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The Ebola/Zika/Other [Infectious Diseases] Thread
Mayabird
Pecking at the keyboardRegistered User regular
Pecking at the keyboardRegistered User regular
Edit: 2/6/16 Zika discussion begins on page 44
We've all been talking about this everywhere else so I figured I should get together a centralized thread for it.
What is Ebola?
Ebola hemorrhagic fever is caused by a virus that infects primates. It is spread through contact with fluids from another infected individual, such as blood, sweat, feces, and semen. The incubation period can be between 2-21 days, but is usually a little over a week from infection to the appearance of symptoms. Symptoms start rapidly and often appear flulike - high fever, headaches, fatigue, muscle pains. Vomiting and diarrhea are also common, as are rashes and also bleeding, internal and from mucus membranes; it's called a hemorrhagic fever for a reason. Vomit and stools can often become bloody as well. This is not a pleasant disease. Fatality rates have been as high as 90% in some outbreaks. In the current outbreak, it appears to be approximately 50-60%, but accurate overall statistics are hard to come by. I'll get into this later.
EDIT: From reports as of 23 September, Case Fatality Rates is approximately 71% in this epidemic.
Fruit bats are believed to be the reservoir for the virus, as they can be infected without showing symptoms, unlike great apes like chimpanzees and gorillas, who also have extremely high fatality rates upon infection. It apparently jumps from bats to humans when people eat the bats. More on this later as well.
A brief history of Ebola
The very first case/first outbreak of Ebola was in 1976 in a village in what's now the Democratic Republic of the Congo. Of 318 people infected, 280 died. The virus was named after the nearby Ebola River, That same year, there was another outbreak in Sudan - 284 infected, 151 dead. Three years later, at the same site in Sudan there was another tiny outbreak, and then aside from some laboratory exposure the virus didn't bother anybody until 1994, after which outbreaks occurred every year or two. Until now, all the outbreaks have either occurred in central Africa or were connected to an outbreak in central Africa.
The current epidemic and where it's striking
The current epidemic of Ebola is the largest outbreak and first real epidemic in history. It's striking in three countries currently:
Guinea
Population 11.5 million. The outbreak began here in December 2013, with the first known cases being a 2 year old boy who died, followed soon by the deaths of his sister, mother, and grandmother. By May it had spread to the capital Conakry, the country's largest city (population of 2 million) and center of its economy.
Sierra Leone
Population 6 million. Its capital and largest city Freetown has 1.2 million people; it was founded as a colony for freed slaves by the British. A civil war was fought here between 1991 and 2002; anywhere between 50,000-300,000 were killed and 2.5 million people (almost half the population) became refugees.
Liberia
Population 4 million. Liberia was founded by freed slaves from the United States; its capital and largest city Monrovia (current population 1 million or so) was named after James Monroe. It suffered not just one but two successive civil wars, from 1989 to 1997, and then 1999-2003. Somewhere between 250-500,000 died in these wars.
All three countries are rich in natural resources and desperately, terribly impoverished. Illiteracy, malnutrition, lack of clean water and medical facilities, overcrowded slums, etc etc, if it's terrible they have it. Now they also have Ebola. By March 2014 it had spread to Liberia, and by May it was in Sierra Leone. It was first reported in Freetown in July.
There was also a small outbreak in fatalities in Nigeria due to an official who flew from Liberia to Lagos (most populous city of Nigeria and Africa, at 21 million) and died soon after arrival at the airport. The doctor and nurse who treated him died, but due to rapid and effective quarantining of all the people he had come in contact with it is believed to be contained.
UPDATE 4 SEPT: Or maybe not anymore.
UPDATE: 20 OCT Actually, that did get stopped, so yay.
As of August 22nd:
As of September 23rd: 6,574 reported cases and 3,043 reported deaths.
Mind you, this is not an accurate count at all. This is the best we have but it's known to be underreported. The World Health Organization has uncovered widespread evidence of people hiding relatives who have symptoms of Ebola and secret funerals. There is a great distrust of authority (see: three civil wars) so for instance, President Ellen Johnson Sirleaf of Liberia making it a crime to hide people suspected of having Ebola just made more people hide it all the more.
