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Ebola: A Hemorrhagic Fever by Any Other Name

Ebola: A Hemorrhagic Fever by Any Other Name

Call it what it is.

One of the most troubling tendencies of the Obama Administration and their minions in the media is to relabel a problem, giving the appearance that solutions are on their way.

Exhibit 1: An act of terror becomes a “man-caused disaster”. Exhibit 2: The prohibition on the term “illegal alien”.

Now, the illness associated with a terrible pathogen is now being reclassified from “Ebola Virus Hemorrhagic Fever” to “Ebola Virus Disease”.

LI #08 Ebola VD

This seems to be an attempt to lull people into a false sense of security, lumping it with other “Virus Diseases” like the flu and the common cold.

I have taught bloodborne pathoghen safety from the early 1990’s, when healthcare, security, and first-aid providers were worried about contracting AIDS. Ebola is rated as a class 4 pathogen because of its fatality rates in humans and the fact that there is no cure or treatment.

It is, and remains, a “hemorrhagic fever”. It did not stop being a Class 4 pathogen once it hit the Dallas hospital. The mechanism of attack, which includes destruction of the endothelial cells that weaken the blood vessels and cause excessive bleeding, has not changed. Once the blood vessels are weakened, a suite of devastating symptoms occurs, as noted in a Business Insider article published in July of this year.

The progression of symptoms is alarming. Initially, the fever, weakness, muscle pain, headache, and sore throat associated with Ebola could be mistaken for a bad flu.

But it is soon followed by vomiting, diarrhea, rash, and impaired organ function. A large proportion of those infected also bleed profusely, both internally and externally. Blood often flows from puncture sites (e.g., where IVs have been inserted) and mucous membranes (e.g., the nose, the eyelids).

Ebola is one of at least 30 viruses known to cause this constellation of symptoms, called viral hemorrhagic fever syndrome.

Note that as of July, Ebola was still being called a hemorrhagic fever.

The best way for our country to prevent any epidemic, including one involving Ebola, is to ensure the public is fully informed. As a professional who specializes in hazardous materials response, the moment my concern transformed to worry was when I saw the image of hired hands power-washing away Ebola-infected vomit:

This situation called for a hazardous materials response: protective suit, double gloves, respiratory protection, containment of the disinfectant spray flow and rinse water, and arrangements to fully decontaminate the personnel responding.

The good news is, the HazMat crews have finally arrived.

A Dallas apartment where the first person diagnosed with Ebola in the United States had stayed is finally getting a thorough cleaning, days after the diagnosis left four people quarantined there with soiled towels and sweat-stained sheets from the Ebola patient.

After some delays, the first of three phases to clean the apartment began Friday afternoon. While the process will take days, at least sheets and towels that Ebola patient Thomas Eric Duncan used have been removed.

The bad news: The Washington, DC area hospitals are reporting that they were visited by a patient concerned about Ebola exposure:

Two Washington area hospitals said within hours of each other Friday that they had each admitted a patient with symptoms and travel histories associated with Ebola.

A person who had recently traveled to Nigeria came to Howard University Hospital in the District overnight “presenting symptoms that could be associated with Ebola,” spokeswoman Kerry-Ann Hamilton said in a statement.

While the professionals at the Centers for Disease Control and Prevention (CDC) are highlighting the fact that “direct contact” with a person’s blood is needed for infection, the fact is that prior to this epidemic, the nature of how Ebola spread was not widely understood. Furthermore, I find it difficult to believe that an NBC cameraman, who now is infected, had any “direct contact” with a carrier as defined by the CDC. The crew would have been informed of the hazards, as they were known at the time.

Neo-neocon brilliantly summarized the communications glitch that prevented the travel records of US Ebola patient zero, Thomas Eric Duncan, to make its way to healthcare personnel. This also underscores the importance being properly informed.

The best response to provide the public the details they need, and to develop serious containment and quarantine plans. Perhaps President Obama can appoint Rudy Giuliani, who didn’t have to relabel anthrax to address a disease scare in New York.

