Ebola epidemic

[bcr229]

This isn't likely to help - http://www.flutrackers.com/forum/showthread.php?t=227176.

 

[WebSlave]

I suspect that will get MUCH worse before it gets better.

 

[WebSlave]

Ebola Is Rapidly Mutating As It Spreads Across West Africa

by MICHAELEEN DOUCLEFF
August 28, 2014 2:08 PM ET

For the first time, scientists have been able to follow the spread of an Ebola outbreak almost in real time, by sequencing the virus' genome from people in Sierra Leone.

The findings, published Thursday in the journal Science, offer new insights into how the outbreak started in West Africa and how fast the virus is mutating.

An international team of researchers sequenced 99 Ebola genomes, with extremely high accuracy, from 78 people diagnosed with Ebola in Sierra Leone in June.

The Ebola genome is incredibly simple. It has just seven genes. By comparison, we humans have about 20,000 genes.

"In general, these viruses are amazing because they are these tiny things that can do a lot of damage," says Pardis Sabeti, a computational biologist at Harvard University and the lead author of the study.

Hidden inside Ebola's tiny genome, she says, are clues to how the virus spreads among people — and how to stop it.

"As soon as the outbreak happened and was reported in Guinea," she says, "two members of my lab flew out and worked to set up the diagnostics to pick it up in Sierra Leone."

The team helped to find the first Ebola cases in Sierra Leone. They also immediately shipped diagnostic samples from the patients back to the U.S. and started sequencing the viruses' genomes.

"We had 20 people in my lab working around-the-clock," Sabeti says.

Their furious pace paid off. After just a week or so, the team had decoded gene sequences from 99 Ebola viruses. The data offered a treasure-trove of information about the outbreak.

For starters, the data show that the virus is rapidly accumulating new mutations as it spreads through people. "We've found over 250 mutations that are changing in real time as we're watching," Sabeti says.

While moving through the human population in West Africa, she says, the virus has been collecting mutations about twice as quickly as it did while circulating among animals in the past decade or so.

"The more time you give a virus to mutate and the more human-to-human transmission you see," she says, "the more opportunities you give it to fall upon some [mutation] that could make it more easily transmissible or more pathogenic."

Sabeti says she doesn't know if that's happening yet. But the rapid change in the virus' genome could weaken the tools researchers have to detect Ebola or, potentially, to treat patients.

Diagnostic tests, experimental vaccines and drugs for Ebola — like the one recently used to treat two American patients — are all based on the gene sequences of the virus, Sabeti says. "If the virus is mutating away from the known sequence, that could be important to how these things work."

The new genomic data also indicate that the outbreak started when just one person caught Ebola from an animal. Since then the virus has been spreading through human-to-human transmission — not through humans eating infected bush meat (wild game) as was first thought.

"We're really concerned because a lot of the messaging going around ... is, 'Don't each bush meat; don't eat mango; don't anything that might be in contact with animals,' " she says. "When you see some of those fliers, you're like, 'OK, you just told them not to eat all the main sources of food.' "

So the advice from health officials to avoid bush meat may be doing more harm than good, she says.

Sabeti and the team also compared the Ebola genomes from Sierra Leone with those found in previous outbreaks in Central Africa. Their findings suggest the virus has been circulating around West Africa for about a decade.

"This study is really an impressive tour de force," says virologist Stephen Morse of Columbia University.

But he says he's not surprised the virus is mutating so rapidly.

"We've seen this in a number of infections — SARS for example, influenza and HIV of course," Morse says. "Very often when a new virus is introduced into the human population very suddenly, it will show accelerated rates of evolution."

So should we be concerned that the virus might pick up a mutation that makes it more contagious or deadly?

"That's very hard to say. In most cases, the answer would be 'no,' " Morse says. "But Ebola is obviously a concern and very virulent. I'd say it's too early at this point to speculate on what any mutation or any change, even with rapid evolution, might lead to."

