The scariest thing about the Ebola in Dallas? The infected person had symptoms for 4 days before

[boomer55]

being admitted to the hospital and at one time was waiting for awhile in the emergency room.

The person became sick Sept. 24, and he sought care two days later. He was sent home but returned to a hospital and was admitted Sept. 28.

How many people did he come in contact with? How many people did the now quarantined ambulance crew come in contact with?

http://www.nbcdfw.com/news/health/Case-of-Ebola-Confirmed-in-the-US-CDC-277648611.html?_osource=SocialFlowTwt_DFWBrand

[Control-Z]

1. So what is being asked is how many people rubbed their nose

up against his runny nose, kissed him or had sex with him while waiting in the ER but don't remember? Or exactly who and how many swaped bodily fluids with him in any other imaginable way?

That really is scary.

[Generic Other]

2. If he sneezed into the air

fluid could be passed. Or if he sweat. Seems like there are lots of ways for this to spread. I'm just glad they have him in quarantine. Ebola is a horrific sounding illness.

[uppityperson]

3. If I skinned my knee and he rubbed his sweaty body on the abrasion, that might work.

Or if he sneezed juicily right into my face, but I don't recall the last time that has ever happened. And no, no one rubbed their sweaty body over my freshly abraded bloody knee.

This is a good reminder for me to get my annual flu shot.

[boomer55]

6. CDC says otherwise.

http://www.cdc.gov/vhf/ebola/transmission/qas.html?mobile=nocontent



ptoms of Ebola disease. Although coughing and sneezing are not common symptoms of Ebola, if a symptomatic patient with Ebola coughs or sneezes on someone, and saliva or mucus come into contact with that person’s eyes, nose or mouth, these fluids may transmit the disease.

[uppityperson]

18. As I said, sneezed jucily in my face. nt

[Control-Z]

19. Hence, bodily fluid exchange.

Completely different from airborn viruses. It would be the direct fluids on your face, nose, mouth, or the unfortunate open, gaping wound you might have on your brow that might infect you. When was the last time a stranger sneezed his mucus directly into your mouth or noise? Oh, never? That's what I thought. The only people to have ever done that to me were my children when they were very young. That is why families are the most at risk.

Please tell me you understand these differences?

[Generic Other]

73. At a school? Sneezes spread germs constantly

Sneezes are said to be rather forceful and the germs travel up to 15 feet or so as anyone in an enclosed area who has been sneezed on can attest.

I am not expecting to catch ebola from a wayward sneeze, but yes I have seen what happens when sneezes go airborne. Yuck.

[pipi_k]

74. Also...

Person coughs or sneezes into his hand, then touches doorknob or other surface, someone else comes along immediately and touches doorknob or surface, then gets an itchy nose or eye, and touches eye or nose with finger that has virus on it.

[Generic Other]

75. This thread makes me queasy

like I should bathe in Purell before going in public. Let's face it, we all have varying degrees of knowledge about protecting ourselves and others. If it weren't so, we would have far fewer cases of flu or colds. Some people use caution; others just infect.

[Jamastiene]

133. After might be better,

for the Purell bath. That way you won't spread it around your home.

[kestrel91316]

154. That's exactly how it happens. Easy peasy.

[liberalmuse]

57. If he used the restroom...

and did not thoroughly wash his hands (at the very least, 1 minute soaping up and rinsing with hot water - how many people do this?), and someone with a cut came in contact with the faucet handles or door handle, then I imagine they could get infected. Our bodily fluids are in more places than we'd like to think. He could have rubbed his eye or wiped his mouth with his hand and touched a chair handle or magazine. Some people are overreacting, but others are just as bad by suggesting you'd have to roll around in a bucket of an infected person's mucus before getting infected, when obviously this isn't true. Even doctors who have taken precautions have become infected, so it's not really out of line to worry that he may have infected others.

[uppityperson]

59. Which leads me to research how long the virus can live outside the body with answers....

http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php

(big clip)
SURVIVAL OUTSIDE HOST: Filoviruses have been reported capable to survive for weeks in blood and can also survive on contaminated surfaces, particularly at low temperatures (4°C) Footnote 52 Footnote 61. One study could not recover any Ebolavirus from experimentally contaminated surfaces (plastic, metal or glass) at room temperature Footnote 61. In another study, Ebolavirus dried onto glass, polymeric silicone rubber, or painted aluminum alloy is able to survive in the dark for several hours under ambient conditions (between 20 and 250C and 30–40% relative humidity) (amount of virus reduced to 37% after 15.4 hours), but is less stable than some other viral hemorrhagic fevers (Lassa) Footnote 53. When dried in tissue culture media onto glass and stored at 4 °C, Zaire ebolavirus survived for over 50 days Footnote 61. This information is based on experimental findings only and not based on observations in nature. This information is intended to be used to support local risk assessments in a laboratory setting.