The worst response is to rebrand this disease. You can’t power-wash away the fact that Ebola isn’t some flu derivative, but a hemorrhagic fever.

(Please check out my Canto Talk program from this past Thursday, which discusses Mandy’s fundraiser and the media response to Ebola).

[Featured image: WFAA News Video].

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Comments

I can only conclude that the man who is operating the power washer was completely unaware of the hazard he was confronting. Otherwise, that is some powerful negligence on someone’s part.

I’m sure that he is now aware of the peril that he is in and is now enduring the longest 21 days of his life.

No, they renamed it from Zaire strain Ebola virus to Ebola virus. They didn’t rename it from “Ebola virus hemorrhagic fever” because it wasn’t ever called that. Just like “H5N1 flu” was never called “H5N1 flu respiratory infection” and the proprietor here is not called “William Jacobsen Professor of Law Law Teacher” and chickens aren’t called “Rhode Island Red Chicken Birds”. It’s redundant. They renamed it because (a) there’s no such plaice as Zaire any more, and (b) they’ve decided the is the genus example.

For Gods sakes, at least google this stuff.

    Skookum in reply to chasrmartin. | October 4, 2014 at 9:44 pm

    The disease Ebola causes is a hemorrhagic fever, which you would have known had you followed your advice and googled it.

    steffmckee in reply to chasrmartin. | October 4, 2014 at 9:55 pm

    Charlie:
    I understand your point, but Ebola does belong to a group of hemorrhagic fevers such as Lassa and Marburg, The CDC’s and the Travis County Health Department’s initial reactions leaves much to be desired.

    Charles:

    “Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans.”
    http://www.who.int/mediacentre/factsheets/fs103/en/

    From WHO’s website. I think this term was developed recently.

      gasper in reply to gasper. | October 4, 2014 at 10:31 pm

      It strikes me as odd that WHO would use the words “formerly known as”, as if the name was used eons ago rather than just a week ago. People who study this bug should refer to it by its “former name” and ignore these damned language changers.

        Lina Inverse in reply to gasper. | October 5, 2014 at 8:27 am

        gasper: Try months, at minimum. For the last few months I’ve been following it on the excellent, non-government ProMED Mail site, run by the International Society for Infectious Diseases (which covers everything, including plant pathogens), and during that period it’s always been Ebola virus disease (EVD). In fact, within the last week the editor for those items stopped editing them from “Ebola” to EVD because that was taking too long.

        I’m sorry, but to the extent Leslie Eastman is claiming this was a political change timed with its actual arrival in the US, she’s wrong. There’s more than enough to criticize the inept, politicized and off focus CDC that as of late has had much more important things to do that to focus on infectious diseases.

          Thanks for pointing this out. In fact, CDC uses the term Ebola Hemorrhagic Fever (HVF) up through July 14, 2014, then on July 16, 2014 begins referring to it as Ebola Virus Disease (EVD). Although the term EVD may have been in existence for a while, it doesn’t appear to have been commonly used until then. And, CDC consistently refers to WHO when using the term EHF. I am going to continue looking, but the universal change in terminology from HVF to EVD appears to have been very recent. If the CDC wasn’t using it until recently, what motivated the change? It was not done arbitrarily but was certainly done quickly and without explanation.

          Lina Inverse in reply to Lina Inverse. | October 5, 2014 at 5:13 pm

          The timing of the change you’ve found is just before it was officially admitted it was out of control in West Africa, per my just reading about that process which ended with the WHO declaring a “Public Health Emergency of International Concern” on August 8th.

