Ebola and other Epidemics, Inadequate Healthcare Threatens Millions

[jimmy olsen]

Tim's hopes and dreams shattered
http://observationdeck.io9.com/ebola-is-not-that-contagious-1641839156

The reproductive rate of the Spanish Flu was only a little higher than Ebola.

[DontSayBanana]

Tim's hopes and dreams shattered
http://observationdeck.io9.com/ebola-is-not-that-contagious-1641839156

Infectiousness isn't the only factor in throttling an outbreak, though.

At the far end of that chart is measles.  The incubation period for that is minimum 7 days, more than three times the minimum incubation period of ebola at 2 days.  That leaves a much smaller window of opportunity for detecting infected persons.

With two lapses, which is easy in a virus with such a rapid incubation people, in the same timeframe, those 2 people could infect 2 more people each, et cetera, so over the same amount of time, 1 person could be a vector for 8 new cases, as opposed to the 18 for measles.  Within the time the measles has run its course in the first person infected by patient 0, the number of ebola-infected persons has outpaced measles.

[jimmy olsen]

While the incubation period can vary from 2-21 days in Ebola, it typically is 8-10. You'd need to a high viral load to become symptomatic in 2 days.

[derspiess]

Speaking of viral loads...

[jimmy olsen]

Texas is literally worse than Liberia. 

1. Feeding folks who've been quarantined
2. Cleaning contaminated surfaces

[KRonn]

Yikes, looks like those troops should be sent to Texas instead of Liberia. Or maybe Liberian troops can be sent to Texas instead.

[Baron von Schtinkenbutt]

Texas is literally worse than Liberia. 

1. Feeding folks who've been quarantined
2. Cleaning contaminated surfaces

If the pictures on the left were not useless overkill, I would agree with you.

[Valmy]

Texas is literally worse than Liberia. 

I keep telling people this yet everybody still keeps trying to move here.

[Fate]

Tim's hopes and dreams shattered
http://observationdeck.io9.com/ebola-is-not-that-contagious-1641839156

Infectiousness isn't the only factor in throttling an outbreak, though.

At the far end of that chart is measles.  The incubation period for that is minimum 7 days, more than three times the minimum incubation period of ebola at 2 days.  That leaves a much smaller window of opportunity for detecting infected persons.

With two lapses, which is easy in a virus with such a rapid incubation people, in the same timeframe, those 2 people could infect 2 more people each, et cetera, so over the same amount of time, 1 person could be a vector for 8 new cases, as opposed to the 18 for measles.  Within the time the measles has run its course in the first person infected by patient 0, the number of ebola-infected persons has outpaced measles.

No. Ebola could never outpace a measles infection (in a naive population.) You can't ignore the way each virus is spread (direct contact w/ diarrhea/blood versus respiratory droplets) and the fact that the Ebola cannot be spread until persons are symptomatic while influenza and measles can be spread while persons are asymptomatic.

[jimmy olsen]

Not a good sign

http://www.huffingtonpost.com/2014/10/03/nurses-unprepared-ebola_n_5926828.html

U.S. Nurses Say They Are Unprepared To Handle Ebola Patients
Reuters

Posted: 10/03/2014 10:00 am EDT Updated: 10/03/2014 10:59 am EDT

By Julie Steenhuysen

CHICAGO, Oct 3 (Reuters) - Nurses, the frontline care providers in U.S. hospitals, say they are untrained and unprepared to handle patients arriving in their hospital emergency departments infected with Ebola.

Many say they have gone to hospital managers, seeking training on how to best care for patients and protect themselves and their families from contracting the deadly disease, which has so far killed at least 3,338 people in the deadliest outbreak on record.

The U.S. Centers for Disease Control and Prevention has repeatedly said that U.S. hospitals are prepared to handle such patients. Many infectious disease experts agree with that assessment.

Dr. Edward Goodman, an infectious disease doctor at Texas Health Presbyterian Hospital in Dallas that is now caring for the first Ebola patient to be diagnosed in this country, believed his hospital was ready.

The hospital had completed Ebola training just before Thomas Eric Duncan arrived in their emergency department on Sept. 26. But despite being told that Duncan had recently traveled from Liberia, hospital staff failed to recognize the Ebola risk and sent him home, where he spent another two days becoming sicker and more infectious.

"The Texas case is a perfect example," said Micker Samios, a triage nurse in the emergency department at Medstar Washington Hospital Center, the largest hospital in the nation's capital.

"In addition to not being prepared, there was a flaw in diagnostics as well as communication," Samios said.

Nurses argue that inadequate preparation could increase the chances of spreading Ebola if hospital staff fail to recognize a patient coming through their doors, or if personnel are not informed about how to properly protect themselves.

At Medstar, the issue of Ebola training came up at the bargaining table during contract negotiations.

"A lot of staff feel they aren't adequately trained," said Samios, whose job is to greet patients in the emergency department and do an initial assessment of their condition.

So Young Pak, a spokeswoman for the hospital, said it has been rolling out training since July "in the Emergency Department and elsewhere, and communicating regularly with physicians, nurses and others throughout the hospital."

Samios said she and other members of the emergency department staff were trained just last week on procedures to care for and recognize an Ebola patient, but not everyone was present for the training, and none of the other nursing or support staff were trained.

"When an Ebola patient is admitted or goes to the intensive care unit, those nurses, those tech service associates are not trained," she said. "The X-ray tech who comes into the room to do the portable chest X-ray is not trained. The transporter who pushes the stretcher is not trained."

If an Ebola patient becomes sick while being transported, "How do you clean the elevator?"

Nurses at hospitals across the country are asking similar questions.

