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PANDEMIC ALERT LEVEL
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Tracking the next pandemic: Avian Flu Talk

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newbie1 View Drop Down
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    Posted: August 02 2014 at 1:33pm
Ok - I have to admit I'm starting to feel 'paranoid' in part due to so much conflicting information regarding this Ebola breakout.

I think the whole aerosol vs droplet thing is kinda like pot-TAY-toe, pa-tat-toe... if you catch it via lungs - you aren't gonna care how big or small the droplet is!

Then this article: http://news.ca.msn.com/world/us-doctor-with-ebola-in-atlanta-for-treatment

Which in part says..."Health experts say a specialized isolation unit is not needed for treating an Ebola patient. Standard rigorous infection control measures should work at any hospital."

I'm sorry - maybe this isn't 'as catchy' as flu - but it's kill rate is high enough that I would have thought they would have a bit better attitude towards containment/isolation then this.
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Post Options Post Options   Thanks (2) Thanks(2)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: August 02 2014 at 2:31pm
Droplets and aerosols are distinct from each other, and there really is a significant difference. Pathogens like influenza are supremely successful in spreading in part because they are truly airborne. The oft quoted line is that someone with flu sneezes in a corridor, and everyone that walks through for the next ten minutes is at risk of being infected. In humans, seasonal flu is principally respiratory - it infects, multiplies and moves on to another host using our lungs and related plumbing. In converting an airway epithelial cell into a virus factory, it ultimately kills it and causes enough irritation to initiate a sneeze, and that forceful exhalation can generate wind speeds of 100mph and push large droplets AND smaller aerosols a good way out from the victim (check out rickster58's avatar for a great example). Droplets are heavier and tend to settle on surfaces faster, while aerosols can stay suspended for much longer periods.
Ebola is not primarily respiratory - it infects endothelial cells in the linings of blood vessels and makes them "leaky", hence the whole hemorrhagic thing. If it affects blood vessels in the lungs or airway it could certainly cause bleeding there, but I'm not aware of it specifically initiating a sneeze response in a significant number of victims. All I'm hearing is that victims can cough up blood and sputum. That would be heavier droplets expelled by a 50mph cough, and they would settle pretty quickly and much closer. I know there's a certain amount of semantics involved because an inhaled droplet can still infect you, but you'd need to be standing pretty close and breathing in before gravity cleared them out of the air.
It's really not airborne - we'd have seen it spread much further and faster if it was.

Good to see he was able to walk into the hospital Thumbs Up


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Post Options Post Options   Thanks (0) Thanks(0)   Quote nc_girl Quote  Post ReplyReply Direct Link To This Post Posted: August 02 2014 at 2:37pm
What I'd like to know is why 1) they haven't mentioned in the past few days that this is a 'new' strain of ebola which was stated when it first showed up, 2) that other versions of ebola tend to peter out because secondary infections are  not as 'strong' as the primary infections so it tends to 'fade away' with proper precautions.  Not so with this version of the virus.

Any thoughts?

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Post Options Post Options   Thanks (1) Thanks(1)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: August 02 2014 at 2:42pm
Thanks JD.  I've been trying to make the droplet/aerosol  point for some time.  You put it very clearly.  Thank you.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: August 02 2014 at 2:55pm
This one has a lower CFR too - EBOV has managed an average of 83% over the last few decades, peaking at 90%. This outbreak is averaging 60%.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: August 02 2014 at 3:05pm
You're welcome, Technophobe. I've been arguing the same point for days with friends who are panicking on Facebook over this. I was watching the coverage of the doctor arriving at Emory University Hospital this morning, and one of the reporters interviewed two experts and tried her hardest to get them to admit it was airborne. The exasperation in their voices as they kept saying that it wasn't made you realize they must have been asked the same question a hundred times.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote onefluover Quote  Post ReplyReply Direct Link To This Post Posted: August 02 2014 at 3:38pm
We do know, as discussed enoumerous times on this forum that a lower CFR generally means more virulant or contagious. However in this case it in no way indicates Ebola is more readily transmissible outside of close physical contact I agree. But the lower than average current CFR of Ebola indicates something differant is in the mix. To me. It could merely be that a higher percentage have sought medical help in this outbreak.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 02 2014 at 9:10pm
Look Ebola is nothing to look away from but I am hoping our medical facilities and a more educated population not running to the bush to a healer will avoid everyone but third world countries from having this run rampant.

