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This is what happens when you treat Ebola like a JV virus

This is what happens when you treat Ebola like a JV virus

Lack of concern, until it was upon us. Just like ISIS.

News has spread on social media that a second Dallas nurse known to be infected with the Ebola virus took a flight to Cleveland while experiencing a low grade fever—an early symptom of the disease.

It turns out that the Centers for Disease Control and Prevention rules lead Amber Vinson to continue with her travel plans.

According to the government spokesperson, when Vinson called in, the staff she talked with looked on the CDC website for guidance. At the time, the category for “uncertain risk” had guidance saying that a person could fly commercially if they did not meet the threshold of a temperature of 100.4

So, she did.

This situation underscores the biggest failure of the current response to the American Ebola situation: People are desperately clutching to the “it’s not easily transmissible” mantra. The problem is that Ebola’s origins, modes of transmission, and rate of infection are not completely understood.

Ebola is listed as a Class 4 Pathogen, per the CDC’s own site:

LI #15 c

Two of the most common bloodborne pathogens with which most people are familiar are the Hepatitis B Virus (which can sometimes cause fatal liver damage) and HIV (which leads to AIDS). Hepatis B Virus is a Class 2 pathogen, and HIV rates as a Class 3. Good precautions have been developed over the years to successfully protect healthcare workers from contracting these diseases.

Yet, it seems the style of training and nature of protection was not changed when dealing with the higher risks associated with Ebola when it was first encountered in Dallas. A review of the allegations of the nurses union regarding the treatment of America’s Patient Zero, Thomas Duncan, demonstrates the problems with this approach:

Claim: The nurses’ protective gear left their necks exposed

After expressing concerns that their necks were exposed even as they wore protective gear, the nurses were told to wrap their necks with medical tape, the union says.

“They were told to use medical tape and had to use four to five pieces of medical tape wound around their neck. The nurses have expressed a lot of concern about how difficult it is to remove the tape from their neck,” Burger said.

Claim: Nurses got no ‘hands-on’ training

“There was no mandate for nurses to attend training,” Burger said, though they did receive an e-mail about a hospital seminar on Ebola.

“This was treated like hundreds of other seminars that were routinely offered to staff,” she said.

The nurses have every right to be worried. Ebola has already claimed the lives of over 200 doctors, nurses, and healthcare workers since June; and while close contact with bodily fluids is the likeliest mode of transmission, aerosols of bodily fluids count — especially if such sprays hit the eyes, mouth, or cuts/abrasions on skin.

The highly respected Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota just advised the U.S. Centers for Disease Control (CDC) and World Health Organization (WHO) that “there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles,” including exhaled breath.

CIDRAP is warning that surgical facemasks do not prevent transmission of Ebola, and healthcare professionals (HCP) must immediately be outfitted with full-hooded protective gear and powered air-purifying respirators.

As proof that more protective gear is needed for worker safety, this ABC News Video catches a glimpse of the transfer of Vinson to a flight to Atlanta for treatment at Emory Hospital, which has the containment areas necessary for Ebola-infected patients.

American video journalist Ashoka Mukpo, who was stricken with Ebola while on assignment for NBC in Liberia, is currently being treated for the virus at a hospital in Nebraska. He will receive blood transfusions from a doctor who survived Ebola, and a recent tweet indicates he is recovering. Meanwhile, his colleague broke her voluntary quarantine to go out to a New Jersey restaurant for soup.

The New Jersey Health Department issued a mandatory quarantine after NBC reporter Dr. Nancy Snyderman was reportedly seen getting takeout at a Hopewell eatery.

President Obama tried to allay the increasingly nervous American public by offering himself as an example:

“I want to use myself as an example so people have a sense of the science here. I shook hands with, hugged and kissed – not the doctors – but a couple of the nurses at Emory because of the valiant work that they did in treating one of the patients. They followed the protocols, they knew what they were doing and I felt perfectly safe doing so. This is not a situation like the flu where the risks of a rapid spread of the disease are imminent.”

