Ebola

[Val_2]

Have to admit now watching news bulletins I am quite worried. It only takes one person as we have seen in the states to get in and infect others and it spreads. How do you feel about it?

[JSKS]

Somewhere in the order of 5000 people have contracted ebola this year. 500,000 will die from flu worldwide and three quarters of a million from malaria. In the UK nearly 3000 people will die in road accidents and 7 from malaria; 30 people will have fatal anaphylactic reactions and 12% of all deaths will be from infectious diseases.

While sensible precautions to prevent the introduction and spread of the disease are a given, I'm not sure it's time to worry just yet.

The one positive to be drawn from this is that the spectre of ebola in the West won't half speed up the search for a vaccine, to which end I expect that governments will suddenly become more interested in helping that effort.

[Quillan]

What concerns me is people's ignorance due to mis information. There was a good piece on the BBC news last night. Ebola is not airborne, you could stand in the same room as somebody who has it and not get infected although I would not suggest you try it of course. It can only 'transfer' from one human to another by bodily fluids i.e. blood, sex or somebody sneezing or coughing in your face. The nurse in Spain contracted it (according to Spanish doctors on TV last night) because she was treating a person who had it and wiped her mouth with her hand forgetting to wash it first.

http://www.nhs.uk/conditions/ebola-virus/pages/ebola-virus.aspx

It does not help that rags like The Daily Mail decide to scare people by telling untruths like it is airborne which if you read just about every other source is not true.

Most of the 'Europeans' who have contracted it have been working with the victims and have mainly been doctors, nurses or other medical staff.

Basically I wouldn't lose any sleep over it.

[JSKS]

Well said, Quillan.

Remember the fear and ignorance over HIV in the early 80s? While ebola is clearly a different pathogen with a different pathogenesis, mode of spread and virulence the fundamental principle obtains - isolation of the virus and elimination of behaviours which cause it to spread should prevent a pandemic. But I think it only right to emphasise ''should''.

The key to preventing a greater problem is to deal with the outbreak at source. It is reassuriing to see that the UK government has sent aid to Sierra Leone. If the developed countries follow this lead then it should (should, mind) be possible to contain the spread.

[Quillan]

[quote user="JSKS"]Somewhere in the order of 5000 people have contracted ebola this year. 500,000 will die from flu worldwide and three quarters of a million from malaria. In the UK nearly 3000 people will die in road accidents and 7 from malaria; 30 people will have fatal anaphylactic reactions and 12% of all deaths will be from infectious diseases. While sensible precautions to prevent the introduction and spread of the disease are a given, I'm not sure it's time to worry just yet. The one positive to be drawn from this is that the spectre of ebola in the West won't half speed up the search for a vaccine, to which end I expect that governments will suddenly become more interested in helping that effort.[/quote]

According to WHO only 3,800 have died so far (09/10/2014) which based on your figures means you have just over 23% chance of surviving.

[JSKS]

Quillan,

That is a rough figure. In fact the 3800 confirmed deaths don't include those whio have died away from the ebola centres. The best guess is that about half of cases go unreported but you will find a different figure depending on which epidemiologist you canvass!.

The mortality rate for ebola is around 50% and is influenced by a complex number of factors such as general health, access to supportive treatment and so forth. Generally, no figures for this, one would expect a lower mortality in more affluent societies. Sad but true.

Incidentally, I was a consultant surgeon not a virologist so it's perfectly possible that I'm talking bo11ocks!

[DraytonBoy]

For once the UK is doing something positive ahead of anyone else. Hopefully other 'wealthy' countries will join in and try and deal with the problem at source.

[richard51]

Quillan

Where on earth do you get the 23% chance of survival from?

[Chancer]

50K cases minus 38K deaths = 12K survivors

12K divided by 50K multiplied by 100 makes a percentage survival rate of 24% which is close enough to 23% for me not to argue.

 

[Jazzer]

May now be in France:

http://www.lefigaro.fr/flash-actu/2014/10/09/97001-20141009FILWWW00380-un-cas-d-ebola-suspecte-a-cergy-pontoise.php

[richard51]

OK Chancer I see where it comes from.

However I fail to see what on earth the relevance of such a derived figure can possibly have on the comments made before with respect to relative risks. It really only adds a certain amount of confusion to the discussion on risks.

[nomoss]

[quote user="DraytonBoy"]For once the UK is doing something positive ahead of anyone else. Hopefully other 'wealthy' countries will join in and try and deal with the problem at source.[/quote]

???? Like what????

A couple of days ago David Cameron said:-

"It would be impractical and a waste of resources to check passengers arriving at UK airports from West Africa"

Yeah, right, Dave.

[JSKS]

Nomoss.