A survey by National Nurses United of some 400 nurses in more than 200 hospitals in 25 states found that more than half (60 percent) said their hospital is not prepared to handle patients with Ebola, and more than 80 percent said their hospital has not communicated to them any policy regarding potential admission of patients infected by Ebola.

Another 30 percent said their hospital has insufficient supplies of eye protection and fluid-resistant gowns.

"If there are protocols in place, the nurses are not hearing them and the nurses are the ones who are exposed," said RoseAnn DeMoro, executive director of National Nurses United, which serves as both a union and a professional association for U.S. nurses.

Unlike influenza or the common cold, which can be spread by coughing and sneezing, Ebola is only spread by contact with bodily fluids from someone who is actively sick. That means the risk to the average person is low, but for healthcare workers, the risk is much higher.

As of Aug. 25, more than 240 healthcare workers have developed the disease in Guinea, Liberia, Nigeria, and Sierra Leone, and more than 120 have died, according to the World Health Organization.

Many of these infections occurred when healthcare workers were removing the personal protective gear - masks, gowns, gloves or full hazmat suits used to care for the patients, said biosafety experts.

Sean Kaufman, president of Behavioral-Based Improvement Solutions, an Atlanta-based biosafety firm, helped coach nurses at Emory University through the process of putting on and taking off personal protective equipment (PPE) while they were caring for two U.S. aid workers flown to Atlanta after becoming infected with Ebola in West Africa.

Kaufman became known as "Papa Smurf" to the Emory nurses because of the blue hazmat suits he and others wore that resembled the cartoon character.

"Our healthcare workforce goes through so many pairs of gloves that they really don't focus on how they remove gloves. The putting on and the taking off doesn't occur with enough attention to protect themselves," he said.

Nurses say hospitals have not thought through the logistics of caring for Ebola patients.

"People say they are ready, but then when you ask them what do you actually have in place, nobody is really answering that," said Karen Higgins, a registered nurse at Boston Medical Center.

Higgins, an intensive care unit (ICU) nurse, said hospital officials have been teaching nurses on one of the regular floors how to care for an Ebola patient.

"I said, well, that's great, but if the patient requires an ICU, what is your plan," she said. "They looked at me blankly."

(Reporting by Julie Steenhuysen; Editing by Lisa Shumaker)

[Razgovory]

Moran 

Why is everyone misspelling that word recently?  Is it some sort if statement?

[DontSayBanana]

Why is everyone misspelling that word recently?  Is it some sort if statement?

http://www.urbandictionary.com/define.php?term=moran

And this dude's name is actually Moran.  Unfortunately apt.

[Valmy]

Moran 

Why is everyone misspelling that word recently?  Is it some sort if statement?

Ignorant of Missouri's proud cultural heritage?  For shame Raz.

[jimmy olsen]

1000 cases of Dengue fever a day in China?

http://timesofindia.indiatimes.com/world/china/Dengue-spreading-alarmingly-in-China-Report/articleshow/44314516.cms

Outbreak of Marburg fever in Uganda
http://kfm.co.ug/health/another-marburg-outbreak-confirmed-in-uganda.html

Liberia continues its inevitable collapse as the army melts down

http://www.liberianobserver.com/news/ebola-kills-8-soldiers

Ebola Kills 8 Soldiers
Fri, 10/03/2014 - 00:24 admin
-Kesselly Barracks Deserted
By:
C.Y. Kwanue
At least eight soldiers, among them two commissioned officers and two medical staff, have reportedly lost their lives to the deadly Ebola virus disease (EVD), the Daily Observer has reliably learnt.

Those victimized by the EVD have been identified as, Private (PVT) Calvin Sackie, Corporals (Cpls) Florson Louise, Fanbiman Samuel, and Private First Class (Pfc) Anthony Sheriff.

Others are Sergeant (Sgt) Kromah, who was assigned as the Armed Forces of Liberia (AFL) medic and another medic from the Ministry of National Defense (MOD) identified as Annitta Sackie.

The two commissioned officers victimized by the EVD were up to press time not named.

The deceased, according to our source, contracted Ebola recently at the Edward Binyan Kesseley (EBK) Barracks when a lady unsuspected of carrying the disease, visited one of the victims, Cpl Floson Louise.

The 'concubine' who visited the late soldier has also been victimized by the disease. She is yet to be identified.

"When she slept at the EBK, it was thereafter the soldiers contracted the disease, and could not survive despite "intensive treatment" at the various Ebola Treatment Units in Monrovia," our source disclosed.

This latest setback among the rank and file of the already sparse number of soldiers has reportedly created panic among them, to the extent that some of them have begun to desert the various barracks across the country.

Based on this information, the Daily Observer yesterday contacted Defense Assistant Minister for Public Affairs, David K. Dahn, who neither confirmed nor denied the report.

He, however, told this newspaper via mobile phone, "The whole West Africa is being threatened by Ebola, of which the AFL is no exception, because they are among other Liberians being afflicted by the EVD."

He disclosed that the military is carrying out some measures at its barracks to decongest the soldiers. "This is why the barracks have become so quiet  since the Ebola outbreak in the country."

The latest deaths of the soldiers sadly add to several  Para-military and other security personnel, including officers of the Liberian National Police (LNP), that  have died.  Others, including  close family members, had  been quarantined and subsequently released, having completed their 21 days isolation.

[jimmy olsen]

Sierra Leone seems to have inexplicably decided to stop months of lying and reported 121 deaths in the last day. At least I hope they've stopped lying, if that's a substantial under count things are worse then I thought.

http://www.reuters.com/article/2014/10/06/us-health-ebola-leone-idUSKCN0HU0ZT20141006