Possible Case Of Ebola In Canada

Yomach writes: "As reported on the CBC this morning, and in the Globe and Mail, a tropical disease case has been isolated in a Hamilton hospital and is being tested for Ebola. Samples have been shipped to a Winnipeg Federal Lab which has Biological Level 4 facilities for testing. If the patient is diagnosed with Ebola , it will be the first human case in North America. She flew in to Toronto from the Congo, via New York, on Saturday."

Comments

Spread scenario unlikely

[alienmole]

This CDC page on Ebola nicely summarizes current knowledge of the virus. The bottom line is that an epidemic-level spread through a Western society is highly unlikely. The normal precautions that medical personnel take are sufficient to prevent infection. Aerosol transmission "has not been documented among humans in a real-world setting, such as a hospital or household."

That's not to say it couldn't spread at all, on a more limited basis, but just that statistically, you're incredibly unlikely to become infected by it. You're far more likely to get AIDS from your dentist... ;)

Containment is the only thing we can do ...

[JoeGee]

We live in an age of rapid travel, where anyone can be virtually anywhere else in under 36 hours. You can be immersed in odd Congo bacilli or virii on Wednesday and dying due to an unknown disease in Des Moines on Friday.

Except for the fact that Ebola kills so quickly I am really surprised it has not reached North America or Europe sooner. We should feel very lucky this woman's symptoms did not manifest at JFK ...

• Where the flight attendent held the victim's head as the ambulance was summoned, then went back to her work and developed a fever halfway to San Diego, shrugged it off as a cold, and infected her second plane full of people when they reloaded to take 300 tourists to Sydney.
• And the EMT's who transported the victim went on to do a hospital to hospital transfer from a hospital in Brooklyn to an inpatient/outpatient facility upstate.
• And the nice man who got the lady a drink of water went on back to Knoxville, Tennessee to teach his sixth graders and collapse in the middle of Sunday school ...
• And so on, and so on ...

I suspect that outside of a few specialy labs like the CDC in Atlanta, and possibly in the hospitals of larger cities, most doctors are not sufficiently versed with new or non-regional diseases to recognize the symptoms of something like Ebola.

Similarly I suspect that many doctors simply would not think to take appropriate precautions when dealing with a patient like this lady. When you think of hemorrhaging, you think of bruising, you think of trauma. You will take blood and body fluid precautions but until you are in the middle of stabilizing this patient and notice the fever of 104 degrees it might not occur to you to do something against aerosols:

The ambulance en route describes a patient hemorrhaging severely, sweating, and bruising. When are severe beatings normally contagious?

We need more training of physicians, and like it or not we need more careful checks of incoming individuals in customs, before they are allowed in country (be that country Canada, the US, Mexico, or Tonga.) AIDS does not frighten me -- it is hard to catch, it is long term, and it's already here. It's the virii like Ebola or hantavirus that frighten me.

No reason to panic

[peccary]

Ebola kills so many people in Africa because their health-care practices are so miserable that the hospitals become loci of disease.

Canada would scarcely be touched, because when you call your doctor for a visit they'll tell you to wait a week and see how you feel, and you'll just die at home without having had a chance to spread the infection.

Getting loose in NY is probably not a big deal either, as there is a standard protocol for dealing with this and other hemorrhagic fevers, and that is: isolation units and strict bodily fluids precuations. Treatment consists of symptom management until the infection runs its course, and is probably far more survivable with intensive Western medicine than has been the case in African hospitals.

Re:No reason to panic

[Schwarzchild]

Actually, if you're in New York you probably don't have to worry about the Ebola when you should worry more about Tuberculosis (especially the antibiotic resistant one). I read in a book (can't remember the book maybe it was the hotzone?) that said that a survey of people admitted to one New York hospital revealed that 50% of people had tuberculosis.

This is scary but it turns out that one of the local neighborhoods has a particularly high concentration of tuberculosis bacteria in the air. I'm not sure if it's at dangerous levels but it's still scary.

Quarantines still happen to people.

[Schwarzchild]

It would seem we would have to relearn quarantine the hard way. We do it to pets, but not to people. Silly isn't it?

We still quarantine people. I remember watching a Nightline story where they talked about the problem with the spread of the anti-biotic resistant version of tuberculosis in New York a few years ago and they managed to contain it to a few people. Inorder to contain it, they had to quarantine those people. As I remember, some of the people had been under strict quarantine for months...possibly even beyond a year...whatever it took for them to get over the special version of tb or probably to die from it.

Re:I was sure...

[alienmole]

Here's a CDC page on Ebola which doesn't definitively state that Ebola Reston is not dangerous to humans, but rather that the few humans known to have been infected with it have developed antibodies, without any symptoms.

Here's what the page has to say about airborne transmission:

The Ebola-Reston virus subtype, which was first recognized in a primate research facility in Virginia, may have been transmitted from monkey to monkey through the air in the facility. While all Ebola virus subtypes have displayed the ability to be spread through airborne particles (aerosols) under research conditions, this type of spread has not been documented among humans in a real-world setting, such as a hospital or household.