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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsIt's Over: Texas' Ebola Outbreak Has Ended
The Ebola outbreak in Texas has ended.
As of midnight Friday, it was 21 days since anyone got Ebola or was in contact with someone who got Ebola.
* * *
Now, three weeks later, it’s clear that no one else was infected. As predicted by the Centers for Disease Control and Prevention and many other experts, the people at greatest risk were health care workers in close, prolonged contact with a patient who was actively having symptoms. Not even Duncan’s fiancée, Louise Troh, who cared for Duncan after he became ill and who lived in her apartment with him, became infected.
“I think it is a reinforcement of the basics of what we know about this disease,” said Health and Human Services Secretary Sylvia Burwell.
Texas state health officials say they monitored 177 people, including health care workers, household members and others, who had contact with Duncan, Pham or Vinson or with medical specimens or waste.
The last person being monitored handled medical waste on Oct. 17, the state health department said in a statement. “We’re happy to reach this milestone, but our guard stays up,” said Dr. David Lakey, commissioner of the Texas Department of State Health Services.
Earlier this week, Ohio stopped monitoring 163 people who may have been in contact with Vinson.
* * *
The 21 days is based on the longest known incubation period for Ebola. Experts say most transmissions happen between 6 and 12 days.
They also point out that patients only transmit the virus after they’ve developed symptoms, usually vomiting or diarrhea but also — not likely but possibly — an initial fever. Vinson said she flew with a temperature of 99.5 degrees, not considered a fever.
Now, a single U.S patient remains in isolation: Dr. Craig Spencer, a Doctors Without Borders volunteer who became ill after his return from treating Ebola patients in Guinea, is being treated in New York’s Bellevue Hospital.
http://www.nbcnews.com/storyline/ebola-virus-outbreak/its-over-texas-ebola-outbreak-has-ended-n242931
It has been 15 days since Dr. Spencer was isolated. It is almost certain that he did not infect anyone pre-isolation. Ebola, as predicted, was contained when it arrived to the US. Unfortunately two health workers were infected, but Ebola never spread outside of a hospital in the US. It was contained.
It should be clear to everyone now that the anti-science hysterics were counter-productive and caused more harm than good. Hopefully, everyone has learned that freaking the fuck out is the wrong approach.
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BeyondGeography
(39,374 posts)Well played, ebola. Well played.
malaise
(269,058 posts)Stunningly convenient
rurallib
(62,423 posts)or at least that is the way the media will play it
Any time there has been an accomplishment or good news during this administration, it's just a blip on the media's radar. There and gone -- poof. Give them any reason to report on something oh-so-scary or negative though, it's a never ending barrage. This country is getting stupider by the moment, thanks to the MSM.
johnnyrocket
(1,773 posts)Bleh.
snooper2
(30,151 posts)
groundloop
(11,519 posts)David Perdue ran ads that were insinuating the Obama administration was exposing the country to an Ebola outbreak, and then associated Michelle Nunn with Obama.
stillwaiting
(3,795 posts)It might not be completely eliminated, but the hysteria will be drastically reduced.
LiberalElite
(14,691 posts)
BlancheSplanchnik
(20,219 posts)Thing is, they work for the dark side. And they use battle axes.
We liberals miss one opportunity after another arguing amongst ourselves over which surgical instruments should be used against which battle-axe attack....meanwhile, those fucks already bought the operating room 20 years ago.
malaise
(269,058 posts)
BlancheSplanchnik
(20,219 posts)
..........I work nights so i'm in "wake up and get coherent and ready for work" mode 
I'd laugh if it were just a game.
malaise
(269,058 posts)
BlancheSplanchnik
(20,219 posts)Laughing is good!
uppityperson
(115,677 posts)BlancheSplanchnik
(20,219 posts)It cracks me up, too.
SummerSnow
(12,608 posts)
drray23
(7,634 posts)Any more hysterical posts of the type "we are all going to die" from some of our DU members like they used to.
Now maybe people can cool off and stop being so unhinged.
morningfog
(18,115 posts)they will suffer from amnesia and reignite the same stupidity. And if reminded, they will claim this time is different/worse because if some non-scientific reason.
yellowcanine
(35,699 posts)
Ms. Toad
(34,076 posts)as proof for anything you believe is "woo," you would be mocking whoever was doing the promoting as completely unscientific.
100.4 is a somewhat arbitrary point at which to declare something a fever, and the CDC has expanded its definition of fever to include any temperature at which the person feels like they have a fever - likely because 13% of people with Ebola do not run a fever at all, and 100.4 is not a magic number. The CDC also now considers fatigue to be a symptom of Ebola which, which - for persons with high or some risk exposure (the level of exposure Vinson and Spencer had) calls for isolation in a hospital until it is proven not to be Ebola. Both Vinson and Spencer experienced fatigue about 3 days prior to developing a fever. At least one, possibly both, of Vinson's flights were after she began experiencing fatibue
*Symptoms of Ebola to consider:
For high and some risk levels: fever (temperature of 100.4˚F/38˚C or higher or feeling like they have a fever), severe headache, fatigue, muscle pain, vomiting, diarrhea, stomach pain, or unexplained bruising or bleeding.
For low risk levels: fever (temperature of 100.4˚F/38˚C or higher or feeing like they have a fever), vomiting, diarrhea, or unexplained bruising or bleeding.
High, Some, and Low risk levels
People in the High, Some, and Low risk levels who have fever or other possible symptoms of Ebola MUST have a medical examination to make sure they don’t have Ebola. They will remain isolated in a hospital until doctors and public health workers are certain that Ebola is not a concern.
