'Toontime: Pants on Fire!

Monvrovia, Liberia

Further: A New York doctor who worked for the humanitarian organization, Medicines Sans Frontières in Guinea has contracted Ebola. He returned home to Harlem and is now in isolation at a Manhattan hospital. The doctor had contact with others on the subway, in taxis, and at a bowling alley before being admitted to Bellevue. His fiancee is under quarantine as well as two friends. Apparently the doctor was self-monitoring for disease symptoms and detected a fever Thursday after being home a week. He flew from Guinea via Brussels to JFK where he passed the screening process since he was then asymptomatic. The Brooklyn bowling alley he visited is temporarily closed for decontamination.  His apartment has also been sealed.  Currently the entire approach of authorities in  combating this outbreak is based on the hypothesis that Ebola is not an airborne infection or one that can be contracted from contaminated surfaces.

Meanwhile, an example of how the epidemic is spreading in Africa is the case of a young girl traveling to Mali from Guinea by bus. Crowded, long-distance buses are an institution in Africa since air travel is too expensive for most Africans. Forty-three people came into contact with the girl who showed symptoms including a bleeding nose while traveling more than 600 miles from Guinea through the capital, Bamako, to Kayes were she is now hospitalized.  The exposed persons have been identified and isolated for observation. The girl was traveling to relatives in Mali after her mother died. Mali is now the sixth African country to be affected by the epidemic. The WHO announced that vaccines will become available in 2015. Two are now being tested in humans and five more will enter clinical trials in January.

Latest:{23.10.14}The Current Occupant finally announced travel restrictions from West Africa this week.   However doctors have characterizing the new rules as "political theater". Is political theater an effective defense against a disease that is extremely fatal with even gruesome symptoms? NOT. An expert in infectious disease at Virginia Tech University said the regulations would be hard to implement since they are not an outright ban on flights, but are more intensive screening operations at five airports to which West African air travelers are restricted entry. Another expert said the screens were due in part to political pressure of an election year. So far, 562 passengers from the infected region have entered the United States with no or very little medical follow up. Passengers coming from Liberia, Sierra Leon, and Guinea will now be monitored for the 21 day incubation period* of the virus. Up until now federal spokespersons maintained travel bans were unnecessary. Officials even dragged out Kofi Annan, former UN Secretary General, in the propaganda push-back. He absurdly characterized travel bans as tantamount to "condemning West Africans to death" on BBC's Newsnight programme. He also had to acknowledge that West African governments have responded miserably to the disease spread.

A new study from Virginia researchers shows Ebola is spreading very fast with each infected person infecting on average 2.22 other persons. The entrenched virus is spreading through everyday activities. In the past 20 epidemics it was transmitted primarily in rural areas, hospitals, and during washing of bodies before burial. Without effective medication or coordinated intervention the researchers say the disease is in its "opening phase rather than near its peak". The current epidemic will cause these poor, fragile and unequipped countries great distress on a scale only exceed by China's nightmare experience with the SARS epidemic (that disease reached 29 other countries). The infected nations may even suffer a functional collapse requiring armed occupation to enforce mandatory, mass quarantines of infected individuals. Sierra Leon shut down for three days of mandatory quarantine, but the effort failed to stop the infection's spread. The three thousand US military personnel in the region have been ordered to help build treatment facilities.

Whatever the reason for the reversal in US policy, the restrictions are easing public fears about the disease entering the United States. PNG, the Internet's high-impact blog will continue to follow the Ebola story for readers. US Person wishes to thank the Current Occupant for reading PNG.

*researchers studying previous Ebola outbreaks have calculated varying incubation periods. In the Congo (1995) and Uganda (2000) epidemics the mean incubation periods were calculated as 5.3 and 3.35 days respectively (Chowell et al)  Eichner et al calculated a mean time of 12.7 days using a different method for the Congo outbreak.  The WHO response team published a incubation time distribution based on nine months of data from the West African epidemic and found a mean time of 11.4.  The conclusion from these disparate distributions is that 21 days is not written in the virus' DNA.  Methodology makes a difference.  In 0 to 12% of the cases an individual can have an incubation period greater than twenty one days.

