German hospital: UN worker dies of Ebola

[Omaha Steve]

Source: AP-Excite

BERLIN (AP) — A United Nations medical worker who was infected with Ebola in Liberia has died despite "intensive medical procedures," a German hospital said Tuesday.

The St. Georg hospital in Leipzig said the 56-year-old man, whose name has not been released, died overnight of the infection. It released no further details and did not answer telephone calls.

The man tested positive for Ebola on Oct. 6, prompting Liberia's UN peacekeeping mission to place 41 staff members who had possibly been in contact with him under "close medical observation."

He arrived in Leipzig for treatment on Oct. 9. The hospital's chief executive, Dr. Iris Minde, said at the time that there was no risk of infection for other patients, relatives, visitors or the public.

FULL story at link.


Read more: http://apnews.excite.com/article/20141014/eu-germany-un-ebola-af521d996e.html

[davidpdx]

1. Very sad

The death toll continues. I hope they get this under control soon. Some of it is just pure stupidity that precautions aren't being taken.

I haven't heard of any cases here in Asia yet, but that doesn't mean it won't happen.

Asia on Alert for Ebola Outbreak

At South Korea's Incheon International airport, a major hub for air travel in Asia, quarantine inspections of arriving passengers are being enhanced.

Authorities say all passengers are being recorded by an infrared camera to detect fevers.

South Korea Foreign Ministry spokesperson Han Hye-jin says this is being done because Ebola is becoming a big concern.

She says the South Korean government, in association with health authorities, is paying attention and carefully determining if additional measures are needed.

The country's Centers for Disease Control and Prevention says it established an Ebola task force in April and is prepared for possible infections in South Korea.

It is also urging South Koreans not to visit the affected African countries.

Full story at the link:

http://www.voanews.com/content/asia-on-alert-for-ebola-outbreak/1968678.html

[dixiegrrrrl]

2. For every Ebola patient in US, we have to isolate 40-70 staff.

Think about that...
The guy who died in Dallas, and whose nurse got sick, had 70 people involved with his treatment.
They are all being monitored.

Now this poor guy in Berlin dies, and 41 people are placed in "close medical observation."
which I suspect is a phrase for quarantine.

And...
A battalion of 800 Sierra Leone soldiers awaiting deployment as peacekeepers in Somalia has been placed in quarantine after one of its members tested positive for the deadly Ebola virus, military officials said on Tuesday.
http://www.democraticunderground.com/10025663179

800!!
because of one positive test.

[Bragi]

3. The economic cost of Ebola is going to be enormous

The numbers of health workers cited above to care for a single Ebola-infected patient are indeed enormous.

If you add up the real costs associated with trying to contain the virus in West Africa, the costs of preparing health systems and hospitals globally to identify potentially-infected travelers, and the cost of caring for infected travelers who arrive in other countries, the reality is that a large chunk of health spending in the immediate future is going to be devoted to managing this outbreak.

This cost will hit countries with weak and under-financed health systems especially hard. This is a big deal economically, and in terms of human well-being. Unfortunately, we have to deal with Ebola day-by-day, as there are no easy and quick solutions.

[AngryOldDem]

5. I heard on the news this morning that this will most likely bankrupt Sierra Leone.

This will be very politically destabilizing throughout the world as well.

[LisaL]

6. What about US?

The costs for caring for Mr. Duncan alone have got to be astronomical.
Now they are monitoring 70 health workers who took care for Mr. Ducnan, and Mr. Duncan's original contacts before he was admitted to the hospital.
All of that because of a single case.
What if there is more of them?

[AngryOldDem]

8. I was just making an observation.

It's gone beyond speculation that the economic impact will be ruinous. Sierra Leone is just a very early example -- extrapolate that to a more developed country and the costs become pretty damned clear.

Hence, my other observation that this will also be a POLITICALLY destabilizing force as well.

[Yo_Mama]

9. Yes, I saw several articles about this aspect

The World Bank is supposed to be providing emergency loans.

But they need everything and huge manpower.

[Bragi]

10. Much of Africa is at big risk

It's hard for me to understand how the virus can be prevented from spreading throughout much of Africa.

I see no reason to think that people from the now-infected countries won't flee to neighboring countries to try to save their own lives, ultimately leading to infecting many more people.

Given Africa's way underdeveloped health systems, I don't see what there is to prevent most of Africa, and most of its health care workers and systems, from being overwhelmed by this virus.