A study on transmission of ebolavirus from fomites in an isolation ward concludes that the risk of transmission is low when recommended infection control guidelines for viral hemorrhagic fevers are followed Footnote 64. Infection control protocols included decontamination of floors with 0.5% bleach daily and decontamination of visibly contaminated surfaces with 0.05% bleach as necessary.
(clip)

SOURCES/SPECIMENS: Blood, serum, urine, respiratory and throat secretions, semen, and organs or their homogenates from human or animal hosts Footnote 1 Footnote 2 Footnote 53. Human or animal hosts, including non-human primates, may represent a further source of infection Footnote 54.

An interesting article that covers a lot, including that Canadian study which turns out may have had problems
http://www.npr.org/blogs/goatsandsoda/2014/09/12/346114454/how-do-you-catch-ebola-by-air-sweat-or-water

(clip)
Note: A study in 2012 showed infected pigs passed on the Ebola to monkeys without touching them. Besides the fact that people aren't pigs or monkeys, the lead author has pointed out it's possible the monkeys caught the virus when droplets from the pigs splashed into their cage during cleaning.
(clip)
The virus is most abundant in blood and diarrhea. In fact, a milliliter of blood typically carries about a million infectious particles. And in a controlled lab, just a small drop of blood from an infected monkey can be strong enough to kill a million of its companions, Schmaljohn says.

A CDC study in 2007 found that Ebola is shed through other bodily fluids during the illness, such as saliva, breast milk and semen. In most cases, these fluids were not visibly contaminated by blood, but they still contained the virus. That study didn't look at sweat, but another one suggested that Ebola could be passed on through sweat. Researchers suspect the amount of Ebola in these other fluids, like saliva and sweat, to be much lower.

(clip)
A drop of blood can remain contagious outside the body. And virus particles can survive for days or weeks, depending on the environment. Ultraviolet light, heat and exposure to oxygen gradually deactivate the virus, while cooler temperatures and humidity help keep it active.

[LeftyMom]

5. Ebola is not spread by aerosols (coughing, sneezing)

Direct contact with bodily fluids only. Which is why transmission is usually to family members, health care workers and burial crews.

[boomer55]

8. See above for cdc info on sneezing n coughing

[LeftyMom]

13. You're misreading that.

If somebody sneezes three seats over from you on the bus you're fine. If they sneeze directly in your face AND the sneeze somehow has blood or vomit in it AND it comes in contact with your mucus membranes, theoretically you could be infected.

Would you be? Almost certainly not. But it's theoretically possible.

Ebola is a viral disease that is not transmitted like the flu. Flu viruses infect the lungs of ill people, while Ebola infects tissues that line the intestines and blood vessels that underlie the skin.

Flu spreads when flu viruses leave lung cells and enter fluids in the respiratory tract, and can be expelled through coughs and sneezes. Those infectious particles can then be inhaled or swallowed and so transmit the flu to others.

Since Ebola viruses do not enter lung tissues, they cannot be transmitted through sneezing and coughing, but instead enter fluids that exit the body out of the intestines or, less so, through the skin, in sweat.

http://today.uconn.edu/blog/2014/08/west-africas-ebola-outbreak-a-look-at-the-facts/

Long story short: if you're not living with, caring for or burying sick people, you're almost certainly fine.

[LisaL]

14. How could he be misreading it when he quoted it directly from cdc?

I don't know who wrote this blog you are quoting, but methinks cdc is more credible.

[boomer55]

15. You need real information from credible sources like the WHO

People can be exposed to Ebola virus from direct physical contact with body fluids like blood, saliva, stool, urine, sweat etc. of an infected person and soiled linen used by a patient.


http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/epr-highlights/3648-frequently-asked-questions-on-ebola-hemorrhagic-fever.html

[LeftyMom]

16. Direct physical contact. Not sneezing. It's not aerosol transmissible and its's not in lung tissue.

Your very own quote contradicts what you're saying.

[boomer55]

17. Are you being obtuse on purpose?

Patient sneezes. Saliva from sneeze hits another person in the nose, eyes or mouth That person can contact Ebola. The cdc says it and the WHO says it.

[librechik]

38. i think you should volunteer to be sent to liberia, immediately. You know how to beat that virus!

n/t

[kestrel91316]

78. You seem unfamiliar with the concept of fomites, which can transmit ebola if contaminated by

infected bodily fluids.

[boomer55]

115. seriously? this is true?

[Aerows]

118. Kestrel's a vet

I have no doubt she is informed about disease and the way they spread. She doesn't bullshit like I suspect many in the CDC and WHO are doing to prevent panic.

[boomer55]

121. damn.....

[Aerows]

129. Fomite

A fomes (pronounced /ˈfoʊmiːz/) or fomite (/ˈfoʊmaɪt/) is any object or substance capable of carrying infectious organisms, such as germs or parasites, and hence transferring them from one individual to another. Skin cells, hair, clothing, and bedding are common hospital sources of contamination.

*My addition. I'm not certain how the transmission is occurring, though many attempt to say it hasn't gone airborne. I can believe that, but I think it is more highly transmissible than stated.