Yes, the nurses at Emory Hospital have the proper training and equipment, so he will probably be just fine. However, there are many passengers who were exposed to Vinson during her flight that have reasonable cause to be concerned.

Ebola is not a JV virus. Rapid, aggressive response and mandatory quarantines must be given serious consideration — both here and abroad.

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Comments

From the CDC’s own website a month ago (reported by Gateway Pundit, as I recall – I have a screen shot of it).

“Because we still do not know exactly how people are infected with Ebola, few primary prevention measures have been established and no vaccine exists”.

They’ve since scrubbed that entry.

Its FAR more contagious than HIV, and HIV/AIDS has killed over 30 million so far, with over 35 million currently infected.

Ebola you can get just from contact with the bodily fluid of someone infected – if they sneeze or cough and any droplets touch you, or you touch their sweat, and it may even be airborne (contrary to CDC claims).

I keep seeing Leftists comparing it to the flu or the common cold, which of course are far more contagious but don’t have the >70% mortality rate.

But, it seems to me the HIV comparison is far more apt.

    DINORightMarie in reply to Aarradin. | October 16, 2014 at 8:36 am

    I keep seeing Leftists comparing it to the flu or the common cold, which of course are far more contagious but don’t have the >70% mortality rate.

    Nope!! Ebola is indeed MUCH more contagious than either a cold or a flu virus. We haven’t had it here till now; so, now that it’s here, in Dallas (and perhaps other places, soon), we can see Ebola is MUCH more easily transmitted than either a flu or cold virus.

    That these two women already have gotten it without anyone knowing HOW……yeah, much more contagious than a cold, or the flu.

    BTW – we don’t require HazMat gear for heath care workers treating patients with either the cold or a flu virus………because simple hand washing and common-sense hygiene habits take care of the risk of transmission – because they BOTH are less easily “caught” than Ebola.

      “Nope!! Ebola is indeed MUCH more contagious than either a cold or a flu virus. “

      Cite?

        See NPR or Forbes for articles on contagion rates. Ebola is SAID NOW to be be slightly less contagious than HIV. Michael Doucleff at NPR (02 October 2014) writes the following “Even in the current epidemic in West Africa, where the virus has been out of control, each person who has gotten sick has spread Ebola to only about two others, on average.”

        Yet, how accurate is that data? The situation on the ground there is somewhat unstable and chaotic, and the authorities there have already claimed that they fear serious underreporting. Changes in human habits of movement and easier supplies of money (real and electronic forms)) in those poor nations, improved transportation systems have increased commerce and commerce means contact.

          creeper in reply to bvw. | October 16, 2014 at 10:11 am

          The data we’re getting out of Africa is no more reliable than what we get out of Washington. Underreporting is a serious problem.

          Though I am unable to find a link, I read an interview with an African health care worker last week. He said that the hospital he works in reports no cases of Ebola but that he personally knew of ten people who had died there of the disease.

          Here’s a little more on under-reporting.

          http://www.voanews.com/content/un-health-worker-dies-of-ebola/2482999.html

        Follow on, re the Forbes article by Dan Diamond: He’s wrong about the death rate of 50%, that’s under what is being reported elsewhere of 70%-80%. WHO just reported 70%.

        Also I seem to remember seeing some report that the incubation interval varies. Dan says the max period is 21 days. Yet another article at Forbes by Jon Fortenbury reports: “Dr. Charles Haas pointed out that between 0.1 and 12 percent of the time, the incubation period for someone infected with Ebola was longer than 21 days. The 0.1 figure comes from the 1976 Ebola outbreak in Zaire.”

        On ebola, there are few certainties right now.

        All I was looking for was scientific/medical evidence supporting the claim that

        “Ebola is indeed MUCH more contagious than either a cold or a flu virus.”

