No, We Aren’t All Going to Die Because Ebola Patients Are Coming to US for Treatment

Here is my post from Friday at Emptywheel:

Scary, color-enhanced electron micrograph of Ebola virus particles. Creative Commons license courtesy of Thomas W. Geisbert, Boston University School of Medicine.

With the death toll now over 700 in an Ebola outbreak that has been building since February, Americans are suddenly up in arms about the virus, but only because it was announced yesterday that up to two Americans infected with the virus may be transported to Atlanta for treatment. Yes, the virus is especially deadly, with a death rate of 70-90% of infected patients, but the virus does not spread particularly efficiently and is not airborne. Writing at CNN.com, biologist Laurie Garrettpoints out a disaster scenario for the virus. Rather than an outbreak in the US, which seems extremely unlikely, Garrett outlines how the virus could spread in the much more densely populated Nigeria rather than the more remote areas of Guinea, Sierra Leone and Liberia where it is now concentrated.

Before getting into the details of the current outbreak and its possible spread to Nigeria, a little background on the virus. From the World Health Organization, we have this information on how the virus spreads:

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.

Of particular relevance to the two patients who may be transported to Atlanta for treatment (they work for Samaritan’s Purse, an aid organization) and the tragic death of Sheik Umar Khan, Sierra Leone’s top Ebola doctor, the information from WHO continues:

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.

The fact that these health care givers become infected because standard infection control precautions are not strictly practiced in no way should suggest that they are uninformed or careless. Instead, Garrett points out in her article the stark realities facing health care providers in the three countries where the outbreak rages:

To show how ill-equipped these nations are to battle disease, per capita spending on health care, combining personal and governmental, amounts to only $171 a year in Sierra Leone, $88 a year in Liberia and $67 a year in Guinea, according to the Kaiser Foundation.

For those who want more detail on the virus, this succinct summary of the structure of the Filovirus family of viruses and their mode of operation is very informative.

For the panic-motivated hypochondriacs among us, initial symptoms of this virus mimic the onset of most other viral infections.

The most recent update from WHO on the outbreak can be read here. The update summarizes the assistance that is being provided to the countries where the outbreak is ongoing. Significantly, WHO is not advocating travel restrictions at this time.

Returning to Garrett’s article, she points out the factors that would lead to chaos should Ebola spread in Nigeria: (more…)

No, We Aren’t All Going to Die Because Ebola Patients Are Coming to US for Treatment

Here is my post from Friday at Emptywheel:

Scary, color-enhanced electron micrograph of Ebola virus particles. Creative Commons license courtesy of Thomas W. Geisbert, Boston University School of Medicine.

With the death toll now over 700 in an Ebola outbreak that has been building since February, Americans are suddenly up in arms about the virus, but only because it was announced yesterday that up to two Americans infected with the virus may be transported to Atlanta for treatment. Yes, the virus is especially deadly, with a death rate of 70-90% of infected patients, but the virus does not spread particularly efficiently and is not airborne. Writing at CNN.com, biologist Laurie Garrettpoints out a disaster scenario for the virus. Rather than an outbreak in the US, which seems extremely unlikely, Garrett outlines how the virus could spread in the much more densely populated Nigeria rather than the more remote areas of Guinea, Sierra Leone and Liberia where it is now concentrated.

Before getting into the details of the current outbreak and its possible spread to Nigeria, a little background on the virus. From the World Health Organization, we have this information on how the virus spreads:

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.

Of particular relevance to the two patients who may be transported to Atlanta for treatment (they work for Samaritan’s Purse, an aid organization) and the tragic death of Sheik Umar Khan, Sierra Leone’s top Ebola doctor, the information from WHO continues:

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.

The fact that these health care givers become infected because standard infection control precautions are not strictly practiced in no way should suggest that they are uninformed or careless. Instead, Garrett points out in her article the stark realities facing health care providers in the three countries where the outbreak rages:

To show how ill-equipped these nations are to battle disease, per capita spending on health care, combining personal and governmental, amounts to only $171 a year in Sierra Leone, $88 a year in Liberia and $67 a year in Guinea, according to the Kaiser Foundation.

For those who want more detail on the virus, this succinct summary of the structure of the Filovirus family of viruses and their mode of operation is very informative.

For the panic-motivated hypochondriacs among us, initial symptoms of this virus mimic the onset of most other viral infections.

