Thursday, October 30, 2014

MSF warns Liberia Ebola 'progress' could be illusory

http://www.rappler.com/world/regions/africa/73588-liberia-ebola-progress-illusory

Wednesday, October 29, 2014

now close to 14000 Ebola infections...

"...now close to 14000 Ebola infections..."

http://apps.who.int/iris/bitstream/10665/137376/1/roadmapsitrep_29Oct2014_eng.pdf?ua=1

Also: "...A total of 521 health-care workers (HCWs) are known to have been infected with EVD up to the end of 27 October, 272 of whom have died..."

Remember when there were just under 10000 cases? That was just ONE WEEK AGO!
http://drmkessler.blogspot.com/2014/10/who-ebola-response-roadmap-situation.html

Act NOW.

Isolate & treat

"...Health experts say the key to stopping Ebola is breaking the chain of transmission by tracing and isolating those who have had contact with Ebola patients or victims. ..."

http://abcnews.go.com/Health/wireStory/5000-ebola-health-workers-needed-west-africa-26502424

Correct. Quarantine and treat NOW. Don't wait for the virus to have spread to all continents.

Who is supposed to be able to pay for the supportive treatment of the entire world population when eventually everyone has been infected?
Sure, the rich industrialized nations can, but what is the rest of the world population supposed to do? They won't be able to pay for the high tech medicine we are able to afford.

Thus, rich nations have the moral obligation to contain Ebola by all means, including quarantine for all by "isolating those who have had contact with Ebola patients or victims", and help treat those already infected.

Monday, October 27, 2014

Ebolavirus dried onto glass, polymeric silicone rubber, or painted aluminum alloy is able to survive in the dark for several hours under ambient conditions (between 20°C and 25°C and 30–40% relative humidity) (amount of virus reduced to 37% after 15.4 hours), but is less stable than some other viral hemorrhagic fevers.
When dried in tissue culture media onto glass and stored at 4 °C, Zaire ebolavirus survived for over 50 days.
This information is based on experimental findings only and not based on observations in nature. This information is intended to be used to support local risk assessments in a laboratory setting.

http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php

Thus, practice meticulous hand hygiene as outlined here: http://drmkessler.blogspot.com/2014/10/how-not-to-catch-ebola.html and here:
http://drmkessler.blogspot.com/2014/10/opinion-which-products-you-may-want-to.html

Sunday, October 26, 2014

Over 10000 Ebola Virus Disease cases now...

Over 10000 Ebola Virus Disease cases now and no end in sight, which is however no surprise for the informed reader.

http://apps.who.int/iris/bitstream/10665/137185/1/roadmapupdate25Oct14_eng.pdf?ua=1

All projections point to increasing case numbers. The speed of the increase in cases could be decreased IF appropriate containment methods were employed on a global scale. IF drastically measures were taken, it could even be contained and eradicated. BUT, politicians would need to have the guts to do this.

Friday, October 24, 2014

From Pigs to Monkeys, Ebola Goes Airborne

"Old" news from 2012 which the scientific community already knew back then. Ebola does indeed potentially go airborne.

...There are three likely candidates for the route of transmission: airborne, droplet, or fomites.
...
Airborne and droplet transmission both technically travel through the air to infect others; the difference lies in the size of the infective particles. Smaller droplets persist in the air longer and are able to travel farther- these droplets are truly “airborne.” Larger droplets can neither travel as far nor persist for very long. Fomites are inanimate objects that can transmit disease if they are contaminated with infectious agents....

http://healthmap.org/site/diseasedaily/article/pigs-monkeys-ebola-goes-airborne-112112

What does this mean for the general population? Practice good hygiene as detailed previously to prevent transmission of viral diseases: How not to catch Ebola. and here: Which products you may want to have to prevent transmission of viral diseases.

It is easy and cheap enough to do and you do NOT need special education or training for it. Take the japanese population as an example as seen in photo below.

KOBE, JAPAN - MAY 20: People on the street wear face masks because of the outbreak of swine flu near Sannomiya JR station May 20, 2009 Kobe

Prepare NOW. As correctly pointed out by some in the general news media, the "common flu" has to this point killed more people than Ebola. By taking the above linked precautions, you are protecting yourselves from all virus infections.