          That period necessarily the disease Ebola causes, and perhaps the people who do this sort of thing decided “hemorrhagic fever” was too specific, if we’re seeing other syndromes that don’t match as well.

        gasper in reply to gasper. | October 5, 2014 at 12:05 pm

        WHO uses the term Ebola Hemorrhagic Fever (EHF) in a PDF file dated March 23, 2014 on the first case reported in New Guinea, but uses the term Ebola Virus Disease (EVD) in the online report (same date) that references the PDF file. Prior reports refer to EHF; all subsequent reports use EVD. It appears WHO began this trend and CDC caught up to it later on. Personally, I don’t see anything sinister in the name change. I think EVD is easier to remember. Of course, just the term “Ebola” is satisfactory for most purposes.

          gasper in reply to gasper. | October 5, 2014 at 2:52 pm

          acronyms are not my forte. I mangled them a few times in the last couple of posts.

          Lina Inverse in reply to gasper. | October 5, 2014 at 5:23 pm

          Of course, just the term “Ebola” is satisfactory for most purposes.

          Indeed, but medical types want to be very clear, and that can describe both a virus and the disease. In their own communications they don’t want you to have to figure out based on context.

          For that matter, not long ago the Zaire strain was renamed “Ebola virus“, I would guess because it’s significantly distinguished from the other members of the Ebolavirus family. Two are not common, and so far less deadly (although still very bad), two seem to be primate but not particularly human diseases.

          gasper in reply to gasper. | October 6, 2014 at 7:07 pm

          Lina: we don’t say someone has Herpes Virus Disease. It’s just, “they have Herpes”. If someone has Ebola it is understood they have the disease. It is used quite often in scientific literature that way. I am not a novice in this field. I worked in the biomedical field for many years and am quite familiar with BSL 4 agents and viruses in general and how they are contained, and spread. I am also familiar with the mentality of the people who work with them and know how cavalier many can be when working with hazardous agents. Rats and mice are used to study the disease which means they can be a vector of the disease. Do you think there may be mice in that Dallas apartment? Think maybe a roach can’t get a virus attached to it, or even injest it? How about being on a dust particle, or a house fly, or any other number of vermin. It’s more than getting on dirt. It can hitch a ride on things that travel about.

      enzo in reply to gasper. | October 5, 2014 at 1:05 am

      On wikipedia, ‘Ebola hemorrhagic fever’ has redirected to ‘Ebola virus disease’ since 2002. http://en.wikipedia.org/w/index.php?title=Ebola_hemorrhagic_fever&action=history

The best way for our country to prevent any epidemic, including one involving Ebola, is to ensure the public is fully informed.

Actually, the best way is to keep it out, i.e., travel restrictions. Unfortunately, this operation is being run by Obola, not by physicians who care about our lives. The CDC is a lying, nefarious, political hack organization that’s willing to play PC footsie with our lives. If any Americans contract ebola here and die, all of the above should be brought up on charges of negligent homicide.

Notably lacking from this, your fifth ebola article, Leslie, is your assurance that there is no need for us plebes to worry. Thank you for not keeping that meme. Your analysis is always appreciated.

Outbreaks in sub-Saharan Africa are likely initiated by someone contracting the virus from bushmeat or bodily fluids of a carrier bat or infected primate. Thus, most outbreaks have been, until this year, confined to bush villages. The standard practice is to isolate the village experiencing the outbreak until the disease burns itself out.

Now the disease has infested cities, which cannot be isolated and where the populace is far more mobile than that in the villages. So mobile that the disease is now here. Yes, we have better sanitation and, despite the ravages of ObamaCare, better health care facilities, but we are even more mobile, more arrogant, more overconfident, and we have a government that screws up everything it touches. We also may have a low tolerance to this virus of jungle origin, like Native Americans had a low tolerance to the smallpox virus.

I am skeptical about the party line that an infected person is not contagious until symptomatic. The camerman is cause for skepticism, like the author states, but the American obstetrician who may have contracted the virus from an asymptomatic patient provides further reason to question the conventional wisdom. Plus, why are so many Ebola health care professionals catching the virus? They certainly know the risk and the precautions to take.

The habit of changing names to confuse people (and pretend to greater knowledge than those poor ignorant fools still using the old name) is not just something this administration does. It’s a general liberal habit. It’s actually one of the most annoying things they do.