Widespread panic is not productive, but neither is an insistence that the actions of Vinson and Spencer are models for disease prevention. Yes. We got lucky this time. That doesn't prove what they did was consistent with best practices any more than not impregnating anyone the first 3 times you have sex proves that you are infertile.
ZombieHorde
(29,047 posts)Woo may be supported by politicians, etc., but not usually by many, many scientists.
Ms. Toad
(34,076 posts)ZombieHorde
(29,047 posts)Ms. Toad
(34,076 posts)published in reputable medical journals, the CDC, or has been acknowledged by Vinson & Spencer.
Cal Carpenter
(4,959 posts)It isn't luck, it is SCIENCE.
Don't bring woo into this. What we know about ebola is based on 40 years of research and thousands of cases.
Some protocols have been tightened up, and rightfully so (eg the air travel). Hospitals are better prepared. But there was no significant risk even with Vinson flying - if there was, some of her hundreds of fellow passengers and contacts would have undoubtedly been infected. Even Duncan didn't pass it on to his family with intimate contact when he was very ill. And Spencer didn't do anything wrong, he infected no one.
This is NOT LUCK.
Just stop.
Ms. Toad
(34,076 posts)If you bothered to read the information at the link, anyone who is at high or some risk must be isolated and treated as if they have Ebola once they show any symptoms, including fatigue or merely feeling as if they have a fever. The current CDC guidelines would have required Spencer to be isolated, and treated as if he had Ebola, when he first experienced fatigue, 3 days before his fever.
None of the peer reviewed studies (science, not woo) are as definitive as you seem to be about the moment when someone becomes contagious. There are documented cases in which Ebola was contracted with no known contact with Ebola - meaning that the person who infected them was not in a full blown disease state. Ebola has also been documented on surfaces in isolation (i.e. heavily and frequently cleaned) rooms in the absence of any visible liquid, and the studies which documented it suggest that it is more likely that Ebola will be found on the surface in areas which are less regularly and thoroughly cleaned than isolation rooms.
What we know is from parts of the world where there is less scientific rigor than there is in most first world studies. We know the macro scale risk of contagion. What we don't know yet - and what every peer reviewed study I have read refuses to make a categorical statement about - is the micro level. At what point does someone become contagious, and how much of what kind of contact does it require? We know from restrospective review that most people not in intimate contact with someone with full blown Ebola do not contract it. We also know that a few do. Science has yet to fill in those gaps
And, because too many people in this country were too arrogant about our superiority to understand the risks associated with donning and doffing protective gear, two nurses contracted Ebola - and a nurse and doctor who knew they were at some risk for Ebola ignored the first signs of Ebola and continued to circulate in the public.
Fortunately, this seems to have been a wake-up call and the CDC has significantly revised its guidelines. Those guidelines now line up pretty precisely with what I suggested should have been the guidelines for hospital workers and those exposed to Ebola; suggestions I made several days before the CDC changed its guidelines.
That no one else contracted it was luck, not science. We will not always be that lucky.
yellowcanine
(35,699 posts)No one - not in Texas - not the members of Duncan's family even though they had close contact with him while he was just starting to be symptomatic. None of the people on planes, subways, bowling alleys, whatever. Not ONE. We are talking about hundreds of people here. How is that luck? It isn't. The science is correct. You do not get Ebola from someone who is not exhibiting severe symptoms of Ebola - vomiting, etc. You don't get it from sitting next to them on a plane, bus or subway. You don't get it from sitting in a seat which they occupied only minutes before. You don't get it from breathing the same air. We don't have to quarantine people who do not have symptoms. Christie is wrong. LePage is wrong. The Army is wrong. The CDC has it right.
Ms. Toad
(34,076 posts)both Spencer and Vinson from being in the public 3 days before they were isolated. So apparently, even though you say the CDC has it right - you have no idea what the CDC actually says.
So yes, it is luck - just as it is luck when you sometimes have unprotected sex and don't wind up pregnant. 3 data points (Vinson, Spencer, and Pham) do not constitute proof.
uppityperson
(115,677 posts)when my partner was not fertile?
No. Same as it wasn't luck that no one got ebola from someone who was not contagious.
Ms. Toad
(34,076 posts)It was to point out the stupidity of the logic being used by the people who are saying that because no one else was infected by Duncan after the two nurses, it proves that the only way Ebola is contagious is direct exposure to someone with the most significant symptoms.
A single case in which the only people who were infected were those directly exposed to Mr. Duncan at the peak of his symptoms no more proves that it is the only way Ebola is spread than does the fact that you had unprotected sex a couple of times with you boyfriend you believe to be infertile proves that he actually is infertile.
uppityperson
(115,677 posts)"So yes, it is luck - just as it is luck when you sometimes have unprotected sex and don't wind up pregnant. "
It wasn't about "luck"? I agree. It is about science.
Ms. Toad
(34,076 posts)have chosen to ignore the limits of what science knows with respect to Ebola. Beyond the main period of transmission, we don't know the precise point at which someone becomes capable of passing the virus on, and we don't know how long virus lives on surfaces - or how capable of creating infection it is when picked up from those surfaces.
We do know that there are cases that epidemiologists have not been able to track to the direct contact with a symptomatic Ebola patient. We do know that the virus has been detected on surfaces in places which are very regularly cleaned, after cleaning. Those are things we need to learn more about - and until we do, we need to treat anyone who has been exposed, who is experiencing any symptoms - even symptoms which are not unique to Ebola - as if they have Ebola until the symptoms are proven to have been caused by something else.