Just my .02

[kestrel91316]

150. Google: fomite(s).....................

we learned all about fomites and their role in infectious diseases waaaaaaaayyyy back when I was an undergrad studying MICROBIOLOGY. In 1976.

[Aerows]

125. Thanks for being an incredible source of knowledge

I truly think this could become a health care problem.

I try to keep everyone updated as well as I can, but you have far more medical knowledge and credentials that me.

[kestrel91316]

151. Thank you. I'm just trying to correct as much misinformation as possible.

Though it's a Herculean task.

[Kelvin Mace]

28. I am reading it quite plainly

Although coughing and sneezing are not common symptoms of Ebola, if a symptomatic patient with Ebola coughs or sneezes on someone, and saliva or mucus come into contact with that person’s eyes, nose or mouth, these fluids may transmit the disease.

Seems pretty straightforward to me. Transmission of the disease is possible by coughing and sneezing if "saliva or mucus come into contact with that person’s eyes, nose or mouth, these fluids may transmit the disease."

[grahamhgreen]

53. I concur.

[Mojorabbit]

136. I still am hoping they will get a handle on this thing in Africa. So many people have died.

Here for a photo the cdc took of the spray of a sneeze. http://www.livescience.com/7757-5-essential-swine-flu-survival-tips.html

[kestrel91316]

77. Ebola is spread by ALL bodily fluids:

The usual suspects - blood, urine, and feces.

But also - semen, saliva, tears, snot, and SWEAT.

Which is probably why Mr. Duncan caught it from that woman by picking her up and carrying her to the hospital. Pretty much endless possibilities for disaster.

[pnwmom]

132. It's more than theoretically possible. Step 1, someone forcefully sneezes

Step 2, infected droplets land on hand of nearby person. Step 3, that person rubs his nose or eyes.

And these viruses linger for hours, making step 3 definitely possible.

[pnwmom]

23. The scariest part is no one at the hospital followed procedure. He was supposed to have been asked

whether he had been traveling. And he wasn't.

http://www.democraticunderground.com/10025607692

[morningfog]

51. He was asked and he said he came from west Africa.

The nurse didn't pass it on or follow protocol.

[pnwmom]

131. How many people came into contact with his fluids in the ambulance

in the 2 days AFTER he was finally admitted to the hospital on the 28th -- until they finally took the ambulance out of service to clean it, and put the crew under observation?

[boomer55]

4. Pretty sure sneezing transmits it and it lives for awhile outside the host

[rainbow4321]

11. Which is why he is on 2 types of isolation

Both contact AND droplet. Droplet includes mask and usually goggles. Protects against cough, sneezes, etc from spreading the germs

Press conference today said he was on both.

[pnwmom]

24. But he was sent home with symptoms because no one asked him if he'd been traveling.

http://www.democraticunderground.com/10025607692

[kestrel91316]

79. They asked, he told, they proceeded to ignore him. Yup, best medical system in the world. Uh huh.

[boomer55]

22. sneezing video in slow motion....

http://www.discovery.com/tv-shows/mythbusters/videos/slow-motion-sneezes.htm

[Duer 157099]

7. Even if he managed to transmit it to people he was in contact with

it's highly unlikely that it was further passed on since it can only transmit when the person has symptoms, which presumably takes some days to exhibit. So, the ambulance workers may have been exposed, but they could not transmit it until they themselves started to show symptoms.

I suspect it will be a rather small group involved and everyone will be ok.

[pnwmom]

25. He was sent home WITH SYMPTOMS, so he had at least two days of possibly transmitting it

after the symptoms developed.

http://www.democraticunderground.com/10025607692

[Duer 157099]

30. I understand that

What I was trying to say was that the people he may have exposed and infected--that THEY would not be able to transmit it until THEY showed symptoms.

[pnwmom]

32. Now they're saying he may have infected 12 - 18 people -- because the stupid hospital screwed up.

And this was a large Dallas hospital. Hopefully we'll only need one wake-up call.

[deutsey]

58. Wow. I haven't seen that 12-18 figure

I'm not challenging you, but I'm just curious to learn more: do you have a linK, please?

[pnwmom]

61. It's in most of the articles by now, but here:

http://www.nytimes.com/2014/10/02/us/after-ebola-case-in-dallas-health-officials-seek-those-who-had-contact-with-patient.html?_r=0

Health officials in Dallas said Wednesday that they believed Mr. Duncan came in contact with at least 12 to 18 people when he was experiencing symptoms. So far, none has been confirmed infected.

SNIP

The five children who had contact with Mr. Duncan are being kept home from school, according to David Daigle, a spokesman for the federal Centers for Disease Control and Prevention team that is working with local health officials to trace the contacts. Adults without symptoms do not have to stay home or be quarantined, but will be visited once a day for 21 days by health teams to have their temperatures taken and be checked for signs of illness. The first round of visits to contacts took place on Wednesday afternoon, Mr. Daigle said.

