Wednesday, July 30, 2014

What We're Not Being Told About The Ebola Outbreak - And Why a Pandemic Is Not Impossible

The Ebola virus in an electron micrograph

Researcher working with Ebola using a BSL-4 positive pressure suit

Ok, I readily admit my specialty is not biology, viruses or human epidemiology. Hence, you may take this blog post for what you believe it's worth. But I have been following news of the latest Ebola outbreak in West Africa and I become more alarmed with every new report - especially the latest in which an American (Patrick Sawyer) actually got on a plane and flew into Africa's 2nd largest city (Lagos) with 21 million people.

The medical media cognoscenti continue to soft soap the incident and I believe it may be to prevent any public alarm. But I think the public ought to have plenty alarm and here's why:

In the most recent AP report (Denver Post, 'New Fears About Ebola Spread After Plane Scare', July 29, p. 13A), we are informed:

"Witnesses say Sawyer, a 40-year old Finance Ministry employee en route to a conference in Nigeria, was vomiting and had diarrhea aboard at least one of his flights with some 50 other passengers . Ebola can be contracted from traces of feces or vomit, experts say."

I would like you to read that over again and think about it. If a passenger is ill on a plane he or she has two choices, reach for a barf bag or try to make it to the nearest rest room and let it rip. In the last case it is probable no "witness" would have been present to see anything and especially any diarrhea. If the passenger couldn't make it and is constrained to release in his seat - THEN it is likely there would be witnesses to both unfortunate emissions (in the case of the diarrhea, more likely as a god awful odor - which in fact, the Ebola virus produces.)

Now, the fact bio-lab and CDC et al research workers have to wear  BSL-4 positive pressure suits when working with the virus (see above image) means it is no walk in the park for any unprotected people if a guy on a passenger plane displays any eruption of body fluids! I mean, this is serious! It means possibly five or six people might have been affected, if not more. And at the Ebola phase of fluid ejection, even bloody droplets from the victim's eye can cause infection.

Now, here's the bitch. As the article observes:

Sawyer was quarantined upon arrival in Lagos - a city of 21 million people-  and Nigerian authorities say his fellow travelers were advised of Ebola's symptoms and allowed to leave.

Allowed to leave!? WHY?  WTF!  This disease kills 60- 90% of those infected!

They ought to have ALL been quarantined on the spot, given the "authorities" had no a priori clue who had come into direct contact with Sawyer's bodily fluids - if even in a happenstance way  - say him rushing out of his seat to the toilet with drops of virus-laden stool leaking from his spattered trousers (the diarrhea is almost as bad as c.diff. and cholera) onto hapless passengers. Who, may have believed it to be just some juice from a drink (though the odor ought to give it away).

My point is that if those who work with Ebola need positive pressure suits, and people in an airplane have nothing and are exposed and allowed to walk out of the airport - then something is seriously amiss. The "authorities" did not practice due diligence and allowed 5 or more possibly infected sources of the virus to escape!

Then there's the problem with "looking for symptoms".  The sad fact is that they can take up to 21 days (3 weeks) to manifest and some sources cite 25 days. By that time most of the passengers might have forgotten about it. The next thing, the symptoms are initially vague and general - often mistaken for a bad flu.

The symptoms usually begin with severe headache, sore throat and muscle pain accompanied by a burning fever.  As it progresses, hiccups are often soon to follow with severe nausea. By now, it's critical the person get himself to a treatment center to begin prepping for the process of re-hydration, because the explosive vomiting and diarrhea will soon follow, along with hemorrhagic bleeding from multiple orifices. At that phase, the danger for cross infection of others is at a maximum.

In the movie, 'Contagion', many passengers aboard commercial aircraft are infected by the victims of the depicted deadly virus coughing or sneezing. The problem is that they don't turn themselves into hospitals, but they go home to try to recover. There, they infect loved ones, and the epidemic soon turns into a pandemic.

Could it happen with Ebola? If so, it would mean airborne infection is possible in the new outbreak and we're not being informed. Indeed, Canadian scientists believe the disease can now be transmitted through the air, which would explain the rapid spread of this new outbreak and the deaths of 3 doctors (two Americans and an African)  who took every precaution, including positive pressure suits. As reported in the link above:

"Canadian scientists have shown that the deadliest form of the ebola virus could be transmitted by air between species. In experiments, they demonstrated that the virus was transmitted from pigs to monkeys without any direct contact between them.

The researchers say they believe that limited airborne transmission might be contributing to the spread of the disease in some parts of Africa."

If that is the case we're really for the high jump. But let's stay conservative and hope it's no more than a possibility. In that case the spread would require a long chain of total screw ups by everyone involved, from airport authorities to local officials to the CDC. But hey, after several old supply stores of smallpox and anthrax were found improperly stored at the latter, it could happen!

Sawyer, the American working with the Nigerian government, ultimately would have returned home to Minnesota - and indeed was planning to do so next month. So what if, I say IF - he'd have still not shown his symptoms outwardly by the time he got on a jet home. Then, after arriving home had begun dispersing the virus to his family via his bodily fluids - they'd have surely tried to clean up after him.

I would argue all would have been infected.

Well, Sawyer was stopped in his progress at Lagos Airport, but a lot of possibly infected people (who came into contact with him on the plane) are on the loose. The medical authorities insist the risk from any of them - say catching a plane to New York or Chicago - is "low" and they'd "likely report to a medical center if they see symptoms".

Let's hope these medical soothsayers are right.

For my part,  I remain skeptical.  Actually you can call me a pessimist! Reinforcing my pessimist take is this statement from Dr. David Heymann, Professor or Infectious Diseases at the London School of Hygiene and Tropical Medicine, quoted in the Post piece (ibid.):

"The best thing would be if people did not travel when they're sick, but the problem is that people won't say when they're sick. They will lie in order to travel, so it is doubtful that travel recommendations will have a big impact."

I suspect the same applies to those who travel,  then show symptoms, and are supposed to then report to a medical center, pronto.

We have to trust that the medical gurus are right and affected people are cooperative enough to understand the greater good trumps anything else. I am just not so sure that will hold.

UPDATE: Friday, Aug. 1:

Dr. Jon La Pook informs viewers  (CBS) this a.m. that U.S. entry airports are NOT screening any passengers from West Africa - specifically from  the affected nations.  Need I say, must I, that this amounts to callous oversight for which we may a dear price? By contrast, the Chinese have  sophisticated infrared-thermal detectors trained on all arriving passengers and sequester any with temperature readings above 99.5F. The Chinese take their nation's interests and welfare seriously and we evidently do not. Meanwhile, the words of media medical gurus like LaPook and Richard Besser (from ABC) continue to ring hollow on how they are "certain" any problems can be contained here in the U.S. Sorry, I don't buy it.

Further, I predict this ghastly virus will spawn an outbreak on our shores before the month is out. I also challenge LaPook's and others' claims that "infection can only occur by direct contact with bodily fluids". I challenge it because Canadian drs. have already demonstrated in their labs it can spread by air! Further, the patients being flown to the U.S. for treatment are being contained in AIR TIGHT vestibules and - once they arrive at Emory University in Atlanta for treatment - will be confined to special isolation units with their own air systems and filtration.

Now, you figure it out,  dear reader. Who exactly is being fed a load of bollocks here? Should we be lulled into a sense of false security, or should we ourselves begin taking every precaution we can? You be the judge!

See also:


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