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Texas Health Worker Tests Positive For Ebola
Thomas Eric Duncan, the first person to have been diagnosed in the U.S. with Ebola, and who subsequently died of the disease, was treated at Texas Health Presbyterian Hospital in Dallas. Now, in a second diagnosis for the U.S, an unidentified health-care worker from the hospital has tested positive for Ebola as well. According to the linked Reuters story, Texas officials did not identify the worker or give any details about the person, but CNN said it was a woman nurse.
The worker was wearing full protective gear when in contact with Duncan, Texas Health Resources chief clinical officer Dan Varga told a news conference.
"We are very concerned," Varga said. "We don't have a full analysis of all of the care. We are going through that right now."
...
The worker was self-monitoring and has not worked during the last two days, Varga said.
The worker was taking their own temperature twice a day and, as a result of the monitoring, the worker informed the hospital of a fever and was isolated immediately upon their arrival, the hospital said in a statement.
(Also covered by the Associated Press, as carried by the Boston Globe, which notes that "If the preliminary diagnosis is confirmed, it would be the first known case of the disease being contracted or transmitted in the U.S.")
I'm sure that there's a protocol you could follow to prevent catching the flu from flu patients, too, but I doubt it would be practical to practice medicine at the same time. I think that as Western medical personnel are beginning to be infected, it becomes less easy to just say "the training/equipment/conditions were the problem". At some point, we need to look at how the containment protocol interacts with the treatment protocol, and see if it actually works.
Remember, correctly executed withdrawl is just as effective a form of birth control as a correctly applied condom, but a greater share of condom users use them correctly than those who attempt pulling out.
"Because Science" is one step from "Because old book". Try "Because of my experiment testing my falsifiable assertion".
So you honestly believe those thousands who got infected licked another's bodily fluids?
You may have prestigious friends, or not, but you just sound like an ignorant moron.
Reality is that most people are not as vigilant as professional scientists handling bioweapons that could wipe us out many times over.
If you lived in Africa, you would know how deadly and debilitating HIV/AIDS can be.
yet Ebola continues spreading.
No, no really. There are more and more victims in Guinea, Sierra Leone, and Liberia. But it was stopped in Senegal and Nigeria. All African nations are not the same. In terms of institutions and infrastructure, Guinea, Sierra Leone, and Liberia are at or near the bottom. While primitive by Western standards, Senegal and Nigeria are far more functional countries. If they were able to control and contain the disease, then more developed countries should not have much difficulty doing the same.
Simplest explanation is always right.
No. Most likely. But in the absence of more information, most certainly NOT "always right".
No.
We MIGHT (and I stress "might") be getting to time to panic the first time we get an ebola victim who hasn't been to Africa, and hasn't been in contact with any known Ebola victim.
Note that this case is one of the 48 people who are currently being monitored due to contact with that ebola victim who brought it here from Africa.
"I do not agree with what you say, but I will defend to the death your right to say it"
well no, I bet a dollar there was a tear in his suit. Simplest explanation is always right.
Be prepared to lose a dollar. The protocol for donning and removing the protective gear is very complex, and very hard to get perfect. When putting the suit on, it's possible to get gaps between the goggles and suit without even knowing it. And when taking it off, a tiny flap of the contaminated suit brushing against a clean surface is almost impossible to detect.
In contrast, Tyvek suits are very hard to tear unless you're doing hard physical labor in a rough environment. Most hospital settings don't have the infectious care nursing staff crawling through piles of dirty rebar or squeezing along rough mortared brick walls.
John
The barrier protocols are quite onerous. It doesn't need to be idiocy, fatigue is enough to induce human error. Experts have pointed to this as a factor in the spread of Ebola in West Africa; aside from the fact that most people have access to medieval levels of health care, or facilities that lack things like latex gloves, supplying hospitals with equipment is not enough. The workload of health care workers has to be kept light enough that they can take the extreme precautions needed without making errors.
It is also possible that the barrior protocols have a bug somewhere in them.
Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.
Last I saw, that debate wasn't split on party lines. Some of each party said both. Oh, but no, let's just treat every single event that ever happens like one US political party is always right and the other wrong. Because when you get elected in one party you become a god. They're not at all just people with their own opinions and ideas who make mistakes. And when you get elected to the other party, you sit around wringing your hands trying to think about how to screw up. Because they too aren't just people trying to stumble through awesome responsibilities.
Behold the brilliance of American politics. Nothing in the world is more important than choosing which group you'll worship.
For those who said "No need to panic" ... are we there yet?
Nope. And we never will be. Panicked people make stupid decisions that make the situation worse.