There is no real point in checking passengers on arrival as, at any one time, a reasonable proportion of passengers will display a rise in core temperature. To test for ebola is not a 2 minute job. All you'd end up with is loads of fit and well people being isolated until their cold, ear infection, etc clears up.

What the government has done is to send an army field hospital plus support to the area to limit the spread in the focal area. It is generally agreed that it's better to contain the focus rather than let it spread and for each country to get isolationist. That is the way of global pandemic.

[JSKS]

The 23% survival figure thing:

This all stems from my saying that there were around 5000 cases. Someone got a bit pedantic and said 3800 (the current WHO estimate). This was then, through a loop of illogic, used as the two figures to determine the mortality (or survival) rate.

The mortality rate for ebola is about 50%.

[nomoss]

JSKS

What I was thinking about, rather than an impractical impromptu medical examination, is a simple face-to-face interview for people arriving in the UK from certain areas, regarding where have been in the previous few days. Not that difficult, and, using the right personnel, this could filter out people who are at risk, even though they are not even aware of it themselves.

[JSKS]

Nomoss,

That, however, would mean quaranteening for up to 28 days for anyone who had been in an infected area at any time in the previous 28 days. I've no idea how many people that would be but where would you put them?

Surely, limiting the disease at source is more effective along with screening within the infected areas?

[Frederick]

[quote user="nomoss"]JSKS

What I was thinking about, rather than an impractical impromptu medical examination, is a simple face-to-face interview for people arriving in the UK from certain areas, regarding where have been in the previous few days. Not that difficult, and, using the right personnel, this could filter out people who are at risk, even though they are not even aware of it themselves.

[/quote]

As much as we would all like to think people would tell the truth at such an interview . It has already been shown that when it comes to Ebola contact and possible transfer people will tell lies. Especially if they thought they would not get past the controls if they mentioned they had been in an area that had it .

[nomoss]

[quote user="JSKS"]Nomoss,

That, however, would mean quaranteening for up to 28 days  quarantine, by definition, is for forty days[:)]. It worked well in the 14th Century [:)] for anyone who had been in an infected area at any time in the previous 28 days. No, I'm simply suggesting that people are made aware of the possible risks to which they have been exposed, so that if they subsequently display any symptoms they are aware of what they should do.  I've no idea how many people that would be but where would you put them? I don't know, but they managed in the C14, and we're a lot smarter now, n'est-ce pas? Surely, limiting the disease at source is more effective along with screening within the infected areas? Sure. But why not take a few basic precautions?

[/quote]

[richard51]

And just to clarify, whatever way you work it out, the normally accepted value of risk of 1 in 20,000 is not (yet) reached in the UK or France.

This was, I think, the main thrust of the thread.

[richard51]

nomoss

If I was you I'd just give up trying to justify

[nomoss]

[quote user="richard51"]nomoss

If I was you I'd just give up trying to justify

[/quote]

It should be "If I were you" [:D]

[idun]

Discussed this with Dr friends a few weeks ago and I'm not worried. As they said, it is relatively easy to avoid contamination IF one is sensible.

Now IF it becomes airborne, then we would all be at risk quite quickly. Long time since the human race has had a full grown pandemic that has killed millions. Would I be worried, no, I don't think I would.

[JSKS]

Nomoss.

I get your point about making people aware and agree that anyone whohas passed through a risk area should be thus informed.

As for pedantry about the origin of the term ''quarantine'' - I'm not sure that advances the discussion any as the modern, medical, accepted definition is to place a sterile cordon around a potential or proven locus of infection until such time as the risk is no longer present.

And if I were you I wouldn't gve up trying to justify. All discussion raises the level of knowledge.

I repeat that I am not an expert in communicable diseases; in fact, I have no professional experience of managing epidemics other than some knowledge of the basic principles of infection control.

However, I am always cautious of action induced through hysteria, press sensationalism and political opportunism. I would be hopeful that those who are experts in such matters get the political, financial and manpower support they need to deal with this threat in the most medically effective manner.

[richard51]

Nomoss

Point taken.

I was a Clinical Scientist rather than a linguist.

Nb A consultant surgeon (urology) was once in awe of me in that I had a higher degree, whereas he only had two first degrees. His dad was a Clinical Scientist though  .

.

[JSKS]

Idun,

In strict terms we currently have an HIV pandemic (it's easy to forget how many die of this in Africa, Asia and South america now that HIV is essentially controllable in the West).

The last pandemic that seriously affected the developed countries was probably the Spanish flu of 1918-1919.

Taking the definition of a pandemic as an epidemic that crosses national boudaries then we need to accept 20th century pandemics of malaria, cholera, smallpox, measles etc.

What is worrying about ebola and the other viral haemorrhagic fevers is the inability to effectively treat the infected. Also we now live in a world where people travel further and faster than in the past. So while I doubt whether it's time to worry about ebola in Europe it would be unwise to be too complacent.