I am glad the CDC finally has caught up - I just wish the people worshiping the CDC's wisdom or screaming about science, would actually pay attention to what the CDC is now saying and (2) pay attention to the actual science rather than ego or politics or whatever it is that drives you and others to deny the reality that we really don't yet know the exact point at which someone becomes contagious.
uppityperson
(115,677 posts)symptoms? You mean that science? "we don't know the precise point at which someone becomes capable of passing the virus on" but we do know when they are not capable of that. That is when they are asymptomatic. It is true they do not know how long a person has to be symptomatic before becoming contagious, but they do know when they are not contagious. That is science and continuing to use it to base sound decisions on is not simply "screaming about science" but good logic.
You said "luck", I replied "luck", you said "it wasn't about luck", and continue to insult.
OK, now rather than discussing the issue, you get to do another insulting attempt at a rejoinder.
No need to reply as I will now ignore your insults.
Ms. Toad
(34,076 posts)was applying (that one isolated case in which something doesn't happen proves that it can't happen) with an assertion that had nothing to do with the point of the example (that when we act on the basis of the pseudoscience being touted as absolute fact around here and nothing bad happens, it is just luck). I get annoyed when my words are twisted around to suggest I said something I didn't say.
And I get annoyed at the repeated assertions that when I recite scientific studies, epidemiologic studies, and the CDC, that what comes back are assertions that I am being unscientific.
uppityperson
(115,677 posts)In case you didn't, or someone is interested, my health care worker pedantry makes me post this..
http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm
Fatigue can be a normal and important response to physical activity, emotional stress, boredom, or lack of sleep. Fatigue is a common symptom, and it is usually not due to a serious disease. But it can be a sign of a more serious mental or physical condition. When fatigue is not relieved by enough sleep, good nutrition, or a low-stress environment, it should be evaluated by your doctor.
(clip)
Causes
There are many possible causes of fatigue, including:
Anemia (including iron deficiency anemia)
Depression or grief
Iron deficiency (without anemia)
Medications such as sedatives or antidepressants
Persistent pain
Sleep disorders such as insomnia, obstructive sleep apnea, or narcolepsy
Thyroid gland that is underactive or overactive
Use of alcohol or drugs such as cocaine or narcotics, especially with regular use
Fatigue can also occur with the following illnesses:
Addison disease
Anorexia nervosa or other eating disorders
Arthritis, including juvenile rheumatoid arthritis
Autoimmune diseases such as systemic lupus erythematosus
Cancer
Congestive heart failure
Diabetes
Fibromyalgia
Infection, especially one that takes a long time to recover from or treat, such as bacterial endocarditis (infection of the heart muscle or valves), parasitic infections, hepatitis, human immunodeficiency virus (HIV) AIDS, tuberculosis, and mononucleosis
Kidney disease
Liver disease
Malnutrition
Certain medications may also cause drowsiness or fatigue, including antihistamines for allergies, blood pressure medicines, sleeping pills, steroids, and diuretics.
The "actions of Vinson and Spencer are models for disease prevention" indeed. We didn't "get lucky" but the science backing when a person is contagious was right. Rather like having sex while infertile will most likely not result in pregnancy.
Ms. Toad
(34,076 posts)Both are medically trained, should know the difference between fatigue and being a little sleepy. Both found that symptom significant that they reported it to the CDC and medical providers who were tracking down when they might be contagious.
No scientific, peer reviewed article, published in a reputable publication that I have found is as certain as the statements you are making. All of them talk about low risk, not zero risk. And the CDC finds fatigue a significant enough symptom to now recommend that, in combination with high or some risk, a person experiencing fatigue be isolated and treated as if they had Ebola until it is proven otherwise.
While I don't always agree with the CDC (most recently when they had inadequate standards, and too low a threshold for treating an exposed person as if they had Ebola), you have been a defender of the CDC - and science - and are currently standing on the side rejecting it by insisting that we absolutely know all about how Ebola is transmitted. We just don't yet. We know the most significant way it is transmitted and have to (as the CDC has now recognized) be cautious about the ways that have not yet been ruled out (like low level symptoms following exposure).
We are not talking about isolating anyone who experiences fatigue, or isolating someone for the incubation period. The isolation recommended by the CDC is once fatigue occurs during the incubation period for someone who is at high or some risk for contracting Ebola - and continues only until Ebola is ruled out. Pretty much what I've been saying the guidelines should have been since Vinson stepped on that first plane, and again when Spencer ignored the same early symptom and went bowling, among other things.
uppityperson
(115,677 posts)The science backing when a person is contagious was right.
Ms. Toad
(34,076 posts)That we know the period which is most contagious.
We don't know precisely when that period starts (there are 13 cases with no known direct contact, of the 50+ cases which epidemiologists began with). One of those is the transmisson documented via fomites. The other 12 mean, at a minimum, that science has not been able to exclude transmission without direct contact with an obviously symptomatic person.
We don't know how easy transmission via fomites is (there is one documeted case).
Because of the latter two points, the CDC recommends that anyone with "high" or "some" risk who experiences any symptoms of Ebola (including fatigue) to be isolated and treated as having Ebola until it is proven they don't.
If that is what you mean by science, I agree.
If what you mean by science is what has been most frequently asserted on DU - that transmission is impossible without symptoms more significant than fatigue, or that transmission is impossible via fomites, you are not actually expressing what is scientifically known.