The most recent update from WHO on the outbreak can be read here. The update summarizes the assistance that is being provided to the countries where the outbreak is ongoing. Significantly, WHO is not advocating travel restrictions at this time.

Returning to Garrett’s article, she points out the factors that would lead to chaos should Ebola spread in Nigeria:

Were Ebola to take hold in that country [Nigeria], spreading from person-to-person in a densely populated, chaotic city such as Lagos, the worldwide response would swiftly spin into uncharted political and global health territory.

Consider the following: Nigerian physicians are on strike nationwide; hundreds of girls have been kidnapped from their schools and villages over the past six months by Boko Haram Islamist militants — and none has been successfully freed from their captors by the Abuja government.

Nigeria is in the midst of national election campaigning. President Goodluck Jonathan’s government is, at best, weak. The nation is torn apart by religious tension, pitting the Muslim north against the Christian south. Islamists in the north have long distrusted Western medicine. They have opposed polio vaccination and have kidnapped and assaulted central government health providers.

Garrett’s plea is for an already-planned African summit on Monday to be used to develop a coordinated plan for dealing with the virus:

One way or another, Obama must take advantage of Monday’s Africa summit to press the case for calm and appropriate responses. These would include specific post-Ebola financial commitments to Liberia, Sierra Leone and Guinea.

The possibility that the epidemic might take hold in Nigeria must be confronted, and plans of action must be considered. The world cannot afford to make decisions in the heat of panic about such things as international airport closures, withdrawal of foreign oil workers, negotiations for outbreak responses with northern imams, hospital and clinic infection control training across thousands of Nigerian health facilities, deployment of international assistance teams for rapid diagnostics and lab assistance and countless other contingencies.

Sadly, Garrett points out important information on the damage that has already been done in this outbreak:

When this Ebola epidemic eventually ends, the health budgets of these nations [Liberia, Sierra Leone and Guinea] will have been bankrupted, and many of their most skilled and courageous physicians, nurses, Red Cross volunteers and hospital workers will have perished.

Let’s hope that Monday sees the beginning of stronger coordination to put more resources where they are needed to halt the spread of this ongoing disaster.

Shanghai Culls Poultry as H7N9 Spreads, But Relevant US Research Remains Suspended Due to Security Theater

Partial screen capture of the home page of the Chinese news agency Xinhua (http://www.xinhuanet.com/english/), showing the culling of poultry in Shanghai.

Crossposted from emptywheel.net

Yesterday saw a number of developments in the ongoing story of the emerging H7N9 virus in the Shanghai region of China, as the virus was identified in pigeons being sold at a meat market and the culling of all poultry at that market was initiated. One close associate of an infected person still is being monitored in isolation after developing possible symptoms of the virus and might turn out to be the first case of person to person transfer of the virus. Meanwhile, the CDC already has started work in the US that could lead to a vaccine.

As I pointed out yesterday, key questions to be addressed in understanding how dangerous this virus will be revolve around the issue of how the virus jumps from one host to another and whether it acquires the ability to transfer from one person to another. Sadly, the most directly relevant research in the US on these questions remains suspended due to a cowardly display of security theater by the National Science Advisory Board for Biosecurity. Back in late 2011, I wrote about this board asking two prominent scientific journals to censor work that had been approved for publication. The work eventually was published, but only after a hiatus of about six months. As I pointed out at that time, the fears expressed by NSABB were then shown to be entirely unfounded.

In their report online today on the latest developments in the H7N9 emergence, CNN provided a link at the bottom of their story to this story they published back in January, with the headline “Bird flu research resumes — but not in U.S.” From that report:

 Drama surrounding research on the deadly H5N1 avian flu continues, as 40 scientists urge work on the virus to continue in countries that have established guidelines on the safety and aims of the research. The United States is not among them.

This new correspondence, a letter from researchers published Wednesday in the journals Science and Nature, comes after a “voluntary pause” in the research, which scientists announced in January 2012.

/snip/

In many countries, those objectives have been achieved, according to the letter, and researchers who have permission from their governments to continue this research should do so.

Ah, but the US never misses out on an opportunity to over-play its hand when it comes to security theater, so the work hasn’t restarted here: (more…)

H7N9: A New Influenza Virus Emerges

This post originally appeared on April 4 at emptywheel.net and has been crossposted without changes, making a few of the time references a bit off. The post is in two parts. The first part deals with the news that a new flu virus has emerged. The second part, which comes below the fold, provides a bit of biological and public health information to help put the news into perspective.