[deutsey]

62. Thanks. The only number I had heard was for the children

[uppityperson]

64. They aren't confirmed infected since are in incubation period and testing won't show anything.

It is good they are following up on monitoring all those people, best wishes to Mr Duncan in his recovery.

[pnwmom]

140. Correct. They were exposed -- so only possibly infected. Hopefully no one was. n/t

[Sancho]

139. Cdc on tv said transmission was

2 to 20 days after infection. In theory, he could have infected kids and others who could have passed it on and it has not showed up yet. For example, a kid was contracted it the day before he went to the hospital might have been infected a couple days before he was diagnosed. That child had time in school for incubation to occur (2 days) and spread it.

[uppityperson]

141. If none of the kids have symptoms, they would not have exposed anyone else yet. Only after showing

symptoms do you become contagious. And as far as I have read, none of the kids have shown symptoms.

In theory you are right, it COULD have happened, which is why that hospital emergency department needs to have their butts dragged over the coals.

[Sancho]

147. Yea...on CNN they tried to pin the doctor from CDC down on exactly WHEN you could pass it on...

some people start with milder symptoms (at least for a few hours), but are contagious. He said even someone in the "early stage" of development could have enough virus to transmit it. He said an infected person had been documented anytime between 2 and 20 days! Apparently, the onset of symptoms varies widely from person to person.

I was thinking of all the years my wife and I caught things from school children.

I heard on the radio they were looking for about 80 people he had contact with from the time he was first discharged. Apparently, his kids also had visitors in the home! I'm sure the EMT's etc. are going to spend three weeks isolated.

[kestrel91316]

156. Speaking as a veterinarian with a microbiology degree, out of an abundance of caution,

personally i would consider any exposed person with the slightest elevated temperature to be shedding ebola virus like there's no tomorrow.

But that's just me. And my extreme caution saved me and 21 other people from rabies once.

[grahamhgreen]

60. I don't think our for profit health care gives a sht.

[deutsey]

63. I think that's the weakest link in our system, right there

Everyone's heads are so far up their bottom lines, I'm concerned they won't notice a real crisis until it's too late.

[kestrel91316]

80. He had FOUR days to spread it - Sep 24-28.

[lunasun]

109. I heard an intake nurse did not relay to the drs. the fact there was recent travel to Liberia though

told.
Clearly the hospital workers were not educated re Ebola and recent travel was not discussed with the full team diagnosing him.
American hospitals are not in a heads up mode about this but it really has happened here as we see....

http://www.boston.com/health/2014/10/01/ebola-case-stokes-concerns-for-liberians-dallas/WNPf889Gx9riLBD6K5DaAL/story.html
"But the diagnosis, and the hospital’s slip-up, highlighted the wider threat of Ebola, even in places far from West Africa.

‘‘The scrutiny just needs to be higher now,’’ said Dr. Rade Vukmir, a spokesman for the American College of Emergency Physicians."
..................

[pnwmom]

111. And the irony is the hospital had just had a training session about Ebola. Apparently it didn't work

[lunasun]

114. Oh that I did not know. Only takes one brain dead ER employee to set unaware Ebola out

on the street in a major city I guess.

[boomer55]

9. Also the cdc says the virus has a long shelf life outside the host

Ebola on dried on surfaces such as doorknobs and countertops can survive for several hours; however, virus in body fluids (such as blood) can survive up to several days at room temperature.

[kestrel91316]

81. OH SHIT. I was wondering about that and that is very bad news. Do you have the link? SHIT.

[Aerows]

91. And people that get well from it

remain contagious for up to seven weeks.

People are infectious as long as their blood and secretions contain the virus. For this reason, infected patients receive close monitoring from medical professionals and receive laboratory tests to ensure the virus is no longer circulating in their systems before they return home. When the medical professionals determine it is okay for the patient to return home, they are no longer infectious and cannot infect anyone else in their communities. Men who have recovered from the illness can still spread the virus to their partner through their semen for up to 7 weeks after recovery. For this reason, it is important for men to avoid sexual intercourse for at least 7 weeks after recovery or to wear condoms if having sexual intercourse during 7 weeks after recovery.

http://www.who.int/csr/disease/ebola/faq-ebola/en/

[kestrel91316]

92. Well fuckety fuck. I had heard THREE MONTHS for the sperm but I didn't hear about the vaginal fluids

Good. Just great. People survive to become Typhoid Marys.

[Aerows]

93. The thing is

that it seems the health care associations are trying to downplay the contagion of the virus to prevent panic. I understand that, and that a mass panic could end up worse than what they are trying to prevent. On the other hand, downplaying the virulency leads to people not realizing how infectious it is and can give people a false sense of security.

It's a mess.

[kestrel91316]

95. I cringe when I hear the head of the CDC saying it can't happen here. LIKE HELL IT CAN'T.

That sort of magical thinking and hubris can be deadly.

