Monday, November 17, 2014

Ebola Just a Plane Ride Away


Breaking: Dr. Martin Salia who was transported from Sierra Leon to Omaha, NE has died of his Ebola infection. Apparently, the infection was far advanced by the time of his arrival at Nebraska Medical Center, and treatment is hampered by the lack of an effective vaccine. Some are questioning the decision to fly him 5700 miles for treatment when he was critically ill. He reportedly suffered kidney failure en route. The US State Department facilitated the 16 hour flight. Efforts to save him included placing him in a ventilator, administering an experimental drug, ZMapp, and survivor-plasma transfusions. A co-missionary in Sierra Leon, said Dr. Salia's efforts to help are appreciated by Sierra Leoneans. RIP.

Latest: {14.11.14}A doctor working in Sierra Leon and diagnosed with Ebola will be transported to Omaha, NE for treatment at the Nebraska Medical Center. The doctor reportedly lives in Maryland and is a permanent resident of the US. He was working at Kissy United Methodist Hospital, Freetown as a general surgeon. When patients found out about the case, they fled the 60 bed hospital. The surgeon will be the third Ebola patient admitted to the Omaha hospital and the 10th person to be treated in the United States. The New York doctor who contracted the disease last has been released from hospital. The surgeon from Sierra Leon is expected to arrive Saturday. He tested positive for the disease on November 10th after exhibiting symptoms for a few days. Five other doctors in Sierra Leon have died of Ebola infections. The Omaha hospital was chosen because it is one of only four equipped to handle highly dangerous diseases, two of the other hospitals, at Emory University, Atlanta and National Institutes of Health, Maryland are in 21 day isolation periods.

Yet More: {29.10.14}The irrational reactions to the Ebola epidemic were topped yet again when a nurse exposed to the Ebola virus in West Africa refused to submit voluntarily to a twenty-one day quarantine at her home in Maine. So the Maine governor sent in the state police to enforce her isolation at home. Nurse Kaci Hickox told reporters she was not going to be "bullied by politicians" after she tested negative on arrival in New Jersey. The combative nurse threatened to go to court to gain her freedom if the quarantine was not lifted by Thursday morning. New Jersey's Governor Christie told her to go ahead and get in line. To emphasize her uncooperative behavior she went for a bike ride in her home town on Thursday. At the executive rental in Washington, DC the Current Occupant told Americans that there may be more Ebola cases, adding it was impossible to "hermetically seal ourselves off"; We can certainly make it more difficult to contract the disease by reducing the flow of unofficial travelers to and from West Africa*. Not wanting to appear argumentative, Mr. President, but how much are you willing to bet that Australia has fewer reported cases of Ebola infection per capita than the United States by the time this epidemic is over? California became the latest state to implement a 21 day quarantine for persons who have personal contact with an infected individual. US Person wonders is there is a death wish operating at the White House?

*Exit screening of international travelers in the airports of the three infected West African capitals would be an acceptable less "draconian" alternative to a visa ban such as implemented by Australia.  Given the confused politics of the region, the chances of that happening are small.

Further:{29.10.14} Australia has announced a visa ban for travelers from affected West African countries, while the Current Occupant attempted to explain the contradictory approaches takes by the US Army and some states on imposing temporary quarantines for soldiers and medics returning from the region. Soldiers are required to spend three weeks at a facility in Italy before returning to the US. The CO told reporters soldiers have to follow orders while medical personnel have civil rights to be considered. Let that be a lesson to any young person thinking of joining the Army. Predictably Australia is being criticized as discriminatory for its visa action, but the government's immigration minister told parliament the government was working to protect Australians. There is an understandable shortage of health care workers willing to go the region to fight the deadly epidemic; any medic willing to run the risk of contagon while treating victims should understand the need for a relatively brief period of isolation to help stop Ebola's spread to uninfected countries. New federal guidelines says medics returning from treating patients in West Africa should be monitored but not quarantined. New Jersey and New York, two of the states adopting a quarantine policy said they will continue their course. The two nurses that contracted the disease from 'Patient Zero' in Dallas have been released after recovery. No hospitals west of Denver have been designated to receive Ebola victims and only twenty-four out of 100 public health labs are ready to test for the deadly virus.

More: {8.10.14}Thomas Eric Duncan, the first US Ebola victim  has died in Texas. RIP. The LA Times reports that some scientists who have studied the Ebola virus say that CDC assurances the disease is not an airborne infection are premature. The virus could mutate rapidly once it passes through multiple human hosts, something it has never done before.  This epidemic has already killed more people than all previous outbreaks combined.* Dr. C.J. Peters, who battled a 1989 outbreak among research monkeys tortured in Virginia said there was insufficient data to exclude the possibility that it can spread through air in tight quarters. Like an airplane cabin, doctor? Dr. Phillip Russell, a former biological weapons virologist, said there are too many unknowns to be dogmatic about the way the virus spreads. Infected individuals could become desperate to reach the United States or Europe by air transportation in the hope of receiving experimental treatment not available in West Africa. Initial symptoms of infection such as fever or headache could be masked by the use of readily available analgesics. If more infections turn up here, its time to raise the watery drawbridge in US Person's humble opinion. The general of the army's Africa Command, David Rodriguez, said American troops will be supporting aid efforts in the infected region for "about a year" or until it the epidemic is under control. Controlled exceptions to an air travel quarantine can therefore be made for official business or humanitarian relief. Tell that to the White House, and damn the profit margins.