        If there is evidence that that claim is true, I’m happy to accept it. I’m not one of those “look away – nothing to see here” Obama administration types. But I would like to see a source for the claim Ms DINORightMarie makes. It’s not really an outrageous ask, is it?

          Ebola is less contagious than cold or flu.

          It is more deadly than a colds and most strains of flu, though. That is why it is so concerning.

          It is more contagious than HIV, but HIV can live in an unsymptomatic host for longer, leading to more potential transmissions. Higher Ro factor.

          Ebola doesn’t wait on scholarship or peer-reviewed studies, ma’am.

      DINORightMarie: BTW – we don’t require HazMat gear for heath care workers treating patients with either the cold or a flu virus………because simple hand washing and common-sense hygiene habits take care of the risk of transmission – because they BOTH are less easily “caught” than Ebola.

      The R0 (basic reproduction number) for influenza is 2-3, while less than two for Ebola. Influenza is easily transmitted by air, while Ebola requires exposure to body fluids. Also, there is very low risk of transmission when Ebola is asymptomatic. That means it is feasible to drive the R0 for Ebola to zero through isolation. The danger at this point in the U.S. is to health-care professionals, but that problem is amenable to a technological solution.

      We don’t require HazMat for influenza because there is an effective vaccine, medical masks along with hand-washing can stop the virus, and mortality per infection is much lower than Ebola. Nonetheless, tens-of-thousands die from influenza every year in the U.S.

        It’s likely that ebola can be transmitted by air, and it is certain that we are not sure of all of the transmission methods yet. “By air” may be a very ineffectual means of any transmission of ebola, but it can’t be excluded now.

          bvw: It’s likely that ebola can be transmitted by air

          Ebola has been around for quite some time, and medical scientists have some experience with the disease. While there is always the possibility, do you have actual evidence for your claim?

          Fen in reply to bvw. | October 16, 2014 at 12:07 pm

          I’ve read the same studies, and I think you are confusing aeroslized with airborne – they are not the same thing.

          I think your claim about it being as easy to catch as the flu or cold is unfounded. Else, there would be many many more infections showing up by now.

          I agree with your points that we don’t really know how easily it can be spread. But I would caution you to be more skeptical, else your other good points will be dismissed as alarmist.

          Henry Hawkins in reply to bvw. | October 16, 2014 at 1:14 pm

          Ebola viri mutate upon transmission and an airborne version, if not already extant, is quite possible.

          The bottom line is this: if you don’t know the exact infection vectors of a given viral strain, you proceed with ‘worst case’ assumptions guiding your practice.

          bvw in reply to bvw. | October 16, 2014 at 4:13 pm

          Henry Hawkins makes the best point in reply to my statement.

          And, there’s another point I haven’t seen mentioned in the media coverage. In Africa the source well of the virus is small mammals as I understand. What if it jumps to small mammals on other continents?

          bvw in reply to bvw. | October 16, 2014 at 4:19 pm

          Ebola variant may have been transmitted by air:
          “Transmission of Ebola virus from pigs to non-human primates”
          Scientific Reports 2, Article number: 811
          Published 15 November 2012

          bvw: Ebola variant may have been transmitted by air

          Ebola is a primarily a respiratory ailment in pigs, which are also very efficient at generating large aerosol droplets. According the Kobinger, one of authors of the study, “Ebola is not suddenly an airborne virus, like influenza.”

      Technical people make the distinction between “contagious” and “infectious.” It IS less contagious than the flu, in part because flu both causes coughing and sneezing and is truly “airborne” — that is, it floats, and for very long distances. Ebola is not “airborne” although it can be contained in very small droplets that are propelled when, for example, somebody vomits or diarrhea is flushed. Ebola is, however, infectious as it gets, with only one to ten viral copies needed to cause disease in a new host.

      Normal people do not care about the distinctions among these terms, and they have a point.

        Actually, infectious refers to any disease that can be transmitted; contagious refers to person-to-person transmission.

