large-droplet exposure, it also maximizes the possibility of aerosol inhalation.

As noted by early aerobiologists, liquid in a spray aerosol, such as that generated during coughing or sneezing, will quickly evaporate, which increases the concentration of small particles in the aerosol. Because evaporation occurs in milliseconds, many of these particles are likely to be found near the infectious person.

The current paradigm also assumes that only "small" particles (less than 5 micrometers [mcm]) can be inhaled and deposited in the respiratory tract. This is not true. Particles as large as 100 mcm (and perhaps even larger) can be inhaled into the mouth and nose. Larger particles are deposited in the nasal passages, pharynx, and upper regions of the lungs, while smaller particles are more likely to deposit in the lower, alveolar regions. And for many pathogens, infection is possible regardless of the particle size or deposition site.

It's time to abandon the old paradigm of three mutually exclusive transmission routes for a new one that considers the full range of particle sizes both near and far from a source. In addition, we need to factor in other important features of infectivity, such as the ability of a pathogen to remain viable in air at room temperature and humidity and the likelihood that systemic disease can result from deposition of infectious particles in the respiratory system or their transfer to the gastrointestinal tract.

]We recommend using "aerosol transmissible" rather than the outmoded terms "droplet" or "airborne" to describe pathogens that can transmit disease via infectious particles suspended in air.

Altogether, these epidemiologic and experimental data offer enough evidence to suggest that Ebola and other filoviruses may be opportunistic with respect to aerosol transmission.28 That is, other routes of entry may be more important and probable, but, given the right conditions, it is possible that transmission could also occur via aerosols.

Guidance from the CDC and WHO recommends the use of facemasks for healthcare workers providing routine care to patients with Ebola virus disease and respirators when aerosol-generating procedures are performed. (Interestingly, the 1998 WHO and CDC infection-control guidance for viral hemorrhagic fevers in Africa, still available on the CDC Web site, recommends the use of respirators.)

Facemasks, however, do not offer protection against inhalation of small infectious aerosols, because they lack adequate filters and do not fit tightly against the face.1 Therefore, a higher level of protection is necessary.

To summarize, for the following reasons we believe that Ebola could be an opportunistic aerosol-transmissible disease requiring adequate respiratory protection:

Patients and procedures generate aerosols, and Ebola virus remains viable in aerosols for up to 90 minutes.
All sizes of aerosol particles are easily inhaled both near to and far from the patient.
Crowding, limited air exchange, and close interactions with patients all contribute to the probability that healthcare workers will be exposed to high concentrations of very toxic infectious aerosols.
Ebola targets immune response cells found in all epithelial tissues, including in the respiratory and gastrointestinal system.
Experimental data support aerosols as a mode of disease transmission in non-human primates.

Risk level and working conditions suggest that a PAPR will be more protective, cost-effective, and comfortable than an N95 filtering facepiece respirator.

Acknowledgements

We thank Kathleen Harriman, PhD, MPH, RN, Chief, Vaccine Preventable Diseases Epidemiology Section, Immunization Branch, California Department of Public Health, and Nicole Vars McCullough, PhD, CIH, Manager, Global Technical Services, Personal Safety Division, 3M Company, for their input and review.