If you get Ebloa in Haiti or South/Central America this could get ugly.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: August 02 2014 at 9:22pm
Originally posted by FluMom FluMom wrote:

Look Ebola is nothing to look away from but I am hoping our medical facilities and a more educated population not running to the bush to a healer will avoid everyone but third world countries from having this run rampant.
If you get Ebloa in Haiti or South/Central America this could get ugly.


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Post Options Post Options   Thanks (1) Thanks(1)   Quote onefluover Quote  Post ReplyReply Direct Link To This Post Posted: August 02 2014 at 10:02pm
Originally posted by jacksdad jacksdad wrote:

Originally posted by FluMom FluMom wrote:

Look Ebola is nothing to look away from but I am hoping our medical facilities and a more educated population not running to the bush to a healer will avoid everyone but third world countries from having this run rampant.
If you get Ebloa in Haiti or South/Central America this could get ugly.



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This is what JD has been saying all along. Except for the Zombie Region and ugh, lettuce-for-TP Region. (Sorry Mom, that was in very poor taste!)

In fact we may end up being encroached upon but the only cases actually on our soil are carefully imported for research.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Elver Quote  Post ReplyReply Direct Link To This Post Posted: August 02 2014 at 11:23pm
Droplets or aerosol, aren't we splitting hairs here? The Zaire strain of Ebola passed between species with "no direct contact".

http://www.nature.com/srep/2012/121115/srep00811/full/srep00811.html
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: August 03 2014 at 3:27am
Yes it is hair splitting.  Sometimes a hair's breadth is all it takes.
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Post Options Post Options   Thanks (1) Thanks(1)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: August 03 2014 at 4:24am
i've been wondering about this EBOLA 

i have been watching this virus for the last 20 years,

it has never moved like this,

mostly it peters out very quickly ,as you can see the people are infected

this one has an incubation rate of 14 days i believe,

not sure if this is the differance,

have to  dig a bit more..... 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote nc_girl Quote  Post ReplyReply Direct Link To This Post Posted: August 03 2014 at 8:13am
Thanks carbon!  Me too!  I've asked questions on the board but they're getting ignored.  1st point is how are they so sure this is not airborne when there is evidence that at least one other ebola was airborne and how are they so sure it's not more virulent when the secondary infections are just as strong as the primary ones so it's not just dying out like usual? 

I've never seen an ebola event last this long and spread like this one.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote newbie1 Quote  Post ReplyReply Direct Link To This Post Posted: August 03 2014 at 9:50am
Thanks JD - I get the 'hair splitting' difference - I do, but I posted this as I did NOT like the attitude of - any of our hospitals with rigid cleaning protocals can control this type attitude!

A video that was posted (I believe on this blog) showed the docs suiting up; knee high boots, full suit, head cover, goggles, mask (N95 looking one), four (yes 4!!!) pairs of gloves, apron...walk thru disinfectant both going in & out of 'hospital' etc.
I think this is pretty rigid for prevention - and the docs are still getting it!

So sorry if I'm a bit paranoid about the CDC screwing up (again!!!) this time with handling of the Ebola 'materials' and such - and then to read that hospital they are going to isn't even a level 4 containment...??? I thought this place was supposed to be one of only 4 in US of it's type?
I'm honestly glad the volunteers were able to come home - they are heroes... however - it has broken international protocols for containment to move this type of disease out of country it's in & it's put a whole nation (continent) at risk - jmo...   

There are WAY too many unanswered questions with this strain - the fact that many have said 'man made' for the incubation to go from short term (all other 'natural' strains) to up to 21 days - many are saying this is a weaponized form, and to read new posts about the weapons lab being in the middle of all this...hmmmm TOO MANY QUESTIONS!!!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote newbie1 Quote  Post ReplyReply Direct Link To This Post Posted: August 03 2014 at 9:51am
Originally posted by carbon20 carbon20 wrote:

i've been wondering about this EBOLA 

i have been watching this virus for the last 20 years,

it has never moved like this,

mostly it peters out very quickly ,as you can see the people are infected

this one has an incubation rate of 14 days i believe,

not sure if this is the differance,

have to  dig a bit more..... 