Previous outbreaks typically struck small isolated villages, quickly went through the limited population, and then burned out from lack of new victims. While the same factors (poverty, funerary practices, distrust of authority including attacking health care workers) were in play, the isolation of these areas acted as a kind of effective quarantine, preventing it from spreading outwards. Ebola's rapid progression to death ironically kept it from getting any worse. Unlike, say HIV, where someone can be asymptomatic but infectious for upwards of ten years, Ebola patients are only infectious when symptoms are showing and if they don't make it, for a period of time after they die. However now for the first time, the virus has spread to major cities, cities crammed with slums, slums crammed with people who lack any facilities for basic hygiene. For these reasons, Doctors Without Borders/Médecins Sans Frontières has stated that the current outbreak is "totally out of control."
What's the deal with the funeral practices? I always hear about this.
Funeral practices in many of these areas consist of a LOT of handling of the bodies. Hand-washing and hair-braiding or whatever by the relatives to prepare the body for the funeral, and then often handling of the body including touching and kissing during the funeral. Big families mean lots of people going to the funerals, so one funeral can lead to 20 or more new infections.
Because bodies can stay infectious for days, standard practices for a patient who dies is to dispose of the corpse as rapidly as possible, cremation or bagging followed by rapid burial. Since this flies in the face of all the cultural/religious practices of people there it tends to cause a lot of anger and resentment, and has on several occasions in the past lead to crowds murdering doctors and nurses who were only trying to keep everybody else from dying.
It seems to be getting pretty crazy.
Remember that the biggest dumbass on the internet, one who's been educated on TV and barely literate comment sections and has a brain full of lies and deceptions, still has learned more about Ebola than a good portion of the people who are being affected right now. “OH GOD EBOLA BLOOD DEATH GET AWAY FROM THE BODY TOUCH AND YOU DIE AAAAAH!” is more knowledge about it than an illiterate slum dweller whose family fled from their home village years ago. What do they see? Someone gets sick, goes to the hospital, and the hospital isolates them until they die. More and more people go in, and more often than not they don't come back out, and then they're not even allowed to bury their loved ones properly. They don't know what's happening or why, there are often language barriers, there's no trustworthy news so people fall back on rumors. Evil government people killing folks, or magic, or who knows what else the rumor mill comes up with.
Even if people do have knowledge about it, though, there's often not much that can be done. During Liberia's civil wars, 95% of the health care facilities were destroyed. Hospitals, clinics, pretty much everything. Many of the known cases and fatalities of Ebola are from doctors and nurses who were treating other Ebola patients and became infected themselves. They often lack such basic medical equipment as gloves. At some hospitals, nurses have gone on strike until they can get something, anything to protect themselves, because otherwise treating Ebola patients is a death sentence. This is leading to secondary medical issues such as people dying from other, more common and treatable diseases like malaria because no one remains to treat them or the incredibly limited medical facilities are already swamped.
I'm going to be that hipster jerk who comes in the thread and berates people all smugly about being upset about this disease when others kill way more people every year.
Screw you too buddy, and there's a reason why this disease causes more fear than others that kill more: one of the deepest and most primeval human fears is fear of the unknown, and Ebola is a disease that we don't know much about. We're pretty sure now that fruit bats are the reservoir, but we're not entirely sure and we only got this hypothesis in the last few years. We don't have a known good treatment or cure. “Keep them hydrated and they kinda seem to have a slightly better chance of survival” and “we whipped this serum thingy together and think it probably should work; at least we really hope so” don't exactly inspire confidence.
Yes, childhood diarrhea kills 800,000 children a year and this is an absolute travesty but we know damn well how to treat it – oral rehydration therapy is a fairly simple mixture of clean water, sugar, and salt that you feed to someone to keep them from dying of dehydration and replace electrolytes. There's a formula to it. Any of us could whip it together in a few minutes. That there are still 800,000 deaths a year is due to other crappier elements of the human condition like apathy and laziness, but these don't inspire fear (though should inspire some righteous indignation and action). A disease that strikes suddenly, hits everybody, kills over half of them within a week, and oh god some of them look like they're bleeding out their eyes, and there's jack all we can do – that scares people.
