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How Nigeria Stopped Ebola
HughPickens.com writes Pamela Engel writes that Americans need only look to Nigeria to calm their fears about an Ebola outbreak in the US. Nigeria is much closer to the West Africa outbreak than the US is, yet even after Ebola entered the country in the most terrifying way possible — via a visibly sick passenger on a commercial flight — officials successfully shut down the disease and prevented widespread transmission. If there are still no new cases on October 20, the World Health Organization will officially declare the country "Ebola-free." Here's how Nigeria did it.
The first person to bring Ebola to Nigeria was Patrick Sawyer, who left a hospital in Liberia against the wishes of the medical staff and flew to Nigeria. Once Sawyer arrived, it became obvious that he was ill when he passed out in the Lagos airport, and he was taken to a hospital in the densely packed city of 20 million. Once the country's first Ebola case was confirmed, Port Health Services in Nigeria started a process called contact tracing to limit the spread of the disease and created an emergency operations center to coordinate and oversee the national response. Health officials used a variety of resources, including phone records and flight manifests, to track down nearly 900 people who might have been exposed to the virus via Sawyer or the people he infected. As soon as people developed symptoms suggestive of Ebola, they were isolated in Ebola treatment facilities. Without waiting to see whether a "suspected" case tested positive, Nigeria's contact tracing team tracked down everyone who had had contact with that patient since the onset of symptoms making a staggering 18,500 face-to-face visits.
The US has many of these same procedures in place for containing Ebola, making the risk of an outbreak here very low. Contact tracing is exactly what is happening in Dallas right now; if any one of Thomas Eric Duncan's contacts shows symptoms, that person will be immediately isolated and tested. "That experience shows us that even in the case in Nigeria, when we found out later in the timeline that this patient had Ebola, that Nigeria was able to identify contacts, institute strict infection control procedures and basically bring their outbreak to a close," says Dr. Tom Inglesby. "They did a good job in and of themselves. They worked closely with the U.S. CDC. If we can succeed in Nigeria I do believe we will stop it here."
The first person to bring Ebola to Nigeria was Patrick Sawyer, who left a hospital in Liberia against the wishes of the medical staff and flew to Nigeria. Once Sawyer arrived, it became obvious that he was ill when he passed out in the Lagos airport, and he was taken to a hospital in the densely packed city of 20 million. Once the country's first Ebola case was confirmed, Port Health Services in Nigeria started a process called contact tracing to limit the spread of the disease and created an emergency operations center to coordinate and oversee the national response. Health officials used a variety of resources, including phone records and flight manifests, to track down nearly 900 people who might have been exposed to the virus via Sawyer or the people he infected. As soon as people developed symptoms suggestive of Ebola, they were isolated in Ebola treatment facilities. Without waiting to see whether a "suspected" case tested positive, Nigeria's contact tracing team tracked down everyone who had had contact with that patient since the onset of symptoms making a staggering 18,500 face-to-face visits.
The US has many of these same procedures in place for containing Ebola, making the risk of an outbreak here very low. Contact tracing is exactly what is happening in Dallas right now; if any one of Thomas Eric Duncan's contacts shows symptoms, that person will be immediately isolated and tested. "That experience shows us that even in the case in Nigeria, when we found out later in the timeline that this patient had Ebola, that Nigeria was able to identify contacts, institute strict infection control procedures and basically bring their outbreak to a close," says Dr. Tom Inglesby. "They did a good job in and of themselves. They worked closely with the U.S. CDC. If we can succeed in Nigeria I do believe we will stop it here."
Once you have a couple dozen actual cases on your hands, this method is quickly overwhelmed. All it takes is for a few infected people to slip through and infect several people before they can be found and isolated. Nigeria did the right thing and was lucky.
It only takes one stupid uncooperative idiot ( maybe from a certain news station) to spread the disease.
And I wouldn't compare USA (or for that matter EU ) citizens to Nigerian citizens, Nigeria is known for it scare tactics, I don't see our governments try the same tactics without getting trouble back.
Let alone that no lower class person will stay home from their job for 3 weeks without pay, they will lose their job and get evicted.
Or is the government finally going to pay for those kind of expenses?
So, USA is following safety standards equivalent to those in Nigeria?
American exceptionalism at its finest. We know everything, the rest of world doesn't know jack shit.
Keep having that attitude and Ebola from an insignificant problem in the US will become a great problem.
Ebola is not a smart virus, killing its host so soon. It can be handled quite easily -- just isolate the people and you have your results within a month. ... I don't get the comparison the CDC drew. HIV can spread easier and stays in the body for such a long time, giving the virus many years to contaminate more hosts before becoming problematic. It's a bigger problem by magnitudes.