ReverendDeuce
(1,643 posts)... that the CDC is lying and ebola can survive in an infectious form for up to eighty years!!!1 And my only safe course of action is to buy his colloidal silver and SURVIVOR SHIELD Patriot Powder!
Initech
(100,081 posts)
DeadLetterOffice
(1,352 posts)If not this, then something else.
whereisjustice
(2,941 posts)Democrats in the election. He caused panic by saying our health care workers, specifically nurses, are too incompetent to follow the procedures, causing locals yokels to grab their guns and go crazy. It all turned out to be lies from an administrator who should have been fired.
More high ranking CYA. From NSA to FBI to CIA to CDC. Unaccountable.
Whatever spine Democratic Party had left was surgically removed by this bungling..
morningfog
(18,115 posts)He said protocols weren't followed and they clearly weren't. That does not mean the nurses were incompetent. It means somewhere along the line there was a mistake which is obviously true. As nurse Vinson said, she was not properly trained. That had nothing to do with her competence, but with the training she received.
TorchTheWitch
(11,065 posts)The PPE protocols that the CDC recommended were woefully inadequate. They did not call for head to toe covering. They did not call for any supervision of care workers suiting up nor did they have any training or supervision in removal. The nurses claim that it was them asking for better PPE protection and the hospital immediately ordering what they believed they should have. At some point they got their act together much better with the help of 2 workers from Emery coming and helping them step by step in getting in and out of their PPE with their supervision. It was through this process that the CDC changed its protocols.
Frieden immediately blamed the care workers as becoming infected not because the CDC gave them inadequate protocols (thus the hospital not HAVING correct PPE to begin with) with no supervision or other help but because they must have breached the CDC's inadequate protocols he refused to acknowledge were inadequate even when the CDC ended up having to change those protocols later and also deciding that any other person found to have Ebola in the US would be assessed and cared for by a specified experienced team and why Pham was eventually moved to a BS4 facility and why Vinson was immediately sent to one.
The nurses were the ones smart enough to immediately be aware that the CDC's PPE protocols were inadequate which is why they compensated as best they could themselves using tape to cover their necks and adding whole head hoods since the CDC's PPE protocol did not call for head to toe coverage.
No, he didn't say they were too incompetent to follow CDC protocols, but he DID blame the nurses for becoming infected by breaching the CDC's protocols when that is NOT why they became infected. They became infected because the CDC's PPE protocols were woefully inadequate which the nurses recognized and the hospital worked with them to immediately get them what they said they needed.
60 Minutes did an extensive interview with four of the nurses that cared for Mr. Duncan. One nurse that cared for both Mr. Duncan and Ms. Pham until she was sent to a BS4 hospital was not part of that program and was furious with the CDC, Texas Health Dept. workers and the hospital for what occurred during his stay.
Yes, Frieden should have been fired especially when he gave inadequate CDC PPE protocols to care workers in US hospitals when he his own self wore head to toe PPE when he went to West Africa and merely spoke to Ebola infected people at a safe distance of several feet. He was asked in the congressional hearing why he would do that and not provide similar PPE protocols for care workers in the US to which he blah, blahed a non-answer answer.
The two nurses infected became infected in the beginning of Mr. Duncan's care when the nurses did not have proper PPE gear. One of the nurses in the 60 Minutes interview was damn lucky she wasn't another infected victim when she described an incident when Mr. Duncan was in the bathroom vomiting so copiously that it far overran one of the standard barf bags and went all over the walls and the floor that she had to clean up herself when she was still having to wear PPE gear that the CDC recommended that exposed her neck and didn't cover her head. Had she also become infected because of the incident or similar incidents Frieden would have blamed her becoming infected by breaching protocol when she didn't and was wearing what the CDC PPE protocol said.
His language STILL blamed the nurses for their becoming infected by breaching protocols when they got infected because the CDC's protocols were shit, and the nurses KNEW that they were and tried to compensate for that inadequacy as best they could with what was on hand and asking the hospital to order the proper PPE gear which they immediately did.
Those care givers on their own knew that the CDC's protocols were inadequate and took it upon themselves to better protect themselves and have the hospital order the gear that the CDC SHOULD have called for and DIDN'T.
morningfog
(18,115 posts)He never blamed the nurses. He said there was a breach in protocol. Not the same thing. They did change the protocol, and perhaps it was inadequate. Or perhaps because there were two infections, possible from breaches of protocol, the CDC never to change the protocol to compensate for the inevitable breaches.
Only 2 were infected remember. And, no one knows when they were infected. It could have been, indeed it is more likely,in Duncan's final days. Both nurses treated him in his last day or two of life. He was the most contagious then and it is consistent with their infection timeline.
Enthusiast
(50,983 posts)Can never be too careful.
Capt. Obvious
(9,002 posts)
mountain grammy
(26,625 posts)Come on, America, take your medicine! 
B2G
(9,766 posts)Just legitimate concern.
And I have said all along our greatest risk is not from returning HCW, but from average folks returning who don't self monitor as stringently as doctors and nurses do. Or have a distrust of the healthcare system and may not end up in the hospital until the disease is well advanced, increasing the risk of transmission to others.
To those of you saying the risk is over, you're wrong. Until it's over in W. Africa, we are at risk here in the US. To say otherwise is not dissimilar to climate deniers saying climate change is a bunch of bunk because we had a very cold winter last year.
morningfog
(18,115 posts)There will undoubtedly be more cases to arrive in the US.