        “People can be infected with dangerous diseases in a number of ways. Some germs, like those causing malaria, are passed to humans by animals. Other germs, like those that cause botulism, are carried to people by contaminated food or water. Still others, like the ones causing measles, are passed directly from person to person. These diseases are called ‘contagious’.”
        http://www.bt.cdc.gov/preparedness/quarantine/

        inspectorudy in reply to Valerie. | October 16, 2014 at 2:28 pm

        I am not trying to be argumentative but if someone with Ebola sneezes in you face along with the millions of droplets that accompany any sneeze why would that not carry the Ebola virus? The Center for Infectious Disease says that it is possible to transmit Ebola via a cough or sneeze. One thing that I do not like is for people like Shepard Smith getting on his high horse and telling everyone to not be worried or to be alarmed. He is reading a teleprompter just like Obama. We also have Friedan telling us that we can’t get Ebola on a bus and then says that if you have Ebola you can transmit on a bus.

This may make many liberals actually think now that it’s a life or death situation directly affecting them. Of course many others will die with “It was Bush’s fault” on their lips.

    DINORightMarie in reply to gasper. | October 16, 2014 at 8:41 am

    They won’t care till it’s them – or a close family member/friend – who is affected.

    Then they will scream that the government needs to come and take care of it….NOW NOW NOW!!! As they panic, screech, and have a nervous breakdown.

    Then, when some selfless Christian (or other good Samaritan) comes and helps them, they will complain, and then conveniently forget that it was these people, not the government, where were there when their need was greatest.

    Self-centered ingrates, fear-filled, government-loving lemmings, all –> that is who the leftists are.

DINORightMarie | October 16, 2014 at 8:29 am

This is not a situation like the flu where the risks of a rapid spread of the disease are imminent.

WHAT?!?! THIS MAN IS DANGEROUS!!! WHAT AN IDIOT TO SAY EBOLA ISN’T AS “IMMINENT” OR AS HIGH A RISK OF “RAPID SPREAD” AS THE FLU!!!!

Everyone is focusing on several bits in this idiotic taped speech of O’s yesterday, but no one is remarking on this INCREDIBLY FOOLISH, DECEIVING statement. Calling it naive does not even come close!!

Ebola is NOTHING like a “flu” – it is exponentially WORSE!!

That this man is the Commander in Chief, the so-called leader of this nation and the free world……..we all should be in DC with pitch forks demanding he resign! Then, since he’s so inclined to help the “little people,” let him go to West Africa – see how “safe” he feels then!! Or Dallas – my guess is they’d run him out of town on a rail!!!

(Of course, we know for him it is “just words” – he does not have the courage to DO anything heroic, to act in a way that shows he cares AT ALL for the life of ANY other human, besides himself!! /end rant )

Yes, Ebola is easier to transmit than HIV. However, what is interesting to note is how unlike HIV, all scientific medical indications are that a vaccine for Ebola should be achievable. The fact that there is currently no vaccine developed for Ebola is a reflection of the impact of the anti-vaccine scandals and the risk averse nature of our current culture. Vaccines represent enormous investment and the barriers to developing such vaccines are enormous. As a society we have to assess our zero risk mentality.

    tencz65 in reply to RuthC. | October 16, 2014 at 8:59 am

    As a society we have to assess our zero risk mentality.

    WE did re-assess and the majority wanted the anti-developing culture of ‘ObamaCare .’ enough said on our Fraud of a president !!

I think we have to assess firing everybody at the top level of CDC…

http://michellemalkin.com/?p=160424
Great: Nurse later diagnosed with Ebola flew because CDC told her it was OK despite low-grade fever

This is idiotville, being played with a really BAD viral plague.

Interesting that with the facts before us you come to the conclusion that this is incompetence and I see it as pure malice.