Influenza schematic (click to embiggen)

According to the latest reports I can find, there are now three confirmed deaths and ten confirmed cases of people infected with a new strain of Type A (bird) influenza virus that has been designated H7N9. All cases have been in eastern China. The good news is that there is not yet evidence to suggest that this virus can spread from one person to another (although that question has not yet been fully answered), which is a prerequisite for a pandemic. The bad news, though, is that the animal host from which the infections were acquired has not been identified.

Earlier this week, Laurie Garrett began assembling what is known about the emerging cases of H7N9 infection and putting those cases into the context of mysterious mass die-offs of pigs and birds in the same general region of China (Garrett is asking important questions here since previous flu pandemics have come from swine or bird hosts):

By the end of March, at least 20,000 pig carcasses and tens of thousands of ducks and swans had washed upon riverbanks that stretch from the Lake Qinghai area all the way to the East China Sea — a distance roughly equivalent to the span between Miami and Boston. Nobody knows how many more thousands of birds and pigs have died, but gone uncounted as farmers buried or burned the carcasses to avoid reprimands from authorities.

While environmental clean-up and agricultural authorities scrambled to remove the unsightly corpses and provide the anxious public with less-than-believable explanations for their demise, a seemingly separate human drama was unfolding. On Feb. 19, a man identified by Xinhua, China’s state news agency, only as Li, an 87-year old retiree, was hospitalized in Shanghai with severe respiratory distress and pneumonia. On March 4, Li went into severe cardio-respiratory failure and succumbed.

On Feb. 27, a man identified only as Wu, a 27-year-old butcher or meat processor, fell ill with respiratory distress, was hospitalized, and died on March 10. The day Wu succumbed a third individual, a 35-year-old woman identified as Han, was hospitalized in the city of Nanjing, though she came from distant Chuzhou City, in Anhui province, about 300 miles northwest of Shanghai. Han is reportedly in critical condition, in intensive care. To date, no connection between the three individuals has been found.

The key question of whether person-to-person transmission of the virus can occur is made somewhat murky by the family of Li: (more…)

Late Night FDL: Pouting Baby Says “Will Bloomin’ Rich Mike Make a Stupid Move?”

"Will Bloomin' Rich Mike make a stupid move?" (photo courtesy of Jim White)

Pouting Baby is talking to us again.  —  JW

This has been an amazing month.  The Occupy Wall Street group started as just a handful of people who wanted everyone to know how the super rich mean people who run Wall Street have stolen from everybody else and made it impossible for most people to make any money.  Now there are people all over the world joining in the protests, with over 1400 cities in the US having protests along with 869 cities in 71 countries.  Mr. Kevin has been following the story every day here at FDL and has kept us informed as it has turned into a huge movement.

Today, we learned that Bloomin’ Rich Mike might ask the police in New York City to try to move the original Occupy Wall Street group out of the park where they have been staying.  There could be trouble if that happens:

Owner Brookfield Office Properties plans to clean the park where several hundred protesters have been sleeping on Friday, a move that demonstrators believe is a ploy to remove them.

“Seems likely that this is their attempt to shut down #OWS (Occupy Wall Street) for good,” protesters said in a statement on Thursday. “We know where the real dirt is: on Wall Street … We won’t allow Bloomberg and the NYPD to foreclose our occupation. This is an occupation, not a permitted picnic.”

Since the protesters say they won’t be moved out, everyone is worried that there could be fighting.  Would Bloomin’ Rich Mike be stupid enough to make the police move the protesters out?  A lot of people think that instead of shutting down the protests, it would only make them a lot larger if the police move in and there are problems.

Another crazy thing about this is that the park owners are trying to say the park is dirty and needs to be cleaned.   All day today the protesters have been talking on Twitter about how they are cleaning the park up themselves.  Also, a nice man has offered to pay for any cleanup that is needed so that there won’t be a fight.  Here’s a video from the park showing that it’s not filthy: (more…)

Late Night FDL: Pouting Baby Says “Creepy Clarence and Mrs. Ginni T Are In Big Trouble Now”

"Creepy Clarence and Mrs. Ginni T are in big trouble now" (photo courtesy of Jim White)

Pouting Baby is talking to us again. — JW

I know I’ve talked about Creepy Clarence and Mrs. Ginni T a lot. I asked why Mrs. Ginni T made mean phone calls to Professor Hill. Then I asked why Creepy Clarence is allowed to lie. After that, I asked why Bow Tie Boy hired Mrs. Ginni T. Tonight I want to get back to Creepy Clarence’s lies, because now Common Bob and his friends have found out that Creepy Clarence’s lies are even bigger than we first thought.