Thursday, October 23, 2014

WHO: EBOLA RESPONSE ROADMAP SITUATION REPORT

Status as of October 22nd, 2014.

12 page report with high yield facts.

http://apps.who.int/iris/bitstream/10665/137091/1/roadmapsitrep22Oct2014_eng.pdf?ua=1

Wednesday, October 22, 2014

Live Ebola Map

http://www.liveebolamap.com

This map service seems more up to date than the one I previously posted.

Can Ebola virus infect via the skin?

...A patient in the late stages of Ebola virus infection (such as the Dallas patient) is shedding high amounts of virus particles in body fluids. If virus-laden droplets land on the skin, the virus can readily enter via cuts or abrasions. Even if the skin is intact, the droplets could be inadvertently transferred to mucous membranes of the eye, nose, or mouth, initiating infection. For this reason it is important that the skin be entirely covered when caring for Ebola virus infected patients....

http://www.virology.ws/2014/10/19/can-ebola-virus-infect-via-the-skin/

Sunday, October 19, 2014

Opinion - which products you may want to have in the mid-term future

- Any kind of glove that is waterproof, at least at it's inner-hand contact surface. Can get a simple pair in the supermarket for just under $4. Non-waterproof is fine IF and only IF you don't touch anything wet which could permeate through the glove material. Anything you touch when you are not at home, touch only with gloves and disinfect them before you take them off. Why? Someone could have contaminated the surfaces you are touching (especially in the supermarket!), remembering that Ebola survives for several hours on dry surfaces and much longer on wet surfaces!
-- Learn sterile glove technique, for example here:
https://www.youtube.com/watch?v=Y9B3sefAFeY but do watch a couple different videos to learn it properly. Did not find any video on how to take off the gloves while remaining sterile. Well, imagine that the how to put them on videos were reversed.

- Safety goggles. Wear them everywhere so no one's sneeze gets into your eyes...

- Simple face masks, but any kind of covering material should suffice. Wear them everywhere so no one's sneeze gets onto your lips... (Even had that happen to you...?) I have never been to Japan, but I have been told that some wear these face masks in public to decrease their exposure rate to viruses. Clever!

- Condoms might also sell much better than they currently do. Remember you read that semen carries the Ebola virus for up to 7 weeks...

Hey, by following the above (at least the top three items...), even the simple flu infection rate will probably drop!

How NOT to catch Ebola

Another great write up by the BBC.

DON'T TOUCH
Ebola is spread by direct contact with contaminated body fluids. Blood, vomit and saliva can all carry and spread the deadly virus.

COVER YOUR EYES
If an infected droplet does get on to your skin, it can be washed away immediately with soap and water or an alcohol-based hand sanitiser.

The eyes are a different matter. A spray of droplets from a sneeze directly into the eye, for example, could let the virus in.

SURFACES
Minute droplets on a surface that hasn't been adequately cleaned could, in theory, pose a risk. And it's unclear how long the virus could sit there and remain a threat. Flu viruses and other germs can live two hours or longer on hard environmental surfaces like tables, doorknobs, and desks.
Soap and water or alcohol-based hand sanitisers readily disrupt the envelope of this single-stranded RNA virus, and decontamination with dilute bleach is effective and readily available even in remote settings.

CONDOMS
...according to the World Health Organization Ebola can be found in semen for seven weeks and some studies suggest it can be present for up to three months.

For this reason, doctors say that people who recover from Ebola should abstain from sex or use condoms for three months.

http://www.bbc.com/news/health-29518703

How Ebola Virus spreads.

The BBC did an outstanding job on the write up of HOW Ebola spreads. Especially the diagrams are a great work of art and no prior medical knowledge needed to understand the data being presented.

http://www.bbc.com/news/world-africa-26835233

The safest incubation period for Ebola is not 21 days, it's double that, a total of 42 days...

The safest incubation period for Ebola is not 21 days, it's double that, a total of 42 days before an all clear should be given on any Ebola virus outbreak. On October 14, 2014 a World Health Organization (WHO) publication stated as much and more.