A number of scientists working on the project contracted Ebola while treating patients. "Five of them passed from Ebola," Sabeti says, including Dr. Shiek Humarr Khan. He was Sierra Leone's top virologist and had treated dozens of Ebola patients before catching the virus.

Health workers in Sierra Leone, who talked to NPR in the spring, blamed a lack of proper protective equipment for infections at the government-run hospital in Kenema, where Khan worked.

"The work [treating patients] is just that dangerous," Sabeti says. "Another British nurse at the hospital has just come down with Ebola. You're seeing so many infections going on. It's an extraordinary thing that's going on right now [in Sierra Leone]."

Source: http://www.npr.org/blogs/goatsandso...dly-mutating-as-it-spreads-across-west-africa

 

[WebSlave]

A Few Ebola Cases Likely In U.S., Air Traffic Analysis Predicts

by RICHARD KNOX
September 04, 2014 1:11 PM ET

It's only a matter of time, some researchers are warning, before isolated cases of Ebola start turning up in developed nations, as well as hitherto-unaffected African countries.

The current Ebola outbreak in West Africa has killed more people than all previous outbreaks combined, the World Health Organization said Wednesday. The official count includes about 3,600 cases and 1,800 deaths across four countries.

Meanwhile, the authors of a new analysis say many countries — including the U.S. — should gear up to recognize, isolate and treat imported cases of Ebola.

The probability of seeing at least one imported case of Ebola in the U.S. is as high as 18 percent by late September, researchers reported Tuesday in the journal PLOS Currents: Outbreaks. That's compared with less than 5 percent right now.

These predictions are based on the flow of airline passengers from West Africa and the difficulty of preventing an infected passenger from boarding a flight.

As with any such analysis, there's some uncertainty. The range of a probable U.S. importation of Ebola by Sept. 22 runs from 1 percent to 18 percent. But with time — and a continuing intense outbreak in West Africa — importation is almost inevitable, the researchers told NPR.

"What is happening in West Africa is going to get here. We can't escape that at this point," says physicist Alessandro Vespignani, the senior author on the study, who analyzes the spread of infectious diseases at Northeastern University.

To be clear, the projection is for at least one imported case of Ebola — not for the kind of viral mayhem afflicting Guinea, Liberia and Sierra Leone.

"What we could expect, if there is an importation, would be very small clusters of cases, between one and three," Vespignani says.

But the probability increases as long as the West African epidemics keep growing. And that means U.S. hospitals, doctors and public health officials need to heighten their vigilance.

The same is true for a roster of 16 other nations, from the U.K. to South Africa, which are connected to West Africa through air traffic, Vespignani and his colleagues say.

There's a 25 to 28 percent chance that an Ebola case will turn up in the U.K. by late September. Belgium, France and Germany will have lower risk. "But it's not negligible," Vespignani says. "Sooner or later, they will arrive."

The probability of imported cases in Africa is higher, not surprisingly. There's more than a 50 percent probability Ebola will show up in the West African nation of Ghana by late September, according to the study. Gambia, Ivory Coast, Morocco, South Africa and Kenya are among 11 African countries where Ebola could pop up.

Officials at the U.S. Centers for Disease Control and Prevention had a presentation on the numbers on Tuesday. The CDC has deployed teams of personnel in West Africa to help bring Ebola under control. And here at home, the agency is charged with preparing both the U.S. medical system and the American public for the possibility that the deadly virus could sneak into this country.

Biostatistician Ira Longini from the University of Florida agrees that Ebola doesn't pose a public health threat in the U.S. and other developed nations. But that doesn't mean that preparation isn't urgent.

"We certainly need to make sure that staff and leadership of American medical centers understand the implications of Ebola," says Longini, who also worked on the study. "We need to have diagnostics in place to identify Ebola quickly. We need quite a few local labs to do this and not just rely on sending samples to the CDC. And we need to make sure isolation and quarantine of contacts takes place. If it doesn't, we could have a small cluster of cases."