[credit: Dave Granland]
BC Idonwanna axez: Want 'em trade suit for blanket?

More: {15.10.14}A second health worker in Texas contracted Ebola, a direct result of the inadequate official response to the spread of the disease. Nurse Amber Vinson also cared for 'Patient Zero', Thomas Duncan. A preliminary test performed Tuesday indicates she is infected. Other health care workers are expected to become infected since there were about 100 persons involved in the fatal case. The common areas of the apartment complex where Nurse Nina Pham, the first nurse to become ill is being cleaned. The nurse's union at Presbyterian Hospital in Dallas complained publicly "of confusion and frequently changing protocols." The union's spokesperson went so far as to say, "there were no protocols." CDC is said to be "rethinking" its approach to containing the deadly outbreak. That rethinking should delete the public relations rhetoric and impose air travel restrictions to and from West Africa where the disease is out of control. Seventeen cases of Eobla virus infection have been reported outside of the region.

Latest: US Persondoes not want to appear draconian or be accussed of being a'Charlie' Chicken Little. The onslaught of Ebola appears as unstoppable as ISIS. The second case of infection in the United States has been confirmed after health officials touted new screening procedures at international airports where travellers from West Africa continue to be admitted. Anybody with a motive to enter the United States can lie about their health especially if they are in the asymptomatic incubation period of the disease. A travel embargo must be imposed to eliminate the possibllity of an erroneous or even fradulent clearance. No amount of cliche-filled public pablum will stop a disease that is extremely deadly. Fatality rates now exceed 70%.  The infected health worker cared for "patient zero" Thomas Eric Duncan who died Wednesday of the Ebola virus at Texas Health Presbyterian Hospital. The worker reported a fever Friday night. CDC said the infection indiciates a breach of an exacting safety protocol. You don't say. What about a breach of protocol at an airport screening? Each new case of infection increases the chance of an epidemic, but apparently the bottom line controls even the safety of the American public.

{10.10.14}To US Person it seems the federal government is playing a game of chicken with the Ebola virus epidemic. The government makes citizens practically publicly undress and stand in an X-ray chamber to check their underwear before boarding a flight, but refuses to impose travel restrictions to prevent the spread to this country of a deadly disease that has already killed over 4000 people in more than 8000 reported cases. The World Health Organization says Ebola is now entrenched in the three capitals of the affected countries. Granted our health facilities are somewhat more robust than Liberia, Guinea and Sierra Leone, but the United States has already chalked up the death of our "patient zero". Perhaps more are to come because that unfortunate man was in close contact with several individuals while he was contagious.

This situation naturally brings up the question: what effective treatments are available and for whom? The short answer is none. The experimental drug (ZMapp) that saved the life of a white doctor and nurse who contracted the disease in Liberia was apparently not administered to Mr. Thomas, or if it was, his infection was too far advanced to recover. Furthermore experimental drugs only exist in very small amounts which explains why the infected cameraman who was brought back from Liberia is being treated with blood serum transfusions from the surviving doctor. The transfusions are an effort to introduce effective antibodies into the patient without an effective vaccine available. If the virus mutates into a disease that is airborne it will spread very rapidly unless all infected individuals are immediately and strictly quarantined. The necessary facilities for strict mass quarantines do not exist.

The AIDS pandemic only killed 28 million.The flu pandemic of 1918-19 killed 50-100 million people worldwide. The old proverb still holds true: an ounce of prevention is worth a pound of cure. If Ebola is in reality only transmitted by close contact with contagious individuals or their bodily fluids, then regional travel restrictions should be effective, as in the case of the SARS epidemic, in stopping the spread of the disease before it reaches the United States. We have the time and facilities to treat a few special cases, but if Ebola escapes and enters the US population at large--an epidemic--our health facilities will be overwhelmed. Tell that to the pharmaceutical CEOs.

[credit: Randy Bish, Pittsburg Tribune-Review]
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