But the risk of spread in the US is, as demonstrated, is very very low. Even with the bungling in Dallas, not one single person was infected outside of the hospital. The two infections were caught very early and recovered fully and quickly.
And there was more than legitimate concern. There was a suspension of critical thought and a willful denial of science among many people, including governors and posters on DU. It was rampant stupidity and hysteria. Even when presented clear facts based on clear science, there were some who refused to acknowledge it and gave false information about the risks.
Even now, they say we simply got lucky. When in fact what we got was exactly what has been known of the virus for 40 years. No one was infected by a patient in the early stages of infection. No one was infected who did not have direct contact with the bodily fluids of a severely ill Ebola patient.
LanternWaste
(37,748 posts)I saw the same thing with the Y2K 'concerns' too... 
from a lot of techies and the government.
B Calm
(28,762 posts)SheilaT
(23,156 posts)There were far too many people saying, What If? What If? What if the incubation period is longer than 21 days? What if an asymptomatic person can spread the disease? We should absolutely quarantine just to be sure.
There was an appalling lack of understanding of science, of epidemiology, of infectiousness, of contagiousness.
If Ebola were as easy to catch as the freak-outs thought, then all of Duncan's housemates would have gotten ill, not to mention a great many of the patients who were in the ER with him -- and he went twice with actual Ebola. But only two health care workers contracted it, and they were treated because it was caught early.
Something else to keep firmly in mind is that if Ebola were wildly contagious when not symptomatic, practically everyone in West Africa would have gotten it by now. But so far (and I realize this is only so far) about 12,000 people have gotten it, out of a combined population of around 22 million for the three countries involved: Guinea, Sierra Leone, and Liberia. And even with such limited health care as is available in those three countries, only about half of those who got it have died. And here, we've only lost one patient to Ebola, the unfortunate Mr. Duncan who went undiagnosed for so long that nothing modern medicine had could save him.
Yes, this is a terrible disease, and yes, everything possible needs to be done to eradicate it, perhaps make a vaccine against it. But the hysteria evinced everywhere, including here on DU has been disgusting and ignorant.
B2G
(9,766 posts)The WHO has documented cases on incubation periods lasting longer than 42 days. Epidemiologists indicate asymptomatic people can spread the virus.
Your figures of 12,000 cases has been discredited by both the CDC and WHO. They both admit the numbers are higher by a factor of at least 2-3.
To think you can draw concrete conclusions about this disease from one case (Duncan) is wildly inappropriate. There is much we still don't know about ebola, especially when it comes to urban settings.
To keep saying this is settled science is mind-boggling to me.
And asking these types of questions is not hysteria or panic-mongering.
morningfog
(18,115 posts)There is a single report which claims that, based on self-reports and statistical derivatives, that 2% may incubate beyond 21 days. But, there is no actual documentation of that whatsoever. In fact, there is very little support for even the 21 day incubation period and many epidemiologist think that, based on the data, the incubation period probably ends at 14 days. That is not to say that 21 days isn't good practice for observation. But, 42 day number is not reliable and not used.
And there has never been, not once, not a single case, of an asymptomatic person infecting another. There are no mystery cases. None.
The science is settled. Ebola has been well studied for 40 years. It looks different in the west because we have greater resources to treat it. Ebola a miniscule risk to the public at large i the US and other developed nations. Everything we have seen in the US and in the current outbreak in Western Africa is consistent with our prior knowledge. Nothing about the virus has changed or surprised the medical community.
It is quite simply a resource allocation issue. We can handle it here without a serious risk to the public. They can't in the nations experiencing an outbreak in W. Africa.
B2G
(9,766 posts)You obviously haven't read the many threads here that have been posted that directly contradict that 'the science is settled".
Whatever helps you sleep at night I guess.
morningfog
(18,115 posts)There is no direct contradiction. There are some people hypothesizing and fomenting silly thinking.
I will gladly read and consider anything you provide which contradicts the settled science.
Specifically, I would be quite interested in any report suggesting that even a single person has ever been infected by an asymptomatic individual. Or, a report that even a single person has ever been infected who did not have direct contact with the bodily fluids of a very ill ebola patient.
Seriously. This is the problem. People believe stuff that isn't true because someone on the internet said it. I will read anything you post and respond to it.
People Carrying Ebola, in Some Cases, May Be Free of Symptoms
By LAWRENCE K. ALTMAN
Published: June 27, 2000
The Ebola virus, which has caused deaths from high fever and bleeding in African outbreaks, can also infect without producing illness, according to a new finding by African and European scientists.
The possibility of asymptomatic infection was only suggested in earlier studies, they said in last week's issue of The Lancet, a medical journal published in London. Now they said they had documented such infections for the first time. They found that the Ebola virus could persist in the blood of asymptomatic infected individuals for two weeks after they were first exposed to an infected individual. How much longer the virus can persist is unknown.
All outbreaks of Ebola have been controlled by standard infection control measures such as effective body disposal, destroying or sterilizing contaminated equipment and appropriate use of gloves. But if people can be carriers without showing symptoms, it means control might be more difficult.
''This degree of containment would be virtually impossible if symptom-free carriers posed a significant threat of infection,'' Dr. Alan G. Baxter of Newtown, Australia, wrote in an editorial in the same issue of The Lancet.
Scientists have known that Ebola usually spreads from an infected person to another individual and through contamination in clinics or hospitals. The new finding suggests that some cases may result from healthy carriers. How often is unknown. The finding could help scientists in their long-term quest to develop effective therapies to treat the virus or perhaps even a vaccine to prevent infection.
