Ebola: Facts, Opinions, and Speculations.

this is the whole WHO page about Ebola before they modify it again.
Even in its last modification in April only three months ago, when the disease been a month on! most of the talk is about Reston Virus which they refer to it as RESTBV only! even if you happen to find the wiki page for Reston the tile not mention ebola, so people key wording ebola in wiki will never find reston.
they will keep thinking that RESBV or what ever they keep changing its acronym in the page, is the ebola virus and that no human ever dies from it!
Even doctors from africa could be decieved by such a page!

Ebola virus disease


Fact sheet N°103
Updated April 2014

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Key facts
Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans.
EVD outbreaks have a case fatality rate of up to 90%.
EVD outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests.
The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.
Fruit bats of the Pteropodidae family are considered to be the natural host of the Ebola virus.
Severely ill patients require intensive supportive care. No licensed specific treatment or vaccine is available for use in people or animals.

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Ebola first appeared in 1976 in 2 simultaneous outbreaks, in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. The latter was in a village situated near the Ebola River, from which the disease takes its name.

Genus Ebolavirus is 1 of 3 members of the Filoviridae family (filovirus), along with genus Marburgvirus and genus Cuevavirus. Genus Ebolavirus comprises 5 distinct species:
1.Bundibugyo ebolavirus (BDBV)
2.Zaire ebolavirus (EBOV)
3.Reston ebolavirus (RESTV)
4.Sudan ebolavirus (SUDV)
5.Taï Forest ebolavirus (TAFV).

BDBV, EBOV, and SUDV have been associated with large EVD outbreaks in Africa, whereas RESTV and TAFV have not. The RESTV species, found in Philippines and the People’s Republic of China, can infect humans, but no illness or death in humans from this species has been reported to date.

Transmission

Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

Ebola then spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids. Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.

Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.

Among workers in contact with monkeys or pigs infected with Reston ebolavirus, several infections have been documented in people who were clinically asymptomatic. Thus, RESTV appears less capable of causing disease in humans than other Ebola species.

However, the only available evidence available comes from healthy adult males. It would be premature to extrapolate the health effects of the virus to all population groups, such as immuno-compromised persons, persons with underlying medical conditions, pregnant women and children. More studies of RESTV are needed before definitive conclusions can be drawn about the pathogenicity and virulence of this virus in humans.

Signs and symptoms

EVD is a severe acute viral illness often characterized by the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

People are infectious as long as their blood and secretions contain the virus. Ebola virus was isolated from semen 61 days after onset of illness in a man who was infected in a laboratory.

The incubation period, that is, the time interval from infection with the virus to onset of symptoms, is 2 to 21 days.

Diagnosis

Other diseases that should be ruled out before a diagnosis of EVD can be made include: malaria, typhoid fever, shigellosis, cholera, leptospirosis, plague, rickettsiosis, relapsing fever, meningitis, hepatitis and other viral haemorrhagic fevers.

Ebola virus infections can be diagnosed definitively in a laboratory through several types of tests:
antibody-capture enzyme-linked immunosorbent assay (ELISA)
antigen detection tests
serum neutralization test
reverse transcriptase polymerase chain reaction (RT-PCR) assay
electron microscopy
virus isolation by cell culture.

Samples from patients are an extreme biohazard risk; testing should be conducted under maximum biological containment conditions.

Vaccine and treatment

No licensed vaccine for EVD is available. Several vaccines are being tested, but none are available for clinical use.

Severely ill patients require intensive supportive care. Patients are frequently dehydrated and require oral rehydration with solutions containing electrolytes or intravenous fluids.

No specific treatment is available. New drug therapies are being evaluated.

Natural host of Ebola virus

In Africa, fruit bats, particularly species of the genera Hypsignathus monstrosus, Epomops franqueti and Myonycteris torquata, are considered possible natural hosts for Ebola virus. As a result, the geographic distribution of Ebolaviruses may overlap with the range of the fruit bats.