HIV on the other hand
You cannot predict what happens in face of a real treat from the - lucky - turnout of just one single case. That is statistically meaningless. The next time the same process may as well fail at one point...
Yes, but Nigeria went "Isolate THEN test", the US is doing "Test (and by the time they test possible other people may be infected) then isolate" i.e. Nigeria took this seriously, the US isn't.
Nigeria does it better.
"If any question why we died, Tell them because our fathers lied."
The single most informative bit of wisdom from the Bible is Ecclesiastes, this to address your sig.
If you have written me off as a religious nut, think again, it's fast and easy to read and will tell you everything you need to know about human life.
"If any question why we died, Tell them because our fathers lied."
No, the US is hoping that it will be able to handle the situation as well as Nigeria did.
So far it isn't.
Watch this Heartland Institute video
No, it learned them from the Ugandans.
Watch this Heartland Institute video
It's one thing to have the official protocols in place. However the biggest problem is with cultural attitudes. If you have a huge portion of the population who are highly superstitious, and suspicious of the government, scientists, and modern medicine, as well as a lack of basic social safety nets, then you have a recipe for disaster. So what may have worked well in Nigeria is not guaranteed to be so effective in USA.
The Texas Health Presbyterian Hospital seems to have been overwhelmed with one case. That one case did not "slip through". he was turned away and sent home. Training was non-existent, proper supplies were not available. It's a fiasco.
Nigeria was more than lucky; they were prepared. Texas Health Presbyterian was not.
Countries do some things well, and other things badly. Apparently Nigeria has done a good job at stopping Ebola. We should respect that, and learn lessons from them on how to stop it here in the US.
But on the other hand, people that actually know what they're talking about say travel bans are counter-productive and hence bullshit. Who to believe?
[FUCK BETA]
Obama's response to Ebola is driven by politics and media not science or health. Doing this here would of course be condemned as being racist, homophobic, Islamophobic, immigrantophobic, and anyway, we're way passed the point where it's even practical to conduct face to face visits. So much time has gone by that we're in the millions of visits needed. No I'm afraid the best approach is Obama's approach which is to do nothing and blame it on someone else until it burns itself out.
Oh, wait ...
Sent from my ASR33 using ASCII
This disease can spread from surface contact with contaminated fluids (which Ebola victims tend to leak profusely). Indoors, even dried fluids can remain infectious for hours. All it takes is to touch the fluids and then touch your eyes or mouth (which you do all the time) Something like the NYC subway provides very good conditions for spread, once the first sick people take a few trips
Hmm, interesting theory, that.
Both Nigeria and the USA began their ebola problems with one (1) Liberian man entering their country with ebola.
Nigeria ended up with ~20 ebola cases, of which 9 died.
So far, the USA has had ~3 cases, of which one has died.
Now, the USA isn't done yet. Probably. Maybe. We'll see.
But so far, our situation is essentially identical with Nigeria's, and our outcome is the same as or better than their outcome. Note the "so far" - it's important.
"I do not agree with what you say, but I will defend to the death your right to say it"
From the NYT today:
http://www.nytimes.com/2014/10...
Federal health officials effectively acknowledged the problems with their procedures for protecting health care workers by abruptly changing them. At 8 p.m. Tuesday, the Centers for Disease Control and Prevention issued stricter guidelines for American hospitals with Ebola patients.
They are now closer to the procedures of Doctors Without Borders, which has decades of experience in fighting Ebola in Africa. In issuing the new guidelines, the C.D.C. acknowledged that its experts had learned by working alongside that medical charity.
But...
The Doctors Without Borders guidelines are even stricter than the new C.D.C. directives
So, USA is following safety standards equivalent to those in Nigeria?
Ever been to Africa? I have. They know a hell of a lot more about infectious disease than we do. They deal with it every day.
Yeah, good luck with that. The last thing I saw on TV was people from her plane made hops to at least four states.
The President should have just ordered people with passports and travel stamps from these countries to not be allowed to enter the US.
A travel ban would kill more people than Ebola ever would.
Due to western workers refusing to travel to certain countries in Africa because of Ebola, the Cocoa crop has already been threatened:
http://www.reuters.com/article...
There are also travel bans between those countries. Because of that, the migrant workers that harvest them will have no work for the year. No income. Many will starve to death. MORE than would have been killed by Ebola. As bad as dieing from Ebola is, Starvation is worse.
Panic will always kill more people than the disease. Think critically before you demand action. The cable news networks are reveling in the profit they are making off of your panic.