I think we need a nurse to head the CDC instead of the hand-waving egghead we have. There is such a thing as a doctoral level nurse, and it is nurses that actually take care of patients.

I believe we have the means to stop this developing epidemic cold, just as CDC Director “Dr.” Thomas Frieden, and President Obama, have said. What we do not have from either man is any action reasonably calculated to head off the epidemic.

The President had business to issue executive orders triggering reasonable containment measures at our borders, weeks ago, perhaps something along the lines of the measures successfully taken by the countries bordering on Liberia, Sierra Leone and Guinea. Yes, it would be necessary to narrowly tailor the orders to reduce the economic impact on those and other countries, and to allow aid to flow in. Further, provisions for voluntary isolation by returning Americans (like a couple of the doctors did) enforceable by court order (against the reporter who claims to be a doctor) are fully feasible.

We know how to craft narrow executive orders, or at least past administrations did. I am sure the present administration could find someone who still knows how to do this.

In the absence of a President who knows how to take action, and with one who does not know how to appoint a person capable of taking action, it may be necessary to publicly point out that we need a person who understands physical procedure and patient care at the operative level. That would be a nurse.

Good nursing is critical to turning back this epidemic, not to mention preserving the lives of our medical people. Good nursing is not necessarily the product of academic degrees in laboratory work. The Red Cross, as I recall, was established by a nurse who refused to follow the lax standards set by doctors of the day, thereby saving the lives of many wounded in the Civil War.

If the President will not do it, if the CDC cannot be led by a competent person, then it is incumbent on the States to to protect their citizens by appointing nurses to oversee their individual efforts.

If you ask me the CDC puke that answered the phone should be brought up on multiple charges of reckless endangerment, and if anyone exposed as a result dies, Manslaughter as well. same with Vinson, she was an acute care nurse who knew the was potentially infected and was beginning to show signs of infection, she KNEW she shouldn’t be flying. she knew it enough to look to the CDC for permission to fly to release her from her own responsibility. Sorry, if she survives she needs to stand trial as well.

I have heard people claim that both Obama and the CDC are incompetent and have underestimated the risks of Ebola in the USA. I don’t believe anyone is really that stupid. Ask yourself what you would do if you purposefully wanted a epidemic here and then ask yourself if that is a better explanation than “incompetence”.
The biggest mistake we make is assuming that everybody has good intentions like we have. We have trouble imagining that such evil people could be running our Government and it’s institutions.

Noblesse Oblige | October 16, 2014 at 10:50 am

The first thing that needs to be done is to fire Frieden and get someone in there who knows what he or she is doing and knows how to manage a large center. The second step is to implement immediate travel restrictions to and from afflicted areas. The third thing that needs to be done is to disperse needed personnel and full equipment per CIDRAP recommendations to hospitals and clinics across the country.

You can bet that none of this will be done. The central government will do what failed governments always do: more of what has not worked.

Now that Americans have caught the ebola fever, Obama’s cure is more cowbell

One congressman on FOX said he’d spoken with the CDC head about stopping visitors from the Ebola stricken countries. Frieden’s argument included not wanting to harm the young economy of Liberia. So the CDC guy is out there pushing Democrat talking points.

But the hysteria over Ebola in the US is already costing (probably) billions, as all sorts of activities are curtailed, schools are canceling classes, and family of people that return from Liberia (with no Ebola exposure) are put on leave. Maybe our economy is important too.

    Ragspierre in reply to Midwest Rhino. | October 16, 2014 at 11:37 am

    The man has tested positive for one of the most DEADLY diseases known to man; Collectivist “thinking”.

    It is a form of dementia, and has killed tens of millions of people in just the last century.

    He needs to be quarantined FAR from the levers of power.

The “under 100.4” protocols for letting this second nurse fly MAY turn out to have been reasonable. But now they have to be changed because of the mass hysteria that will follow, even when exposure risk is near zero. That should have been anticipated.