According to the publication on the WHO website, there are no 100 percent safety margins; however,...

http://www.who.int/mediacentre/news/ebola/14-october-2014/en/

Saturday, October 18, 2014

"When even the smallest doubt remains, we will ensure the health and safety of the Belizean people."

The government of Belize refused, saying: "The passenger never set foot in Belize. When even the smallest doubt remains, we will ensure the health and safety of the Belizean people."

http://www.telegraph.co.uk/news/worldnews/ebola/11171462/Carnival-Magic-returns-to-Texas-after-Belize-and-Mexico-refuse-to-allow-possible-Ebola-victim-to-disembark.html

USHA: Cleaning and Decontamination of Ebola on Surfaces

Guidance for Workers and Employers in Non-Healthcare/ Non-Laboratory Settings
Workers tasked with cleaning surfaces that may be contaminated with Ebola virus, the virus that causes Ebola hemorrhagic fever (EHF), must be protected from exposure. Employers are responsible for ensuring that workers are protected from exposure to Ebola and that workers are not exposed to harmful levels of chemicals used for cleaning and disinfection.

https://www.osha.gov/Publications/OSHA_FS-3756.pdf

WHO: Infection prevention and control guidance for care of patients in health-care settings, with focus on Ebola

Overview

This document [provided on the linked page] provides a summary of infection control recommendations when providing direct and non-direct care to patients with suspected or confirmed Filovirus haemorrhagic fever, including Ebola or Marburg haemorrhagic fevers. These recommendations are interim and will be updated when additional information becomes available. The sections of the guidance cover:

General patient care
Direct patient care (for suspected or confirmed patients with haemorrhagic fever)
Waste management
Non-patient care activities: diagnostic laboratory activities, movement and burial of human remains, post-mortem examinations, managing exposure to virus through body fluids, including blood.

Following the link you will find current aseptic technique guidance which is slightly more elaborate than that what was published by the CDC.

http://www.who.int/csr/resources/publications/ebola/filovirus_infection_control/en/

Look for links labeled "Steps to put on personal protective equipment".

Please note that as of today, the CDC has NO recommendations! I did however find some yesterday...

http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html

"PPE Recommendations are forthcoming"

Friday, October 17, 2014

Travel ban and 21 day Quarantine NOW

The Ebola virus is a Category A Biological "Weapon"

http://www.bt.cdc.gov/agent/agentlist-category.asp

IMMEDIATE travel ban and 21 day quarantine are imperative NOW.

Thursday, October 16, 2014

EBOLA: LESSONS LEARNED, FROM IDWEEK 2014

EBOLA: LESSONS LEARNED, FROM IDWEEK 2014
http://www.idweek.org/ebola_idweek_2014/

FAQ: Safe Management of Patients with Ebola Virus Disease (EVD) in US Hospitals

Publish Date:

Tuesday, October 14, 2014

In response to the Ebola public health emergency, the American Hospital Association (AHA) has provided an Ebola education package for CME providers. This package contains information that the American Hospital Association believes would be useful to healthcare providers and institutions right now, including this FAQ. An informational PowerPoint is available here.

Go to this publication:

EBOLA FAQ.doc

Source: Accreditation Council for Continuing Medical Education
http://www.accme.org/news-publications/publications/public-health-resources/faq-safe-management-patients-ebola-virus

Ebola outbreak case number projection

Oct 8th, 2014: 8033 confirmed cases.

Nov 11th, 2014 prediction: over 18000 cases.

Source: http://healthmap.org/ebola/#projection

http://www.domesticpreparedness.com/Government/Government_Updates/Enhanced_Ebola_Screening_to_Start_at_Five_U.S._Airports_%26_New_Tracking_Program_for_All_People_Entering_U.S._From_Ebola-Affected_Countries/?utm_source=DomesticPreparedness&utm_campaign=cac30fde32-DPJ_Weekly_Brief_October_15_201410_13_2014&utm_medium=email&utm_term=0_9a091366ad-cac30fde32-196506413

Dr. Kessler's random collection of Emergency Preparedness topics