Ebola case in Dallas.

mccardey said:

I had a bad cough once, and nobody cared at all.

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Well there was also throwing up and fever involved. I remember the cough because it went on for months, unlike the other things.

Asking if you've done any international travel recently sounds like a pretty standard thing to do when people get sick like that, but probably it's not standard or something that gets forgotten all the time.

chompers said:

I have never been asked if I'd recently travelled. And I don't think that ebola would be the first thing to come to mind, particularly for a country that doesn't have it. A lot of its symptoms sound like it could be other illnesses. Yes, it is unfortunate that it didn't get caught earlier, but I can see how it got overlooked.

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It's a common question to ask a patient in an er with unexplained symptoms. It's especially common in a large city er, where they routinely get patients from anyplace.

Last year this time, no, Ebola wouldn't come to mind quickly. Now? I think it absolutely should. It's not like it's not in the news, often, and the CDC and the WHO sent out specific alerts/guidelines to hospitals.

Sorry, I can't see any excuse for not asking if an adult with unexplained symptoms of that type had recently travelled.

mccardey said:

I had a bad cough once, and nobody cared at all.

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That Hapax had been to Mexico?

mccardey said:

I had a bad cough once, and nobody cared at all.

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"I care." - Luke Skywalker

I remember there being some talk a couple of months ago about Ebola possibly being transmitted with in, like a meter, radius by aerosol droplets of the infected. Not hardly the same as airborne, but still not awesome. Don't know if that was confirmed or proved false, or not.

Let's just hope the CDC doesn't let us down.

Karen Junker said:

I haven't been keeping up on the news about this disease -- are they saying how many people could have it and not be symptomatic? Also, how it is spread, etc.?

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All indications are that it is spread solely through direct human contact, e.g., not aerially.

But, some years ago, a very similar virus destroyed a research population of chimpanzees at some high-level facility on the Atlantic Coast in or near Washington, D.C., via aerial transmission. The place was essentially nuked, in a biological sense. That particular virus apparently did not affect humans.

A variety of Ebola capable of aerial transmission would be about as scary as an approaching bolide the size of the one that killed the dinosaurs.

caw

blacbird is talking about Ebola Reston, a different strain of the virus, not the one affecting any parts of Africa atm, to anyone's knowledge I'm aware of. The Congo outbreak was, I think, the strain more common there, not the one in West Africa, but they're similar.

Diana Hignutt said:

"I care." - Luke Skywalker

I remember there being some talk a couple of months ago about Ebola possibly being transmitted with in, like a meter, radius by aerosol droplets of the infected. Not hardly the same as airborne, but still not awesome. Don't know if that was confirmed or proved false, or not.

Let's just hope the CDC doesn't let us down.

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The CDC? The agency that left Smallpox in a closet and forgot where they put Anthrax? Define 'let us down,' heh.

It's spread by body fluids, so it can be transmitted in that way, yes.

If someone coughs close to another person, and the droplets are quickly inhaled, maybe possible (airborne transmission is also technically droplets, but they're very very tiny and stay suspended in the air). If someone coughs into their hand, puts that hand on a pole in a bus, then you put your hand on the pole, then rub your eyes, sure, that's possible.

Someone with Ebola is feverish and sweaty, wipes their forehead with their hand, passes you a cup, you take it, touch your eyes or mouth - voila.

Luckily, if you're not symptomatic, you're not contagious, and if you are symptomatic, you're probably so sick you're just laying around, not going out and interacting with people.

Thus the greatest danger is to family and medical personnel. In a city though, when someone goes to hospital, is sent home and then goes back days later, the possible vectors are disturbing.

Since it is not clear whether this patient is a US citizen - I think there's a fair chance he isn't - then the question of why they didn't ask, or he didn't volunteer, about foreign travel seems particularly valid.

I just hope that this news doesn't cause someone else's family to panic and move someone from the hospital at the risk of their own health. Or several someones.