But an immediate effect is to raise the need to reasses health policy about one of the most virulent viruses known and to determine how often healthy carriers transmit it, said the scientific team headed by Dr. E. M. Leroy of Franceville, Gabon.
One concern is transmitting Ebola through blood transfusions. Dr. Thomas G. Ksiazek, an expert in Ebola at the Centers for Disease Control and Prevention, a federal agency in Atlanta, said that such concern would be much greater in Africa than in the United States, where blood banks usually ask people who have been in Africa in recent months not to donate because of the threat of transmitting malaria.
Dr. Leroy's team said another public health concern was transmission of Ebola virus from healthy carriers through sex. Other scientists have detected Ebola in semen.
About 70 percent of people with symptoms of Ebola have died in widely publicized outbreaks in the central African countries of Gabon, the Democratic Republic of the Congo and Sudan.
Illness often begins abruptly, from 5 to 10 days after exposure to Ebola virus, with symptoms like fever, headache, vomiting and diarrhea. Then bleeding can occur internally or ooze from needle sites and through the nose and mouth. Death usually occurs from five to seven days after the onset of illness.
Dr. Leroy's team studied 25 individuals who never developed symptoms although they lived with family members and cared for them without using gloves and other precautions in two outbreaks in Gabon in 1996.
Using standard virologic techniques, the scientists from Gabon, Germany and France said they could not detect the virus in the blood of the healthy contacts. But Dr. Leroy's succeeded by using a technique known as polymerase chain reaction to grow the tiny amount of virus present.
http://www.nytimes.com/2000/06/27/world/people-carrying-ebola-in-some-cases-may-be-free-of-symptoms.html
morningfog
(18,115 posts)It does not directly contradict what is known.
It is not evidence of an asymptomatic person infecting someone. There is no evidence that that has ever happened. There have been several reports and some study on people who, like those in the article, appear to be immune. Whether it is that they are never infected or whether it is that they are infected but never get sick is what this article looks into.
But, it does not change the fact that no one has ever been shown to be infected by an asymptomatic person.
B2G
(9,766 posts)Proving they actually infected someone is much more difficult given the nature of ebola outbreaks.
morningfog
(18,115 posts)Many people are exposed and never infectious.
The point remains, there is no case where someone was infected who was not in direct contact with bodily fluids of a severely ill Ebola patient. There is no evidence of an asymptomatic (or even early symptomatic) person infecting another.
Cal Carpenter
(4,959 posts)Duncan is the only person who died in the US of this disease. He is the only case diagnosed on US soil with this disease. But the conclusions people are coming to and the protocols developed by the medical community are based on THOUSANDS OF CASES AND 40 YEARS OF RESEARCH.
I don't normally do caps lock but for fuck's sake, how many times does this need to be pointed out?
SheilaT
(23,156 posts)more than 21 days after last exposure.
Is that not proof enough? And there are no cases of asymptomatic people spreading the virus.
The CDC and WHO think that the actual number of Ebola cases may be higher, but so far they have not been able to demonstrate that accurately. And even so, the percentage of people infected is a tiny fraction of one percent of the population of those countries.
And why can't I draw conclusions from Duncan? No one who lived with him got Ebola. No one in the ER with him got Ebola. To say that we can't draw conclusions from this, or to keep on saying we just don't know, is mind-boggling to me.
B2G
(9,766 posts)21 Days Not A Long Enough Quarantine For Ebola, New Study Suggests
A 21 day quarantine, after being infected with the Ebola virus, has become the standard quarantine recommendation for avoiding the spread of the virus. That’s not long enough to eliminate the risk, suggested a new study published yesterday in PLOS Currents: Outbreaks.
By looking at data from past Ebola outbreaks, as well as the first nine months of the current Ebola outbreak, Drexel University environmental engineering professor 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, either by a few days or even a couple of weeks. The 0.1 figure comes from the 1976 Ebola outbreak in Zaire, which had far fewer cases analyzed than the other Ebola outbreaks looked at in this study that have had a higher number of cases with longer incubation periods, such as the Ebola outbreak in Congo in 1995 and the current outbreak in West Africa. In the first nine months of the current Ebola outbreak in West Africa, five percent of patients had an incubation period beyond 21 days, according to WHO Ebola Response Team in a study published in the New England Journal of Medicine.
“While the 21-day quarantine value, currently used, may have arisen from reasonable interpretation of early outbreak data, this work suggests reconsideration is in order and that 21 days might not be sufficiently protective of public health,” wrote Haas in the study.
The Ebola incubation period, which is the period between virus onset and symptom display, is on average two to 21 days, according to World Health Organization. Death or recovery typically follows right behind that. Once someone recovers from Ebola, they can no longer spread the disease (though it may be present in semen for up to three months), according to the Centers for Disease Control and Prevention (CDC). Most people don’t deviate from that two to 21 day incubation period, as this study shows, and many don’t see a doctor before symptoms arise, making a 21 day isolation sufficient for most. But with this current Ebola outbreak, which has claimed more than 4,000 lives and which has an increasing number of people being quarantined before symptoms arise, one way to get ahead of this virus may be by setting a longer quarantine period, so those who survive it may not spread it to others toward the end of the incubation period, Haas suggested in the study.