References

Oberg L, Brosseau LM. Surgical mask filter and fit performance. Am J Infect Control 2008 May;36(4):276-82 [Abstract]
CDC. Ebola hemorrhagic fever: transmission. 2014 Aug 13 [Full text]
ECDC. Outbreak of Ebola virus disease in West Africa: third update, 1 August 2014. Stockholm: ECDC 2014 Aug 1 [Full text]
Martin-Moreno JM, Llinas G, Hernandez JM. Is respiratory protection appropriate in the Ebola response? Lancet 2014 Sep 6;384(9946):856 [Full text]
Papineni RS, Rosenthal FS. The size distribution of droplets in the exhaled breath of healthy human subjects. J Aerosol Med 1997;10(2):105-16 [Abstract]
Chao CYH, Wan MP, Morawska L, et al. Characterization of expiration air jets and droplet size distributions immediately at the mouth opening. J Aerosol Sci 2009 Feb;40(2):122-33 [Abstract]
Nicas M, Nazaroff WW, Hubbard A. Toward understanding the risk of secondary airborne infection: emission of respirable pathogens. J Occup Environ Hyg 2005 Mar;2(3):143-54 [Abstract]
Bauchsch DG, Towner JS, Dowell SF, et al. Assessment of the risk of Ebola virus transmission from bodily fluids and fomites. J Infect Dis 2007;196:S142-7 [Full text]
Formenty P, Leroy EM, Epelboin A, et al. Detection of Ebola virus in oral fluid specimens during outbreaks of Ebola virus hemorrhagic fever in the Republic of Congo. Clin Infect Dis 2006 Jun;42(11):1521-6 [Full text]
Francesconi P, Yoti Z, Declich S, et al. Ebola hemorrhagic fever transmission and risk factors of contacts, Uganda. Emerg Infect Dis 2003 Nov;9(11):1430-7 [Full text]
Dowell SF, Mukunu R, Ksiazek TG, et al. Transmission of Ebola hemorrhagic fever: a study of risk factors in family members, Kikwit, Democratic Republic of Congo, 1995. J Infect Dis 1999 Feb;179:S87-91 [Full text]
Roels TH, Bloom AS, Buffington J, et al. Ebola hemorrhagic fever, Kikwit, Democratic Republic of the Congo, 1995: risk factors for patients without a reported exposure. J Infect Dis 1999 Feb;179:S92-7 [Full text]
Kuhl A, Hoffmann M, Muller MA, et al. Comparative analysis of Ebola virus glycoprotein interactions with human and bat cells. J Infect Dis 2011 Nov;204:S840-9 [Full text]
Hunt CL, Lennemann NJ, Maury W. Filovirus entry: a novelty in the viral fusion world. Viruses 2012 Feb;4(2):258-75 [Full text]
Bray M, Geisbert TW. Ebola virus: the role of macrophages and dendritic cells in the pathogenesis of Ebola hemorrhagic fever. Int J Biochem Cell Biol 2005 Aug;37(8):1560-6 [Full text]
Mohamadzadeh M, Chen L, Schmaljohn AL. How Ebola and Marburg viruses battle the immune system. Nat Rev Immunol 2007 Jul;7(7):556-67 [Abstract]
Lindsley WG, Blachere FM, Thewlis RE, et al. Measurements of airborne influenza virus in aerosol particles from human coughs. PLoS One 2010 Nov 30;5(11):e15100 [Full text]
Caul EO. Small round structured viruses: airborne transmission and hospital control. Lancet 1994 May 21;343(8908):1240-2 [Full text]
Chadwick PR, Walker M, Rees AE. Airborne transmission of a small round structured virus. Lancet 1994 Jan 15;343(8890):171 [Full text]
Best EL, Snadoe JA, Wilcox MH. Potential for aerosolization of Clostridium difficile after flushing toilets: the role of toilet lids in reducing environmental contamination. J Hosp Infect 2012 Jan;80(1):1-5 [Full text]
Gerba CP, Wallis C, Melnick JL. Microbiological hazards of household toilets: droplet production and the fate of residual organisms. Appl Microbiol 1975 Aug;30(2):229-37 [Full text]
Barker J, Jones MV. The potential spread of infection caused by aerosol contamination of surfaces after flushing a domestic toilet. J Appl Microbiol 2005;99(2):339-47 [Full text]
Piercy TJ, Smither SJ, Steward JA, et al. The survival of filoviruses in liquids, on solid substrates and in a dynamic aerosol. J Appl Microbiol 2010 Nov;109(5):1531-9 [Full text]
Jaax N, Jahrling P, Geisbert T, et al. Transmission of Ebola virus (Zaire strain) to uninfected control monkeys in a biocontainment laboratory. Lancet 1995 Dec 23-30;346(8991-2):1669-71 [Abstract]
Kobinger GP, Leung A, Neufeld J, et al. Replication, pathogenicity, shedding and transmission of Zaire ebolavirus in pigs. J Infect Dis 2011 Jul 15;204(2):200-8 [Full text]
Weingartl HM, Embury-Hyatt C, Nfon C, et al. Transmission of Ebola virus from pigs to non-human primates. Sci Rep 2012;2:811 [Full text]
Reed DS, Lackemeyer MG, Garza NL, et al. Aerosol exposure to Zaire Ebolavirus in three nonhuman primate species: differences in disease course and clinical pathology. Microb Infect 2011 Oct;13(11) 30-6 [Abstract]
Roy CJ, Milton DK. Airborne transmission of communicable infection—the elusive pathway. N Engl J Med 2004 Apr;350(17):1710-2 [Preview]
Canadian Standards Association. Selection, use and care of respirators. CAN/CSA Z94.4-11
Wolz A. Face to face with Ebola—an emergency care center in Sierra Leone. (Perspective) N Engl J Med 2014 Aug 27 [Full text]

