Mount Sinai patient tested for Ebola virus
Source: ABC 7 Eyewitness News
UPPER EAST SIDE (WABC) -- Mount Sinai Hospital is performing tests on a patient who had recently traveled to a West African country where Ebola has been reported, the hospital says.
A male patient with high fever and gastrointestinal symptoms came to the hospital's emergency room on Monday morning.
The hospital says the patient has been placed in strict isolation and is undergoing medical screenings to determine the cause of his symptoms.
"All necessary steps are being taken to ensure the safety of all patients, visitors and staff. We will continue to work closely with federal, state and city health officials to address and monitor this case, keep the community informed and provide the best quality care to all of our patients," the hospital wrote in a statement.
Read more: http://7online.com/health/mount-sinai-patient-tested-for-ebola-virus/239663/
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La Lioness Priyanka
(53,866 posts)Not because I value Indian lives more or anything, but I know that measures can be taken to stop its spread in a developed country with a relatively small population, but if it spreads to a developing country with a giant population, it will create major havoc.
JackRiddler
(24,979 posts)You mean New York City?
La Lioness Priyanka
(53,866 posts)B2G
(9,766 posts)La Lioness Priyanka
(53,866 posts)4. lower populations.
all of these things are good when dealing with any emergency.
B2G
(9,766 posts)La Lioness Priyanka
(53,866 posts)B2G
(9,766 posts)"but I know that measures can be taken to stop its spread in a developed country"
You DON'T know that. It's never been in a developed country before.
La Lioness Priyanka
(53,866 posts)and those did not turn into national epidemics, did they?
Divernan
(15,480 posts)And my ex-husband died last year of MRSA contracted at Cleveland Clinic Medical Center.
What I've observed in local hospitals is that they may have just really terrific CDC guidelines and precautions to prevent MRSA, but they are not in fact observed by maintenance people. A room is supposed to be wiped down/disinfected between patients. My daughter was put in a room before that process, and when the orderly/cleaning lady - whatever title she had - came in, she had a bucketful of dirty water, which she used to wipe down the surfaces.
La Lioness Priyanka
(53,866 posts)that landed in the US and have not spread in the US
Hekate
(90,708 posts)
jeff47
(26,549 posts)In Africa, they're using cheap plastic aprons and goggles from the local hardware store. Not much protection. They also have a population that doesn't go to the doctor regularly, so when they get sick they are cared for by untrained people. If they finally do go to the hospital, the hospitals aren't much more than one big room in a building. They also have post-mortem practices that help spread the disease - the family members of the dead are supposed to bathe the dead, which is fantastic for spreading the disease to the family members.
In the developed world, we have biohazard level 4 gear. With that, you could go wading through a vat filled with anthrax and smallpox without getting infected. People in the developed world regularly see doctors, and will go to the hospital when they get very sick. Yes, even people who can't normally afford to go to the doctor will go to the ER when things get bad. The hospitals in the developed world have isolation wards. Our post-mortem practices release the body to trained professionals who wear safety gear when handling the body.
Calling the difference "night and day" does not sufficiently describe the difference. More like night on Earth and day on Pluto.
NickB79
(19,246 posts)So far, it's only been seen to spread via bodily fluids, and even then at the late stages of the disease. In most developed countries, people simply aren't in contact with a person at the late stages of the infection, or after they die of the disease, to sustain transmission.
A person with Ebola in NYC would likely only present a risk to fewer than a dozen people: family that care for them when they start puking and experiencing diarrhea, and then hospital staff that treat the person when they're admitted. And once in a hospital setting, bodily fluids are treated as hazardous materials, complete with safety procedures.
The situation is completely different in places like Africa, where most people do not seek medical attention at hospitals, they are cared for by family until they die, blood/feces/vomit are not handled with the same degree of sanitation, after death their body is cleaned and prepared for burial by friends and family, and is often touched and even kissed at the wake.
Knowing what we know today, Ebola has about as much chance of causing a full-blown pandemic in an industrialized nation as HIV does today.
B2G
(9,766 posts)by kissing someone or having them cough or sneeze on you. HIV patients don't leave their virus on hard surfaces that can live outside of the body for up to 3 days. The HIV virus is not present in urine, feces or vomit (unless it contains blood).
Your analogy is lacking. And yes, I do know how it's transmitted, thanks.
NickB79
(19,246 posts)You can only get Ebola via kisses if you kissed someone in the late stages of the infection, when they're already puking and bleeding out.
Ebola cannot pass easily via sneezing or coughing, unless the person is actively coughing up blood, and you are being sprayed by their discharge (it can't waft through the air like a cold or flu virus). People have SPECULATED that, in the right circumstances, it COULD be transmitted this way, but it's never been observed in practice.
Ebola patients also don't leave the virus on hard surfaces, unless they've contaminated those surfaces with bodily fluids, AND other people walk by and decide to touch said fluids. Personally, I don't stick my hands in random pools of puke on the sidewalk for fun.