Panic is the worst thing in the world for healthcare facilities to deal with, and it's pretty much a given that the "Do I have..." worriers will be out in force with imagined or fear-exaggerated symptoms. Stories like this one have a way of making near-hypochondriacs out of people who normally wouldn't go to a doctor. That fills the ER's and makes it a longer wait for people who actually need medical care. It also increases the population density in the ER, which is never a good thing.

(At least with the "care now" facilities that have popped up in the wake of the Affordable Care Act, it should mediate the congestion.)

What remains of the CDC is a small number of people who are immensely qualified and know exactly what should be done. Whether of not it actually is done is the only question as they have basically only an advisory role given the pathetic amount of funds and front line personal at their disposal.

A second patient who had contact with the patient from the confirmed case is being closely monitored.

http://www.wfaa.com/story/news/heal...n-dallas-county-ebola-patient-cases/16524303/

ETA: This article also has some more information on the contact tracing for this case.

Amazes me how people panic over a disease most people know nothing about.

Seems to me, if its transferred via bodily fluids, it isn't likely to create some nationwide epidemic, unlike influenza. Is it a nasty disease if you catch it? Certainly, but it seems pretty remote in America where cleanliness is almost an obsession that its going to spread very readily

I don't understand why he was released, either, if he said he was here from Liberia. You'd think anyone with a fever who just came from certain regions should be quarantined in some way.

I wouldn't be surprised if the doctors didn't ask. I've never seen a doctor get particularly interested about someone having the common cold, which this looks like at that point, so that's absolutely the problem with something like this in the US, imho.

I have no doubt that we can contain it, but it's sad that other people near the infected really could get it first.

That doctor who sent him home could develop it, I'd think. Of course, he'd be watching for symptoms, so it wouldn't spread, but still.

Shadow_Ferret said:

Amazes me how people panic over a disease most people know nothing about.

Seems to me, if its transferred via bodily fluids, it isn't likely to create some nationwide epidemic, unlike influenza. Is it a nasty disease if you catch it? Certainly, but it seems pretty remote in America where cleanliness is almost an obsession that its going to spread very readily

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The CDC says it poses no significant risk.

Doesn't stop people from being ignorant and paranoid, of course. ("You guys haven't treated any Africans in there, right?")

backslashbaby said:

I don't understand why he was released, either, if he said he was here from Liberia.

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"Liberia? What state's that in?"

You would expect medical staff to be aware of the Ebola outbreak in West Africa, but that expectation may not be fulfilled.

waylander said:

Since it is not clear whether this patient is a US citizen - I think there's a fair chance he isn't - then the question of why they didn't ask, or he didn't volunteer, about foreign travel seems particularly valid.

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The latest news item says he DID volunteer that.

backslashbaby said:

I don't understand why he was released, either, if he said he was here from Liberia.

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And indeed he did. This is the Top Story on the Guardian:
Ebola patient told hospital of Liberia travel but was not initially admitted
Man told staff about his travel history but information was not widely enough shared with the medical team, officials acknowledge
http://www.theguardian.com/world/2014/oct/01/ebola-us-doctors-texas-liberia

Shadow_Ferret said:

Amazes me how people panic over a disease most people know nothing about.

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Lack of knowledge about something potentially dangerous quite reasonably results in fear. Where this results in extra caution, it's a reasonable thing to do.

I recall celebrities not kissing when they met on the Tonight Show because at the time it wasn't known how then-new AIDS was transmitted.

cornflake said:

blacbird is talking about Ebola Reston, a different strain of the virus, not the one affecting any parts of Africa atm, to anyone's knowledge I'm aware of. The Congo outbreak was, I think, the strain more common there, not the one in West Africa, but they're similar.



The CDC? The agency that left Smallpox in a closet and forgot where they put Anthrax? Define 'let us down,' heh.

It's spread by body fluids, so it can be transmitted in that way, yes.

If someone coughs close to another person, and the droplets are quickly inhaled, maybe possible (airborne transmission is also technically droplets, but they're very very tiny and stay suspended in the air). If someone coughs into their hand, puts that hand on a pole in a bus, then you put your hand on the pole, then rub your eyes, sure, that's possible.

Someone with Ebola is feverish and sweaty, wipes their forehead with their hand, passes you a cup, you take it, touch your eyes or mouth - voila.

