Wouldn't fruit bat poop be more likely? I mean, if it were bush meat I'd suspect it was prepared for the child in which case there would have been a second patient-zero. Whereas fruit bat poop can easily get into a 2 year-olds mouth without anyone noticing.
> I mean, if it were bush meat I'd suspect it was prepared for the child in which case there would have been a second patient-zero.
Just speculating, but maybe cooking the meat attenuated the virus, and it was only able to take hold in a person with an underdeveloped immune system. Or, maybe, the disease merely progressed faster in the child and so s/he only looks like patient zero, despite the rest of the people eating having gotten infected at the same time.
The last piece of the article is painful to read. Anyone know how we can contribute to supplies, etc to fight Ebola?
"A Desperate Call for Help
By June and July, Sierra Leone was becoming the center of the outbreak. At the government hospital in Kenema, Dr. Sheik Umar Khan was leading the efforts to treat patients and control the epidemic.
But he was desperate for supplies: chlorine for disinfection, gloves, goggles, protective suits, rudimentary sugar and salt solutions to fight dehydration and give patients a chance to survive. Early in July, he emailed friends and former medical school classmates in the United States, asking for their help and sending a spreadsheet listing what he needed, and what he had. Many of the lines in the “available” column were empty. One of his requests was for body bags: 3,000 adult, 2,000 child.
Before his friends could send the supplies, Dr. Khan contracted Ebola himself. He died on July 29."
Medecins Sans Frontiers (Doctors Without Borders) is an excellent choice. They have been integral to controlling several past Ebola outbreaks, and have been fighting this one since the beginning. They are almost entirely tapped out right now. http://www.msf.org
I can't vouch for them, but the Liberian Ministry of Health also has donation instructions: http://www.mohsw.gov.lr
Not sure why you say MSF is "almost entirely tapped out"—from MSF's website "Please note that Doctors Without Borders' response to the Ebola outbreak in West Africa is fully funded." Nevertheless, they're a pretty excellent charity to donate to (c.f. http://www.givewell.org/international/charities/doctors-with... and note they spend over 85% of funds on programs [~12% on fundraising, and ~1% on management]).
You're right, I revisited the article that gave me that impression [0], and it's very clear that staffing is the resource that is exhausted. Nonetheless, it's an excellent organization and a worthy cause in my opinion.
They're also one of the few charities to whom I donate that doesn't spam me to death after the donation. Give money to the MSF, and you get a few letters a year about what they're doing.
"Unlike most previous outbreaks, which occurred in remote, localized spots, this one began in a border region where roads have been improved and people travel a lot. In this case, the disease was on the move before health officials even knew it had struck."
What if someone in a major US city got infected? How bad could it get? Could they even contain it at that point?
The US has far better medical facilities, better supplies, better communication tools, better handling procedures for corpses and a society that doesn't stigmatize infectious diseases. Taken together, an outbreak here would look very different than an outbreak in Africa, even if a sick patient was dropped into Times Square.
But what if poor people in America get Ebola? They can't afford health care, so may end up hiding their illness to avoid the insane amounts of debt they would get themselves into.
Nobody in the US can be denied emergency medical care, regardless of ability to pay. Poor people already know this, which is why inner-city emergency rooms are overwhelmed with things like "my baby has a cough", making a $50 office visit a $400 bill that will get written off.
> Poor people already know this, which is why inner-city emergency rooms are overwhelmed with things like "my baby has a cough"
The idea that poor children are just left to fend for themselves on basic healthcare like treating a cough in the US is blatantly false.
Poor people who know about the emergency rooms also know that normal healthcare is available for poor children for free from the government, which they get and then take their kids to the doctor like everyone else when they have a cough.
Seriously, the hysteria around people not having healthcare in the US is just incredible relative to the actual facts on the ground. Even if you believe Obama's "40 million without healthcare" claim (I don't), that's just 12% of the country, and the two most vulnerable populations—children and the elderly–were fully covered by the state already without the Obamacare regs.