How long Ebola patients should be isolated is not answered by Haas. The purpose of the study was to not provide a number, but to start the conversation.
http://www.forbes.com/sites/jonfortenbury/2014/10/15/21-days-not-a-long-enough-quarantine-for-ebola-according-to-new-study/
morningfog
(18,115 posts)B2G
(9,766 posts)The WHO themselves confirm it, as does the study by the NEJM on the current outbreak.
morningfog
(18,115 posts)Where is the NEJM study?
B2G
(9,766 posts)Key Time Periods
The mean incubation period was 11.4 days (Table
2 and Fig. 3A), and did not vary by country (Fig.
3B, 3C, and 3D). Approximately 95% of the case
patients had symptom onset within 21 days after
exposure (Fig. 3A), which is the recommended
period for follow-up of contacts.
See figure 3 on pg. 1492.
http://www.nejm.org/doi/pdf/10.1056/NEJMoa1411100
morningfog
(18,115 posts)So, the patient may or may not accurately remember when they were most likely infected.
There is nothing more than that. The 538 article addresses that point. The 42 days just has not been proven to have ever occurred. We KNOW that the cast majority are in the 7-13 period.
Aside from that you have still never shown a single instance of asymptomatic infecting someone.
B2G
(9,766 posts)Incubation period
The period of 42 days, with active case-finding in place, is twice the maximum incubation period for Ebola virus disease and is considered by WHO as sufficient to generate confidence in a declaration that an Ebola outbreak has ended.
Recent studies conducted in West Africa have demonstrated that 95% of confirmed cases have an incubation period in the range of 1 to 21 days; 98% have an incubation period that falls within the 1 to 42 day interval. WHO is therefore confident that detection of no new cases, with active surveillance in place, throughout this 42-day period means that an Ebola outbreak is indeed over.
http://www.who.int/mediacentre/news/ebola/14-october-2014/en/
Ms. Toad
(34,076 posts)with an infection transmitted to two individuals, that those two individuals did not further transmit it.
It says nothing at all about what is possible. Unless you believe that a family in which one person does not transmit their cold to anyone else in the family proves that colds are not transmissible within a family. Or that having sex without using protection even m ultiple times without a resulting pregnancy proves infertility.
Duncan is an anecdote - which is a data point, but not enough data to prove a general principle.
SheilaT
(23,156 posts)No one who lived with him, and who was forced to stay in the apartment with dirty linens for some days after he left, got Ebola. Nor did anyone in the ER with him. Yes, two nurses got it, but they were in contact with him as he became more and more infectious.
And I have yet to see actual examples of anyone getting Ebola after the 21 days. If it were happening, there would already be a few isolated cases in this country. If someone who is not symptomatic could spread Ebola, it would be blindingly obvious by now.
Diseases do not abruptly evolve to change their methods of transmission. They don't. All of this crap about OMG! 21 days isn't long enough! is just crap. Not actual epidemiological reality.
And colds and pregnancy are not at all like Ebola. Duncan is not the only data point. There are lots and lots of others, including the doctor in NY, and the nurse who was initially quarantined in New Jersey and many, many other examples in Africa.
I'd suggest you read such things as the two books by Laurie Garrett, The Coming Plague and Betrayal of Trust. When you're finished with those, read Spillover by David Quammen. Then get back to us.
Ms. Toad
(34,076 posts)(which Duncan, Pham, Vinson, and Spencer provide) proves with what the quantity of reliable anecdotal data, gathered with consistent and regular enough methods, is capable of proving.
may be compelling but does not, in itself, provide proof.http://grammar.about.com/od/ab/g/anecdoteterm.htm
When the data you mention is reviewed, what you are left with is a small number of cases which cannot be traced to a known method of transmission. No peer reviewed research I have read reviewing the available data regarding transmission in the absence of traceable contacts with someone blatantly symptomatic put the risk at zero. All of them which I have read classify the risk as low, but non-zero.
That has nothing to do with changing their methods of transmission, or extending the period of incubation. It has to do with the reality that (1) most of the data is gathered in places where records it is harder to gather information and (2) what data has been gathered includes a number of cases in which there was no identifiable exposure to a symptomatic Ebola patient.
So the reality is we know the most common way Ebola is transmitted. What we don't know yet is whether the most common say Ebola is transmitted accounts for all of the transmission - or whether the dozen or so documented cases which appear to have resulted from indirect contact (via non-obviously contaminated objects) or contact with someone not yet symptomatic are what they appear to be: examples of transmission which contradict all of you screaming that Duncan proves such transmission is impossible.
Calling Duncan proof is exactly like calling the absence of pregnancy after a few sexual encounters proof of infertility. The fact that none of those who were infected by Duncan did not infect anyone else is proof of one thing: Duncan's trail of infection has ended. It is not proof that others in the early stages of Ebola (as Vinson and Spencer were for 3 days before they were isolated) do not pose a risk.
SheilaT
(23,156 posts)Where are the people who really do have absolutely no known contact with either the original (unknown at this point) vector, or with someone who did have symptomatic Ebola.
And again, your pregnancy example isn't viable. We know enough about how pregnancy happens, and how it does not happen even with sexual encounters, to be a valid counter-argument. Doctors who have worked with Ebola since it first manifested in 1976 understand that non-symptomatic people do not infect others with Ebola. Do yourself a favor and read some of the books I've suggested. Oh, and the Reston Ebola is not a valid counter argument, since that form of the disease does not infect humans.