The analysis by Longini, Vespignani and their colleagues takes into account the number of airline passengers coming from West Africa to various countries. For instance, more than 6,000 a week arrive in Britain from Nigeria, many of them originating in other African countries.

Hundreds to several thousands travel every week from West Africa to France, Germany, Spain, Italy, South Africa, Egypt, Saudi Arabia, India, China and other countries.

The researchers calculated the impact of severe restrictions on flights from Ebola-affected regions. An 80 percent reduction in air travelers would do no more than delay the impact of Ebola by a few weeks. (A 100 percent choke-off of air travel is considered impossible.)

"Unless you can completely shut down the transportation systems, these kinds of efforts will, at best, buy you a little time," Longini says. "And they can be quite counterproductive because you're interrupting the flow of help, goods and services. It can make the epidemic worse in the country that's being quarantined."

The basic problem with confining Ebola is that, like any infectious disease, people can be infected without showing symptoms. In Ebola's case, the average incubation period is 7 days, though it can be longer. That's more than enough time for an infected traveler to land on the other side of the world.

Fortunately, an Ebola-infected person can't infect others unless he's obviously sick. At that stage, the virus can spread by direct contact with the infected person or bodily fluids. On average, each case of Ebola infects about two other people. That spread rate is similar to that of the flu, and roughly half the rate of smallpox.

Vespignani, from Northeastern University, says screening airline passengers is not going to prevent Ebola from traveling across the globe. "I don't trust screening too much," he says. "It's difficult. Intercepting passengers that are really not sick is not easy."

Source: http://www.npr.org/blogs/goatsandso...ases-likely-in-u-s-air-traffic-analysis-shows

 

[rcarichter]

Unfortunately, it seems like the most likely chance of it taking hold here is the doctors who risk their lives going back and forth. The business travelers and vacationers to and from West Africa are not likely to be in the same areas as the patients, for socio-economic reasons.
I'm curious, as I know there are many here who strongly oppose government intervention, what would you think of a complete ban of travel from the US to West Africa? It's not like the hikers/reporters who 'accidentally' cross borders in hot zones and get kidnapped. Travel to Africa puts all of us at risk. Lots of rich people vacationing in Morocco. Tough call.

 

[Lucille]

Travel to Africa puts all of us at risk. Lots of rich people vacationing in Morocco.

You know the way the world actually works. No matter what is on the books, often a blind eye is turned to those with wealth and influence.

 

[rcarichter]

You know the way the world actually works. No matter what is on the books, often a blind eye is turned to those with wealth and influence.

Absolutely true!

 

[WebSlave]

Unfortunately, it seems like the most likely chance of it taking hold here is the doctors who risk their lives going back and forth. The business travelers and vacationers to and from West Africa are not likely to be in the same areas as the patients, for socio-economic reasons.
I'm curious, as I know there are many here who strongly oppose government intervention, what would you think of a complete ban of travel from the US to West Africa? It's not like the hikers/reporters who 'accidentally' cross borders in hot zones and get kidnapped. Travel to Africa puts all of us at risk. Lots of rich people vacationing in Morocco. Tough call.

I would not be opposed to anyone going from the USA to West Africa at all. But coming back without going into a substantial isolated quarantine period? Well, that's an entirely different kettle of fish.

Quite honestly, I would be much more worried about terrorists purposely infecting people and then sending them over here before they exhibited any signs. They would be like ticking time bombs. They would have instructions that as soon as they did show symptoms to go about and "spread the wealth" among the Americans.

