To put the risk to passengers on Vinson's flight in perspective, consider Patrick Sawyer

[morningfog]

Patrick Sawyer, Nigeria's index patient, flew into Lagos while infected with Ebola. Sawyer was severely ill on his flights. He collapsed in the terminal. His symptoms were orders of magnitude worse than Vinson's 99.5 degree temperature. And no one, not one passenger, was infected by Sawyer during his travel. All subsequent infections in Nigeria were health care workers providing care to him.

Also consider Duncan's family. They lived with him for four days with a much higher fever and worsening symptoms. While not all the way out of the woods, they are pretty damn close, at day 18 since exposure.

The CDC has made a series of mistakes, blunders and really bad PR decisions. They have lost the public trust. They shouldn't have approved Vinson flying, it just looks really bad. They should have known better.

But, that is a different question than what is the actual risk to the passengers. While it can't be said to be "zero," the risk of infection to the passengers is very, very low. If anyone is infected by Vinson, it would likely be her fiance. But, even he should be fine.

As for the secondary fallout, schools and business where someone who was on Vinson's plane works, there is no scientific basis for it. It is pure hysteria.

I hope Vinson's case is our Ebola teaching moment.

[LeftInTX]

1. I think the passengers are extremely low risk

The downside: When any of them come down with fever etc in the next 21 days, it will require hazmat suits and hospitalizations.

[morningfog]

3. No doubt. This is going to be a long month.

Expect lots of helicopter video of hazmat suits loading ambulances.

[arcane1]

2. Hey, you keep that calm rationality out of here! You're robbing people of a good freak-out!

[lunasun]

4. A rare post here as of late with a voice of reason thanks

The school have to given in to the hysterics to avoid media slants and I bet some would never let their kids ever return if they did not give in with overkill because you know....Ebola could still be lurking thinking it remains indefinitely or some other nonsense

[SheilaT]

5. I, for one, am getting mightily tired

of all the posts here on DU freaking out over Ebola being airborne, or becoming airborne, or how every single person on that Frontier flight is now at risk and on and on.

I wish more people would bother to inform themselves just a little about these things before repeating the same dumb questions and misinformation.

[HuckleB]

6. Recommended and kicked for reality!!!!

[Yo_Mama]

7. A good post, but isn't the problem really the logistics?

First, i agree that Vinson's flight was low risk.

The problem is that to deal with Ebola, the contact tracing has to be very thorough. So now, to take very low risk to no-risk, we have a cast of additional hundreds.

The problem is that when you have a couple hundred really low-risk exposures, the net risk isn't low risk any more.

Apparently the CDC is now contacting the passengers from the first plane flight, because they suspect (probably based on her blood viral count) that she was ill earlier when she took the first flight. It seems that her first test was strongly positive - they jumped on this one right away. They did say that Pham's infection seemed low-grade.

The actual risk is strongly related to the patient's viral count at the time of exposure and symptoms. Her symptoms say low-risk, but I am speculating that the lab results said medium risk.

There's a reason why they are doing this, MorningFog. It's not going to be pure hysteria. They have some sort of methodology behind this. If you have a 2% chance of transmission for each of four people versus a 1% chance of transmission for each of 40 people, you are not better off with the 1%. To resolve the absolute risk, you chase the 1%/40 situation first and harder, because if you don't find any risk at that link in the chain, there either was no transmission or the transmission pops up later somewhere completely unpredictable.

[countryjake]

8. I'd be willing to bet that if this country gets any new Ebola cases...

they will be directly related to Texas Health Presbyterian Hospital and that long week period in which 76 caregivers struggled to keep Thomas Eric Duncan alive. I fear that more of those unfortunate healthcare workers will be in the news every time I read the latest headlines now.

Patrick Sawyer actually threw up twice on those flights he took to get from Monrovia to Lagos and he was dead four days after he arrived in Nigeria. I'll be surprised (sadly) if anyone who was around Nurse Vinson during her trip to Ohio becomes infected by her.

I'm hoping she has a full recovery and gets to dance at her wedding. And I'm especially glad that both nurses have been removed from that Dallas hospital!

[SoapBox]

9. I can't help but wonder...

Did she have anything to drink on those flights? Water, Coke, coffee...served by the Frontier Flight Attendants? And then picked up the used cup, napkins or snack bags...from her? Did she leave anything in the seat back pocket? Maybe tissues? Did she sneeze...or cough? Or use the lavatory?

And there is nothing to be concerned about?

I'll let all of you sit next to, forward of, behind of or in the same seat as her, on your next trip.

I will stand that it was wholly irresponsible of her to have gotten on both of those aircraft.