2 to 21 days on this one Carbon - one of the main things that ppl are saying 'doesn't sit right'... someone (Elvers?) said on another post - if it stinks it's a skunk
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Post Options Post Options   Thanks (1) Thanks(1)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: August 03 2014 at 10:13am
Newbie1 - I hear you. Despite all the precautions they're taking (and you know the western doctors are undoubtedly following protocol to the letter) they're still catching it. Why? That's going to be an educated guess at best, but as me and onefluover were discussing on another thread, I'm willing to bet that the makeshift conditions and lack of bloodborne pathogen training amongst native caregivers is contributing to this, and I'm sure the virus is widespread on surfaces both within the clinics and the living quarters the medical staff are using.
The doctors might be using first world universal precautions and decontaminating after contact, but who's to say everyone is. That would leave them exposed while eating, sleeping, etc. I work in healthcare, and effective infection control requires that you know what you're doing, and that you pay attention to what you're doing 100% of the time. Tired, undertrained staff will spread this among coworkers with ease.
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Post Options Post Options   Thanks (1) Thanks(1)   Quote CRS, DrPH Quote  Post ReplyReply Direct Link To This Post Posted: August 03 2014 at 10:22am
Originally posted by Technophobe Technophobe wrote:

Thanks JD.  I've been trying to make the droplet/aerosol  point for some time.  You put it very clearly.  Thank you.

I agree, thanks JD!  You said it perfectly. 

The physics involved is very complicated.  When we sneeze, a load of snot (technical term) and virus is expelled.  The largest droplets of liquid snot fly all over, as you have likely experienced.  However, much smaller droplets dry nearly instantly, encapsulating the virion particles in a moist center and forming a floating "chip" of snot, called a "droplet nuclei." 

These are insidious, as they can be inhaled deeply into the lung, bypassing our body's defense mechanisms (nasal hair, sinuses etc.).  They also float around for quite a while, suspended by brownian motion and air currents.  This is why we get flu in the winter = less humid air conditions select for more droplet nuclei, and we are bottled up indoor, where we can breath the things in deeply.

» What is airborne transmission?

Airborne transmission refers to situations where droplet nuclei (residue from evaporated droplets) or dust particles containing microorganisms can remain suspended in air for long periods of time. These organisms must be capable of surviving for long periods of time outside the body and must be resistant to drying. Airborne transmission allows organisms to enter the upper and lower respiratory tracts. Fortunately, only a limited number of diseases are capable of airborne transmission.

Diseases capable of airborne transmission include:

  • Tuberculosis
  • Chickenpox
  • Measles
http://microbiology.mtsinai.on.ca/faq/transmission.shtml
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Post Options Post Options   Thanks (1) Thanks(1)   Quote arirish Quote  Post ReplyReply Direct Link To This Post Posted: August 03 2014 at 12:01pm
JD said- This outbreak is averaging 60%.

Don't forget there could be thousands of cases in the bush! I doubt if we'll ever know what the true CFR is!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: August 03 2014 at 1:45pm
There are a number of sides to that paricular coin, arirish. One is that Ebola deaths are more likely to be reported or detected than infections that resolve themselves and are therefore missed, which could mean the CFR is even lower. But that opens up a whole new can of worms because milder infections tend to allow wider spread, and consequently more chances for mutation
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Post Options Post Options   Thanks (1) Thanks(1)   Quote onefluover Quote  Post ReplyReply Direct Link To This Post Posted: August 03 2014 at 2:39pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: August 03 2014 at 2:39pm
i would say there is a lot more cases that are hiding away in the bush,

i watch as ever with interest.....................
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arirish and all,I agree 100%.Johnray1
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Post Options Post Options   Thanks (0) Thanks(0)   Quote gingerlee Quote  Post ReplyReply Direct Link To This Post Posted: August 05 2014 at 9:36pm
That is the same question I have, and no one has mentioned what tests they are using to determine if these suspicious cases of Ebola in other countries are testing negative.  That is why this thing has gotten out of hand.  The people originally infected where testing negative and sent home.  Common sense would dictate that it is a natural event, but because of the research I have done since early April of this year I have come to the conclusion that this is a manufactured event.  I have been telling family and friends who work in health care, especially those who work in emergency rooms to please take ever precaution when seeing someone who is presenting with flu like symptoms.  Better to be safe than sorry, not one for Russian roulette.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Johnray1 Quote  Post ReplyReply Direct Link To This Post Posted: August 06 2014 at 11:51am
gingerlee,you are right. There have been many false negatives,because the test did not work. But no one will admit it.Johnray1
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