Back when I first talked about Creepy Clarence’s lies, Common Bob’s friends told us how Mrs. Ginni T. made lots of money from mean people and Creepy Clarence lied about her getting the money. He said she didn’t earn any money. At that time, we thought that the lie was about $700,000 Mrs. Ginni T. made over a period of six years. Now, it turns out that Creepy Clarence first started lying about Mrs. Ginni T’s job in 1997 and kept lying all the way through 2009. Common Bob’s friends have found that Mrs. Ginni T. made at least $1.6 million during that time.

What’s worse is that when Creepy Clarence first tried to fix the reports where he lied, he tried to claim that he didn’t understand the instructions on the forms. Now we know that from at least 1991 through 1996, Creepy Clarence properly reported Mrs. Ginni T’s job on the same forms that he forgot how to fill out in 1997. Over $1 million of the money Creepy Clarence lied about came from the mean people at Heritage Foundation, where they try to make sure rich people get richer and we fight more wars.

Now Common Bob’s friends want our lawmakers to make Creepy Clarence explain why he lied. If Creepy Clarence keeps on lying, some people think the lawmakers could make Creepy Clarence stop being an important judge. Not everyone, especially Mr. Bmaz, thinks that could happen, though. I hope Mr. Bmaz is wrong and we can get a better important judge than Creepy Clarence. Someone who lies about money shouldn’t be allowed to be an important judge.

Late Night FDL: Pouting Baby Says “Watch Out For Killer Cantaloupes!”

"Watch out for killer cantaloupes!" (photo courtesy of Jim White)

Pouting Baby is talking to us again. — JW

My Mommy tries to get me to eat cantaloupe but I hate it. It’s the same color as yummy sweet potatoes, but it tastes nasty. Now it looks like I have a reason not to eat cantaloupe:

Cases of illness in the U.S. listeria outbreak linked to tainted cantaloupes — already the deadliest in a decade — likely will rise in the next month as more people who have been infected with the bacteria begin to develop symptoms, health officials said on Wednesday.

To date, 13 people have died and 72 people have been infected in the outbreak in 18 states, including two pregnant women, according to the U.S. Centers for Disease Control and Prevention.

Unlike E. coli and salmonella, two common causes of foodborne disease, listeria bacteria can cause illness as long as two months after a person has consumed contaminated food, making these outbreaks especially vexing.

That’s pretty scary. Thirteen people have already died, but since it can take so long to get sick after eating the bad cantaloupes, the doctors think there will still be people getting sick from them for another month. And even though they’ve stopped letting the farm in Colorado where they came from ship out more bad stuff, the germs that make you sick can even grow in the refrigerator, so if there are still bad cantaloupes in peoples’ refrigerators, they are getting even more dangerous every day.

Now when Mommy tries to get me to eat cantaloupe, I can just tell her I don’t want to die. I wonder if the same germs grow on lima beans…

Oh, one more thing. Why is everybody in Boston crying today? None of the bad cantaloupes are there, but everyone in Boston suddenly got really sad late last night.

Late Night FDL: Pouting Baby Says “The Sky is Falling Tomorrow!”

"The sky is falling tomorrow!" (photo courtesy of Jim White)

Pouting Baby is talking to us again. — JW

My Mommy used to read me the story of Chicken Little. I was always sad that nobody believed Chicken Little when she told them the sky was falling. Well, it turns out that she would be right about the sky falling tomorrow, because a great big thing the size of a school bus is going to fall out of the sky:

On Friday (Sept. 23), a dead NASA satellite the size of a school bus is expected to enter the atmosphere, break into pieces and rain down upon Earth. Though space agency officials don’t yet know where the chunks (some weighing as much as 300 pounds) will hit and haven’t narrowed down exactly where, they say the chances of the falling space debris striking a person are extremely small.