The basic problem with Ebola in the US is that everybody in the US who knows what to do about Ebola is over in Africa right now trying to stop it at the source. The folks still stateside are the B team.
Moderating "-1, Disagree" is simple censorship. Have the guts to post your opinion.
RTFA: "They did a good job in and of themselves. They worked closely with the U.S. CDC. If we can succeed in Nigeria I do believe we will stop it here."
No, the US is hoping that it will be able to handle the situation as well as Nigeria did.
So far it isn't.
If we would only learn to allow the free market to decide.
The shepherds did so well protecting the flock that the sheep no longer believed that wolves existed.
Nigeria was more than lucky; they were prepared. Texas Health Presbyterian was not.
This is the strange thing. It isn't like no one knew of the ebola threat, unless you didn't watch television, listen to the news, or use the internet. In addition, terrorist issues include biological warfare, a situation where similar isolation and contamination issues exist. Why didn't a hospital in Dallas Texas have materials on hand to provide a proper response - if it didn't have them.
Maybe we should spend a little less time and money militarizing our police forces, and more time and money getting hospitals to say, 2002 readyness?
Also, we really need to look into exactly Why this person was released. A person of African descent shows up with ebola symptoms, and is sent home. Ill enough to be throwing up in the parking lot is pretty ill.
The shepherds did so well protecting the flock that the sheep no longer believed that wolves existed.
They're Nigerians, not Americans.
Watch this Heartland Institute video
on a side note Nigeria also banned flights to/from these hotspots - Arik Air (Nigeria), Gambia Bird and Kenya Airways have suspended services to Liberia and Sierra Leone. source: https://www.internationalsos.com/ebola/index.cfm?content_id=435&language_id=ENG
Exactly. Typical Obama nanny state government thinks it's their business to protect us from ebola.
The hospital also waited until they got a positive Ebola test result back before taking any safety precautions. Staff were exposed for something like two days and administration resisted isolating the patient. The sample was sent through the normal channels for testing which potentially contaminated their tube system. High-risk individuals who treated Duncan were not placed in quarantine and they allowed something like 70 different people to come into contact with him. Then there's the issue of them initially prescribing antibiotics for a viral infection.
NIH's budget was reduced by $446m from 2010 to 2014, and subjected to inappropriate politically motivated interference in its decision-making. The CDC's discretionary funding was cut by $585m during this same period. Shockingly, annual funding for the CDC's public health preparedness and response efforts were $1b lower for 2013 fiscal year than for 2002. These funding decreases have resulted in more than 45,700 job losses at state and local health departments since 2008.
- Judy Stone, infectious disease specialist
That doesn't seem like a very good October Surprise...
Yes, you absolutely can get it that way.
From the CDC:
"blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola
objects (like needles and syringes) that have been contaminated with the virus
infected animals
Ebola is not spread through the air or by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. There is no evidence that mosquitos or other insects can transmit Ebola virus. Only mammals (for example, humans, bats, monkeys, and apes) have shown the ability to become infected with and spread Ebola virus"
The problem in Africa is any fold. People lying and saying the people their to help are causing it. People spreading rumors that the people their to help are harvesting organs, The tradition of kissing the dead, the habit of not going to the doctor. Africans being target by peddlers of SCAMSs(Supplement, Complementary, Alternative Medicines). All of that is possible with exceedingly high levels of illiteracy, and a high belief in woo.
The Kruger Dunning explains most post on
The performance so far does not inspire confidence. Mistake after mistake and being reactive instead of proactive.
So far neither the CDC (nor WHO) has explained exactly how more cases of Ebola in more locations leads to eventual control. Texas is an informative example of what to expect when Ebola shows up in a new location that has no experience with such an unusual and deadly disease.
[And the flu trolls have to stop. Flu is already endemic. Meanwhile Ebola must be prevented from becoming endemic. There is a very rational reason to be agitated by the apparent lack of competent response. Ebola has never before been contained after an outbreak this large. This outbreak is already twenty times larger than the largest successfully contained outbreak.]
Only a Liberal would equate getting incompetent people out of office as "people are dying", People are dying because of incompetency in the highest levels of government. Typical Liberal putting carts before horses.
Agent K: A *person* is smart. People are dumb, stupid, panicky animals, and you know it.
That is if the nurse(s) knew anything about Liberia. My experience is that people of the United States do not know the difference between Liberia and Belgium.
That's silly. Liberia is where they get books, and Belgium is the place to go for waffles.
But seriously, even Fox news watchers seem to know it's in that country where "Those colored people live" and that it's Obama's fault.