Latest: {06.10.14}Turns out the latest US victim had contact with an estimated fifty people, not five as first reported by corporate media. These are under medical surveillance. Thomas Duncan's condition is listed as critical, and he is on a respirator "fighting for his life" in Texas. An expert in infectious diseases from the National Institutes of Health said she would not be surprised if someone in contact with the first US case comes down with the disease. Other scientists have said, based on air traffic data and disease spread information, there is a 75% chance the disease will reach France by October 24th and a 50% chance the hemorragic fever will hit Britian. Of course that is bad news for the United States because the volume of cross-Atlantic travel from those two countries is enormous. The epidemic is spreading very quickly in West Africa with about 5 new cases a day reported from Liberia. So far 7200 people are reportedly infected. Without advance treatment with experimental drugs the disease is almost always fatal. So far the WHO has not recommended restrictions on air travel from the infected area. Although procedures are in place to handle a disease outbreak in this country, they do not include air travel embargoes. Is that because corporate profits are impacted? You decide.

Update:{30.09.14}It was predictable in an age of intercontinental air travel, but nevertheless avoidable if quicker and more effective action had been taken to stop the disease spread on the African continent. WHO reports more than 6,000 cases of Ebola infection and more than 3,000 deaths in West Africa, but those numbers are consided to be a vast underestimate of the epidemic. The first diagnosed case of Ebola infection in the US is reported from Dallas, Texas. The male patient left Liberia on September 19th and arrived in the US the next day. Four days later he exhibited symptoms of infection. He was isolated by the 28th and is reported critically ill. The CDC is considering experimental treatment; an American doctor and nurse infected in Liberia while treating the sick survived after being returned to the US to receive advanced treatment. Centers for Disease Control insists the patient was not contagious while traveling since he did not show symptoms until four days after arriving. A CDC spokesperson said, "there is zero risk of transmission on the flight". However, initial symptoms of the disease (fever, fatigue, headache) are not disease specific and can be mistaken for ordinary flu or malaria. The Ebola virus can remain incubated for up to 21 days without causing symptoms. A patient is not considered to be contagious until symptoms are apparent.

credit: AP
{30.07.14} The deadly Ebola virus outbreak in Liberia, Guinea and Sierra Leon that has been rampaging for five months is getting worse. Twelve hundred cases have been reported to the World Health Organization (WHO), 729 of those were fatal. A recent victim, Samuel Brisbane was a leading Liberian doctor who was fighting the epidemic. In Sierra Leon, Ebola expert Sheik Umar Kahn also succumbed to the disease. An American physician in Liberia, Kent Brantly is gravely ill despite extensive precautions taken against infection [photo]. Brantly served as the director of an Ebola isolation unit in Monrovia, Liberia. Ebola can be fatal in up to 90% of cases; with expert medical care the fatality rate can be reduced to just 60%. Dr. Brantly is religious and has asked for prayers to help him and those who are caring for him survive the scourge. Elsewhere in Liberia, medical personnel fled from the deadly disease.

credit: BBC
What is even more frighting is that Ebola [molecular model, right] is only a plane ride across the Atlantic from arriving in the United States. That alarming possibility was brought home when a Liberian civil servant with dual citizenship died from from infection before he could board a plane from Lagos, Nigeria to attend his daughters' birthday party in Coon Rapids, MN. The naturalized Liberian took ill on connecting flights from Liberia to Lagos via Togo. He was quarantined at a hospital after collapsing in Lagos airport. He died of Ebola infection on July 25th; after his death the hospital was evacuated and closed for sanitation. The civil servant had been caring for his sick sister. According to his wife in Minnesota, he did not know she was infected with Ebola that begins with a sore throat and fever, but deteriorates to vomiting, diarrhea and internal and external bleeding. Authorities estimate the infected traveler came into contact with forty-five people during his journey.

*Previous outbreaks in Africa have occurred in isolated villages where fruit bats are consumed as a source of protein. Scientists think that fruit bats are unaffected carriers of the virus. The first known outbreak of the deadly disease occurred in the Democratic Republic of Congo over thirty years ago. Investigating scientists then determined the disease was spread by contact with infected patients or their bodily fluids. The head of the CDC said that this was the worst epidemic he has seen since AIDS. The unaswered question is why more effort was not made to stop the disease spread in West Africa before it entered international commerce. Hyperbole? NOT!