But I guess we shouldn’t worry that the sky will fall on one of us. The story says that the chunks won’t be falling on North America. And smart people tell us that people don’t have much to worry about:

According to Mark Matney, a scientist in the Orbital Debris Program Office at NASA’s Johnson Space Center in Houston, the odds that any of the 7 billion people on Earth will be struck by a piece of the soon-to-fall satellite is 1 in 3,200. “The odds that you will be hit … are 1 in several trillion,” Matney said. “So, quite low for any particular person.”

With all the other bad stuff that has been happening, the stock market crash, Georgia murdering Troy Davis and Mr. 0 keeping the wars going, I guess we shouldn’t be surprised that the sky really is falling this time. You probably won’t get hit by any of the pieces, but just to be on the safe side, don’t look up if you are outside tomorrow.

Late Night FDL: Pouting Baby Asks “Why Did the Prime Mister Forget about Egypt?”

"Why did the Prime Mister forget about Egypt?" (photo courtesy of Jim White)

Pouting Baby is talking to us again.  —  JW

Remember when Hoser Mubarak sent his thugs out to kill protesters and shut down the internet in Egypt?  Mr. 0 and the Prime Mister didn’t like that at all:

“The Prime Minister and President Obama were united in their view that Egypt now needed a comprehensive process of political reform, with an orderly, Egyptian-led transition leading to a government that responded to the grievances of the Egyptian people and to their aspirations for a democratic future,” a spokesperson for Mr Cameron said.

/snip/

“The Prime Minister and the President agreed that the Egyptian Government must respond peacefully to the ongoing protests.

/snip/

Mr Cameron also criticised Egyptian efforts to block access to the internet and called for the bar to be lifted.

The Prime Mister said those things at the end of January of this year, but it looks like he’s forgotten about what happened in Egypt, because today he’s saying very different things about the protesters in England. It sounds like he wants to fight them:

Earlier, as he left a meeting of the government’s emergency committee Cobra, he said every contingency was being looked at and “nothing is off the table” in providing police with the resources needed to tackle the disturbance.

Police would get whatever resources they needed, and legal backing for whatever tactics they needed to employ. “We needed a fightback and a fightback is under way.”

That’s just so different from what he said about Egypt. Just a couple of days after he and Mr. 0 had their statement above, the Prime Mister said this by himself: (more…)

Late Night: Pouting Baby Asks “Aren’t You Glad Your Social Security Isn’t in a Private Account?”

"Aren't you glad your Social Security isn't in a private account?" (photo courtesy of Jim White)

Pouting Baby is back and talking to us again. — JW

Today was an ugly day. Lots of people lost a lot of money in what they call stocks. Remember when Little Georgie B wanted to get rid of Social Security and replace it with private stock investments? That would have been a really bad idea today.

Here is how Reuters described the stock market today:

Investors fled Wall Street in the worst stock-market selloff since the middle of the financial crisis in early 2009 in what has turned into a full-fledged correction.

The Dow and the S&P tumbled more than 4 percent on Thursday and the Nasdaq lost 5 percent on fear the United States is staring at another recession and that Europe’s sovereign debt crisis is swallowing two of its largest economies.

But it looks like the crash isn’t over:

Analysts predicted further losses even though stocks have fallen on nine of the last 10 days.

Now just imagine if your Social Security funds were invested in that same stock market that is crashing for the second time in less than three years.

Here’s what Little Georgie B said when he tried to tell us private Social Security accounts would be a good thing, way back in 2001:

. . . Social Security reform must offer personal savings accounts to younger workers who want them. Today, young workers who pay into Social Security might as well be saving their money in their mattresses. That’s how low the return is on their contributions. And the return will only decline further — maybe even below zero — if we do not proceed with reform.

Personal savings accounts will transform Social Security from a government IOU into personal property and real assets; property that workers will own in their own names and that they can pass along to their children. Ownership, independence, access to wealth should not be the privilege of a few. They’re the hope of every American, and we must make them the foundation of Social Security.

I wonder what Little Georgie B has in his mattress today. Because I think even someone as dumb as Little Georgie B knows that the stock market isn’t the place to put somebody’s Social Security money. But I don’t use a mattress for things I want to keep safe. I give them to my Mommy. Too bad lots of older mommies lost money today, too. Even if their Social Security wasn’t in stocks, some of them had other retirement money in stocks that lost a lot of money today.