CDC experts answered questions yesterday on #Ebola in #CDCChat. Now available on Storify. Get the facts:
http://t.co/...
— @CDCgov
This past week
I posted a piece on Ebola that asked about the circumstances in Dallas, and also about the ethics of naming names. Interestingly, a few other pieces that came through deal with the privacy issue.
AP:
Yesterday we distributed some guidance to our staff on coverage of Ebola and enterovirus, two diseases much in the news.
On Ebola, we said that since the United States now has its first diagnosis of the virus, we’re likely to hear increasingly of “suspected cases” in the U.S. and elsewhere. We should exercise caution over these reports.
Often the fact of an unconfirmed case isn’t worth a story at all. On several occasions already, in the U.S. and abroad, we have decided not to report suspected cases. We’ve just stayed in touch with authorities to monitor the situation.
From
NBC4 in DC on a suspected Ebola patient admitted to Howard University Hospital:
"In an abundance of caution, we have activated the appropriate infection control protocols, including isolating the patient," said hospital spokesperson Kerry-Ann Hamilton in a statement. "Our medical team continues to evaluate and monitor progress in close collaboration with the CDC and the Department of Health."
Hamilton did not share further details about the patient, citing privacy reasons, but said the hospital will provide updates as warranted.
And that same link has an item on NBC's own cameraman (freelancer in Liberia that just joined the team) who tested positive in Liberia, which names him.
Finally, NPR has
On Why We Didn’t Join The Rush To Name The Ebola Patient
As NPR correspondents tried to get independent confirmation, why did we hesitate to say what others were reporting and why did it feel to editors like that was the right call? The main reasons should help guide our thinking in other situations.
Well worth a read for what ought to be a thoughtful decision each and every time a name is used.
Four people quarantined in Texas Ebola case will be moved soon to another location: Dallas County Fire Marshal
— @ReutersUS
More politics and policy below the fold.
Here's the consensus on Ebola transmission:
"Ebola is NOT easily transmitted" - Dr A Fauci speaking now at White House #Ebola
— @DrJAshton
Also on Ebola, here are some excellent pieces on how easy (or not) it is to catch, something of a bone of contention on the blog the last few days (and not helped by me misstating that Ebola isn't that infectious. It is in fact highly infectious, quite virulent, just not that transmissible.)
FT:
Ebola is not an especially contagious virus. Prof [Peter] Piot [who helped discover the virus] has said that he “wouldn’t be worried” to sit next to an infected person on the London Underground, “as long as they don’t vomit on you or something”. But the disease exacts a deadly toll.
More from
Julia Belluz:
Here's how you can (and can't) get Ebola
The bottom line: Ebola is difficult to catch
As you'll probably have noted, Ebola isn't very easy to transmit. The scenarios under which it spreads are very specific. And Ebola doesn't spread quickly, either. A mathematical epidemiologist who studies Ebola wrote in the Washington Post, "The good news is that Ebola has a lower reproductive rate than measles in the pre-vaccination days or the Spanish flu." He found that each Ebola case produces between 1.3 and 1.8 secondary cases. That means an Ebola victim usually only infects about one other person. Compare that with measles, which creates 17 secondary cases.
If you do the math, that means a single case in the US could lead to one or two others, but since we have robust public health measures here, it probably won't go further than that. Compare that to West Africa, which is now dealing with upwards of 6,000 cases in a completely broken health system. That's where experts say the worry about Ebola should be placed.
NPR:
No, Seriously, How Contagious Is Ebola?
Note that the higher the number, the more easily the transmission. None of this is to say it's "not a problem"; of course it is. At least, it is if you come in contact with infectious body fluids (see Julia Belluz piece). But when people say "it's not THAT contagious", that's what they mean. If other viruses are even more contagious, Ebola is less. That's why containment should eventually work, at least in the US under better conditions than the West African countries like Liberia (
Nigeria is doing a pretty good job).
By the way, issues remain with soiled linens (see Dallas apartment under quarantine) and hospital waste, but not sewage/effluent in US waste treatment plants.