Ebola virus in animals

Although non-human primates have been a source of infection for humans, they are not thought to be the reservoir but rather an accidental host like human beings. Since 1994, Ebola outbreaks from the EBOV and TAFV species have been observed in chimpanzees and gorillas.

RESTV has caused severe EVD outbreaks in macaque monkeys (Macaca fascicularis) farmed in Philippines and detected in monkeys imported into the USA in 1989, 1990 and 1996, and in monkeys imported to Italy from Philippines in 1992.

Since 2008, RESTV viruses have been detected during several outbreaks of a deadly disease in pigs in People’s Republic of China and Philippines. Asymptomatic infection in pigs has been reported and experimental inoculations have shown that RESTV cannot cause disease in pigs.

Prevention and control

Controlling Reston ebolavirus in domestic animals

No animal vaccine against RESTV is available. Routine cleaning and disinfection of pig or monkey farms (with sodium hypochlorite or other detergents) should be effective in inactivating the virus.

If an outbreak is suspected, the premises should be quarantined immediately. Culling of infected animals, with close supervision of burial or incineration of carcasses, may be necessary to reduce the risk of animal-to-human transmission. Restricting or banning the movement of animals from infected farms to other areas can reduce the spread of the disease.

As RESTV outbreaks in pigs and monkeys have preceded human infections, the establishment of an active animal health surveillance system to detect new cases is essential in providing early warning for veterinary and human public health authorities.

Reducing the risk of Ebola infection in people

In the absence of effective treatment and a human vaccine, raising awareness of the risk factors for Ebola infection and the protective measures individuals can take is the only way to reduce human infection and death.

In Africa, during EVD outbreaks, educational public health messages for risk reduction should focus on several factors:
Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
Reducing the risk of human-to-human transmission in the community arising from direct or close contact with infected patients, particularly with their bodily fluids. Close physical contact with Ebola patients should be avoided. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home. Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.
Communities affected by Ebola should inform the population about the nature of the disease and about outbreak containment measures, including burial of the dead. People who have died from Ebola should be promptly and safely buried.

Pig farms in Africa can play a role in the amplification of infection because of the presence of fruit bats on these farms. Appropriate biosecurity measures should be in place to limit transmission. For RESTV, educational public health messages should focus on reducing the risk of pig-to-human transmission as a result of unsafe animal husbandry and slaughtering practices, and unsafe consumption of fresh blood, raw milk or animal tissue. Gloves and other appropriate protective clothing should be worn when handling sick animals or their tissues and when slaughtering animals. In regions where RESTV has been reported in pigs, all animal products (blood, meat and milk) should be thoroughly cooked before eating.

Controlling infection in health-care settings

Human-to-human transmission of the Ebola virus is primarily associated with direct or indirect contact with blood and body fluids. Transmission to health-care workers has been reported when appropriate infection control measures have not been observed.

It is not always possible to identify patients with EBV early because initial symptoms may be non-specific. For this reason, it is important that health-care workers apply standard precautions consistently with all patients – regardless of their diagnosis – in all work practices at all times. These include basic hand hygiene, respiratory hygiene, the use of personal protective equipment (according to the risk of splashes or other contact with infected materials), safe injection practices and safe burial practices.

Health-care workers caring for patients with suspected or confirmed Ebola virus should apply, in addition to standard precautions, other infection control measures to avoid any exposure to the patient’s blood and body fluids and direct unprotected contact with the possibly contaminated environment. When in close contact (within 1 metre) of patients with EBV, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).

Laboratory workers are also at risk. Samples taken from suspected human and animal Ebola cases for diagnosis should be handled by trained staff and processed in suitably equipped laboratories.

WHO response

WHO provides expertise and documentation to support disease investigation and control.

Recommendations for infection control while providing care to patients with suspected or confirmed Ebola haemorrhagic fever are provided in: Interim infection control recommendations for care of patients with suspected or confirmed Filovirus (Ebola, Marburg) haemorrhagic fever, March 2008. This document is currently being updated.