Luckily, if you're not symptomatic, you're not contagious, and if you are symptomatic, you're probably so sick you're just laying around, not going out and interacting with people.

Thus the greatest danger is to family and medical personnel. In a city though, when someone goes to hospital, is sent home and then goes back days later, the possible vectors are disturbing.

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Some gastrointestinal viruses (noro is one) are spread via droplets of infected vomit or feces. Nasty thought, but if someone barfs in a room, everyone will be inhaling/swallowing the droplets of vomitus.

My understanding is with ebola, you need direct contact with infected vomit, feces or blood. I don't think droplets from across the room do it.

You do need to be symptomatic to spread this kind of ebola, so he wouldn't have infected anyone on the plane. However, I heard on the news this AM that the patient was treated as an outpatient (given antibiotics and sent home) when he first became ill and sought medical care. This raises the possibility that health care workers, plus anyone he lives with, were exposed.

They're saying they're confident the case won't lead to a wider outbreak, but of course, that's what they would have to say at this point if they don't want people to get panicky.

http://www.npr.org/2014/10/01/352925378/first-u-s-ebola-case-confirmed-in-dallas

http://www.npr.org/2014/10/01/352925441/will-the-ebola-case-in-dallas-lead-to-a-u-s-outbreak

For what it's worth, doctors in the area ARE asking questions about travel. I'd actually forgotten that until this thread, but I went in about two weeks ago and that was one of the questions my doctor asked me. And I live in a town too small to be on most maps, where the nearest doctor's office isn't even in town at all.

Somebody screwed up, but others are being more careful.

An infected blanket did it for one man (probably many more, of course), I saw on CNN earlier. So I don't like that CDC graphic that uses infected needles as the only example of infected objects that can pass it. I'm sure the blanket had body fluid on it at some recent point, but that's a far cry from sharing needles, you know?

I hate to think this poor man went to a US doc and came out with confidence that he just had an infection that antibiotics would fix. He'd be less apt to be careful about contact with his family and others because of having been to that hospital and released. That part is simply horrible. Coming from Liberia, you know he was concerned. I really hope the 1st trip to the ER didn't give him a dangerous false sense of security

Roxxsmom said:

Some gastrointestinal viruses (noro is one) are spread via droplets of infected vomit or feces. Nasty thought, but if someone barfs in a room, everyone will be inhaling/swallowing the droplets of vomitus.

My understanding is with ebola, you need direct contact with infected vomit, feces or blood. I don't think droplets from across the room do it.

You do need to be symptomatic to spread this kind of ebola, so he wouldn't have infected anyone on the plane. However, I heard on the news this AM that the patient was treated as an outpatient (given antibiotics and sent home) when he first became ill and sought medical care. This raises the possibility that health care workers, plus anyone he lives with, were exposed.

They're saying they're confident the case won't lead to a wider outbreak, but of course, that's what they would have to say at this point if they don't want people to get panicky.

http://www.npr.org/2014/10/01/352925378/first-u-s-ebola-case-confirmed-in-dallas

http://www.npr.org/2014/10/01/352925441/will-the-ebola-case-in-dallas-lead-to-a-u-s-outbreak

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It's not from across the room, no - that's basically the difference between airborne and a virus that's not but can be transmitted in aerosolized bodily fluids.

If it's airborne (which this Ebola is, to our knowledge, not), the droplets that can cause transmission are both very small and hang in the air.

If it's not but can be transmitted by droplets of fluid, like in a cough or vomit or your classic exploding head, the droplets are larger and only dangerous in a smaller range (like 3 or so feet), then they fall to the ground.

Ebola is transmitted in sweat as well, which can explain the blanket (as can other things, just saying).

It's more dangerous for people who treated him and live with him, obviously, as they're more obviously, likely, clearly able to be exposed. If he's walking around a city symptomatic, however, he's able to create disease vectors wherever the hell he roamed (if he went to a store and handled things after coughing into his hand, or wiping a sweaty brow, and others touched those things and then touched their own faces, for instance).* Hence the hospital workers who apparently didn't even need to ask but were told he just got back from Liberia and had a fever and other symptoms and let him wander off need to be fired. That's just inexcusably irresponsible as a public health worker.