Urine, feces and vomit are treated as hazardous materials in the US for the purposes of clean-up. A person pukes in a Walmart, and they apply disinfectants, wear gloves, etc, same as if there were blood present.
B2G
(9,766 posts)You can only get Ebola via kisses if you kissed someone in the late stages of the infection, when they're already puking and bleeding out.
Infected persons become contagious as soon as they develop symptoms, they don't have to be actively vomiting or bleeding out.
Ebola cannot pass easily via sneezing or coughing, unless the person is actively coughing up blood, and you are being sprayed by their discharge (it can't waft through the air like a cold or flu virus). People have SPECULATED that, in the right circumstances, it COULD be transmitted this way, but it's never been observed in practice.
If you're within 3 feet of an infected person who is sneezing or coughing, you are at risk of infection. Ebola Reston was shown to be airborne. There are no guarantees that this strain won't, or hasn't already, develop this capability.
Ebola patients also don't leave the virus on hard surfaces, unless they've contaminated those surfaces with bodily fluids, AND other people walk by and decide to touch said fluids. Personally, I don't stick my hands in random pools of puke on the sidewalk for fun.
Do you use public restrooms?
Urine, feces and vomit are treated as hazardous materials in the US for the purposes of clean-up. A person pukes in a Walmart, and they apply disinfectants, wear gloves, etc, same as if there were blood present.
If an infected person pukes in the middle of Walmart, I don't even want to contemplate the consequences.
B2G
(9,766 posts)Hekate
(90,708 posts)The Spanish Influenza was deadlier.
I'm not discounting the dangers at all, but public health officials have been at this for a long time.
Hekate
(90,708 posts)Here there are protocols for strict isolation and sanitation, many single-use items, biohazard containers, hospital incinerators, and crematoria. Our mortuary and burial practices are different. I know of few US communities where custom and religion require that families wash and prepare the body themselves (unlike African culture, for instance), and in the case of a deadly communicable disease I'm pretty sure public health laws can be invoked in order to fast-track the deceased to a crematorium rather than whole-body burial.
La Lioness Priyanka
(53,866 posts)JackRiddler
(24,979 posts)if you don't mind, a bit of nervousness is natural about news that a passenger from a flight who disembarked in New York may have carried ebola on to said flight, with all of its other passengers...
Hekate
(90,708 posts)Divernan
(15,480 posts)I am not at all reassured by the statements that passengers are screened when entering planes from countries with the outbreak, and again upon entry in to US airports. People infected with Zaire do not immediately experience symptoms. The incubation period varies from two days to in excess of 21 days, with 4.1% of patients having incubation periods longer than 21 days. Clearly, a trip from West Africa to the US is less than 2 days, leaving plenty of time for asymptomatic Ebola victims to enter the country and move on to great distances from their point of entry.
http://www.kcdc-phrp.org/article/S2210-9099%2811%2900002-6/abstract
Results
The mean incubation period was estimated to be 12.7 days (standard deviation 4.31 days), indicating that about 4.1% of patients may have incubation periods longer than 21 days.
Conclusion
If the risk of new cases is to be reduced to 1% then 25 days should be used when investigating the source of an outbreak, when determining the duration of surveillance for contacts, and when declaring the end of an outbreak.
DhhD
(4,695 posts)ELISA testing. There is a big lab in Maryland.
http://www.medicinenet.com/elisa_tests/article.htm#what_is_an_elisa_test
https://en.wikipedia.org/wiki/Saliva_testing
jeff47
(26,549 posts)about the writing on the disease.
The article you cite assumes the incubation period is a balanced "bell curve". They used the mathematical description of that bell curve to come to their 4.1% conclusion.
You can't assume a mathematical model fits a biological process. To claim it can incubate longer than 21 days, you have to actually find someone who incubated longer than 21 days. The authors of that paper did not do so.
And that doesn't even get into the problem of the lousy data they started with - self-reported information from a small number of people. You're not going to get an accurate incubation period from that due to people miss-remembering details, and there aren't enough people for the average to smooth out the data.
Divernan
(15,480 posts)Particularly since you neglected citing any evidence of your interpretation.
Here's another article for you: Ebola haemorrhagic fever, Lancet. March 5, 2011; 377(9768): 849-862
(published online by the National Institutes of Health).
In pertinent part it states:
Clinical manifestations
The different species of Ebola virus seem to cause somewhat different clinical syndromes, but opportunities for close observation of the diseases under good conditions have been rare. Generally, the abrupt onset of Ebola haemorrhagic fever follows an incubation period of 2–21 days (mean 4–10) and is characterised by fever, chills, malaise, and myalgia.
Having taken graduate level classes in statistics, I find your (uncited) claim that "you can't assume a mathematical model fits a biological process" to be absolutely outrageous! For other DU readers, here's one of many links proving that medical research does utilize mathematical models:
http://pubs.niaaa.nih.gov/publications/arh311/49-59.htm
From Parts Lists to Understanding Systems Behavior
Hans Peter Fischer, Ph.D.