There are real problems with the US healthcare system; we don't need to start spouting nonsense like poor children can only get a cough treated at the emergency room for free.
My wife works as a pediatric nurse; the doctor she worked for until recently treated predominately Hispanic, Medicaid-insured children. She sees first hand what gets covered and what doesn't. For illegal immigrants and their children, the options are very limited (though many do choose to self-pay at doctors' offices).
My point wasn't what isn't available. My point was that, regardless of ability to pay or any other factor, everybody in America has access to the American health care system for acute treatment (something Ebola would certainly be classified as).
Whether you can make it to a doctor's office or are stuck at the ER for your kid's cold depends on a lot of other factors, but, even then, your kid will get seen for that cold.
It's likely easier to control in the U.S. where there are a lot of resources and people are less likely to engage in a lot of physical contact with the infected, and where trust of doctors is a lot higher.
There is also a much more extensive public health system that is alert to the risk of an infected person entering the country.
People keep repeating this as if it were a definitive rebuttal of all fears, but this story gives a few great examples of why the confidence might be misplaced: when your primary diagnostic criterion is a fever (common; easily suppressed with OTC medication) and affirmative answer to the question "have you been to West Africa?", it doesn't really matter how good your public health system is -- it's a going to be a leaky early warning system.
If someone makes it through the airport screens and carries the virus into a city, the epidemiology could become overwhelming before we know an outbreak has begun. So yes, we have the advantage that we have real hospitals and good infection control, but we have the disadvantage that we have huge cities, high population density and lots of personal mobility.
I wasn't referring just to your comment; I've been hearing this as the default response to just about every rational concern since Trump started tweeting and it became a de facto left/right issue.
Obviously he's a moron, but the response from the other side of the debate has been almost as one-dimensional.
Not to mention the terrorism angle. How hard do you think it would be for al queda to get their hands on an ebola victim, harvest a gallon of body fluids, and smuggle it into the US? Because distribution wouldn't be hard at all; down here in texas, there are any number of outdoor misting systems that are aimed at busy streets full of sweltering tourists.
Ebola is nothing new. If terrorists wanted to use it as a weapon, they could have done it a long time ago. Now would actually be a bad time for a bioterror attack, because people are on high alert for anything that could be ebola. It would be a lot more effective if it came out of the blue, giving it time to spread before anyone realized their fever was actually ebola.
>If someone makes it through the airport screens and carries the virus into a city, the epidemiology could become overwhelming before we know an outbreak has begun.
Could, but very unlikely to, as Ebola doesn't spread as easily as cold or flu viruses.
Most of the outbreaks in Africa, where numerous dangerous practices such as hospitals reusing needles helped spread the virus, have had only a few hundred cases. The latest outbreak is pushing towards 2000 cases but local practices that don't exist in the West are contributing significantly.
The point of comfort for the U.S. is that ebola transmission currently requires direct contact with bodily fluids--not that it's easy to diagnose.
If you had a fever and went to work, and it turned out you had ebola, it's still unlikely you would infect your coworkers, because it is rare for American workers to directly contact each others' bodily fluids.
Think of ebola like AIDS that kills faster. That's the right mental model for how it is transmitted. And, it's a good reminder that we have decades of practice managing diseases transmitted that way.
They may have known they were dealing with Ebola, but they didn't have the equipment or facilities to take all the steps necessary to prevent transmission.
Keep in mind these doctors were surrounded by hundreds of cases and potential cases, in field hospitals without even running water. It's quite understandable that they would be at risk even while taking what precautions they could.
Here's the thing: most people get the flu by contact via "bodily fluids". You cough, sneeze, drool, wipe your nose, and so on, then touch something. Someone later touches the same thing (or you), then touches their face, and the transmission has occurred. There have been papers on this.