[Aerows]

98. I know.

It's here. There are likely other cases that will spring up. It is irresponsible to pretend this isn't a public health nightmare. Hell, handling the toxic waste from treating patients with it is a logistical nightmare.

http://www.reuters.com/article/2014/09/24/health-ebola-usa-hospitals-idUSL2N0RP00E20140924

[kestrel91316]

105. Yep. Absolutely horrifying.

[AverageJoe90]

106. It really couldn't happen here, not without shitloads of bad luck and incompetence, anyway.....

Unfortunately, I think many of us know that incompetence is a serious problem in our healthcare system.....which is why this happened.

[Aerows]

116. Unfortunately n/t

[AverageJoe90]

117. The good news is, it does seem that the CDC's trying to keep on top of things.

Thank goodness for that.

[Aerows]

119. AJ90, I have a rather bad feeling about the way

they have handled this. I know they are one of the foremost healthcare consultancies in the world, but consultants have a tendency to fail in execution (which is why they aren't fully practicing physicians to begin with, and are instead medical consultants).

They are indeed doctors, but it seems as though everyone is looking at this at the wrong end of the telescope.

[AverageJoe90]

120. "but it seems as though everyone is looking at this at the wrong end of the telescope." Could you...

try to explain this for me?

[Aerows]

122. Viewing things from a telescope

as though they couldn't happen here, instead of the up close of a microscope.

[AverageJoe90]

124. I think I see what you're getting at.

Well, TBH, I did say that a significant Ebola problem in the U.S. is extremely unlikely, and this is, so far, an opinion that is shared by most experts working on this as well.

It's just that with all the problems our private healthcare system has, that is one of the few things that makes it so it's not impossible. (And unfortunately, it IS a major problem.) Which is why I've personally advocated for the government to step up their involvement; the CDC does a good job, yes, but it just wouldn't hurt to go that extra mile; an ounce of prevention is worth a pound of cure, as the old saying goes.

[Aerows]

126. Oh, no doubt

and thank you for a well-reasoned comment. Our problem is our health care system. Are we prepared to deal with a multitude of patients infected with a disease that generates TONs of waste?

http://www.reuters.com/article/2014/09/24/health-ebola-usa-hospitals-idUSL2N0RP00E20140924

Many studies and assessments conclude we aren't.

[kestrel91316]

157. "The road to hell is paved with good intentions." As they say.

[AverageJoe90]

158. Not necessarily.

In this case, the "road to hell" would be paved, not by good intentions, but by poor preparation.

[kestrel91316]

153. Here's how it happens: scared exposed people like Duncan lying to airport screeners in Liberia to

onto plane; incompetent hospital staff violating every federal guideline they can think of; exposed contacts immediately ignoring advice and leaving their voluntary home isolation, forcing the health department to lower the boom by getting a court order for them to stay fucking put and posting a cop outside their door.

Lather, rinse, repeat. Instant godawful mess.

[AverageJoe90]

155. I *did* mention hospital incompetence, though, didn't I?

I'm still not convinced that an Ebola epidemic is all that likely in the States, though. Even Nigeria and Senegal have managed to get their problems under control.

[lunasun]

113. +1 exactly From the hedging Ebola would burn it self out at the beginning of it spreading

To the can't happen here or near where I live attitude now is all scary thinking

[uppityperson]

142. To be fair, I recall the CDC saying an outbreak like is occurring in WAfrica can't happen here, not

that there will not be ebola in the USA.

[boomer55]

102. dang didnt know that.

[Jamastiene]

135. We are screwn then.

How many men can make it 7 weeks without sex?

[boomer55]

101. here is one

http://www.reddit.com/r/askscience/comments/2cbvtl/how_long_can_ebola_live_outside_of_a_host/

[kestrel91316]

107. Thanks. And this response there is scary:

".....No wonder it spreads so quickly. Just to clarify, if someone in the early stages of ebola decides to get on a bus to get to the hospital, and they sneeze and touch a pole on the bus, the ebola virus is now on that pole and can be passed to anyone who touches it and then wipes their face for several days unless disinfected?....."

Hand >>>> eyes/nose/mouth is so very easy to do and extremely common.

This is why, if it comes to SoCal, I will CEASE using mass transit. It will be bike or walk or carpool with known healthy folks or don't go (I no longer have a car).

[seveneyes]

10. Did the patient tell the medics on the 26th he was just in the hot zone?

Somebody on the 26th was stupid, ignorant or negligent. Or worse.

[LisaL]

12. We don't know.

Hospital says they are investigating why he was sent home.
I agree somebody screwed up badly by sending Ebola patient home. Why he was send home, that is the question.

[pnwmom]

33. They didn't ask and he didn't tell. The hospital made a grave mistake. n/t

[kestrel91316]

82. Worse. They asked, he told, they ignored the significance.

[grahamhgreen]

20. I've been told it can be transmitted with sweat... Even a sweaty high five.

[Kelvin Mace]

29. Told by who?

Possible? Yes, in the same way it is possible I could be the next president. Probable? No.

Avoid high fiving sweaty people who don't feel well.

[BlindTiresias]

36. Probable, actually

It does no service to downplay this just as it does no service to become hysterical.