[Divernan]

10. See post 9. Try not to be terrified of facing reality.

As the evidence piles up, we divide into 2 groups: those brave enough to face reality and take what precautions they can, and those who bury their heads in the sand and say "not to worry". There was a lot of "fear-mongering" about the Nazis' intent before they invaded each new country in their path. Get a clue: viruses have no respect for American exceptionalism.

[LovingA2andMI]

23. Can you expand upon....

What exactly is FEARFUL about saying the obvious? The virus has mutated. Since March 2014 the virus has infected over 4,000 people in the West African and African Contentiant. Maybe taking a view of the CDC website noting the rate of infections of Ebola from 1976 to Present will assist you in understanding the virus has MUTATED:

http://www.cdc.gov/vhf/ebola/outbreaks/history/chronology.html

Also, the Frontier Airlines CEO is making the right moves and stating the truth. About time someone steps up to the plate that clearly has a grip of the inherent dangers of this disease

[morningfog]

6. What do you mean "whether the Ebola virus has mutated such that it is more contagious?"

What evidence is there of that?

[Divernan]

9. All biologists know that viruses DO mutate. Ebola is no exception. There are no exceptions.

I took two classes at Univ. of Pittsburgh on infectious diseases. I can't replicate for you on DU the lectures, slides, etc., demonstrating exactly how viruses mutate, but NO ONE challenges the knowledge that viruses DO mutate. As to Ebola, here is some very recent opinion (last month) info from 2 leading scientists - the director of a university center for infectious disease research, and a former acting director of the CDC that the current Ebola's virus hyper-evolution is unprecedented.

(The following article is from mid-September)

Michael T. Osterholm, PhD, MPH, wrote in a New York Times commentary today that the scale of the epidemic is offering the virus unprecedented opportunities to evolve toward greater transmissibility, which could give it the capability to spread worldwide. He is director of the University of Minnesota's Center for Infectious Disease Research and Policy, publisher of CIDRAP News.

Richard E. Besser, MD, chief health editor at ABC News and a former acting director at the Centers for Disease Control and Prevention (CDC), wrote in the Washington Post last night that a more-contagious Ebola virus could threaten the United States and said the crisis warrants the deployment of thousands of American troops to the affected countries.
What virologists don't like to talk about

The possibility of an airborne-transmissible Ebola virus is one "that virologists are loath to discuss openly but are definitely considering in private," wrote Osterholm. In its current form, the virus spreads only through contact with bodily fluids, he noted, but with more human transmission in the past few months than probably occurred in the past 500 years, the virus is getting plenty of chances to evolve.

"Each new infection represents trillions of throws of the genetic dice," he said.


http://www.cidrap.umn.edu/news-perspective/2014/09/experts-raise-specter-more-contagious-ebola-virus

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 virus’s 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.