    Valerie in reply to irv. | October 4, 2014 at 10:59 pm

    It is a rhetoric trick to divert the conversation from substantive matters to vocabulary trivia. You can and should call every person that tries this nonsense.

And ‘Barack Hussein Obama’ is a voter-caused disaster.

Doug Wright Old Grouchy | October 5, 2014 at 12:03 am

Actually, while I still believe that many of Obama’s actions are due to his desire to radically transform the USA, his totally inept administration compounds any situation, making it worse. His CDC is incapable of dealing with this Ebola outbreak and God Help USA survive Ebola scare.

Of course, Obama is perhaps now pronouncing that “Eboly” is under control in all 57-states.

Mr. Obama is opposed to anything we might do to protect America if it could offend his political base – in this case to temporarily block flights from West Africa, as other countries (Gt. B, France, Asian and many other others) have already done. Why doesn’t he do this too? – because it might appear to American blacks (95% pro-Obama) that we’re treating them harshly, and we allegedly owe them everything in compensation for slavery two centuries ago. Obama’s decisions continue to sacrifice the U.S. for any political gain he sees. Further, nothing short of a ban on flights from West Africa will help since there’s a 3-day incubation period during which no tests are available to detect an infection by screening. And, re. the influx via Mexico, our “screeners” aren’t even giving them a cursory medical exam that would detect flu-like symptoms (appearing 3 days or so after infection). Mr. Obama thinks that might offend his Hispanic base.

Henry Hawkins | October 5, 2014 at 12:13 am

Not rebranding so much as creating a euphemistic name for the virus. The word ‘hemorrhagic’ (blood!) is a very scary word, and they got rid of it. They probably justify the change by believing ‘hemorrhagic’ too scary a term, one that might cause panic amongst the peasants. That’s just the justification. They do it for political reasons. The more you can minimize an issue, event, object of threat, etc., the less people worry about it and the less they expect of you, the government official. Hence, ‘manmade disasters’ instead of terrorism, ‘overseas contingency operations’ instead of war, ‘workplace violence’ instead of terrorism, and now Ebola Virus Disease instead of Ebola Hemorrhagic (Blood!) Fever Syndrome.

    A rose by any other name is yet a crisis to be exploited. The clear and present danger is the corrupt Obola Administration. How many will have to die before the obvious becomes obvious? As you point out, it’s more than just ebola, if that isn’t bad enough.

    I’m not confident that we will overcome the corruption. God help us.

Noblesse Oblige | October 5, 2014 at 2:17 am

We learned all about Newspeak from Orwell when he wrote “1984” in the 1940s. Now we are living it… the power to manipulate populations by rewriting words and ideas into something they are not. It is now clear that this outbreak will not be contained in West Africa, and only a fool would believe what we are fed by a central government that cannot treat our veterans, protect the president or our diplomats in foreign lands, roll out a medical program, hold on to hard won gains in Iraq, or even deliver the mail.

We know several things about Ebola; one of them is that it is an “intelligent” virus and able to quite readily adapt to its environment. There is no good reason to believe that it could not have changed from a purely bold-borne illness to one capable of aerosol transmission; in fact, there seems to be very good reason to suspect it has. That would explain how the incredibly careful medics, and a civilian cameraman working directly for a knowledgable doctor, have contracted this hemorrhagic disease.

Based on our government’s action so far, God help us all! It seems that Donald Sutherland is in charge — where’s Dustin Hoffman and Rene Rouseau when we need the?

That should read “blood-borne”, not bold-borne. This site needs an edit capability!

JackRussellTerrierist | October 5, 2014 at 3:26 am

Well, Leslie, you’re slowly changing your tune. There’s still time to catch up and save credibility by letting us know when it’s time to panic.

    I stand 100% by everything I said in my previous posts. However, I reserve the right to change my mind when I gather new data — especially photos violating all the biosafety protocol I know. I also hold that any of my good Legal Insurrection friends can change their minds, too, upon the revelation of new information.

