Second U.S. Ebola Diagnosis "Deeply Concerning" Admits CDC Chief

[Chris]

They are rewriting the procedures for handling Ebola patients. Apparently one of the problems is that the gear used in such situations is defined by the kind of transmission. Droplet gets one kind, blood borne, less protection when not handling blood products. Ebola is "heavy" droplet transmission, so the gear used was for blood borne, not droplet. That has been changed.

Have they thought of asking for specialist advice from Nigeria?

[Errata]

Have they thought of asking for specialist advice from Nigeria?

Good god no. If they think patient zero was ever near the US, I doubt they associate anything remotely useful with Africa. My bet is they call France. They have two good associations with disease and France.

[c.d.]

I saw a documentary where epidemiologists were studying gay men in San Francisco who frequented the bath houses and who never got AIDS despite having hundreds of sexual partners. It turns out that they were able to trace their ancestors back to Europeans who had survived the plague. Apparently they inherited some sort of immunity.

c.d.

[c.d.]

If you want to read a really good book that will scare the hell out of you, I recommend "The Hot Zone" by Richard Preston. True story about a 1989 incident in which a mutated form of the original Ebola virus was found in a primate research facility less than 15 miles from Washington, D.C.

c.d.

[Ginger]

Good god no. If they think patient zero was ever near the US, I doubt they associate anything remotely useful with Africa. My bet is they call France. They have two good associations with disease and France.

I think 'patient zero' is an entirely valid designation for the fellow that brought it here. As I understand it (and I think I'm correct), the term doesn't refer to the first person ever to have a disease, but to the one who starts a specific cycle of contagion. That's why WHO is designating a patient zero from December 2013 for the current African outbreak, even though many others had the disease long before that.

Other people may differ, but it seems to me that an outbreak of ebola in the North American population is a separate event from the ongoing epidemic in Africa. We live apart from them, and the only link is a few individuals travelling from one population to another. We've got our own patient zero, quite distinct from the 2013 African patient zero.

[Chris]

I think 'patient zero' is an entirely valid designation for the fellow that brought it here. As I understand it (and I think I'm correct), the term doesn't refer to the first person ever to have a disease, but to the one who starts a specific cycle of contagion.

He hasn't started a "cycle of contagion". As a result of what sounds like astonishing incompetence, he's directly infected two medical staff. It may well end there. If there were further infections, it would be surprising if the most advanced nation on earth weren't able to contain them, in the same way that Nigeria and Senegal did.

The "specific cycle of contagion" involves tens of thousands of people in West Africa. That's what the world should be concentrating on.

[Errata]

I think 'patient zero' is an entirely valid designation for the fellow that brought it here. As I understand it (and I think I'm correct), the term doesn't refer to the first person ever to have a disease, but to the one who starts a specific cycle of contagion. That's why WHO is designating a patient zero from December 2013 for the current African outbreak, even though many others had the disease long before that.

Other people may differ, but it seems to me that an outbreak of ebola in the North American population is a separate event from the ongoing epidemic in Africa. We live apart from them, and the only link is a few individuals travelling from one population to another. We've got our own patient zero, quite distinct from the 2013 African patient zero.

Actually the term doesn't refer to any of that. It's a sort of slang for an index case. The first person to be described in medical literature, the first person to present with the disease ever, the first patient to present with a new form of a disease or condition. It's the person in the center of an epidemiological chart, numbered in chronological order. The second patient know to contract the disease is "patient two" for example. "Patient zero" is the presumed source of the outbreak (we don't have an outbreak) who does not know how they were infected. Gaetan Dugas for example was patient zero, despite the fact he was certainly not the first person to contract the AIDS virus. But he didn't know where he got it, had no way of finding out, so the chart ended with him. Patient zero.

Mr. Duncan is not an index case. We know how he got infected, we know where, the epidemiological chart extends far past him. By definition, not patient zero. The only papers written about Mr. Duncan will have to do with the safety precautions used during his care. Should the disease mutate again, the first person to present with the mutation will be "patient zero". And it will mutate. It will take more than a dozen patients with similar medical histories and vaccinations, but our bodies are adapted and medicated in ways that people in other countries are not. Not in a superior way, but we have more access to antibiotics, antivirals, we have more vaccinations, less exposure to serious disease, different social habits, different climate, different immunities, never mind the culture of over the counter drugs. The disease will mutate given enough time. Then we will have a "patient zero".