WHO has created an aide–memoire on standard precautions in health care (currently being updated). Standard precautions are meant to reduce the risk of transmission of bloodborne and other pathogens. If universally applied, the precautions would help prevent most transmission through exposure to blood and body fluids.

Standard precautions are recommended in the care and treatment of all patients regardless of their perceived or confirmed infectious status. They include the basic level of infection control—hand hygiene, use of personal protective equipment to avoid direct contact with blood and body fluids, prevention of needle stick and injuries from other sharp instruments, and a set of environmental controls.

a reply to: reletomp

I was researching this and have the dates:

FACT: Assuming Sawyer immediately infected the nurse who died in Nigeria, only 16 days passed from time of infection, incubation and death.

Sawyer was isolated in the Nigerian hospital July 20.

Sawyer died July 25.

The first Sawyer related death, a nurse, was on August 5.

Now THAT is scary.

originally posted by: loam
a reply to: reletomp

I was researching this and have the dates:

FACT: Assuming Sawyer immediately infected the nurse who died in Nigeria, only 16 days passed from time of infection, incubation and death.

Sawyer was isolated in the Nigerian hospital July 20.

Sawyer died July 25.

The first Sawyer related death, a nurse, was on August 5.

Now THAT is scary.

actually the doctor who treated him died just few days after Sayer!!!

I believe his sister a nurse died in Liberia just few days before he was caught up in Nigeria airplane not 10 days. try read vanguard online it is nigerian journal in english with lots of comments showing you how the comments are petrified and praying to god almighty without mention of jesus christ this time!

Most likely he got infected when he was very close to his dying siister say goodby to her and crying over each other so you need to find the date of her death that would be the fist day of incubation. However the doctor he treated him died shortly after sawyer died. Is it possible the doctor was already infected when he treated sauyer, but thats unlikely since nigeria was free of the disease then. it all started in nigeria (100 million people) with sauyer!

or is it possible that every human have different incubation period based on the virus when it decides when the patiet is ready for the rinse cycle! but that does not not make any sense since all viruses in all bodies should flare in the same slope period!

can any body check when his treating doctore really died after sauyer died because that would be the incubation period for all patients , it fells like its only five days only!! oh my

a reply to: reletomp

Sawyer's Sister died July 7th. Source.

So much longer.

As far as I know, the nurse is the first death after Sawyer in Nigeria.

originally posted by: loam
a reply to: reletomp

Sawyer's Sister died July 7th. Source.

So much longer.

As far as I know, the nurse is the first death after Sawyer in Nigeria.

he could not possibly got infected (inoculated with the virus ) after she died , since the goodby cry over his sister was surely the first day. he could even had been infected even earlier which bring more relief since that will makew the incubation period even longer (disease less harmful this time around, that would combaring with another flare a year later (if) or the previous flare in 2008 I guess, so what was the incubation period in 2008 or what ever the last time Zaire version hit.

I am really disturbed since all viruses are standard in the fact that incubation period is static (take or give a day) for all patients. why this virus is different in the first time in history in being having different incubation period for different people????
any guess as to why, if indeed sauyer incubation period was definitely much longer the the doctor who treated him, it is just impossible!?

Considering how fast suyer died after the symptoms appeared, it he managed to board the airplane to us he would had been very healthy looking and he would have died in mid flight. considering his body would be most virulent the hour after death, all passangers would had been infected but without any body knowing why he died(no medical on plane), so it is possible that upon coming airport personell would had let people go home!!!!!!!

then imagine how destiny made the personel at nigeria airport by intercepting him on doubt and even had a brawl with him, they actually saved us. They the guards must by now are dyinng wjo knows, and who would mention the real unsong heroes in humanity history.

a reply to: reletomp

I have a theory on this.

But first let me explain something. I decided after Isaacs' testimony yesterday that it shouldn't be hard to figure out who the doctor was that Sawyer was traveling with.

I think that doctor was Dr. Samuel Brisbane. He was the Chief Medical Doctor of JFK Hospital, which is the same place mentioned in Issacs' testimony. Moreover, Brisbane died July 26, one day after Sawyer. Again consistent with the next day deaths described by Issacs.