So please keep the self-righteous crap out and instead go donate to Doctors Without Borders and be smug about that instead. Or just donate anyway. Thanks.
Wait...wait...are you saying we should be panicking about this?
No of course not. Unless you're living in West Africa right now or you hunt and eat fruit bats in Bangladesh (fruit bats have been found with Ebola antibodies in Bangladesh, so seriously, if you do you should stop), you'll be fine. If you don't make direct physical contact with someone showing symptoms of Ebola or body fluids from them, you won't get infected. It's not spread through the water or the air or non-bush-meat food. The virus's mutation rate is about 100 times less than that of flu, so it's not going to rapidly evolve into some even deadlier ultra-hyper-virulent teleporting disease. Quarantines are highly effective because it prevents further physical contact. Even the likes of Nigeria, which isn't exactly considered a pinnacle of first world nations, was able to contain two outbreaks before it really was able to happen.
I think this OP is long enough now. Discuss.
Edit 28 Sept: updated some information.
Edit 6 Nov: Eh, let's go ahead and talk whatever other infectious diseases too.
We've all been talking about this everywhere else so I figured I should get together a centralized thread for it.
What is Ebola?
Ebola hemorrhagic fever is caused by a virus that infects primates. It is spread through contact with fluids from another infected individual, such as blood, sweat, feces, and semen. The incubation period can be between 2-21 days, but is usually a little over a week from infection to the appearance of symptoms. Symptoms start rapidly and often appear flulike - high fever, headaches, fatigue, muscle pains. Vomiting and diarrhea are also common, as are rashes and also bleeding, internal and from mucus membranes; it's called a hemorrhagic fever for a reason. Vomit and stools can often become bloody as well. This is not a pleasant disease. Fatality rates have been as high as 90% in some outbreaks. In the current outbreak, it appears to be approximately 50-60%, but accurate overall statistics are hard to come by. I'll get into this later.
EDIT: From reports as of 23 September, Case Fatality Rates is approximately 71% in this epidemic.
Fruit bats are believed to be the reservoir for the virus, as they can be infected without showing symptoms, unlike great apes like chimpanzees and gorillas, who also have extremely high fatality rates upon infection. It apparently jumps from bats to humans when people eat the bats. More on this later as well.
A brief history of Ebola
The very first case/first outbreak of Ebola was in 1976 in a village in what's now the Democratic Republic of the Congo. Of 318 people infected, 280 died. The virus was named after the nearby Ebola River, That same year, there was another outbreak in Sudan - 284 infected, 151 dead. Three years later, at the same site in Sudan there was another tiny outbreak, and then aside from some laboratory exposure the virus didn't bother anybody until 1994, after which outbreaks occurred every year or two. Until now, all the outbreaks have either occurred in central Africa or were connected to an outbreak in central Africa.
The current epidemic and where it's striking
The current epidemic of Ebola is the largest outbreak and first real epidemic in history. It's striking in three countries currently:
Guinea
Population 11.5 million. The outbreak began here in December 2013, with the first known cases being a 2 year old boy who died, followed soon by the deaths of his sister, mother, and grandmother. By May it had spread to the capital Conakry, the country's largest city (population of 2 million) and center of its economy.
Sierra Leone
Population 6 million. Its capital and largest city Freetown has 1.2 million people; it was founded as a colony for freed slaves by the British. A civil war was fought here between 1991 and 2002; anywhere between 50,000-300,000 were killed and 2.5 million people (almost half the population) became refugees.
Liberia
Population 4 million. Liberia was founded by freed slaves from the United States; its capital and largest city Monrovia (current population 1 million or so) was named after James Monroe. It suffered not just one but two successive civil wars, from 1989 to 1997, and then 1999-2003. Somewhere between 250-500,000 died in these wars.
All three countries are rich in natural resources and desperately, terribly impoverished. Illiteracy, malnutrition, lack of clean water and medical facilities, overcrowded slums, etc etc, if it's terrible they have it. Now they also have Ebola. By March 2014 it had spread to Liberia, and by May it was in Sierra Leone. It was first reported in Freetown in July.