*I'm not at all blaming him - he went to the hospital, reported his symptoms and didn't even need to be asked, he apparently volunteered that he'd just been in Liberia and the dolts sent him home.

benbradley said:

Lack of knowledge about something potentially dangerous quite reasonably results in fear. Where this results in extra caution, it's a reasonable thing to do.

I recall celebrities not kissing when they met on the Tonight Show because at the time it wasn't known how then-new AIDS was transmitted.

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Agreed, however one should note that any reaction to something we don't have sufficient knowledge about is totally unproductive at best and highly dangerous at worst, whether the reaction is in the direction of being too concerned or not being concerned enough. We need a cultural climate where we seek out all available knowledge first before we have any kind of reaction, and luckily there is copious amounts of available knowledge on the current strains of Ebola.

benbradley said:

Lack of knowledge about something potentially dangerous quite reasonably results in fear. Where this results in extra caution, it's a reasonable thing to do.

I recall celebrities not kissing when they met on the Tonight Show because at the time it wasn't known how then-new AIDS was transmitted.

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Sure, but the difference here is, we have a ton of information available on Ebola. They just have to look. Its not an unknown disease like AIDS was back in the day. I guess that's my gripe: people would rather panic than become informed.

Shadow_Ferret said:

Sure, but the difference here is, we have a ton of information available on Ebola. They just have to look. Its not an unknown disease like AIDS was back in the day. I guess that's my gripe: people would rather panic than become informed.

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Someone on my FB feed posted a panicky thread about Ebola and implied that it could be transmitted a lot more easily than it actually can. I tried, patiently, to explain that it is nothing to panic about and pointed out why the outbreak in West Africa had taken hold the way it had, and how that could not happen in the US. Nope, she wouldn't have it. She read a book about Ebola 15 years ago (probably Clancy's novel 'Executive Orders) and is convinced that she's right. *headdesk*.
I also just noticed that Ebola is trending on Twitter and, boy, the ignorance and the fingers of blame pointing at Obama and the US government just astonished me.

backslashbaby said:

An infected blanket did it for one man (probably many more, of course), I saw on CNN earlier. So I don't like that CDC graphic that uses infected needles as the only example of infected objects that can pass it. I'm sure the blanket had body fluid on it at some recent point, but that's a far cry from sharing needles, you know?

I hate to think this poor man went to a US doc and came out with confidence that he just had an infection that antibiotics would fix. He'd be less apt to be careful about contact with his family and others because of having been to that hospital and released. That part is simply horrible. Coming from Liberia, you know he was concerned. I really hope the 1st trip to the ER didn't give him a dangerous false sense of security

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If it ends up in your mucous membranes. So yes, a feces, vomit, or bloody blanket could do it if someone wipes their eyes or nose. Not sure how long virus is viable outside the body.

backslashbaby said:

An infected blanket did it for one man (probably many more, of course), I saw on CNN earlier. So I don't like that CDC graphic that uses infected needles as the only example of infected objects that can pass it. I'm sure the blanket had body fluid on it at some recent point, but that's a far cry from sharing needles, you know?

I hate to think this poor man went to a US doc and came out with confidence that he just had an infection that antibiotics would fix. He'd be less apt to be careful about contact with his family and others because of having been to that hospital and released. That part is simply horrible. Coming from Liberia, you know he was concerned. I really hope the 1st trip to the ER didn't give him a dangerous false sense of security

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Apparently, just days before he left Liberia, he had contact with Ebola. His landlord's daughter had the virus, but was turned away from the hospital because it was too crowded with patients. She died that evening. He was with her the entire time, trying to help. He actually drove them to the hospital and carried her into her home when she was too weak to walk.

I agree that the nurse at the hospital dropped the ball, but why the heck didn't he mention that he had close contact with Ebola?

I have to give him credit for being incredibly brave and selfless when trying to save the girl, I just don't understand why he wouldn't mention such a key bit of information.