Hans Peter Fischer, Ph.D, is chief scientific officer of Genedata AG, Basel, Switzerland.
To understand complex biological systems such as cells, tissues, or even the human body, it is not sufficient to identify and characterize the individual molecules in the system. It also is necessary to obtain a thorough understanding of the interaction between molecules and pathways. This is even truer for understanding complex diseases such as cancer, Alzheimer’s disease, or alcoholism. With recent technological advances enabling researchers to monitor complex cellular processes on the molecular level, the focus is shifting toward interpreting the data generated by these so-called “–omics” technologies. Mathematical models allow researchers to investigate how complex regulatory processes are connected and how disruptions of these processes may contribute to the development of disease. In addition, computational models help investigators to systematically analyze systems perturbations, develop hypotheses to guide the design of new experimental tests, and ultimately assess the suitability of specific molecules as novel therapeutic targets. Numerous mathematical methods have been developed to address different categories of biological processes, such as metabolic processes or signaling and regulatory pathways. Today, modeling approaches are essential for biologists, enabling them to analyze complex physiological processes, as well as for the pharmaceutical industry, as a means for supporting drug discovery and development programs. Key words: Systems biology; human biology; complex biological systems; mathematical modeling; computational models; transcriptomics; proteomics; metabolomics
(And this quote, referring to the MEAN, proves that the Lancet, unlike you, accepts the mathematical model/including statistics, applied to the study of disease.)
Route of infection
In human beings, the route of infection seems to affect the disease course and outcome. The mean incubation period for cases of Zaire Ebola virus infection known to be due to injection is 6 · 3 days, versus 9 · 5 days for contact exposures.58 Moreover, the case-fatality
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3406178/
So let me strongly suggest that YOU should consider your own advice to me, i.e., YOU have to be very cautious about the writing on the disease - in this case, YOUR posting. If you choose to take a position discounting peer-reviewed scientific research, than cite some peer-reviewed evidence of your own.
Now, to return to the substance of my post, the article I quoted suggested the asymptomatic period for the Zaire strain could be as long as 25 days. The Lancet article and everything else I've read agrees that at least 21 days is definitely the outer parameter. By the use of the words "in general", the article allows for exceptions, i.e., longer periods of incubation.
The Medical Decision Rule is, when in doubt, treat. The application of that rule to the current outbreak would mean, when in doubt, isolate. As the Lancet article points out, observation of this disease under good conditions have been rare. If one were to accept your critical view, a lot of valuable research would be thrown out and potentially life-saving precautions would be ignored.
Medical decision rule
–
The guiding principle behind everyday medical practice
–
Since the work of the physician is for the good of the
patient, physicians tend to impute illness to their patients
rather than to deny it and risk overlooking or missing it
jeff47
(26,549 posts)It's in the paper you cited when you quoted the 4.1% claim. You did read it, right?
You can create a mathematical model once you have thoroughly studied the biological process.
You can not create a mathematical model when you have very limited data of the biological process.
That is what the people making the 4.1% claim did. They assume a balanced bell curve for incubation period. Why can't they do that? You said it in your first quote:
Actually, the problem here is you didn't bother to read the paper you cite. It appears you just read the summary, and didn't bother looking into how they reached that conclusion.
Their conclusion works if their mathematical model is accurate. They don't know if their model is accurate. They acknowledge this in the paper. You don't. You argue that their model is perfect, and we can use the perfect-for-exciting-headlines 4.1% without the caveats in the paper.
And the basis of this claim is assuming a balanced bell curve for incubation time. You have no evidence that this is actually the case. You have a mathematical model where they put the center of the bell on the mean, and then calculated the shape primarily from the left-hand side of the bell.
Anyone with a high fever could have smallpox. We must isolate them, just in case. Sure, there are zero reported cases of smallpox infection, but the virus could have been laying dormant somewhere.
You are making the same argument. There are zero reported cases of Ebola incubation longer than 21 days. With thousands of victims, we should have at least 1 person in that 4.1% group. You are demanding we ignore those results because it makes the mathematical model pretty.
Earth_First
(14,910 posts)Thankfully we are much better equipped to deal with such an emergency.
...and with news out of the hot zone that the experimental serum may have worked on a handful of infected individuals...we may be well on our way to solving this humanitarian crisis.
I would be lying if I told you this didn't concern me though...
#staytuned
Time to shut down all flights from that region.
Heavily screen anyone whos flight origin was there.
This is serious.
PADemD
(4,482 posts)That's what I told my Rep in Congress over a week ago.
Union Scribe
(7,099 posts)for awhile--any time someone with a connection to West Africa is hospitalized no matter what the eventual diagnosis is. I think the UK just had a similar thing happen, and the Ebola test came back negative. Hopefully these will remain false alarms.
Divernan
(15,480 posts)Comments on British news blogs echo what you see in the US. Many people believe their governments would hide the truth to avoid public alarm. Transparency remains in short supply with this administration.