The shepherds did so well protecting the flock that the sheep no longer believed that wolves existed.
Individuals should have the freedom to decide which viruses meat their needs and to choose the type of hemorrhagic fever is best for them.
This is the strange thing. It isn't like no one knew of the ebola threat, unless you didn't watch television, listen to the news, or use the internet.
It isn't that strange. Because if you did listen to the news or watch television, then no, you didn't know about the 'threat', because what has been repeated time after time is 'there is no threat, relax, we can deal with this, we're prepared'. Nigeria probably had a quite different message running through both media and government knowing that they have one single chance to stop this and that's at the source. Screw up a single thing and the preview of what happens was available next door.
Some like to think our health care standards make a difference, that the West is more civilized and it can't happen here. But the thing is, after a few ICU places and a few quarantine beds, modern medicine is left with aspirin and electrolytes as far as 'treatment' goes which doesn't give us much edge on African medicine. This needs to be taken as seriously in the developed world as it does in Nigeria, and we need to get useful treatments available _now_.
To be fair, there is an incubation period of about a week (the time between infection and transmissibility). You can still have geometric progression and not really know it for a couple of months before it becomes a crisis.
That said, Ebola has been around for years in Africa, where people don't have some basic sanitary practices. Even with a long incubation period, we'd have already seen a global outbreak if this virus were really as bad as the fear-mongerers are making it out to be.
Keep in mind that there's a difference between an exposure from one viral particle (as you might get from being handed a beverage cup) and a mass of them (handling the bodily fluids of the exposed as a nurse would). With one particle, your immune system has time to detect and react. It is those exposed to the mass particulates who will likely die.
I'll do what I can to avoid being exposed. I'll wash my hands, cook my food, and stay away from obviously sick people. Since I'd have done that anyway, my life hasn't changed much...
The Texas case just exposes (again) the fallacy that the US has the best healthcare in the world.
This hospital made too many amateur mistakes to count:
- Sent the guy home with antibiotics when he presented with a fever after travel to Ebola infected area.
- Did not institute full isolation protocol until three days after he was admitted (thus exposing nurses and other patients to the disease).
- Did not follow CDC protocol even after confirmed Ebola.
I don't read your sig. Why are you reading mine?
Nigeria was more than lucky; they were prepared. Texas Health Presbyterian was not.
This is the strange thing. It isn't like no one knew of the ebola threat, unless you didn't watch television, listen to the news, or use the internet. In addition, terrorist issues include biological warfare, a situation where similar isolation and contamination issues exist. Why didn't a hospital in Dallas Texas have materials on hand to provide a proper response - if it didn't have them.
Materials and preparation cost money. Hospitals that don't have them make more money than hospitals that don't, unless they actually have an Ebola outbreak. Hospitals figure they never will, so they don't prepare.
That is what happens when you don't mandate preparation by regulation and audit compliance, and combine that with a competitive market-based healthcare system. Nobody has incentive to prepare for anything unlikely to occur. If anything does go wrong they just throw their hands in the air and say that nobody could have seen this coming and beg for help from the (CDC/Federal Reserve/FEMA/whatever).
Sent the guy home with antibiotics when he presented with a fever after travel to Ebola infected area.
THAT mistake I can understand. They've seen SO many cases of Ebola after all. But permitting scores of people to be in the room with the guy *after* they decided to test for Ebola was a preventable error. And failing to tell the folks involved in his treatment to stay away from public transportation for a safety period following their contact with a confirmed Ebola patient was total amateur hour. Seriously, WTF do we have a no-fly list for anyway?
Moderating "-1, Disagree" is simple censorship. Have the guts to post your opinion.
> It isn't that strange. Because if you did listen to the news or watch television, then no, you didn't know about the 'threat', because what has been repeated time after time is 'there is no threat, relax, we can deal with this, we're prepared'.
No, it is strange. The "there is no threat, relax" message is not actually said in those words, (but close enough), is addressed to the non-medical public, and the motive to reduce panic in the populace is a correct one. The "we're prepared" part means that "we" medical staff, supposedly INCLUDING nurses in Texas, have an ounce of intelligence and training, and are in fact prepared. If the first nurse in Texas had bothered to be aware, training or not, of the outbreak in Africa, and made sure the Doctor was informed of the patient self-reporting that he had been to Liberia, none of this would have happened on US soil. What kind of idiot doesn't realize that it's CRITICAL to pass on this information repeatedly until it is acknowledged? I could see that, with no nurse training whatsoever.
Now we are one or two steps perilously closer to that critical mass where you can't track down everyone that all the people had contact with, as mentioned by in earlier comment.