[alkuluku]

[Chris]

Please can someone reassure me that ordinary Americans aren't as bizarrely self-obsessed as the American media?

Ebola deaths in the USA: 1
Ebola deaths in the rest of the world: 4921

[Steadmund Brand]

Please can someone reassure me that ordinary Americans aren't as bizarrely self-obsessed as the American media?

Ebola deaths in the USA: 1
Ebola deaths in the rest of the world: 4921

Sorry.. I wish I could... but for the most part it's sad but true... a vast majority of Americans do not think for themselves.. they just repeat and believe whatever they are told by whichever 24 news stations they want to believe


Steadmund Brand

[Caligo Umbrator]

Please can someone reassure me that ordinary Americans aren't as bizarrely self-obsessed as the American media?

Ebola deaths in the USA: 1
Ebola deaths in the rest of the world: 4921

Hi Chris

Just saw this thread.

Unfortunately, I cant reassure you of any such thing.
A quick glance at Facebook will tell you that indeed there are a great many 'bizarrely self-obsessed' Americans.

My wife's parents ( who watch and listen to almost exclusively the Fox networks ) were actually led to believe that 'The Ebola Crisis' was a deliberate ploy by the government to scare the population, so that measures to introduce martial law could be undertaken.
They believed the hype from the various commentators enough that they went out and bought a handgun each and 2 months supply of foil-wrapped 'patriot survival rations'.
I'm not sure what they intend to do with all of that but I can say I won't be making any poorly chosen remarks about the quality of the food on offer when I visit them this Christmas.

I live in Dallas and the apartment complex that the unfortunate gentleman from Liberia visited is just 2 blocks away - the hospital he attended is on the corner of my street and close enough to be visible from my 2nd floor porch/balcony.

I know a chap who is a nurse there and, from what he's told me, I can confirm that what Archaic said above is generally correct.
The patient went to the hospital, was examined and sent away. 2 days later he goes there again, in a much worse condition and this time he is admitted. The medical staff suspected Ebola - that's why he was tested for it, but the senior management ( from what I have been told ) were concerned at least as much about unnecessary expenditure as they were about precautions.
From what I understand, there was a feeling that this patient was unlikely to actually have Ebola and so the protocols that should have been followed from the start, were not.
Because there was a seeming unwillingness to provide the correct protective clothing until a diagnosis had been confirmed, it is indeed true that nurses, for two days, had to close any gaps in their scrubs with various sticky tapes, mainly around the wrists, neck and the cuffs of the trousers/pants. The use of disposable foot coverings ( protective pads which slip over normal footware ) was not required. They were only provided with basic surgical masks, not unlike something one might wear when doing a bit of DIY at home.
I am told however they were permitted to wear three pairs of nitrile gloves.

There was also the issue of waste disposal. Surprisingly, perhaps, for a hospital that can accommodate more than 800 patients at one time, there was no protocol in place for the removal and disposal of virally contaminated hazardous items. This meant that the pillows, bed sheets, the various materials used to clean the patient (who was suffering from diarrhea and projectile vomiting at this stage) and much of the outerwear the nurses used, had to be stored in a corner of the patients room until a private company agreed to undertake the contract for transfer.
From what I understand they remained there, in a constantly growing mountain, for five days.
There are so many other ways in which 'the ball was dropped' but I think that gives an idea, at least, of the early response.

Yours, Caligo

[DrummondStreet]

Thanks for posting the explanation of how the nurses became infected, Caligo.

[Steadmund Brand]

However.. this is America.. where the # 1 Halloween costume this year is Ebola patient (or for women Sexy Ebola nurse I bet....pathetic that every costume for women now has to be sexy whatever.....i'm not against sexy mind you.. but this is going too far....plus.. it's not "sexy" it's "whoreish" )

Steadmund Brand--

[Errata]

However.. this is America.. where the # 1 Halloween costume this year is Ebola patient (or for women Sexy Ebola nurse I bet....pathetic that every costume for women now has to be sexy whatever.....i'm not against sexy mind you.. but this is going too far....plus.. it's not "sexy" it's "whoreish" )

Steadmund Brand--

Sounds like you agree with the Bill Theiss theory of sexiness. A woman in a bikini is never as hot as a woman wrapped in a towel.

[Steadmund Brand]

Sounds like you agree with the Bill Theiss theory of sexiness. A woman in a bikini is never as hot as a woman wrapped in a towel.

that would all depend on the woman... and the bikini... and the towel


Steadmund Brand--