It's easy to get fixated on aerosol transmission because it's fancy, but "bodily fluids" are a damned effective vector for the everyday transmission of a virus.
(Also, HIV is a pretty poor model for this. As viruses go, HIV is pretty hard to transfer -- even heterosexual sex has a low rate of seroconversion.)
The flu virus is very good at getting you to spread your bodily fluids all over the place: it makes you cough violently. The droplets are also invisible, so it's easy for others to touch them without knowing.
Ebola has many symptoms, but coughing isn't one of them. By the time you start coughing up blood, most people in the developed world will know better than to touch that blood.
> Ebola is not like the flu. You're not going to catch the disease from simply being across the room from someone who has it.
> Basically every health agency in the world agrees on this point. In order to catch Ebola, you have to come in contact with bodily fluids — such as sweat, saliva, vomit, or diarrhea — of someone who already has Ebola and is exhibiting symptoms. (A person who is infected but not yet showing symptoms generally isn't infectious.)
> And yet, remarkably, many readers have been unconvinced by this point.
This was the first of many available sources in a quick Google search.
I don't understand why there seems to be so much interest in hyping the threat of ebola to the U.S. Maybe it has to do with the many doomsday virus stories in our culture?
An analogy: a friend of mine worked at a "Wild West" type museum. He got a call from someone who wanted to know if there were any black cowboys. My friend told the caller that yes, there had been many black cowboys. The caller said "that can't be true. How come I never saw any in western movies??"
Does the usage of African instead of Guinean bother anyone else? Africa is widely not recognized as a continent of distinct countries and this isn't helping. It's like referring to people from the U.S., Canada, and Mexico as North Americans.
Yeah, the mistake of referring to Africa as a single nation is unfortunately common in the U.S., made by everyone from from leading Republican politicians to, more sadly, Clayton Kershaw.
Most people compare it to the flu but what about norovirus. It's spread in a versus similar way and pretty much everyone in the US has had it at one time or another...
There are countries named Guinea, Guinea-Bissau, Equatorial Guinea, Papua New Guinea, Guyana and French Guiana.
I think I'm pretty well traveled but even I have difficulty sorting these all out. So even though "Guinean" would be accurate, it would still cause some confusion.
48 comments
[ 3.2 ms ] story [ 118 ms ] threadJust speculating, but maybe cooking the meat attenuated the virus, and it was only able to take hold in a person with an underdeveloped immune system. Or, maybe, the disease merely progressed faster in the child and so s/he only looks like patient zero, despite the rest of the people eating having gotten infected at the same time.
"A Desperate Call for Help
By June and July, Sierra Leone was becoming the center of the outbreak. At the government hospital in Kenema, Dr. Sheik Umar Khan was leading the efforts to treat patients and control the epidemic.
But he was desperate for supplies: chlorine for disinfection, gloves, goggles, protective suits, rudimentary sugar and salt solutions to fight dehydration and give patients a chance to survive. Early in July, he emailed friends and former medical school classmates in the United States, asking for their help and sending a spreadsheet listing what he needed, and what he had. Many of the lines in the “available” column were empty. One of his requests was for body bags: 3,000 adult, 2,000 child.
Before his friends could send the supplies, Dr. Khan contracted Ebola himself. He died on July 29."
I can't vouch for them, but the Liberian Ministry of Health also has donation instructions: http://www.mohsw.gov.lr
[0] http://www.msf.org.uk/article/ebola-official-msf-response-wh...
More charities should be like that.
What if someone in a major US city got infected? How bad could it get? Could they even contain it at that point?
The idea that poor children are just left to fend for themselves on basic healthcare like treating a cough in the US is blatantly false.
Poor people who know about the emergency rooms also know that normal healthcare is available for poor children for free from the government, which they get and then take their kids to the doctor like everyone else when they have a cough.