Ebola is in -all bodily fluids-

Ebola requires -a very low amount of virions to induce infection-

Touching an infected person's sweat is a huge risk. Touching an infected person's sweat that ends up in a microtear in the skin or a mucous membrane will infect you.

[Kelvin Mace]

39. Again, avoid close contact with sweaty sick people

You are FAR more likely to die of a heart attack, a stroke, being run down in the street, being shot or slipping in the bathroom than you are to die of Ebola.

Context.

[BlindTiresias]

40. I understand that

You were the one saying sweat was not a probable route of transmission.

[Kelvin Mace]

42. Getting ebola from a sweaty high five

is WAY down the list on the ways you get infected. So, possible? Yes. Probable? No.

[BlindTiresias]

49. Contact with sweat

Is not an improbable route of transmission as the first stages of the disease make people sweaty but still able to function. Arguably it is the first stages of infection that are more likely to allow people to infect others as when the really serious symptoms begin most people are down for the count and their ability to infect people other than caretakers or people within their close vicinity decreases.

[grahamhgreen]

52. True. In the event it is an epidemic locally, avoid bodily contact like high fives and handshakes...

Gyms, I imagine, would be somewhere to avoid.

I don't have stats on rate of infection from high fives. I would guess transmission is possible not probable, as you say.

[Kelvin Mace]

56. Handshakes are bad news

even when Ebola is not an issue.

[Avalux]

65. I surely hope you are being sarcastic. n/t

[kestrel91316]

85. The very second I hear of a contact being present in SoCal, let alone a confirmed case,

I will be instituting some behavior changes in my own life and some policy changes in my practice, particularly where clients are concerned.

[kestrel91316]

84. West Africans know otherwise. Really, this dangerous disinformation you are spreading must stop.

Ebola can spread via sweat. The consequences are likely to be fatal.

Handshaking is no longer practiced by anyone with half a brain in West Africa because of ebola.

[Kelvin Mace]

145. I give up

If you folks want to live in fear, be my guest.

[kestrel91316]

159. People who don't know a damned thing about virology and epidemiology but who go around giving

terrible advice on the internet are a menace to society.

Unless you have some university level or postgraduate expertise in this subject, you need to stop. You're going to get people killed.

[uppityperson]

148. "Handshaking is no longer practiced". Hugging and kissing is practiced as the cultural norm

Where did you get that "fact" about handshaking in W Africa?

[Aerows]

94. No, it isn't

if you have ANY break in your skin (and all of us have minor breaks in our skin) it can easily get transmitted by sweat.

I realize people are trying to downplay the virulence of Ebola, but if Doctors are getting it, as much as they know about using PPE, you have to question if many of the things that are "accepted" as fact about Ebola are true in this strain.

Would you bet your life on it?

[Kelvin Mace]

144. Again

The person must have Ebola, must be symptomatic, they you must have a sufficiently large break in your skin than then becomes contaminated.

Possible, yes. Probable, no.

[kestrel91316]

160. Microscopic breaks in the skin are sufficient for transmission of all microbial diseases I know of

that can infect via the skin.

Are you even aware that microbes are, um, microscopic??

It only takes between 1 and 10 Ebola virus particles to cause infection.

[grahamhgreen]

47. A producer for medical TV news who was investigating it. Note: it is believed that

this is only after the person is symptomatic.

[Kelvin Mace]

54. Not trying to rag on you

but again, reading the advisories from the World Health Organization and the Center for Disease Control indicate that is a highly improbable vector.

[kestrel91316]

86. Fever is s symptom. It's the first, and can start out looking like any other garden variety bug.

Underestimate this thing at your peril.

[grahamhgreen]

137. We'll find out in a few weeks how many people, if any, this guy infected....

[kestrel91316]

152. He lied to the Liberian screeners at the airport there. Then his family

apparently tried to disobey isolation instructions after about 5 minutes, so they served them with papers and now there's a cop at their door to stop such foolishness.

[kestrel91316]

83. CDC. Virus is found in all bodily fluids including sweat.

Oh, and in recovered males it is found in their semen for up to an additional THREE MONTHS.

[cali]

21. the most disturbing aspect of this story to me, is that he was sent home

what that says is the staff at the hospital wasn't well versed in protocols such as determining if this man had recently come from a part of the world where the infection is.

[logosoco]

27. ^^this^^^

I guess it is possible that he could have lied (I did watch the House MD series!).

When we got back on a road trip from St. Louis to Albuquerque, NM, my husband got real sick. He had a high fever and just wanted to sleep for three days. I finally made him go to the urgent care center. I explained to them several times where we had been, they did not seem interested. They finally just gave him a dx of urinary tract infection, even though he had none of the symptoms for that. I think it was easier for them to chalk it up to that, since he is older-ish.

I would think it would be helpful for them to figure out how he got it as well, if only to learn more about how it can or cannot spread.

[pnwmom]

34. He didn't lie. The hospital acknowledged they didn't ask. n/t

[logosoco]

43. Wow. It seems like that would be kind of standard.

When I think of the kinds of questions i have been asked under medical interactions, it seems like that would be important in trying to make a dx.