One thing these outbreaks in Europe and the US show - we don't know enough about Ebola.
There is no "outbreak" in the US or Europe. And not knowing enough about Ebola is not the same as saying we know nothing about Ebola, and what we know says there is not going to be an outbreak here -- just a few isolated cases of transmission. Thus far there have been one confirmed case of endemic transmission in the US and one in Europe, both nurses. The other "cases" were people with other viral diseases. One transmission does not an "outbreak" make, except to people who are panicky. It's normal in a situation like this for "suspected cases" to pop up all over the place. What do you expect, with the media spreading panic.
The CDC is now saying that the transmission in TX was caused by a "breach of protocol", which is not surprising given that the barrior protocols are exacting and onerous.
Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.
You know, I've heard that many times now, yet Ebola continues spreading.
And it is still correct. There is no need to panic. Ebola gets WAY more press than the severity of the actual risk justifies.
Basically stop freaking the hell out. The people that can and will deal with this outbreak are dealing with it. Panic will accomplish nothing productive. Quite the opposite in fact.
So perhaps it would be better to panic and spend some serious dough to crush the outbreak while it's still possible, rather than wait for it to turn into the doomsday scenario a deadly and highly contagious disease has every potential to become?
First off, ebola is NOT "highly contagious". It's actually rather hard to get. Unless you have been in direct contact with the sweat, blood, tears, feces or other bodily fluids of a symptomatic ebola patient then you have nothing to worry about. Medical personnel who are treating such patients directly are at highest risk for obvious reasons. This is nothing shocking though it probably means someone made a mistake.
It is incorrect that "every" pathogen has to potential to become a "deadly and highly contagious disease". Go talk to an infectious disease doctor and they will tell you that the biology of most viruses and bacteria prevents them from ever becoming a threat to humans. It's actually quite hard for that to happen even in a rapidly mutating virus which ebola is not. What you are suggesting is almost as unlikely as all the air in the room suddenly deciding to be on just one side of the room because, hey, it's theoretically possible. The real world probability of most viruses and bacteria mutating into something harmful to humans is actually vanishingly small if not actually zero.
You're kidding me right?
A woman working under biohazard 4 conditions, wearing a hermetically sealed suit, working with a patient she KNOWS has ebola and is infectious; gets Ebola herself, and you are seriously trying to play it off like it's no worse than HIV? Acting like a know-it-all expert on infectious diseases and trying to reassure everyone that this isn't going anywhere and isn't dangerous?
Look, I'm not trying to fear-monger here for the sake of it, and I'm certainly no ebola-expert, but trying to reassure everyone that this is just going to blow over with this idiocy about how safe Ebola is and how nobody can catch it unless they fucking lick infected blood when that is increasingly not the case just sets me right off. Even the media has done a complete 180 on their usual fear-mongering. Let's suppose for a moment that this woman did something out of procedure - she didn't clean her suit or something, and she touched it, then rubbed her eyes.
That's not HIV-level infectious. That's influenza/cold-level infectious, and that is extremely worrying, because the CDC seems to be grossly incompetent in this entire situation and I'm beginning to wonder if the corporations involved who have the potential to make literal billions to trillions off Ebola vaccines aren't giving little nudges here and there to maintain a certain level of incompetence in the matter. We aren't even quarantining Africa - the CDC says that wouldn't do anything. Like hell it wouldn't. The first thing we did when SARS was worrying people was to quarantine and shut down air travel, but apparently we're finding out only just now that this didn't work and won't work for Ebola, so let's just spend millions trying to screen for it ineffectively at the airports into our countries? I'm sorry, I'm not buying this. I'm not buying anything the mass media are telling us about this disease anymore. How many times does the mass media have to lie to people before they stop actually trusting them?
Did you know that one of the Ebola strains quite possibly moved through an air gap to cause infection?
http://www.nature.com/srep/201...
We also know that the Filovirus family can easily become airborne:
http://www.nature.com/nbt/jour...
This virus is spreading into the tens of thousands range in West Africa. That's an immense breeding ground for it to adapt to a new host. We know that Ebola strains can become airborne, and we keep having doctors getting sick with the virus in spite of hefty precautions against it. So why are we assuming it can't be airborne and can't be transmitted during its incubation period? Why are we assuming it has low infectivity when doctors in full protective gear are getting it? When people are literally getting this virus from just touching things that ebola victims have touched? Why is nobody taking precautions in case it IS highly infectious? This isn't some joke of a virus that kills 2% of the people it infects; almost everyone who gets it dies. This isn't something to be jovial and careless around, yet we took more precautions around SARS than anything we're doing with Ebola. It's fucking madness, and I keep seeing people parrot this bullshit that we shouldn't be worried, have nothing to fear if we aren't literally bathing in Ebola-blood like West Africans obviously are, and so on.