There was also a small outbreak in fatalities in Nigeria due to an official who flew from Liberia to Lagos (most populous city of Nigeria and Africa, at 21 million) and died soon after arrival at the airport. The doctor and nurse who treated him died, but due to rapid and effective quarantining of all the people he had come in contact with it is believed to be contained.
UPDATE 4 SEPT: Or maybe not anymore.
UPDATE: 20 OCT Actually, that did get stopped, so yay.
As of August 22nd:
CDC website wrote:The World Health Organization, in partnership with the Ministries of Health in Guinea, Sierra Leone, Liberia, and Nigeria reported 2615 suspect and confirmed cases of EVD [Ebola Virus Disease], including 1528 laboratory-confirmed cases, and 1427 deaths
As of September 23rd: 6,574 reported cases and 3,043 reported deaths.
Mind you, this is not an accurate count at all. This is the best we have but it's known to be underreported. The World Health Organization has uncovered widespread evidence of people hiding relatives who have symptoms of Ebola and secret funerals. There is a great distrust of authority (see: three civil wars) so for instance, President Ellen Johnson Sirleaf of Liberia making it a crime to hide people suspected of having Ebola just made more people hide it all the more.
Previous outbreaks typically struck small isolated villages, quickly went through the limited population, and then burned out from lack of new victims. While the same factors (poverty, funerary practices, distrust of authority including attacking health care workers) were in play, the isolation of these areas acted as a kind of effective quarantine, preventing it from spreading outwards. Ebola's rapid progression to death ironically kept it from getting any worse. Unlike, say HIV, where someone can be asymptomatic but infectious for upwards of ten years, Ebola patients are only infectious when symptoms are showing and if they don't make it, for a period of time after they die. However now for the first time, the virus has spread to major cities, cities crammed with slums, slums crammed with people who lack any facilities for basic hygiene. For these reasons, Doctors Without Borders/Médecins Sans Frontières has stated that the current outbreak is "totally out of control."
What's the deal with the funeral practices? I always hear about this.
Funeral practices in many of these areas consist of a LOT of handling of the bodies. Hand-washing and hair-braiding or whatever by the relatives to prepare the body for the funeral, and then often handling of the body including touching and kissing during the funeral. Big families mean lots of people going to the funerals, so one funeral can lead to 20 or more new infections.
Because bodies can stay infectious for days, standard practices for a patient who dies is to dispose of the corpse as rapidly as possible, cremation or bagging followed by rapid burial. Since this flies in the face of all the cultural/religious practices of people there it tends to cause a lot of anger and resentment, and has on several occasions in the past lead to crowds murdering doctors and nurses who were only trying to keep everybody else from dying.
It seems to be getting pretty crazy.
Remember that the biggest dumbass on the internet, one who's been educated on TV and barely literate comment sections and has a brain full of lies and deceptions, still has learned more about Ebola than a good portion of the people who are being affected right now. “OH GOD EBOLA BLOOD DEATH GET AWAY FROM THE BODY TOUCH AND YOU DIE AAAAAH!” is more knowledge about it than an illiterate slum dweller whose family fled from their home village years ago. What do they see? Someone gets sick, goes to the hospital, and the hospital isolates them until they die. More and more people go in, and more often than not they don't come back out, and then they're not even allowed to bury their loved ones properly. They don't know what's happening or why, there are often language barriers, there's no trustworthy news so people fall back on rumors. Evil government people killing folks, or magic, or who knows what else the rumor mill comes up with.
Even if people do have knowledge about it, though, there's often not much that can be done. During Liberia's civil wars, 95% of the health care facilities were destroyed. Hospitals, clinics, pretty much everything. Many of the known cases and fatalities of Ebola are from doctors and nurses who were treating other Ebola patients and became infected themselves. They often lack such basic medical equipment as gloves. At some hospitals, nurses have gone on strike until they can get something, anything to protect themselves, because otherwise treating Ebola patients is a death sentence. This is leading to secondary medical issues such as people dying from other, more common and treatable diseases like malaria because no one remains to treat them or the incredibly limited medical facilities are already swamped.