If certain mutations occurred, it would mean that just breathing would put one at risk of contracting Ebola. Infections could spread quickly to every part of the globe, as the H1N1 influenza virus did in 2009, after its birth in Mexico.

Why are public officials afraid to discuss this? They don’t want to be accused of screaming “Fire!” in a crowded theater — as I’m sure some will accuse me of doing. But the risk is real, and until we consider it, the world will not be prepared to do what is necessary to end the epidemic.

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. Richard Preston’s 1994 best seller “The Hot Zone” chronicled a 1989 outbreak of a different strain, Ebola Reston virus, among monkeys at a quarantine station near Washington. The virus was transmitted through breathing, and the outbreak ended only when all the monkeys were euthanized. We must consider that such transmissions could happen between humans, if the virus mutates.

[blackspade]

16. So, no evidence.

I understand informed speculation, but that is not evidence.

[MNBrewer]

18. Ebola would be unique among all life forms on the planet if it did not undergo mutation

as it replicates. And it does, in fact, undergo mutation.

http://www.nature.com/news/ebola-virus-mutating-rapidly-as-it-spreads-1.15777

While these mutations do not indicate that an airborne version is on the way, to deny that mutation/evolution is occurring in ebola is to deny science and the basic nature of all life on this planet.

Ebola IS mutating. Ebola IS evolving.

[Bluenorthwest]

43. Do you also fear that HIV, also mutating, is going to leap at you one day from across the room?

If not, why not? If so, what real basis is there for not only the fear but the actions that will result from that fear?
Have you spent your life afraid of certain population groups because you think HIV is apt to mutate and spread itself via a glance from a cursed homosexual?

Can you name for me any virus that has mutated in the fashion you speak of, becoming transmitted in new and easier ways while retaining the symptoms and rate of fatality that made it famous? If not, why not?

[AverageJoe90]

62. There simply is no evidence of such.

Indeed, even HIV didn't mutate to that extreme. But I bet that won't stop the fearmongering from continuing for a good while, especially if Repugs think it might help their chances during this election season.

[MNBrewer]

74. I don't "also fear" that, because I never said that I feared that ebola would do the same

Denying that both viruses are evolving is anti-scientific, however.

[Divernan]

19. Post 5: 300 new mutations which have yet to be studied re transmission

This virus is mutating at an unprecedented rate. That is a fact - not speculation. The unexplained deaths of multiple medical professionals who were supposedly following WHO/CDC guidelines - those deaths are facts. Consensus is building around the world that we must get AHEAD of this virus if we hope to stop it. That means stopping the spread of infections. That means taking extreme precautions, particularly in reducing exposure of healthy people (such as airline passengers) and isolating those exposed.

[LovingA2andMI]

24. Thank you for this clear information and EVIDENCE....

Unfortunately, a group of posters are working in unison to "poo-poo" any evidence that the Ebola Virus has mutated (anyone that has studied high school biology should be able to reasonably determine this fact).

Why they are doing this? It is unknown, however, hopefully folks will search out the evidence and verify information on the CDC website (and the CDC has dropped the ball in America with Ebola -- however -- the numbers on the site below are valid) that clearly proves some type of virus mutation has taken place since March 2014 with the clear and evident increase in overall infection rates in Africa, v.s. the infection rate from 1976 to March 2014

Outbreaks Chronology: Ebola Virus Disease

[Towlie]

27. Can't we just say "evolved", or have the right-wingers succeeded in turning that into an obscenity?

[AverageJoe90]

65. None. Because none exists. nt

[peacebird]

7. Good move. Smart to be proactive AND smart to realize how scared many folks are.

This will help them keep customers

[Paper Roses]

8. I hope the people cleaning this plane are protected.

Will the cleaning crew wear bio-hazard gear? Are they prepared to properly dispose of any cleaning products and vacuum debris?
How incredibly foolish this young woman was to have taken her trip with everything that has been happening.

