This is not a panic thread. The doctor in NYC that may have Ebola has sought treatment and isolation prior to infecting anyone else and hopefully with good attention will recover.

However, this is a good example of how our current screening strategy is IMO too lax and allows at-risk people into the country. This person was responsible and a doctor but what about those are neither of these things? There are people on both sides of the isle calling for restricting travel from West Africa to the US and I agree.

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Replace turf grass with native plants that don't need irrigation and synthetic fertilizers or chemicals that can go into our waterways and ocean

The problem is that we are playing with fire. Under the current policy, people with ebola will get here. That's been proven by the actuality. So far as we know, we have been able to pick out these folks, isolate them and stop the chain. But we are relying heavily on that happening in every case. But that is gambling against Murphy's Law proving itself true. I don't understand why we would take that chance. It is baffling.

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I :heart; Q

Some of the public health experts that I hear don't like the idea of attempting to restrict travel for affected countries point out that it is impossible to really do effectively, because few travel here directly.

They also fear that an announced travel ban to the USA will create more incentives for people to lie about where they have been, thus making things even more confused, thus worse.


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"The truth is incontrovertible.
malice may attack it,
ignorance may deride it,
but in the end,
there it is." -Sir Winston Churchill

Doctors really do make the worst patients

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"The truth is incontrovertible.
malice may attack it,
ignorance may deride it,
but in the end,
there it is." -Sir Winston Churchill

All we have to do is look at their passports. That should tell the tale. Sure, it won't be perfect, but it would have stopped the 2 that already made it.

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I :heart; Q

Maybe we should ban flights. Not to stop Ebola, but because your chance of dying in an airplane crash are greater than your risk of contracting Ebola.


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“It is the heart of US policy to use fascism to preserve capitalism while claiming to be saving democracy from communism “ - Michael Parenti

Craig A. Spencer, MD, MPH, is an assistant professor of medicine atColumbia University 

and fellow in international emergency medicine at New York-Presbyterian Hospital. 

Dr. Spencer recently returned to the U.S. after volunteering with MSF* to care for Ebola-stricken patients

in the West African country of Guinea.

He has not worked at the hospital since returning on October 17.

 

*MSF is "Dr.s Without Borders" for Americans.

Presumably, the guy's a US citizen, traveling on a US passport, 

Assuredly, he is a Certifiable HERO. 

 

Edit - forgot the link and apparantly the Dr. was following protocol for returnees

Article says he's the first of about 700 who have returned who's become ill

http://www.forbes.com/sites/davidkroll/2014/10/24/ny-doctor-craig-spencer-followed-msf-protocols-for-staff-returning-from-ebola-stricken-west-africa/

 

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add a signature since I'm here in profile anyway

Edited: 10/24/2014 at 09:38 AM by tom

And it's way better that he is getting treated here, vs trapped in Africa.
I hear that the Nurse in Tx is now "ebola free".

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"The truth is incontrovertible.
malice may attack it,
ignorance may deride it,
but in the end,
there it is." -Sir Winston Churchill

Nice thread title.

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A gentle answer turns away wrath, but a harsh word stirs up anger.

Most Republicans and Democrats support a travel ban on flights coming in from highly infected areas. The government has restricted flights going into war torn countries to protect U.S. citizens. Why wouldn't they restrict travel coming in from East Africa to protect us? Seems like a no-brainer. I don't even care if it just makes it more difficult for the infected to get here. That is better than what is going on now.

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"The government who robs Peter to pay Paul can always depend on the support of Paul," - George Bernard Shaw

“Don’t underestimate Joe’s ability to f—k things up.” - Barack Obama

“End of quote. Repeat the line.” - wise words from Joe Biden

Or maybe it's worse.


-------------------------
"The truth is incontrovertible.
malice may attack it,
ignorance may deride it,
but in the end,
there it is." -Sir Winston Churchill

Not only that, I don't know if that doctor in NY was exhibiting symptoms at the time, but he went to a bowling alley! Know what happened?

EBOLA his best score ever!

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The modern conservative is engaged in one of man's oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness -
John Kenneth Galbraith

Now it's a panik thread.

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A gentle answer turns away wrath, but a harsh word stirs up anger.

not a no brainer if you understand how ebola is or isn't spread

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we are they, they are us -- Thich Nhat Hanh

Dr Spencer was following MSF's protocol for health care workers returning from work with Ebola patients.  

MSF should be as good as anyone at dealing with infectious disease. 

Good one!

Christie and Cuomo announce that the CDC and Obama's policies on ebola are not good enough for New Jersey and New York. They announce a mandatory 21 day quarantine for high-risk travelers.

This approach seems to make the most sense.

-------------------------
"The government who robs Peter to pay Paul can always depend on the support of Paul," - George Bernard Shaw

“Don’t underestimate Joe’s ability to f—k things up.” - Barack Obama

“End of quote. Repeat the line.” - wise words from Joe Biden

Do explain how having fewer people here that have been in close proximity to people with ebola is a bad thing.