[countryjake]

10. But do you get what the OP has said about Patrick Sawyer?

The Liberian-American, who was the first case of Ebola in Nigeria, was bad sick during the flights he took to get from Monrovia to Lagos. The government of Nigeria and the Togo-based carrier, ASKY Airline, tracked and monitored almost 200 passengers and the flight crews from those flights throughout the month of August.

None of them ever presented with an Ebola infection.

Patrick Sawyer was dead four days after he landed in Nigeria.

[pnwmom]

13. I read that it was very difficult for them to trace all the people he was in contact with.

Do you have a link?

[countryjake]

14. It was, but they did it. Trackers made 18,000 face-to-face visits.

Nigeria fears fourth Ebola frontline after infected man lands in Lagos
http://www.theguardian.com/world/2014/aug/13/ebola-nigerian-capital


Nigeria’s Actions Seem to Contain Ebola Outbreak
http://www.nytimes.com/2014/10/01/health/ebola-outbreak-in-nigeria-appears-to-be-over.html?_r=0


Nigeria and Senegal: stable – for the moment
http://www.who.int/csr/disease/ebola/ebola-6-months/nigeria-senegal/en/


A Glimmer Of Hope: Nigeria May Have Beaten Ebola
http://www.npr.org/blogs/goatsandsoda/2014/10/02/353253523/a-glimmer-of-hope-nigeria-may-have-beaten-ebola


What can Nigeria’s Ebola experience teach the world?
http://www.theguardian.com/global-development/poverty-matters/2014/oct/07/nigeria-ebola-experience-teach-world

[pnwmom]

11. We know that he had contact with very few people in the airport.

And anyway, one or two lucky situations is not an acceptable sample size. No one put on quarantine or even self-observation for 21 days should be flying.

http://www.washingtonpost.com/news/to-your-health/wp/2014/08/08/four-new-ebola-cases-in-nigeria-all-related-to-american-to-who-brought-virus-there/

Four new Ebola cases:

"They're all contacts of Patrick Sawyer," said Gregory Hartl, a spokesman for the WHO in Geneva. He said all are health care workers, cleaners or others at the hospital where Sawyer was taken after he collapsed in the airport following a flight from Liberia to Nigeria. "We know that he had contact with very few people at the airport," Hartl said.

[Warren DeMontague]

12. I would be surprised if anyone on either of those flights caught it.

I think people are most at risk of catching ebola when the prior patient is in the terminal stages of the disease- the body becomes a "viral bomb", as Richard Preston puts it in The Hot Zone. Basically whole portions of the body are being converted into ebola virus, cells become viral "bricks" that then explode, etc.

Of course our medical protocols expect heroic attempts at life-saving measures when patients hit these near-terminal levels. I suspect it is likely that the combination of the late stage of the disease combined with the heroic measures undoubtedly taken to save Duncan's life, contributed to the infection of the two nurses.

I think if we are serious about planning on dealing with a steady stream of continual ebola importations from W Africa- and the fact that the administration continues to refuse to consider any from or restrictions on visa holders means we most inevitably will- then I think our care facilities need to have a serious, difficult, and potentially harsh conversation about the potential of heroic measures to realistically save the life of any ebola patient whose infection is that far along - pretty unrealistic, I think, once the virus has taken over that much of the body there is very little hope for the patient - versus the high risk those heroic measures will pose to the attending health care personnel.

It goes against standard medical ethics, which say to throw everything plus the kitchen sink at someone who is about to die- and under normal ethical constraints that would be the way to go, morally. But this disease may call for different approaches. It is possible that once an ebola patient passes a certain threshold the best thing to do is to manage their pain and isolate them as much as possible.

[Lee-Lee]

15. Because it worked out ok one other time is not a solid basis for a theory or claim

A sample size of one when determining anything is useless.

One time I saw a person get into a horrific auto accident where the car flipped 4 times after hitting a tree- and the woman walked away. She had a blood alcohol level of .10 and wasn't wearing a seatbelt. Another time I saw a man drive with a .15 and make it 7 miles to his driveway without crashing. I don't go advocate driving drunk based off these accounts, which would be the equivalent of your logic of "these two times people were close to an infected person and were ok, so nobody should worry".

[morningfog]

16. These samples, however, are entirely consistent

with everything we know of this virus. These aren't anomalies, they are confirmation of past findings.

The viral load increases as the infection progresses. Others are at the greatest risk just before and just after death. They are not very infectious with just a fever. In fact, I have looked for, and challenged several on here to find, any case where an infection occurred by indirect or direct contact with an Ebola infected person with only a fever. No one has been able to find one.

There have been some 9000 infections with the current outbreak, when the point of infection is known, it is usually health care workers treating several ill, or family treating severely ill or during burial practices or in handling or cleaning the bodily fluid waste of someone severely I'll.