Seriously, the hysteria around people not having healthcare in the US is just incredible relative to the actual facts on the ground. Even if you believe Obama's "40 million without healthcare" claim (I don't), that's just 12% of the country, and the two most vulnerable populations—children and the elderly–were fully covered by the state already without the Obamacare regs.
There are real problems with the US healthcare system; we don't need to start spouting nonsense like poor children can only get a cough treated at the emergency room for free.
My point wasn't what isn't available. My point was that, regardless of ability to pay or any other factor, everybody in America has access to the American health care system for acute treatment (something Ebola would certainly be classified as).
Whether you can make it to a doctor's office or are stuck at the ER for your kid's cold depends on a lot of other factors, but, even then, your kid will get seen for that cold.
I don't know where you got "hysteria" from...
There is also a much more extensive public health system that is alert to the risk of an infected person entering the country.
If someone makes it through the airport screens and carries the virus into a city, the epidemiology could become overwhelming before we know an outbreak has begun. So yes, we have the advantage that we have real hospitals and good infection control, but we have the disadvantage that we have huge cities, high population density and lots of personal mobility.
Obviously he's a moron, but the response from the other side of the debate has been almost as one-dimensional.
Bio-terrorism looks so easy.
Could, but very unlikely to, as Ebola doesn't spread as easily as cold or flu viruses.
Most of the outbreaks in Africa, where numerous dangerous practices such as hospitals reusing needles helped spread the virus, have had only a few hundred cases. The latest outbreak is pushing towards 2000 cases but local practices that don't exist in the West are contributing significantly.
If you had a fever and went to work, and it turned out you had ebola, it's still unlikely you would infect your coworkers, because it is rare for American workers to directly contact each others' bodily fluids.
Think of ebola like AIDS that kills faster. That's the right mental model for how it is transmitted. And, it's a good reminder that we have decades of practice managing diseases transmitted that way.
Doctors who knew they were working with Ebola still managed to get infected. So it can't be that hard to get it.
We don't need to panic, but it would be unwise to be too complacent.
Yes, but these doctors often don't even have the equipment to provide proper antiseptic medical care let alone containment-type biosuits.
In addition, quarantines can be rolled out quickly and effectively in modern countries with well-developed communication infrastructure.
This is not to say that we should be complacent. However, a bad flu epidemic poses more direct hazard to the modern world.
It's easy to get fixated on aerosol transmission because it's fancy, but "bodily fluids" are a damned effective vector for the everyday transmission of a virus.
(Also, HIV is a pretty poor model for this. As viruses go, HIV is pretty hard to transfer -- even heterosexual sex has a low rate of seroconversion.)
Ebola has many symptoms, but coughing isn't one of them. By the time you start coughing up blood, most people in the developed world will know better than to touch that blood.
> Basically every health agency in the world agrees on this point. In order to catch Ebola, you have to come in contact with bodily fluids — such as sweat, saliva, vomit, or diarrhea — of someone who already has Ebola and is exhibiting symptoms. (A person who is infected but not yet showing symptoms generally isn't infectious.)
> And yet, remarkably, many readers have been unconvinced by this point.
http://www.vox.com/2014/8/10/5980553/ebola-outbreak-virus-ae...
This was the first of many available sources in a quick Google search.
I don't understand why there seems to be so much interest in hyping the threat of ebola to the U.S. Maybe it has to do with the many doomsday virus stories in our culture?
An analogy: a friend of mine worked at a "Wild West" type museum. He got a call from someone who wanted to know if there were any black cowboys. My friend told the caller that yes, there had been many black cowboys. The caller said "that can't be true. How come I never saw any in western movies??"
Not very, barring unexpected mutation: http://www.vox.com/2014/7/30/5948995/why-ebola-would-never-g...
[1] http://www.africaisacontinent.com/common-mistake
[2] http://mlb.mlb.com/news/article.jsp?ymd=20101220&content_id=...
I think I'm pretty well traveled but even I have difficulty sorting these all out. So even though "Guinean" would be accurate, it would still cause some confusion.