Let's talk a bit about the Current Ebola outbreak.
Jul 31, 2014 20:59:13 GMT -5
UnforseenWeather, Hawkeye, and 2 more like this
Post by Erick on Jul 31, 2014 20:59:13 GMT -5
For those who dont know, I make my living as a CBRN/WMD scientist, my degrees are in Chemistry but I have done a lot of Molecular biology as well , have been a Senior on-site scientist for CBRN/WMD responses to include forensics, trained other scientists in mobile lab Ops for WMD outbreaks and a bunch of other stuff, blah, blah , blah.
So I thought it might be useful for people here if I talk a bit about the current outbreak.
Please excuse my typos.
First Lets get some references right so we can discuss this intelligently:
Outbreak: Lots more cases than normal
Epidemic: geographically widespread outbreak
Pandemic: very widely spread outbreak such as affecting a large part of the world.
A short synopsis on what Ebola is:
- Viral, specifically a Filovirus (very untypical form looks like a twine or twig , most viruses are more compact)
- Hemorrhagic fever causing (lots of internal and some external bleeding due to tissue and blood vessel degradation
- Contrary to Wikipedia not really all that infectious, certainly alot less than the flu or cold, extreme precautions are taken are due to lack of cure and lethality.
- Lethality rates up to 90% (this strain a lot less, more later)
- Incubation period 2-21 (!) days.
The Virus is called Ebola Virus (though many add a specifier for the strain) the disease state is called EVD, which means Ebola Virus Disease.
Original symptoms: Many are similar to Influenza and many other lesser diseases, : sore throat, fever, headaches, muscle pains.
Also later diarrhea, nausea, vomiting, which then progresses to the Hallmarks of the Hemorrhagic fevers , bleeding from eyes, ears, anus etc etc
But the very early stages it is not as obvious as to what it is, (unless you use advanced detection such as PCR to look for Virus titer in the bloodstream)
What happens normally in Ebola Outbreaks?
a) some people get sick and die in one village
b) same in a neighboring village
c) maybe a couple of medics
- Virus fizzles out as it kills quickly and everyone stays away from the obviously infected who are bleeding out of all orifices as they lie dying
- All infected humans are dead. no more transmisison
- Outbreak over
What happened here?
we have a) and b) and c) but no fizzling.
the disease just keeps going and going.
Why whats different?
back in March I was in a discussion group with some Scientists and MD’s and it was already obvious to me that this outbreak was different.
Why? because it wasn’t stopping and was spreading over 3 countries.
As I asked the folks in the discussion group what they thought was making the difference this time? as the outbreak was surely distinct, both geographically and in its spread?
I was told,, no F. its the same as usual, bats are the reservoir, then primates got sick, then humans from primates yada yada blah blah, blah
But something WAS different, wasn't it?
It was obvious 1st we very rarely had outbreaks in this part of Africa and when we did they were short and small. the only outbreak that ever came close was in the heart of Ebola country Central Africa not west.
Fast Forward 3 months,
the Outbreak is still going strong and many are calling it an Epidemic.
And we find out something interetsing:
- This strain IS different genetically from other Ebola strains
- It is less lethal (lethality 50-65%)
- The onset of hemorrhagic symptoms occurs much later in the disease progression
Those of you that have enjoyed the Seminars on the morning of Day 2 of CRCD will understand now why this strain has not stopped:
- Less lethality often means slower onset of symptoms so individuals can be infectious , even if only a little, while free or largely free of symptoms.
- Slow onset not just of symptoms in general but of symptoms specific to EVD will create windows in which people will not yet engage in social distancing with infected people with predictable results.
When human being go “Yuck he looks like a real sick dude, I;m gonna stay away” this disgust reaction is how nature creates social distancing mechanisms to protect people.
When the virus shows the nasty symptoms late than this protectio n mechanism is devalued.
I am convinced this is why this particular outbreak is ongoing.
Witness the Liberia official Sawyer (family resident in Minnesota), he was well enough to board a plane to Lagos Nigeria, to hold on to tickets and take a seat while being in late stage of EVD.
This is evidenced by the fact that he collapsped shortly after arrival.
yet when getting his ticket and boarding he did not display the typical Ebola symptoms or NO ONE would have let him on the plane!
This is why this is spreading.
Its not MORE lethal than “normal” Ebola it simply is gentler in its symptoms and actually less lethal in speed of death and in % lethality.
This is why it hasnt fizzled.
As some of you will recall I always harp on it that LESS lethal diseases can easier become an epidemic than more lethal ones right?
What does this mean for us?
Its easier for someone to travel to the US and not display symptoms and get sick here and spread it here.