Ms. Toad
(34,076 posts)Rather than just respond off the top of your head with the popular line on DU.
http://www.ncbi.nlm.nih.gov/pubmed/9988170
http://www.ncbi.nlm.nih.gov/pubmed/17940942
The pregnancy example is perfectly applicable. Someone who doesn't know if they are fertile or not concludes after a few times when no pregnancy resulted that he is infertile. Here, we know the main mode of transmission - but we don't know the limits of because the known modes of transmission do not account for all of the cases of Ebola - even after thorough epidemiological tracing. So the assertion by the OP that a few instances in which Ebola was not transmitted is proof that it can't happen by people in the early stages of Ebola (as both Dr. Spencer and nurse Vinson were) cannot transmit it is just like a person with unknown fertility status concluding that he is infertile because he got lucky the first few times he had sex. It may just be that his sperm count is really low - and most times he will be unable to impregnate someone - but occasionally he will. Similarly, if someone in the early stages of Ebola is contagious - but not very contagious because they are not yet producing the overwhelming quantity of virus they will later produce - most of the time no one will get infected, but sometimes they may (those cases where no known contact of the kind that we know transmits infection).
SheilaT
(23,156 posts)some twenty years ago they were not able to completely determine precisely how everyone was infected. That does not strike me as invalidating what we know about the transmission of Ebola, specifically the particular one that is out there now. Again, if it were passed more casually, don't you really think it would be obvious by now? We now have an unfortunate lot of information about Ebola in this recent outbreak, and nothing so far indicates it is easily passed on.
Unknown fertility status, and getting pregnant simply are not valid comparisons.
Ms. Toad
(34,076 posts)we would know by now. It does not invalidate what we know about the most common means of transmission. But nothing we know currently invalidates what was found in the study that was done in another outbreak, with careful contact tracing, there were cases which did not appear to have been contracted via the most common means of transmission. They started with 50+ cases that did not appear to have the normal exposure, and narrowed it to 12 - not zero - but 12.
You might want to take some basic logic classes if you do not see how the lack of a specific outcome in a few trials does not prove that no other outcome is possible. Whether that is a lack of pregnancy, or lack of developing an Ebola infection. When you make an absolute statement, a single point of contradiction proves you wrong. Just as a single pregnancy would invalidate the conclusion of infertility, a single infection that cannot be traced to the most common means of transmission proves that there are other means of transmission. I've given you 12 cases.
That doesn't make it easily passed on, but it does mean we don't know everything about how it can be passed on - and we need to be more cautious about isolating early in cases where there has been known exposure to Ebola. That is what I have been saying since Nurse Vinson continued to engage with the public after she first experienced fatigue - and as of October 27, that is also the CDC's position. The moment someone with high or some risk of exposure to Ebola has ANY symptoms, including simply fatigue, they need to be isolated and treated as if they actually have Ebola until it is proven they don't.
Orsino
(37,428 posts)morningfog
(18,115 posts)Scootaloo
(25,699 posts)morningfog
(18,115 posts)none in Gabon.
It is, as has been the case for months, serious in three West African nations.
It is a shame that the hysteria in the US resulted only in a focus on the US and actually caused less help to go to the nations that need it. We need to focus our efforts there.
uppityperson
(115,677 posts)There is a table at this first link that shows cases by total and last 21 days. I can't figure out who to copy it. Also further down it shows cases by week by country.
http://apps.who.int/iris/bitstream/10665/137510/1/roadmapsitrep_5Nov14_eng.pdf?ua=1
http://abcnews.go.com/Health/wireStory/worst-ebola-epidemic-numbers-26753186
Experts warn the actual number of cases and deaths are likely far higher than what's been reported, because people may be reluctant to seek care and officials are too overwhelmed with control efforts to record every single case. The vast majority of patients are in Guinea, Sierra Leone and Liberia. Cases and deaths are typically only recorded days after people become symptomatic or die, which complicates a real-time understanding of Ebola.
(clip)
According to WHO, 4,707 beds are needed across West Africa in Ebola treatment clinics; at the moment, just 22 percent of the necessary number are operational. The agency estimates a further 2,685 beds are needed for basic Ebola clinics where minimal treatment is provided and people are mostly isolated while waiting for test results. At the moment, just 4 percent of beds in these community clinics are available.
(clip)
WHO reports that 549 health workers have been infected with Ebola, of whom 311 have died. Since Ebola is spread via contact with the bodily fluids of a patient, health workers are at high risk of catching the disease. The U.S. Centers for Disease Control and Prevention recommends that no skin be showing in a health worker treating Ebola patients......
True Blue Door
(2,969 posts)Just a handful of anecdotal infections. Gleeful media hysteria does not an outbreak make.
Initech
(100,081 posts)
HereSince1628
(36,063 posts)Every infection but Duncan's was acquired INSIDE a hospital.
And the reasons that happened might range from known mis-marketing of protective aprons by a Wisconsin corporation, to failures of the hospital to commit adequate human and logisitical resources to protect their staff.
morningfog
(18,115 posts)never was a US outbreak. It was the headline supplied. I really just wanted to bring the "It's over" news to the attention of everyone.
HereSince1628
(36,063 posts)Nonetheless, there is something to learn.
The failures, Ebola cases in staff, that emerged really are limited in the type of people who were endangered. If that's going to be prevented, it's not good enough to say "danger over". It's essential to say "immediate threat over, time to deal with leaks".
Laura PourMeADrink
(42,770 posts) KamaAina
(78,249 posts) 
okieinpain
(9,397 posts)america would have been squashed. i mean geez 2 people got infected in the states that I know about, that's of biblical proportions.
randys1
(16,286 posts)wipe us out
WinkyDink
(51,311 posts)JI7
(89,252 posts)fearmongering whores they are