Liz Szabo with quotes from some medical infectious disease experts:
If Ebola spread that easily, there would be millions of cases, not thousands, [Peter Hotez, dean of the National School of Tropical Medicine and professor at Baylor College of Medicine in Houston] says.
"In general, Ebola is not easy to get," [Julia Shaklee Sammons, medical director of infection prevention and control at the Children's Hospital of Philadelphia] says.
And
Liz Szabo's own thoughts:
Writing about public health can make you a little crazy.
After 14 years as a medical reporter, I'm a self-confessed germaphobe. I buy hand sanitizer in bulk. I haven't touched a raw chicken in years. I no longer eat sprouts or cantaloupes, which have caused far too many food poisoning outbreaks.
But I'm not even a little worried about getting Ebola.
Because viruses aren't all the same. Because Ebola is not the flu. And Dallas is not West Africa.
WaPo:
The Ebola virus is highly infectious but not very transmissible. That may sound to a lay person’s ear like a contradiction. What this means is that very little virus – in animal experiments, as few as 10 virus particles (virions) – can potentially lead to a fatal infection. That’s the “infectious” part of the equation.
But it’s not easy for that virus to be transmitted. Ebola is much less contagious than measles or influenza. It’s not an airborne virus. It’s transmitted through bodily fluids. The overwhelming majority of people who have been infected with Ebola are people who have directly cared for a person who is actively sick with the disease or have handled the body of someone who has died from it.
And maybe the read of the day from
Jon Cohen:
Omeonga, along with two other health care workers infected in Liberia, Kent Brantly and Nancy Writebol, has received widespread media attention for receiving an experimental cocktail of antibodies called ZMapp. All three survived; none of them knows if the treatment helped. But all three wonder about another question that has important implications for other health care workers: How did they become infected?
Surprisingly, no one has a firm answer. “Every day I'm still thinking, When was I contaminated?” Omeonga says, although he suspects the hospital director was the source. Writebol, a clinical nurse associate who worked for a missionary group called SIM at the ELWA 2 Ebola Treatment Center in Monrovia and helped health care workers don and doff PPEs, is similarly stumped. “Nobody is really sure, least of all me,” she says. Brantly, a doctor in the same center, also has only hunches but says, “I am fully convinced that I did not contract Ebola in my work in the treatment unit.” (Read Q&A's with Ebola survivors at http://scim.ag/....)
And don't miss some excellent diaries by
d3clark and
SkepticalRaptor on Ebola.
Finally, on that "other virus", enterovirus D68, from the NY Times:
Federal health officials on Friday said that they failed to detect the presence of enterovirus 68 in samples of spinal fluid taken from nine children suspected of developing a neurologic illness linked to the infection.
The enterovirus infection has been driving an outbreak of respiratory sickness – mostly in children, and in some cases very severe – that began in August and spread to more than 40 states. The infection mostly causes symptoms similar to that of a bad cold or the flu. But health officials have also been investigating reports of children who developed facial drooping, muscle weakness, paralysis and other neurologic symptoms.
The Centers for Disease Control and Prevention was first alerted to a cluster of nine children with such symptoms in Colorado on Sept. 12. All of the children had developed fevers and respiratory sickness shortly before the onset of their neurologic symptoms, and imaging scans showed that they had spinal cord lesions.
Testing on nasal samples eventually showed the presence of enterovirus 68 in four of the children and rhinovirus – the cause of the common cold – in a fifth.
But on Friday, the C.D.C. announced that more invasive tests failed to show the presence of enterovirus in cerebrospinal fluid samples taken from the children.
In some cases the tests may not be precise or sensitive enough to find the virus, or the virus itself may simply be too elusive, said Dr. Daniel Pastula, an epidemic intelligence service officer with the C.D.C. As a result, it is too early for the C.D.C. to rule out the possibility that the neurologic symptoms were caused by enterovirus, he said.
“The spinal fluid tests aren’t always 100 percent,” he added. “Sometimes it will fail to identify the culprit or the virus even if it is causing neurological disease. Even if it’s negative, we can’t say for sure that enterovirus 68 was not involved.”
Dr. Pastula said the other possibility was that some of the children developed an enterovirus infection that was unrelated to their neurologic illness.