-------------------------
"The government who robs Peter to pay Paul can always depend on the support of Paul," - George Bernard Shaw

“Don’t underestimate Joe’s ability to f—k things up.” - Barack Obama

“End of quote. Repeat the line.” - wise words from Joe Biden

http://www.cnn.com/2014/10/24/...y/index.html?hpt=hp_t2


http://www.cnn.com/2014/10/17/...ml?iid=article_sidebar

-------------------------
"The truth is incontrovertible.
malice may attack it,
ignorance may deride it,
but in the end,
there it is." -Sir Winston Churchill

Who wants to take a chance?




Evidence shows infections started in lungs of non-human primates
http://www.bbc.com/news/science-environment-20341423




USAMRIID
https://www.scribd.com/doc/243228798/US-Army-Medical-Management-Of-Biological-Casualties-Handbook-USAMRIID-BlueBook-7th-Edition-Sep-2011-1

Isolation and Decontamination:

All VHF patients should be cared for under strict contact precautions, including hand hygiene double gloves, gowns, shoe and leg coverings, and face shield or goggles. Airborne precautions should be instituted to the maximum extent possible and especially for procedures that induce aerosols (e.g., bronchoscopy). At a minimum, a fit-tested, HEPA filter-equipped respirator (such as an N-95 mask), a battery-powered, air-purifying respirator (PAPR), or a positive pressure-supplied air respirator should be worn by personnel sharing an enclosed space with or coming within 6 feet of a VHF patient. Multiple patients should stay in a separate building or a ward with an isolated air-handling system when feasible. Ideally, VHF patients should be isolated in a negative-pressure isolation


Filoviridae:

Four species of Ebola virus (Zaire, Sudan, Reston, Ivory Coast) and a new proposed species (Bundibugyo) have been identified. The Zaire and Sudan species of Ebola virus cause severe disease with high CFRs.

Filoviruses may be spread from human to human by direct contact with infected blood, secretions, organs, or semen. Although frequently considered possible, spread from human to human by the airborne route occurs rarely, if it occurs at all.
Who wants to take that chance?


ISOLATION AND CONTAINMENT

These viruses pose special challenges for hospital infection control. With the exception of dengue and hantaviruses, VHF patients harbor significant levels of potentially infectious virus in blood, body fluids, or secretions. Special caution must be exercised in handling hypodermic needles and other sharps that could result in parenteral exposure. Strict adherence to VHF-specific barrier precautions will prevent nosocomial transmission in most cases. Lassa, CCHF, Ebola, and Marburg viruses may be particularly prone to nosocomial spread due to periods of high viremia corresponding with


VIRAL HEMORRHAGIC FEVERS (VHFs)

117

bleeding propensity. In several instances, secondary infections among contacts and medical personnel without direct body fluid exposure have been documented. These instances have prompted concern of a rare phenomenon of aerosol transmission of infection. Therefore, when VHF is suspected, additional infection control measures are indicated. The patient should be hospitalized in a private room with an adjoining anteroom to be used for donning and removing protective barriers, storage of supplies, and decontamination of laboratory specimen containers. A negative-pressure isolation room with 6 - 12 air exchanges per h is ideal for all VHF patients and is strongly advised for patients with significant cough, hemorrhage, or diarrhea. All persons entering the room should wear double gloves, impermeable gowns with leg and shoe coverings (contact isolation), eye protection and HEPA (N-95) masks or positive-pressure air-purifying respirators (PAPRs). Note that though, that aerosol transmission person-to-person, if it occurs, is a rare occurrence. In the absence of a large, fixed medical-treatment facility, or in the event of an overwhelming number of casualties, isolation rooms may not be available for all casualties. At a minimum, VHF patients should stay together in a separate building or in a ward with an air-handling system separate from the rest of the building when feasible. Access should be re-stricted to those personnel required to care for the patients. Personnel should wear contact and respiratory protection while in this patient-care area. Personnel should undergo an external decontamination procedure at the point of leaving the contaminated patient-care area. A building, room or designated area that is separated from the patient-care area should be established for donning and removing protective gear. All waste (including linens) leaving the patient-care area should be decontaminated with bleach or quaternary ammonium compounds and double-bagged in clearly labeled biohazard waste bags. Ideally, this waste will be incinerated or autoclaved. Laboratory specimens should be double-bagged, and the exterior of the outer bag should be decontaminated before transport to the laboratory. Excreta and other contaminated materials should be autoclaved, or de-contaminated by the liberal application of appropriate disinfectants. Clinical laboratory personnel are at significant risk for exposure and should employ a biosafety cabinet (if available) with barrier and respiratory pre-cautions when handling specimens. Clinical specimens should be handled

118

MEDICAL MANAGEMENT OF BIOLOGICAL CASUALTIES

in a designated, isolated space within the lab. Access to this space should be limited and thorough decontamination of the space and equipment should be routine. No carrier state has been observed for any VHF, but excretion of virus in urine or semen may occur for some time during convalescence. Survivors should avoid sexual contact for at least 3 months. In fatal cases, there should be minimal handling of the remains, which should ideally be sealed in leak-proof material for prompt burial or cremation.