[HockeyMom]

31. If it Ebola is that contagious, it's too late

too many stops (Ft. Lauderdale, Atlanta, Cleveland). and additional passengers, before anyone realized she was on there. Have you ever flown a budget airline making numberous stops? I am not talking about the seat she sat in. Toilets. Waste materials. From arrival to departure is about 15 minutes to clean up the plane. Did the cleaning crew use Hazmat suits and spray it all down before the next takeoff? Wanna buy a bridge?

[blackspade]

12. The only issue I have with the OP...

Is that it is unlikely that the virus has mutated.
There is no evidence of that.

[Divernan]

14. Post 5: Researchers have identified more than 300 new viral mutations in the latest strain of Ebola,

[mnhtnbb]

20. Five co-authors of the article in Science contracted Ebola and lost their battle with it

before the article was published.

http://www.sciencemag.org/content/345/6202/1369.full

[spike91nz]

13. This ebola epidemic

may well reveal the failure of capitalism to respond to those threats upon the common well being. If they continue to calculate the response in terms of profits and losses, and fail to implement precautions due to the costs to business, then the disease will skate away from their opportunity for control. Waiting for the market to respond to a problem that grows exponentially will only reveal that it cannot respond to such threats in a timely manner and cannot anticipate a cost that is not directly realized corporately and individually. The private (for profit) health-care system will fail to provide the precautions without financial incentive to do so and such incentive does not present until it is already too late to prevent it. Cost benefit analysis will not compel a preparedness for such disasters as they are rare in their occurrence but they are potentially disastrous in their effects. Compromising the country's economy for the benefit of the corporate class and dedicating military resources to the support of oil interests, has left the nation handicapped in its capacity for effective response to this common threat which might well produce a catastrophic collapse of the system if it continues to escape confinement.

[Divernan]

15. Brilliant analysis! Welcome to DU

And buckle your seat belt around here! With all the crises going on in so many areas, and with too many people feeling frightened, insecure and helpless, there is a lot of anger directed at those bearing the bad news.

[TBF]

17. Welcome to DU -

If you are so inclined we also have a small group called "Socialist Progressives" here: http://www.democraticunderground.com/?com=forum&id=1024

We are a smaller group of democratic socialists, anarchists, Trotskyists ... and basically anyone who questions whether capitalism is the economic system this country (world) needs. Based upon your post here I'd certainly welcome your participation. Solidarity.

[LovingA2andMI]

25. As a M.B.A. degree individual this analysis....

Is the best I've read YET from a business point of view on why the Profit Motive Associated with America's Privatized Band-Aid Health Industry. Thank you for making it!

[PasadenaTrudy]

35. Agree with you 100% n/t

[Vinca]

21. This is like telling Timmy that Lassie has died.

He feels tired, Timmy. A little later: Lassie needs to rest, Timmy. Later: He's taking a nap, Timmy. And, finally: Timmy, I have some bad news. Drip, drip, drip. We deserve to know what has and has not happened re ebola in actual time.

[Renew Deal]

29. You're missing the spoiler alert!

[marions ghost]

30. Lassie is a girl

...but good analogy

[NV Whino]

37. Nit picky here

Lassie was played by a male dog.

[marions ghost]

40. Lassie was referred to by the term "she"

therefore the illusion has more truth than the reality

[NV Whino]

47. Well, I can, but won't argue that.

Can't tell you how disappointed I was with Hollyweird's deception. My life was never the same.

[marions ghost]

49. Hollywood in general

is a life lesson in the nature of deception. All is story. Story is all.

Kind of like our current political image-making and emphasis on personal "narrative." If illusion could have been kept contained in the world of Hollywood...but now the distinctions are blurred...it's a tough time for realists.

[YarnAddict]

26. PR move

There is probably zero possibility of anyone picking up the virus from the aircraft, but Frontier wants to reassure the flying public that they are taking it seriously, and going above and beyond. They probably weighed the costs of taking the plane out of service and cleaning it four times, and decided that if it costs $1,000,000 it would be more cost effective than losing customers.