Apparently, rather than seek medical treatment once he was sick, Brisbane decided to stay at his home. Odd choice for a doctor. Of course, eventually he was forced to seek medical treatment. But that seems consistent with the kind of thinking described by Isaacs concerning the doctor who mocked the ebola issue.

Dr. Samuel Brisbane, the Chief Medical Doctor at Liberia’s leading hospital, the John F. Kennedy Medical Center has become the latest casualty of the deadly Ebola virus.

...

Hospital sources say, Dr. Brisbane selected to treat himself at home initially in a bid not to spread the virus to others but was brought to the ELWA hospital where the Samaritan Group has been treating serious cases, when the illness worsened, until his death, Saturday.

Source.

In any event, I learned Sawyer was ordered by Liberian authorities not to leave the country prior to his actual departure for Nigeria. In other words, he was being placed under watch. One possibility is this was done not because of Sawyer's sister's ebola death, which the authorities may not have known about, but rather because of Brisbane's diagnosis, which they would have known given his prominence in Liberia.

So while traveling around denying ebola existed, and visiting ebola patients to prove it, one of them could have caught the virus from someone else and gave it to the other.

Or as the media reports, Sawyer did get infected by his sister, and then he gave it to Brisbane.

there was another doctor from nigeria, that was not traveling with sauyer. that doctor died. may be the accompanying doctor died too.
but we definitely can not measure from the time they met in the plane or before.
I am pretty sure there was another doctor from Nigeria who did not leave nigeria and the 7 nurses too who also from nigeria and were never exposed to ebola before.
any way so that nurse who died after suyer we dont care about the date of her death , but we re looking for the date she started having symptoms!!
because the incubation period ends when the patient start having symptoms (the rinse cycle starts with the symptoms, while the wash cycle starts with exposure date or inoculation moment more precisely(when you start the laundermat!)

!!!

a reply to: reletomp

I'm talking about the doctor in Isaacs testimony in yesterdays congressional hearing...the prominent Liberian doctor who denied the ebola problem existed.

originally posted by: loam
a reply to: reletomp

I'm talking about the doctor in Isaacs testimony in yesterdays congressional hearing...the prominent Liberian doctor who denied the ebola problem existed.

yes, what is the deal with incubation period going from 2 to 22 days, that is the difference in different epidemics for example the epidemic of 2009 could be two days and the epidemic of 2013 coul;d be 22 days, but you cant have them both at the same time unless there were different strains at the same time (like different strains of Zaire at the same time ) which is highly unlikely unless it is all manufactured.
who is isaacs ? the nigeran doctor or the administrator or somebody else.


I am talking about the huge nigerian doctor in CDC director brother of wolfowitz, and elvira rice

Ebola's spread to US is 'inevitable' says US CDC chief

WASHINGTON - Ebola's spread to the United States is "inevitable" due to the nature of global airline travel, but any outbreak is not likely to be large, US health authorities said Thursday.


Already one man with dual US-Liberian citizenship has died from Ebola, after becoming sick on a plane from Monrovia to Lagos and exposing as many as seven other people in Nigeria.



More cases of Ebola moving across borders via air travel are expected, as West Africa faces the largest outbreak of the hemorrhagic virus in history, said Tom Frieden, the head of the US Centers for Disease Control and Prevention.



The virus spreads by close contact with bodily fluids and has killed 932 people and infected more than 1,700 since March in Sierra Leone, Guinea, Nigeria and Liberia.



"It is certainly possible that we could have ill people in the US who develop Ebola after having been exposed elsewhere," Frieden told a hearing of the House Subcommittee on Africa, Global Health, Global Human Rights and International Organizations.

www.gmanetwork.com...

Happy Friday everyone!

a reply to: beezzer

Which is why I dont understand why they have not closed west Africa air travel?

No the out break wont be "large" but for fecks sake that is still airport and medical staff put at risk, even if one American or in my case Brits dies because of a west African traveller when it could have been prevented thats too much!