[pnwmom]

44. It's even worse. His sister says he told them he was visiting from Liberia when they asked for

his Social Security number.

[kestrel91316]

87. They did ask. he told. And then they ignored what he said.

[TorchTheWitch]

143. we know how he got it

He was renting a room in the home of locals. The 19 year old pregnant daughter became ill. She was turned away from the hospital's Ebola ward because they had no more room. She was taken back home in a taxi. Mr. Duncan helped to carry her back into the house by holding onto her legs while her brother carried her from her midsection and another person from her upper body. She died in the home that night. Her brother also died soon after. Other people that also were in contact with her fell ill.

Details here:
http://www.nytimes.com/2014/10/02/world/africa/ebola-victim-texas-thomas-eric-duncan.html

[grahamhgreen]

55. Yes, then was in contact with the general population for 4 days,

We will soon know how infectious this guy was.

[Control-Z]

76. The thing is,

if he felt sick enough to go to the hospital the first time, what are the odds he was out in contact with the general population after that rather than home in bed? His family would be the ones likely exposed.

[grahamhgreen]

138. I don't know, but I think he should release his name and GPS log.

[yeoman6987]

26. So you really think banning flight from those countries

At least until we can get some good procedures going is a bad idea? The more I hear the truth as it drips slowly out into the news, I am not so sure anymore. It was pocked fun of yesterday, but today hopefully some seriousness comes into the discussion.

[Kelvin Mace]

37. Context

Number of people who have died so far due to Ebola outbreak:

3,100 +/-

Number of people who die each year due to:

Malaria - 473,000-789,000
Flu - 250,000-500,000
Air pollution exposure - 7 million

http://www.who.int/mediacentre/factsheets/fs094/en/
http://www.who.int/mediacentre/factsheets/fs211/en/
http://www.who.int/mediacentre/news/releases/2014/air-pollution/en/

[kestrel91316]

88. None of those are increasing exponentially. Ebola is.

[AverageJoe90]

108. It's increasing, but not exponentially. Let's try to stay realistic here.....

[Kelvin Mace]

146. Well then, by all means

be afraid.

[uppityperson]

149. OMG OMG OMG OMGOMGOMGOGOMGOMGG!!!!!!!!!!!!!!!!!!!!111111111111111111111111111111

It is pretty amazing.

[magical thyme]

31. the ambulance crew will not have infected anybody

They were potentially exposed on the 28th. There is a minimum 2 day incubation period before symptoms appear. That takes you to the 30th, when the CDC confirmed the dx.

The hospital had an initial positive dx on the 27 from the Texas lab. They likely were quarantined with that initial dx, if not before. They certainly were quarantined from the 30th on.

All reports state they have not yet shown any symptoms.

[pnwmom]

35. His children were exposed and presumably they were going to school.

Hopefully none of them have been identified as the "possible" second Ebola patient.

[magical thyme]

41. highly unlikely. the worst case incubation period would end on the 26th.

If they got exposed sometime on the 24th, they would not show any symptoms before sometime on the 26th at the earliest. Then they would be home for the weekend. By Sunday, Ebola was suspected, by Monday prelim dx by Dallas lab, confirmed by CDC on Tuesday.

Worst case, they would have developed symptoms sometime on Friday and they would already be hospitalized.

If not on Sunday when Ebola became suspected, then by Monday when Dallas lab diagnosed, they would have been quarantined.

[pnwmom]

45. You're assuming he went to the hospital on the first day he had symptoms. I'm not.

Most people don't go to the hospital on the first day they feel sick.

[magical thyme]

50. no I am not. His 1st day of symptoms was the 24th according to all reports

actually, either the 24th or 25th. I am assuming they were exposed on the 24th, the 1st day he was symptomatic.

His 1st visit to the hospital was the 26th. That is also by chance the 1st possible day they would have shown symptoms if infected.

The incubation period ranges from 2 to 21 days. The 1st day they could have shown symptoms with a 2-day incubation period and initial exposure on the 24th would be the 26th.

[pnwmom]

68. His first day of symptoms was the 23rd according to this report:

He flew on the 19th. So he was contagious, and in the public, from the 23rd till the 28th. He should have been stopped at the hospital on the 26th, but instead he had two more days to infect people.

http://www.boston.com/health/2014/10/01/ebola-case-stokes-concerns-for-liberians-dallas/WNPf889Gx9riLBD6K5DaAL/story.html

‘‘Ebola doesn’t spread before someone gets sick, and he didn’t get sick until four days after he got off the airplane,’’ Frieden said.

[magical thyme]

69. he left Liberia on he 19th. He arrived in Dallas on the 20th.

4 days from the 20th is the 24th.

"The man left Liberia on Sept. 19, arrived the next day to visit relatives and started feeling ill four or five days later, Frieden said."

[B2G]

66. How do we know they weren't in school on the 29th?

Possibly with mild fevers?

Answer: we don't. Bercause no one is saying.