Of course, that just might be the reasoning behind the following "executive order":

Executive Order -- Revised List of Quarantinable Communicable Diseases

July 31, 2014

EXECUTIVE ORDER​

- - - - - - -​

REVISED LIST OF QUARANTINABLE COMMUNICABLE DISEASES​

By the authority vested in me as President by the Constitution and the laws of the United States of America, including section 264(b) of title 42, United States Code, it is hereby ordered as follows:

Section 1. Amendment to Executive Order 13295. Based upon the recommendation of the Secretary of Health and Human Services, in consultation with the Acting Surgeon General, and for the purposes set forth in section 1 of Executive Order 13295 of April 4, 2003, as amended by Executive Order 13375 of April 1, 2005, section 1 of Executive Order 13295 shall be further amended by replacing subsection (b) with the following:

"(b) Severe acute respiratory syndromes, which are diseases that are associated with fever and signs and symptoms of pneumonia or other respiratory illness, are capable of being transmitted from person to person, and that either are causing, or have the potential to cause, a pandemic, or, upon infection, are highly likely to cause mortality or serious morbidity if not properly controlled. This subsection does not apply to influenza."

Sec. 2. General Provisions. (a) Nothing in this order shall be construed to impair or otherwise affect:

(i) the authority granted by law to an executive department, agency, or the head thereof; or

(ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

(b) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

BARACK OBAMA​

Source: http://www.whitehouse.gov/the-press...ised-list-quarantinable-communicable-diseases

Of course, I don't believe for an instant that the US Constitution grants the POTUS any such authority.

 

[bcr229]

Some interesting reading on the lab procedures at Emery for the two ebola patients treated there last month: http://labmed.ascpjournals.org/content/45/3/e109.full

 

[Dennis Hultman]

http://www.nytimes.com/2014/09/12/o...dit_tnt_20140911&nlid=745484&tntemail0=y&_r=2

The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air. You can now get Ebola only through direct contact with bodily fluids. But viruses like Ebola are notoriously sloppy in replicating, meaning the virus entering one person may be genetically different from the virus entering the next. The current Ebola virus’s hyper-evolution is unprecedented; there has been more human-to-human transmission in the past four months than most likely occurred in the last 500 to 1,000 years. Each new infection represents trillions of throws of the genetic dice.

If certain mutations occurred, it would mean that just breathing would put one at risk of contracting Ebola. Infections could spread quickly to every part of the globe, as the H1N1 influenza virus did in 2009, after its birth in Mexico.

Why are public officials afraid to discuss this? They don’t want to be accused of screaming “Fire!” in a crowded theater — as I’m sure some will accuse me of doing. But the risk is real, and until we consider it, the world will not be prepared to do what is necessary to end the epidemic.

In 2012, a team of Canadian researchers proved that Ebola Zaire, the same virus that is causing the West Africa outbreak, could be transmitted by the respiratory route from pigs to monkeys, both of whose lungs are very similar to those of humans. Richard Preston’s 1994 best seller “The Hot Zone” chronicled a 1989 outbreak of a different strain, Ebola Reston virus, among monkeys at a quarantine station near Washington. The virus was transmitted through breathing, and the outbreak ended only when all the monkeys were euthanized. We must consider that such transmissions could happen between humans, if the virus mutates.

 

[Dennis Hultman]

US to send 3,000 troops to Ebola danger zone as Obama administration shuffles military's mission in Africa

The Obama administration said late Monday night that the U.S. military will set up a command post in Monrovia, Liberia, the Ebola outbreak's epicenter
'This effort ... will involve an estimated 3,000 U.S. forces,' according to the White House
Pentagon official says military will 'be the lead dog, and that will make a lot of people nervous. ... No one wants U.S. personnel enforcing someone else's martial law if things go south and the entire region is at risk'
U.S. Africa Command warns servicemen and women: 'Avoid nonessential travel to Sierra Leone, Guinea, and Liberia'
Pentagon is drawing flak for sending 25-bed 'field-deployable hospital' that is meant to treat health care workers, not civilian victims
The U.S. president will travel to the CDC in Atlanta on Tuesday for a briefing about his government's efforts to stem the tide overseas

http://www.dailymail.co.uk/news/art...ation-shuffles-military-s-mission-Africa.html

 

[WebSlave]

Hmm, not sure how I would feel if I were in the military and got those orders. Is that REALLY the job of our military forces? Does Obama even have Constitutional authority to use our military in that manner?