      JackRussellTerrierist in reply to Leslie Eastman. | October 5, 2014 at 11:54 am

      Hopefully the photos are enough to convince you to stop vouching for the CDC. Unfortunately, this forum doesn’t offer a ‘rolleyes’ emoticon or I’d use it here.

      And, folks, don’t let the “We’re changing the name of the disease” meme fool you into refocusing your attention from the disease itself and our political machine and institutions charging forward with decisions or inaction that at least GIVE the appearance of a secret vow to infect America. 🙂

      tom swift in reply to Leslie Eastman. | October 5, 2014 at 12:35 pm

      At this stage you’re looking rather ridiculous. Insisting you were right is simply Obamesque.

      Consider:

      Same disease.

      Same Obama administration.

      Same CDC.

      What new information is needed, really? The important factors are known; none are cause for optimism, and none are going to change any time soon.

    I can’t speak for Leslie but it’s quite possible she believed that if the government and hospitals followed proper infectious disease protocols, in theory there wouldn’t be a grave threat to the population based upon past experiences with Ebola. Unfortunately, that belief discounts the gross incompetence that can be found in the vast majority of bureaucracies, particularly government and even hospitals where optics and political considerations trump facts and evidence.

      I believe the problem was a general assumption that everything will go right…you should always proceed with the caution that many, many things will actually go wrong.

      And that the disease itself will change and adapt to its environment the more chances it is given to do so. This is the nature of RNA viruses.

      Watching everyone dismiss those concerned and watching closely with accusations of ‘panic’ and comments that it just spreads from physical contact (which is clearly not true, because it spreads also through surface contact and possibly through droplets of in the virus floating through the air, even if that is not technically considered ‘airborne’ transmission). Camera men and helpful nurses and doctors are getting this regularly. Family members are getting it. It’s highly infectious. People who aren’t watching carefully are crazy.

The public is entitled to clarity of language from its government, especially in times of crisis. Everyone has heard of ebola and that it is associated with an often fatal hemorrhagic fever. Perhaps less known is that there are 5 known strains of the virus, 4 of which cause hemorrhagic fever in humans and animals. The term ebola virus disease (EVD) may be viewed as more precise in some medical circles, but even there it is not used universally. For example, it is used by WHO and CDC, but not by the National Library of Medicine (an arm of the National Institutes of Health) where it is called Ebola Hemorrhagic Fever.
So using EVD can only serve to confuse a public already justifiably suspicious of this Administration because of its history of outright lying (for instance, about Obamacare) and redefinition (pretending climate change is synonymous with catastrophic anthropogenic global warming).

Re: the power washing without protective gear. This was five or six days after the event. I have been told that the virus can live on surfaces for several hours or maybe a day or two. In the heat in Dallas it seems likely the vomit had completely dried and the virus expired by the time the power washers got there. Also, we can hope they were using a bleach solution, which would kill the virus if it were still living. What’s really shocking is that it was five or six days.

I wonder if the American survivors can remember if they felt vaguely ill before the early symptoms of fever and joint pain presented, and if so, they might have been contagious at the vaguely ill stage. This might account for how the cameraman and OB got the virus.

wasn’t too long ago you told us not to worry as the professionals know how to deal with it and we told you the situation would unfold just as it is now.

    I still stand by my original assessment, too. Sending an American patient into a CDC facility equipped to handle a Level 4 pathogen was the right response.

      as someone who has worn mopp/hazmat/scba outfits in live situations I hope your training classes don’t miss the point as much as you just did.
      that one patient was immaterial to the situation as a whole no matter how much you now want to fixate on him.
      the scenario is unfolding exactly as commentators said it would.
      own it.

It’s worse than a name change. Non Africans have no history of exposure to this virus. We are as susceptible as Native Americans were to measles and smallpox in the 1500s.

Administration liars with credentials or just a portfolio have said that travel restrictions would not work but make things worse. No reporter asks them to explain how or why it would make things worse. Fools like me would like to know.

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