Patient zero felt sick two days before his first hospital visit. Then he spent two days with his family AFTER going to the hospital the first time. Then the family were kept (as guinea pigs I guess?) IN the contaminated apartment for days more after he was admitted (iirc), before they removed and incinerated the bio-hazard waste (at great expense), and finally moved the family.

September 20: The patient arrives in the United States
September 24: Patient shows first symptoms of Ebola
September 26: Patient seeks initial medical care
September 28: Patient admitted to THP Hospital Dallas
Oct. 2 — Members of the family with whom Duncan was staying are confined to their home under armed guard.

None of Duncan’s family, nor the unmasked pressure washer guy that played in the Ebola puke, contracted Ebola, as far as I know (yet). So infected nurse #2 may not even now, be “contagious”, considering how long Duncan was sick, while close to his family.

But airlines and hospitals have to deal with the hysteria and potential lawsuits. And nurses need training and supplies for Ebola protocol, if Obama is going to spread Ebola around out of fairness or something. CDC proposed some shovel ready prevention steps, which Obama rejected in favor of shoveling billions to his unions and donors in Solyndra style fiascoes.

http://www.washingtontimes.com/news/2014/oct/15/cdc-outbreak-prevention-advice-dismissed-by-obama-/

Orwellian PC Religion has infected all branches of government, killing healthy cells, growing the PC “commie cancer”. Incompetence mixed with ego has spread like Dustin Hoffman’s contagion, as allegiance to the Obama Doctrine (fundamental transformation) is top priority. THAT is the real “pandemic”, with Hollywood and MSM the main carriers.

    “The ‘under 100.4’ protocols for letting this second nurse fly MAY turn out to have been reasonable.”

    I don’t see how

    1) If I board a nonstop flight from Cleveland to Dallas (2 1/2 hours) with a 99.4 fever, what are the odds that fever will increase on board the flight during those 150 minutes?

    2) We don’t know with 100% certainty that patients are not contagious below a 100.4 temp

    3) We don’t know what her baseline temp is. Some people run hot, others cold. 99.4 for her could be the same as 100.4 for you.

    4) There is a lag time between when you are shedding the virus and when you *detect* you are shedding the virus

    And the kicker

    5) A small portion of those infected (less than 3%) shed the virus without showing any symptoms at all.

      Midwest Rhino in reply to Fen. | October 16, 2014 at 1:39 pm

      Well, there is experience with Ebola, and those standards probably predate the Obama incompetent regime. I’d think they figured in the margins for error, then subtracted two days to be extra safe.

      And as I tried to point out, look at the folks that were in close contact with Duncan. I’m supposing he was over 100.4 from the day after he showed symptoms.

      But they should change standards for people known to have been in contact with Ebola, for hysteria’s sake if nothing else.

      My point is, there are real scientists out there, and only two workers that were poorly trained have caught Ebola (so far). But the country is in hysteria mode, partly due to Obama lying to us about every damn thing, partly due to instant internet news. Our “open borders protocol” is a real threat though, in the event of a third world contagion.

      If ten people from this nurse’s plane catch Ebola, then the 100.4 standard is out the window. So far the Dallas data we have shows, people can live with Ebola up to puking stage and still not get it, even when held in the victim’s contaminated home for a extra week.

      SARS would be another story, and at least the hysteria MAY disseminate some protocols to hospitals and the general public. But “paranoia will destroy ya” 🙂

Also, on Sept 4, patient zero quit his Fedex job in Liberia to “visit” the US. Any number of motives could have been at play, but the fact that he ended up at a US hospital where he eventually received extensive care is an important fact. He would be unlikely to get that level of care in Liberia. He wasn’t a bad person for doing that – just a desperate person, doing what it takes to survive. Wouldn’t anyone? How many other people in the ebola “hot zone” will see that as an example and find their way here? Who would blame them? How will we handle it?

    Ragspierre in reply to billdyszel. | October 16, 2014 at 12:31 pm

    One thing to bear in mind is the time it takes to get a visa to enter the U.S.