Smart move.

[gvstn]

33. Since normally they only give 7 minutes to clean a plane they need the PR.

http://www.thecollaredsheep.com/undercover-boss-analysis-of-bryan-bedford-ceo-of-frontier-airlines/

[Renew Deal]

28. Imagine getting the phone call saying you sat in the same seat

[Myrina]

53. ... unless she puked, spit or shat all over it, I wouldn't be too concerned.

[SpankMe]

32. If the nurse was symptomatic, then she should be charged with a crime.

She is a nurse with medical training. She's just finished treatment of an Ebola patient. If she comes down with any symptoms whatsoever, she should have put 2 and 2 together and isolated herself and called a hospital.

IF she was symptomatic, she was reckless and indifferent to the safety of the public. If she doesn't die, she should go to jail for a while.

I know I'll get flamed for this. But, health professionals should know better.

[Divernan]

38. She checked first w/ CDC re a slightly elevated temp; they told her she could fly.

Let's put the blame where it belongs - the CDC. Nurses and nurses' unions around the country are raising hell because, contrary to the feel-good, don't-worry-your-little-head PR of the CDC, the hospitals and nurses DO NOT have the requisite training and protective gear/equipment to handle an Ebola patient. This woman checked with the CDC, and as the CDC spokesman so ingeniously put it, she "wasn't told she couldn't fly."
http://abcnews.go.com/Health/ebola-nurse-told-cdc-slightly-elevated-temperature-flight/story?id=26218029

Second Ebola Nurse Told CDC About Slightly Elevated Temperature Before Flight
Oct 15, 2014, 9:56 PM ET
By MEGHAN KENEALLY
Meghan Keneally More from Meghan »
Digital Reporter
via Good Morning America

PHOTO: Amber Joy Vinson, the second Texas nurse to test positive for Ebola, is seen in this 2003 Firestone High School Yearbook Photo.
Amber Vinson, Second American Infected With Ebola

The second nurse who has been diagnosed with Ebola told the U.S. Centers for Disease Control and Prevention she had a slightly elevated temperature prior to flying to Dallas from Cleveland, Ohio, but wasn't "told she couldn't fly" since she didn't meet the threshold for a fever, a CDC official told ABC News.

Amber Vinson, 29, a nurse at the Dallas hospital where an Ebola patient had died, was identified today as the second health care worker at the hospital to contract the deadly virus. She told the CDC her temperature was 99.5 degrees, which is below the 100.4 reading for a fever.

[LeftInTX]

48. Oh My God!!!!!

[SoapBox]

42. SpankMe is correct.

The nurse bears a huge responsibility in this.

Why didn't she call 911 OR head straight to an Emergency Room...if she had told a 911 operator that she was gaining a fever AND that she was a nurse that had been in direct contact with Duncan, working with the other nurse that was already sick...she would have been isolated immediately.

There is something wrong with her story...I'll lay odds that she just wanted to get back to TX and also didn't want to get her mother and her fiancé quarantined.

Who exactly did she talk to at the CDC? And when? dates and times? And what exactly did she tell them?

There are a LOT of details missing.

[SoapBox]

41. Of course she did! She should have had the brains to have called 911, from her mother's house!

This NURSE should have been smarter...

Something has not felt right about her story of "repeatedly" calling the CDC and continually getting an ok to fly...I just think she never told them all about herself.

[AverageJoe90]

64. It does seem qutie strange when you think about it.

It's still possible some lower-level person at the CDC may have screwed up, but this definitely makes sense, having thought about it.

[catbyte]

44. I'm actually weirdly comforted by the fact that no one has tested positive

for Ebola outside of medical personnel. Folks were in a small apartment with Duncan for 2 days but so far they're negative & have passed the point in time when most infections begin. It's cause for concern, sure, but I hope everybody keeps this in perspective. Fox-PAC excepted, of course. They will certainly find some way to tie this to BENGHAZI BENGHAZI BENGHAZI if they haven't already.