[magical thyme]

67. we don't know it for a fact. But Ebola was suspected on the 28th

and they isolated the patient on the 28th, which I would expect would cause them to tell the family to immediately home-quarantine until they got the lab results back on the 29th.

[B2G]

70. You're assuming they had been identified as having contact

on the 28th.

We really don't know who all was exposed at what points. I've read others are ill, but the story seems to change hourly.

Doesn't inspire a great deal of confidence in those in charge, IMO. Things will become clearer in about a week.

[magical thyme]

71. an announcement earlier today did make it sound like someone else probably has it

I'm expecting an announcement probably tomorrow. The turnaround time for testing is 1 day; it was from the 28th to 29th for the state lab, sample sent to the CDC for confirmatory testing on 29th with results on 30th.

[Rex]

46. Please remain calm until we are all dead, thank you.

I swear some of the people on this thread would ONLY care about ebola, if THEY had it. Until then, they snark at everyone and I guess that now included the CDC and the WHO.

Seriously, nobody is in full PANIC mode yet! So save your snarky crap...thanks.

[kestrel91316]

89. Yep. I swear they WANT people to underestimate it and then die.

[LanternWaste]

48. Vegas odds compel me to reserve much more concern about being hit while on my bicycle commute...

Vegas odds compel me to reserve much more concern about being hit while on my bicycle commute to and from the office every day.

[bhikkhu]

72. Sad that we can look at the poor state of medicine in Africa as a cause of the spread

...and then find that the Texas hospital was no better, actually doing about the same thing. Duncan apparently caught the disease while helping transport a woman home who had been turned away at a hospital in Liberia.

[LisaL]

97. Even the second time he went to the hospital, his friend had to call CDC and tell them

that this guy likely had Ebola.
Only then this hospital did something.

[Warpy]

90. He was uninsured

Trust me, that's got a lot to do with it.

[LisaL]

96. He is still infectious whether he has insurance or not.

[Warpy]

100. I suppose they didn't see beyond the word "uninsured."

I didn't have insurance for almost three decades and the way it kept me out of the hospital was downright magical.

[Aerows]

99. Another problem

Handling the waste generated by an Ebola victim.

http://www.reuters.com/article/2014/09/24/health-ebola-usa-hospitals-idUSL2N0RP00E20140924

[boomer55]

103. Now possible in Honolulu

http://khon2.com/2014/10/01/patient-in-isolation-in-honolulu-hospital-officials-say-ebola-a-possibility/

[lunasun]

110. At least they are being proactive and educating the staff and precautions being taken

Dallas ? I dunno he told the hospital about Liberia they didn't think it was important or didn't want to hear it

[mucifer]

104. I was listening to a story on NPR from Africa about the people who remove the bodies of

those who die from ebola. They wear hazmat suits and are terrified when they remove them it is an arduous process. Many of them have died from accidentally coming into contact with body fluids.

[customerserviceguy]

112. What's dangerous about this politically

is that it happened in Texas, and we have a wild cowboy governor there who wants to run for President again.

It's heads I win, tails you lose here. If this thing spreads beyond the one infected person, it creates panic, and we don't need that in the final weeks before the midterm election. If it doesn't spread, it means that Rick Perry gets to claim, "Obama let this into the US, I contained it to Dallas, by being less 'politically correct' than the President was".

It's a political disaster whatever way it turns out.

[kestrel91316]

161. It's a political disaster all right - for Perry. HIS state's doctors and nurses apparently

don't cotton to following those onerous federal protocols for these supposed germs.

"We don't care wut they say up in Washington, we're gonna do things the way WE want to! Yee haw!! Hooray for states' rights and down with that big bad federal gubmint that steals out money!!"

[boomer55]

123. and now they're scrambling to reach passengers on the plane he was on.

http://www.democraticunderground.com/10025610473


This stinks. Its a boolean equation. Its either true or false. This is how panic starts when you say one thing with absolute certainty and then later take actions that directly contradict what was said.

The authorities said with absolute certainty over and over again that there was ZERO chance, NO chance. NONE! NADA! no chance the passengers on the plane were exposed. period end of story.



there is “zero chance” that the patient infected anyone else on the flight, said Dr. Thomas R. Frieden, director of the disease centers. Ebola is spread only by direct contact with body fluids from someone who is ill.

http://www.nytimes.com/2014/10/01/health/airline-passenger-with-ebola-is-under-treatment-in-dallas.html?_r=0

[Aerows]

127. Combatting the biological, contaminated waste

http://www.reuters.com/article/2014/09/24/health-ebola-usa-hospitals-idUSL2N0RP00E20140924

They sent people to Home Depot to get trash cans.

[gordianot]

128. Guess this gives new meaning to the tired over used cliche "Don't mess with Texas".

[Skittles]

130. it's how people with no insurance are "treated"

[Warren DeMontague]

134. Pretty much.

And like the deal in Nigeria, now they have a widening circle of contacts to trace, because of it.

If they had isolated him on the 25th, this would have been far less of a potential problem.