    That alone seems to make his trip here more serendipity than anything else.

Henry Hawkins | October 16, 2014 at 1:18 pm

Reagan faced wolves the minute they eyeballed the property line. Bush faced wolves when they crept onto our porch. Obama is out playing golf while wolves rampage through our kitchen.

True, I don’t know what the visa process takes. And we can probably moderate travel through that process with some success.

    Ragspierre in reply to billdyszel. | October 16, 2014 at 1:59 pm

    Right. I can see no valid reason that the processing period for a visa cannot be collaterally an isolation period for Ebola.

    Seems no great price to impose for entry into this nation.

Ebola spreads slower, kills more than other diseases

This simulation shows how quickly 10 diseases, from more fatal to less fatal, could spread from one person to 100 unvaccinated people.

Just FYI.

    wow, that simulation is extremely misleading!

    Ebola has an R0 of less than two. The disease normally can’t spread unless the person is symptomatic. Victims become immobile quickly. That means it is relatively easy to reduce R0 to less than one.

      Ragspierre in reply to Zachriel. | October 17, 2014 at 9:32 am

      Disease fighters reckon the contagious potential of an outbreak in terms of its RO, or reproduction number. (RO 1 means that each infected person is statistically likely to infect one more person, so the epidemic will neither grow, nor shrink in size. RO 0 signifies that the disease cannot be passed from person to person. Any RO above 1 connotes an expanding epidemic.) Christian Althaus of the University of Bern in Switzerland just released a grim new calculation of the RO for this epidemic that finds that when the outbreak began in Guinea, it was RO 1.5, so each person infected one and a half other people, for a moderate rate of epidemic growth. But by early July, the RO in Sierra Leone was a hideous 2.53, so the epidemic was more than doubling in size with each round of transmission. Today in Liberia, the virus is spreading so rapidly that no RO has been computed. Back in the spring, however, when matters were conceivably controllable, Liberia’s then-small rural outbreak was 1.59.

      The International Society for Infectious Diseases operates a disease notification system called ProMED-mail, which on Friday noted that the spread of the epidemic is suddenly accelerating. From March to July 17, the first 1,000 cases accumulated over four and a half months. The toll reached 2,000 after just one month, on Aug. 13, and then jumped to 3,000 just 13 days later, on Aug. 26. If this trend continues the epidemic could well reach the WHO’s projected 20,000 cases by October. In extensive conversations with MSF and U.N.-associated responders in the countries it is clear that the WHO’s official case reports, which solely reflect lab-confirmed patients who have sought care in medical facilities, under-represents the true toll by at least half, as families are keeping their sick at home and shunning health facilities.

      Read more here: http://www.thenewstribune.com/2014/09/09/3370242/public-health-officials-knew-ebola.html#storylink=cpy

        Ragspierre: Christian Althaus of the University of Bern in Switzerland just released a grim new calculation of the RO for this epidemic that finds that when the outbreak began in Guinea, it was RO 1.5, so each person infected one and a half other people, for a moderate rate of epidemic growth. But by early July, the RO in Sierra Leone was a hideous 2.53, so the epidemic was more than doubling in size with each round of transmission.

        That’s a bit garbled. While the R0 in Sierra Leone reached 2.53, it was reduced to about 1.0 by July. As for Liberia, the study indicates no decline from 1.59 as of August.

        Althaus, Estimating the Reproduction Number of Ebola Virus (EBOV) During the 2014 Outbreak in West Africa, PLOS Current Outbreaks September 2014.

LibraryGryffon | October 17, 2014 at 11:31 am

I’ve recently seen reference to a NEJM article where they discuss the incubation period. While 21 days is accurate for most, they said that over 12% of people who developed Ebola had had longer incubation times.

The author suggested that a 31 day quarantine period would be more accurate, and that even then, it might not catch all cases.

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