However at this time I think it unlikely this strain of Ebola will turn into a pandemic or become a significant problem here, since Ebola is not very transmissible (need to exchange bodily fluids, though 1 airborne transmission from pigs to monkeys has been shown to occur the the lab!)
I covered what I felt was useful+needed but I encourage any and all questions so go ahead and ask, the idea is I give you something interactive and a bit more explanatory than what you get when you just google all this.
So I thought it might be useful for people here if I talk a bit about the current outbreak.
Please excuse my typos.
First Lets get some references right so we can discuss this intelligently:
Outbreak: Lots more cases than normal
Epidemic: geographically widespread outbreak
Pandemic: very widely spread outbreak such as affecting a large part of the world.
A short synopsis on what Ebola is:
- Viral, specifically a Filovirus (very untypical form looks like a twine or twig , most viruses are more compact)
- Hemorrhagic fever causing (lots of internal and some external bleeding due to tissue and blood vessel degradation
- Contrary to Wikipedia not really all that infectious, certainly alot less than the flu or cold, extreme precautions are taken are due to lack of cure and lethality.
- Lethality rates up to 90% (this strain a lot less, more later)
- Incubation period 2-21 (!) days.
The Virus is called Ebola Virus (though many add a specifier for the strain) the disease state is called EVD, which means Ebola Virus Disease.
Original symptoms: Many are similar to Influenza and many other lesser diseases, : sore throat, fever, headaches, muscle pains.
Also later diarrhea, nausea, vomiting, which then progresses to the Hallmarks of the Hemorrhagic fevers , bleeding from eyes, ears, anus etc etc
But the very early stages it is not as obvious as to what it is, (unless you use advanced detection such as PCR to look for Virus titer in the bloodstream)
What happens normally in Ebola Outbreaks?
a) some people get sick and die in one village
b) same in a neighboring village
c) maybe a couple of medics
- Virus fizzles out as it kills quickly and everyone stays away from the obviously infected who are bleeding out of all orifices as they lie dying
- All infected humans are dead. no more transmisison
- Outbreak over
What happened here?
we have a) and b) and c) but no fizzling.
the disease just keeps going and going.
Why whats different?
back in March I was in a discussion group with some Scientists and MD’s and it was already obvious to me that this outbreak was different.
Why? because it wasn’t stopping and was spreading over 3 countries.
As I asked the folks in the discussion group what they thought was making the difference this time? as the outbreak was surely distinct, both geographically and in its spread?
I was told,, no F. its the same as usual, bats are the reservoir, then primates got sick, then humans from primates yada yada blah blah, blah
But something WAS different, wasn't it?
It was obvious 1st we very rarely had outbreaks in this part of Africa and when we did they were short and small. the only outbreak that ever came close was in the heart of Ebola country Central Africa not west.
Fast Forward 3 months,
the Outbreak is still going strong and many are calling it an Epidemic.
And we find out something interetsing:
- This strain IS different genetically from other Ebola strains
- It is less lethal (lethality 50-65%)
- The onset of hemorrhagic symptoms occurs much later in the disease progression
Those of you that have enjoyed the Seminars on the morning of Day 2 of CRCD will understand now why this strain has not stopped:
- Less lethality often means slower onset of symptoms so individuals can be infectious , even if only a little, while free or largely free of symptoms.
- Slow onset not just of symptoms in general but of symptoms specific to EVD will create windows in which people will not yet engage in social distancing with infected people with predictable results.
When human being go “Yuck he looks like a real sick dude, I;m gonna stay away” this disgust reaction is how nature creates social distancing mechanisms to protect people.
When the virus shows the nasty symptoms late than this protectio n mechanism is devalued.
I am convinced this is why this particular outbreak is ongoing.
Witness the Liberia official Sawyer (family resident in Minnesota), he was well enough to board a plane to Lagos Nigeria, to hold on to tickets and take a seat while being in late stage of EVD.
This is evidenced by the fact that he collapsped shortly after arrival.
yet when getting his ticket and boarding he did not display the typical Ebola symptoms or NO ONE would have let him on the plane!
This is why this is spreading.
Its not MORE lethal than “normal” Ebola it simply is gentler in its symptoms and actually less lethal in speed of death and in % lethality.
This is why it hasnt fizzled.
As some of you will recall I always harp on it that LESS lethal diseases can easier become an epidemic than more lethal ones right?
What does this mean for us?
Its easier for someone to travel to the US and not display symptoms and get sick here and spread it here.
However at this time I think it unlikely this strain of Ebola will turn into a pandemic or become a significant problem here, since Ebola is not very transmissible (need to exchange bodily fluids, though 1 airborne transmission from pigs to monkeys has been shown to occur the the lab!)
I covered what I felt was useful+needed but I encourage any and all questions so go ahead and ask, the idea is I give you something interactive and a bit more explanatory than what you get when you just google all this.