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Results
If trends continue without additional interventions, the model estimates that Liberia and Sierra Leone will have approximately 8,000 total Ebola cases (21,000 total cases when corrected for underreporting) by September 30, 2014 (Figure 1). Liberia will account for approximately 6,000 cases (16,000 corrected for underreporting) (Appendix [Figure 1]). Total cases in the two countries combined are doubling approximately every 20 days (Figure 1). Cases in Liberia are doubling every 15–20 days, and those in Sierra Leone are doubling every 30–40 days (Appendix [Figure 1]).
By September 30, 2014, without additional interventions and using the described likelihood of going to an ETU, approximately 670 daily beds in use (1,700 corrected for underreporting) will be needed in Liberia and Sierra Leone (Figure 2). Extrapolating trends to January 20, 2015, without additional interventions or changes in community behavior (e.g., notable reductions in unsafe burial practices), the model also estimates that Liberia and Sierra Leone will have approximately 550,000 Ebola cases (1.4 million when corrected for underreporting) (Appendix [Figure 2]).
The number of people known to have died amid the worst Ebola outbreak on record has topped 4,000, the World Health Organization said Friday. The Geneva-based United Nations agency said the virus had killed 4,033 people out of 8,399 cases over seven months in seven countries by Oct. 8.
The death toll includes 2,316 in Liberia, 930 in Sierra Leone, 778 in Guinea, eight in Nigeria — and one in the United States. A separate Ebola outbreak in Democratic Republic of Congo has killed 43 people out of 71 cases. Thomas Eric Duncan, the first person to be diagnosed with Ebola in the United States, died Wednesday in Dallas.
The number of Ebola cases in West Africa has been doubling about every three weeks. There is little evidence so far that the epidemic is losing momentum.
I would like to request that any further discussion relative to pre-symptomatic transmission to the Ebola: Facts, Opinions, and Speculations. thread; I will post there and link sourced documents supportive of my stance.
Yet the largest study of the current outbreak found that in nearly 13% of "confirmed and probable" cases in Liberia, Sierra Leone, Guinea and elsewhere, those infected did not have fevers.
The study, sponsored by the World Health Organization and published online late last month by the New England Journal of Medicine, analyzed data on 3,343 confirmed and 667 probable cases of Ebola.
Dr. Anthony Fauci, who is helping to shape the U.S. response to Ebola as director of the National Institute of Allergy and Infectious Diseases, was asked by a CNN interviewer on Oct. 4 whether a person could be "contagious without having a fever."
Fauci replied that "the answer to that is no."
He continued: "You never say 100% but it's essentially 100%. … In biology nothing is 100%, but that's quite a reasonable conclusion to make."
Source is a relative who is a nurse (has been for a long time, and is well versed in this virus in particular) and is a patient in one of the few hospitals in the country that does have the facilities to deal with this virus.
As one can imagine, this topic is on many lips in the hospital.
It is this person's opinion that the virus is, and has been, transmissible prior to onset of symptoms.
That is the bigges lie we are being told.
The official assumptions about the frequency of fever in Ebola patients have not been challenged publicly. But Dr. Paul D. Stolley, former chairman of the University of Maryland's Department of Epidemiology and Preventive Medicine, said the matter "requires further investigation."
Given the stakes, he said, the "absolute" assumption that Ebola can be spread only when an infected person displays fever should be reevaluated.
"It may be true," said Stolley, a member of the Institute of Medicine, part of the National Academies. "It just doesn't sound very plausible to me."
Dr. Nick Zwinkels, a Dutch physician, last month closed a hospital he had been running with a colleague in central Sierra Leone after five nursing aides contracted Ebola — possibly from unprotected contact with three patients who were not promptly diagnosed with the virus.
Based on what his staff observed, Zwinkels wrote, "it seems that only measuring the temperature as a form of triage is insufficient."
He added: "It seems that Ebola can present without fever especially in the first phase."
The classic slogan for Firestone tires was "where the rubber meets the road."
When it comes to Ebola, the rubber met the road at the Firestone rubber plantation in Harbel, Liberia.
Harbel is a company town not far from the capital city of Monrovia. It was named in 1926 after the founder of the Firestone Tire and Rubber Company, Harvey and his wife, Idabelle. Today, Firestone workers and their families make up a community of 80,000 people across the plantation.
Firestone detected its first Ebola case on March 30, when an employee's wife arrived from northern Liberia. She'd been caring for a disease-stricken woman and was herself diagnosed with the disease. Since then Firestone has done a remarkable job of keeping the virus at bay. It built its own treatment center and set up a comprehensive response that's managed to quickly stop transmission. Dr. Brendan Flannery, the head of the U.S. Centers for Disease Control and Prevention's team in Liberia, has hailed Firestone's efforts as resourceful, innovative and effective.
NOTICE
Executive Order 13295 was amendedExternal Web Site Icon on July 31, 2014. Subsection (b) was replaced with the following:
"(b) Severe acute respiratory syndromes, which are diseases that are associated with fever and signs and symptoms of pneumonia or other respiratory illness, are capable of being transmitted from person to person, and that either are causing, or have the potential to cause, a pandemic, or, upon infection, are highly likely to cause mortality or serious morbidity if not properly controlled. This subsection does not apply to influenza."
Office of the Press Secretary
For Immediate Release
April 4, 2003
By the authority vested in me as President by the Constitution and the laws of the United States of America, including section 361(b) of the Public Health Service Act (42 U.S.C. 264(b)), it is hereby ordered as follows:
Section 1. Based upon the recommendation of the Secretary of Health and Human Services (the "Secretary"), in consultation with the Surgeon General, and for the purpose of specifying certain communicable diseases for regulations providing for the apprehension, detention, or conditional release of individuals to prevent the introduction, transmission, or spread of suspected communicable diseases, the following communicable diseases are hereby specified pursuant to section 361(b) of the Public Health Service Act:
(a) Cholera; Diphtheria; infectious Tuberculosis; Plague; Smallpox; Yellow Fever; and Viral Hemorrhagic Fevers (Lassa, Marburg, Ebola, Crimean-Congo, South American, and others not yet isolated or named).
(b) Severe Acute Respiratory Syndrome (SARS), which is a disease associated with fever and signs and symptoms of pneumonia or other respiratory illness, is transmitted from person to person predominantly by the aerosolized or droplet route, and, if spread in the population, would have severe public health consequences.
Sec. 2. The Secretary, in the Secretary's discretion, shall determine whether a particular condition constitutes a communicable disease of the type specified in section 1 of this order.
Sec. 3. The functions of the President under sections 362 and 364(a) of the Public Health Service Act (42 U.S.C. 265 and 267(a)) are assigned to the Secretary.
Sec. 4. This order is not intended to, and does not, create any right or benefit enforceable at law or equity by any party against the United States, its departments, agencies, entities, officers, employees or agents, or any other person.
Sec. 5. Executive Order 12452 of December 22, 1983, is hereby revoked.
George W. Bush
The White House,
April 4, 2003.