[AverageJoe90]

63. This, just this.

Had that not been the case, we almost certainly would have seen a far higher number of infections by now.

[Android3.14]

46. I see you edited the OP to remove the crazy statements

Thank you

[Divernan]

71. I didn't edit the OP /link & there were no "crazy statements".

[CullenBohannon]

51. amazing

I think the CDC is basically full of it.

[FarPoint]

52. I sense she has suspicions of having Ebola.

The fact that she called the CDC several times validated that thought. Her clinical background triggered her intuitive side. Yet, denial kicked in and won. She knew in her heart not to fly but that wedding planning took priority. Yes, denial can be very dangerous.

[Divernan]

54. The kind of denial we see here in posts accusing people of panic.

and assuring us that CDC has everything under perfect control.

[Darb]

56. Overstated,

I don't think anyone is "assuring us that CDC has everything under control". I think we all have doubts about how well this thing is being controlled, but we all most certainly are not calling it airborne.

[Man from Pickens]

72. Not seeing anyone who says the CDC has it under perfect control

however, I am seeing vicious, emotional, fallacy-laden rants leveled against anyone who might suggest otherwise.

[kestrel91316]

57. Enough with the "ZOMG EBOLA IS MUTATING" nonsense. Ebola mutates daily.

It HAS not and WILL not mutate into a virus that spreads via aerosol. It can't take the drying. It can't form the tiny particles necessary for aerosol spread. It cannot suddenly become something it is fundamentally not. It spreads via droplets and contact. PERIOD.

[mnhtnbb]

68. Not true. There is disagreement about its ability to mutate to a strain that could be

aerosolized.


From CIDRAP:

We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.1

http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola


I suggest reading the entire article.

[Divernan]

69. Impressively detailed and scientifically current analysis of Ebola mutation/transmission

Submitted to CIDRAP by the authors, who are national experts on respiratory protection and infectious disease transmission. In May they published a similar commentary on MERS-CoV. Dr Brosseau is a Professor and Dr Jones an Assistant Professor in the School of Public Health, Division of Environmental and Occupational Health Sciences, at the University of Illinois at Chicago.


Healthcare workers play a very important role in the successful containment of outbreaks of infectious diseases like Ebola. The correct type and level of personal protective equipment (PPE) ensures that healthcare workers remain healthy throughout an outbreak—and with the current rapidly expanding Ebola outbreak in West Africa, it's imperative to favor more conservative measures.

The precautionary principle—that any action designed to reduce risk should not await scientific certainty—compels the use of respiratory protection for a pathogen like Ebola virus that has:

No proven pre- or post-exposure treatment modalities,
A high case-fatality rate,
Unclear modes of transmission

We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.1

[Divernan]

70. Here are topic headings from this article.

http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola

How are infectious diseases transmitted via aerosols?
Is Ebola an aerosol-transmissible disease?
What do we know about Ebola transmission?
Which respirator to wear?
Practical examples
Implications for protecting health workers in Africa
Adequate protection is essential

To summarize, for the following reasons we believe that Ebola could be an opportunistic aerosol-transmissible disease requiring adequate respiratory protection:

Patients and procedures generate aerosols, and Ebola virus remains viable in aerosols for up to 90 minutes.
All sizes of aerosol particles are easily inhaled both near to and far from the patient.
Crowding, limited air exchange, and close interactions with patients all contribute to the probability that healthcare workers will be exposed to high concentrations of very toxic infectious aerosols.
Ebola targets immune response cells found in all epithelial tissues, including in the respiratory and gastrointestinal system.
Experimental data support aerosols as a mode of disease transmission in non-human primates.

Risk level and working conditions suggest that a PAPR will be more protective, cost-effective, and comfortable than an N95 filtering facepiece respirator.