There are no easy answers to these problems. This is going to get way worse before it gets any better, and the global cost in lives and dollars is going to be enormous.

[Yo_Mama]

12. It's obviously just going to get more expensive the longer we wait.

I agree that the effort will be painful and draining, and the rest of the world has to bear a large part of the expense. But we've got a genuine full-fledged epidemic and it is very hard to see how it won't continue to spread unless we get on top of it quickly.

Because it's not just Africa that is at risk. It's every country and every continent. Surely beating it in Africa is better than having to fight it in Central America, India, Indonesia or China!!

I think what is preventing full-fledged action is more confusion and uncertainty about how to create an effective response and control the risks. Training takes time, mobilization takes time, and coordination can be very difficult.

[Baitball Blogger]

4. Those two or three days in delay make a big difference.

[LisaL]

7. It could, but it was even longer when Dr. Brantly was airlifted back to US.

[Yo_Mama]

11. That's not clear

It's not really clear why some people are sicker than others.

My guess is that one determinant is initial exposure volume and route.

For example, the nurse in Spain is doing pretty well according to accounts, and she was sick five days before going into the hospital. Not her fault - she called the hospital to report the initial illness, then went to a clinic as instructed, and finally another hospital.

Ebola apparently takes a very small viral dose to infect. But still, it is a numbers game. A high initial exposure proliferates more rapidly and has more chance to overtake the body's immune system. That's generally true for all viral diseases.

For flu, many get exposed and then fight it off before getting clinically ill. For Ebola, there is evidence that the same may happen, because antibodies have been found in some of the family members of victims, but these family members never became clinically ill.

And then there's the question of route. A small infection through skin might be easier to fight off with the body's natural defenses than a larger infection through the mouth or the eyes, for example. This is not something that can be ethically studied in people. We have done multiple flu studies, but you can't do such studies in this type of disease.

The only thing you can do is study survivors and contacts.

There are mouse studies which suggest that the survivor blood donation technique will work.
http://jvi.asm.org/content/75/10/4649.full

Well, what works in mice doesn't always work in humans.

But note in that link that they evolved a method whereby they gave a small viral injection under the skin, waited for the mouse's body to generate antibodies, and then gave a large injection into the abdomen. That caused the mouse's body to generate masses of antibodies, which they then harvested by killing the mice. But note also the huge differential between the amount of antibodies harvested from different mice using the same protocol! It seems that immune response will naturally vary.

[Baitball Blogger]

14. Great info. Thanks.

[Yo_Mama]

15. One other thing - health workers with exposures wearing PPE

probably get a much lower initial exposure on average than a person helping a dying person on the street, such as Duncan. By the accounts I read, the woman died within 24 hours of his exposure to her. Poor lady. But poor Duncan! He was closely exposed to a patient at the most infectious stage without any protection at all. I believe the lady's brother, who I'm sure had even more exposure to her, died in about a week.

According to the reports, the way the cameraman who is now being treated in Nebraska thinks he was exposed was in helping to wash a vehicle that had been used to transport a patient. You would expect a much, much lower initial dose from that. A lot of the virus would have died already. He knows he wasn't exposed to an overtly sick person.

So as difficult as it is to keep this in our heads, it is possible that we are mostly seeing the effects of initial exposures and then attributing different disease courses to treatments rather than the real cause - the body having a lower or higher level of infection to combat in the first place.

I'm really talking to myself here - I keep getting excited every time I read of someone doing better, even when I rationally know this proves nothing. The sheer horror of what is happening in West Africa knocks the rationality right out of me.

Over four hundred health care workers have been infected in this epidemic. Over 200 of them are dead. Not very encouraging.

Doctors Without Borders is operating properly equipped facilities with highly trained personnel, and they say they have had 16 infected and 9 deaths:
http://wtop.com/267/3721819/Doctors-Without-Borders-loses-9-medics-to-Ebola

In another example of the disease's relentless march, Doctors Without Borders said Tuesday that 16 of its staff members have been infected with Ebola and that nine have died. The toll highlights the high risk of caring for Ebola patients even at well-equipped and properly staffed treatment centers.

Intimidating.

[Yo_Mama]

13. Preventing dehydration is proven to work, though.

So that should be the first effort. The African doctors who are treating this seem to think that massive oral hydration and then IV if the person can't ingest fluids is the best early treatment. I don't think we should ignore what they are saying.