If our political leaders think its such a great idea to keep travel to west Africa open they should volunteer to work in airports and airlines.

a reply to: crazyewok

We're "little people".

We're statistics, a sad story on the nightly news, a brief passage in a politicians speech.

We're not actually important enough for governments to actually do something.

would you be able to put the testimony of the one before the last one , the director of Samaritan purse?
that would be greaty. because him being really in the middle of the battle recently his testimony is more dreadful than the cdc director. he spoke about the despair of the nations there and how the next ouitbreak would be approximately two weeks from now and it will be world wide. he was sad with no sign of any glimmer of hope. the nigerian doctor even got further when he said"what ever we do the casualties will be dratic" he actually said whatever we do.

It is best sick people stay in their homes. the idea of a patient transported to the hospital in the capital or a city really chill my bones.

I really believe the survivors sghould be made immediate nurses and given salaries 100 times more the salary of a doctor there. they are the only ones who can can actually sleep with the sick with the sick without nothing happening to them.

I really believe that doctors should just stay by the front door of the hut at 5 meters distance at least wjhile the survivor turned nurse be by the patient taking pulse blood pressure . The three doctors outside of different specialties would be watching either through phone skype or through a flashlight held by the survivor.
The patient should have a cup for him self and we he need water he moves and put it away from him one meter at least and then his mom or relative pour the water in the cup. even better the survivor can donate half a pint of his blood to the patient if the doctor recommend it and the survivor approve the negothiated cost.

It is guaranteed that the donated blood so little will save the life of the patient (saving it for good never to get sick again and becoming another survivor)

the triangle of death between the three countries should be quarantined definitely, and with no movement in the streets whatsover like marshal law with all the food and water delivered to the doors of the houses (better be danish butter as incentive)
the quarantied area could also be divided into smaller quarantines areas (by soldiers of course).
Killing the epidemic at it souce will guarantee killing the whole epidemic. it is like cutting the head of the snake.

the people there should treated respectfully with giving them anything they want just to stay home.
People will still die of course but then when the area is stabled by doctors visits and giving bllod, then instead of having a outbreak launch pad we ll have a surviver area.
I cant imagine the epidemic can spread with out its center.\
Very much when the great desertification of Oklahoma in the 20s and 30s thesolution was to grass and rehabilitate only the core parts from where the avalanche of sand starts.
and it worked.

a reply to: beezzer

As near as I can tell, the US strategy seems to be we will just isolate cases as they come, under the theory that will contain any outbreak here. The assumption, of course, is that these people will come to them, the hospitals.

No word on how they plan to deal with people who don't go to the hospital, and therefore infect many others.

Stupid. Stupid. Stupid.

Sawyers example demonstrates much.

originally posted by: reletomp
who is isaacs ? the nigeran doctor or the administrator or somebody else.

Ken Isaacs is the Vice President of Program and Government Relations for an organization called Samaritan's Purse. Samaritan's Purse is the relief organization that Nancy Writebol and Dr. Brantley (the 2 Americans now being treated at Emory University Hospital) work for.

Samaritan's Purse Board of Directors & Key Employees

You'll find him listed at the bottom of the page under "Key Employees".

a reply to: loam

That's the problem. These people think that the infected will behave rationally.

healthcare workers (doctors, nurses) have shown in the past that they won't even be showing up for work!

Just look at past flu's where there have been massive no-shows.

And that was just the flu!

a reply to: reletomp

Incubation in most cases is about two days. If you're very strong, very healthy it can be up to twenty two days. That's the outside incubation period not the norm. Two or three days is the norm.

a reply to: beezzer

I really hope luck is on our side, because after Isaacs' testimony this could be really really bad.

Stuff of nightmares.

originally posted by: reletomp

It is guaranteed that the donated blood so little will save the life of the patient (saving it for good never to get sick again and becoming another survivor)

Rubbish there is no guaranteed treatment for Ebola. Yes they have given blood from survivors but there no data on how effective that is and a lot still go on to die.