No, we DO have something to fear from this - you'd be foolish not to be worried - and I am not satisfied in the least with the way our governments are treating this whole thing. It's almost flippant. I think some serious discussion about this virus getting into western countries uncontrollably needs to seriously start happening. What are you going to do if Ebola ends up in your town? Have you even considered talking about it with your family? With your local community? Is the effort involved in being prepared really worth the risk o
Highly trained workers... hmm...
Before you go on a tangent, think about this:
Look at the average person who works with you.
Note his abilities, how he handles himself, how he acts and how he does his work.
Note that this is what we call "a professional"
Now reevaluate that statement about "highly trained workers".
In my experience, 9 out of 10 times "professional" only means getting paid to do it. It's not a statement of quality.
We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
So basically you're just anxious, because none of this "seems right" in complete absence of empirical evidence?
Somebody in a modern clinical environment who supposedly knew what they were doing got infected.
That right there is empirical evidence of something not being right.
And in your sample of 10 (or 20, who knows!) one person became ill, because, we dunno, but it sounds fishy.
It doesn't to you? "Well, they have to take off those contaminated suits, and some will get infected while
doing that. Shit happens." really isn't the right approach here.
What recommendations would you make, if you were, say, a public health official? Everyone who develops illness has to be treated in something akin to a BSL-4 facility?
No, but how about "don't mix clean and unclean environments, and follow proper decontamination
procedures while moving between them, and before undressing"?
Have you any idea how many plane flights that would require, just to cite one small aspect of the logistics?
Huh? Plane flights? Are we still talking about a controlled clinical environment in a big American city?
And all this to protect from a disease vector that's completely unsubstantiated in the literature?
Or do you do like Judge Clay Jenkins, and personally go to the family's house in shirt-sleeves and drive them to a new home? Which approach is more appropriate? Which one balances our available resources against the actual concrete threat of the disease? Which one is actually workable?
You're losing me here.
What I don't understand: Wouldn't it be possible to put the wearer through a disinfectant decontamination shower before he or she takes off the suit?
There is a strong protocol, and yes, it includes decontamination sprays. As I understand it the protocol includes a disinfectant spray before taking off the suit, a hand spray after removing the first layer of gloves, then another disinfectant spray after stripping. And the gloves and suit are all supposed to come off inside-out, always turning the the hot side to the inside.
Remember that any suit that can protect the wearer against virus is also impermeable to air. That means the suits heat up. They are sweating profusely as soon as they get their suits on, and they can only remain suited up for less than an hour before roasting in their own juices. When every surface is soaked in sweat, it's impossible to recognize when it's the patient's infectious sweat or your own.
We know the best practical approach is to use a buddy system, and have them help each other. Even so, the first buddy to disrobe is still handling the infectious materials while helping the other to strip, so they still have to be vigilant. Repeat that clothing protocol every other hour for a long work day, week after week, and if the wrong piece of fabric ever accidentally brushes on you any time during the process you may get infected with a disease that has a 60% chance of killing you. Or if this is your first time dealing with an Ebola case, how do you know you've followed the protocol perfectly?
Now, cross the ocean. Place all of that in the context of extreme poverty; chronic suit, glove, equipment, and doctor shortages; wailing and shrieking family members; orphaned babies that may be infected; contaminated water supplies; relentless heat; men who tell rumors that Ebola is a disease from the West that is being spread by doctors and is being used to kill Africans, or that Ebola doesn't exist; populations frightened by the presence of workers in "moon suits" coming to collect their dead relatives; a culture that grieves by touching the bodies of the dead; and the dozens of other deadly diseases that still strike Africans constantly, including malaria, dengue fever, AIDS, hepatitis, typhoid fever, and chronic diarrhea caused by rampant bacterial and protozoal infections. Oh, and attacks on clinics by gunmen.
It's almost as if the disease evolved itself to adapt to collapsing health care systems in impoverished nations.
John
No, the protocol needs to be changed if it's inadequate.
The next victim is the trained, well-equipped health care professional who - despite having far better protection and awareness than the vast majority of people in the world - just tested positive for having caught the virus from him.
What's your point in ignoring that glaring little dose of reality?
Some of the best trained people do stupid things. If you want an example of this just look at any record of industrial accidents. Ironically it's the ones who aren't trained that normally take the most care and see the safety breaches in typical tasks.