There have already been medical personnel put into west Africa who were trained to deal with highly infectious diseases who caught Ebola anyway. How well trained and protected are those military personnel going to be? More or less than those medical personnel were?

Anyone else storing provisions, just in case? If this gets into the USA, quarantines are going to become more the rule than the exception. And a point was made by something I read a little while back. Quarantines don't come with a warning. Your first hint that you might be in a locked down "hot zone" might just be a roadblock in front of you.

Even without a quarantine, with Ebola even potentially or rumored on the loose nearby, I sure as heck wouldn't want to be traipsing around out in public at the grocery store. Just one person with the sniffles and all hell would break loose with people heading for the doors. Heck, I would be praying that I don't suddenly have to sneeze.

Anyway, plan accordingly.

Yeah, I know doom and gloom stuff. But sooner or later ONE of them is going to be right on the mark.

 

[Lucille]

Here in Texas, schools receive funding from the state based on daily attendance. All kinds of incentives are used to get the kids in the school so that that school receives maximum funding- drawing for bicycles and other nice items based on attendance, perfect attendance parties, films, pop corn, ice-cream.
Teachers would often not send sick kids to the clinic before 10 (that was the magic hour, if the student was there at 10AM, they were counted there for the day). The kids themselves would often not say anything no matter how sick they were prior to 10AM because they wanted the incentive gifts and parties. Some of the parties were organized by classroom, so you can imagine the peer pressure exerted by the kids on each other to not be absent or go home early.

I would not underestimate educational politics and funding weakening the fabric of any quarantine efforts especially in urban areas where students are frequently bussed out of their area rather than attending the local school they are zoned to.
There would be all kinds of wrangling as to who would bear the burden of paying the various schools for their attendance losses due to quarantine. If you question how local politicians could possibly wrangle about money when there were dead people in the street with blood coming out of their orifices, I suggest listening to them closely some time and getting that 'me and mine first' flavor.

While I totally agree with the concept of preparation, stocking food and so on, I also believe that money and politics may defeat the concept of quarantine.
I'm not even going to get started on favoritism for the rich and powerful, but I can't imagine those sorts of people being unable to come and go, quarantine or not.

 

[bcr229]

Anyone else storing provisions, just in case? If this gets into the USA, quarantines are going to become more the rule than the exception. And a point was made by something I read a little while back. Quarantines don't come with a warning. Your first hint that you might be in a locked down "hot zone" might just be a roadblock in front of you.

Damn, I need more frozen rats...

 

[rcarichter]

With news traveling on an instant basis, I think trying to quarantine a large urban/suburban area could backfire very quickly. The second it hits social media, people will scatter by any means necessary. Perhaps if they shut down the TV, radio, and cell towers first...
I live in a busy suburb, but if every road suddenly shut down, I could get to 2 major rivers pretty easily. No, I'm sure what I'd do then, but you get the idea. And if I happened to have Ebola and died in said rivers, well that would be ugly.

 

[WebSlave]

Here in Texas, schools receive funding from the state based on daily attendance. All kinds of incentives are used to get the kids in the school so that that school receives maximum funding- drawing for bicycles and other nice items based on attendance, perfect attendance parties, films, pop corn, ice-cream.
Teachers would often not send sick kids to the clinic before 10 (that was the magic hour, if the student was there at 10AM, they were counted there for the day). The kids themselves would often not say anything no matter how sick they were prior to 10AM because they wanted the incentive gifts and parties. Some of the parties were organized by classroom, so you can imagine the peer pressure exerted by the kids on each other to not be absent or go home early.

I would not underestimate educational politics and funding weakening the fabric of any quarantine efforts especially in urban areas where students are frequently bussed out of their area rather than attending the local school they are zoned to.
There would be all kinds of wrangling as to who would bear the burden of paying the various schools for their attendance losses due to quarantine. If you question how local politicians could possibly wrangle about money when there were dead people in the street with blood coming out of their orifices, I suggest listening to them closely some time and getting that 'me and mine first' flavor.

While I totally agree with the concept of preparation, stocking food and so on, I also believe that money and politics may defeat the concept of quarantine.
I'm not even going to get started on favoritism for the rich and powerful, but I can't imagine those sorts of people being unable to come and go, quarantine or not.

Yeah..... It might sound cold and callous of me, but I avoid kids like the plague. Literally. Schools are really a bio lab where all the pathogens anyone could possibly get are being mixed all together and dispersed back out into the environment on the hands of those kids. Kids just do not understand the concept of germs and person to person transmission.

I was reading some stuff late last night posted by medical personnel at various hospitals around the country. All of them admitted that their facilities will be very ill prepared to deal with a pandemic. Hospitals are already running at full or over capacity and staff is overworked and worn out just from dealing with the influx of new patients because of obamacare. Many admitted that if even a single patient shows up diagnosed with ebola, they were signing out and heading for the hills.

I also read that there were already 250 known mutations in this strain of Ebola since the epidemic started in west Africa. That virus is rolling the dice pretty vigorously....

 

[Mooing Tricycle]

http://www.reddit.com/r/IAmA/comments/2g79ip/i_work_for_doctors_without_borders_ask_me/

 

[Lucille]

The New York Times has commentary, and I predicted heavy losses from Ebola. They would not even print the comment back in the beginning when everyone was saying it was just a small local issue and would burn itself out.

Their tune has changed, they are printing estimates of possible heavy losses.

http://www.nytimes.com/2014/09/24/h...mates.html?emc=edit_na_20140923&nlid=57474085

 

[WebSlave]

People seem to be studiously ignoring the fact that Ebola is endemic in one or more native animal populations (speculation is fruit bats) and there is nothing at all to rule out something like that happening if the virus gets introduced into new geographical areas. How would things look in the USA if there were a seasonal Ebola outbreak, much like we expect to happen with the flu?

Heck, I'm STILL not convinced that those people who survive Ebola aren't potentially asymptomatic carriers. After all, that seems to be the case with the animal reservoir natively carrying the virus.

There is an article in today's local paper mentioning that some experts expect Ebola to become a permanent problem in west Africa. On the same page is another article that I haven't read yet but the headlines are showing instances of dangerous pathogens escaping from supposedly secure facilities.

It doesn't take a genius to put two and two together and become rather alarmed at the total that comes up.

Oh yeah, and I saw a claimed death rate of 70 percent mentioned. Seems the earlier figures were being fudged with new infections counted into the total infected so the mortality rate was not accurate. A TRUE picture would be a percentage determined from only victims who have had the virus past the time that they either recovered or died from it. That would show the true mortality rate.

Oh yeah, I read somewhere else that Monsanto was getting involved in trying to develop a vaccine for Ebola. Sweet!! NOT!

 

[Lucille]

My review of the TV series 'Blacklist':

I loved it. Layers of plots and personalities, nonstop action, but on another level an exploration of bad guys, a philosophical show and tell of right and wrong and an almost chess-like complexity. Bad guys ranging from amusing 'the Stewmaker' to a scary prelude of an Ebola-like disease where chronic administration of antidotes to those infected depended on their obedience to bad guy plans and agendas.
Entertaining yet thoughtful. Alan Alda as a guest star was a nice touch.

Not that I am painting anyone as a bad guy, but having an antidote to Ebola would place any manufacturer of such an antidote in a position of immense power.
If one was prone to thinking in science fiction terms, one might even wonder if, as in Blacklist, infections might be intentional.