I'm going to be that hipster jerk who comes in the thread and berates people all smugly about being upset about this disease when others kill way more people every year.
Screw you too buddy, and there's a reason why this disease causes more fear than others that kill more: one of the deepest and most primeval human fears is fear of the unknown, and Ebola is a disease that we don't know much about. We're pretty sure now that fruit bats are the reservoir, but we're not entirely sure and we only got this hypothesis in the last few years. We don't have a known good treatment or cure. “Keep them hydrated and they kinda seem to have a slightly better chance of survival” and “we whipped this serum thingy together and think it probably should work; at least we really hope so” don't exactly inspire confidence.
Yes, childhood diarrhea kills 800,000 children a year and this is an absolute travesty but we know damn well how to treat it – oral rehydration therapy is a fairly simple mixture of clean water, sugar, and salt that you feed to someone to keep them from dying of dehydration and replace electrolytes. There's a formula to it. Any of us could whip it together in a few minutes. That there are still 800,000 deaths a year is due to other crappier elements of the human condition like apathy and laziness, but these don't inspire fear (though should inspire some righteous indignation and action). A disease that strikes suddenly, hits everybody, kills over half of them within a week, and oh god some of them look like they're bleeding out their eyes, and there's jack all we can do – that scares people.
So please keep the self-righteous crap out and instead go donate to Doctors Without Borders and be smug about that instead. Or just donate anyway. Thanks.
Wait...wait...are you saying we should be panicking about this?
No of course not. Unless you're living in West Africa right now or you hunt and eat fruit bats in Bangladesh (fruit bats have been found with Ebola antibodies in Bangladesh, so seriously, if you do you should stop), you'll be fine. If you don't make direct physical contact with someone showing symptoms of Ebola or body fluids from them, you won't get infected. It's not spread through the water or the air or non-bush-meat food. The virus's mutation rate is about 100 times less than that of flu, so it's not going to rapidly evolve into some even deadlier ultra-hyper-virulent teleporting disease. Quarantines are highly effective because it prevents further physical contact. Even the likes of Nigeria, which isn't exactly considered a pinnacle of first world nations, was able to contain two outbreaks before it really was able to happen.
I think this OP is long enough now. Discuss.
Edit 28 Sept: updated some information.
Edit 6 Nov: Eh, let's go ahead and talk whatever other infectious diseases too.
Mayabird on
+16
Posts
That said...
Medical personnel in the outbreak areas take an awful risk. Needle stick, or even a few crystals of virus particles to the eyes from a wayward cough containing just enough droplets, and so on. Which is why I'm so in awe of the volunteers at Medecins sans Frontieres and other groups sending help to the overwhelmed doctors in affected areas. Too many have been lost already in the fight to contain this, and I'm glad there's at least an experimental treatment now in ZMapp (which sounds totally like something made-up like Zombrex) to give them a fighting chance if they 'fall' in battle.
Illicit global trade in live specimens of the animals in question is likely to be a much bigger problem than bushmeat, outside of the areas where primates are actively hunted for meat, that is. The last documented occasion where any Ebola strain gained a foothold in the US, it was in a monkey house in Reston, VA. Rather alarmingly, it appeared to be airborne, but it also didn't seem to be harmful to humans, despite being absolutely lethal to the monkeys. It's hard to tell just how subsequent bans on various types of testing on primates have affected our vulnerability to infectious diseases that can cross over from simians, so I'll leave that to future historians.
The center was stuck in what's sometimes described as a neighborhood, sometimes slum, often both, called West Point. It's on a beach and bordered by a river. I've seen population estimates for it anywhere between 50-100,000.
Some reports say that people were resentful that people diagnosed with Ebola were being sent from all over the capital to their neighborhood. Some reports say that people were angry that their relatives were being sent there. This wasn't exactly a hospital - supposedly people had to bring their relatives food themselves, that it was basically a dumping ground to keep the sick separate until they died. Probably a lot of other things too, plus there are the always usual rumors and fears and, frankly, stupid assholes. Three people had been physically carried off by their families the previous night. And then a mob formed, some of them chanting that there was no such thing as Ebola, and just attacked the place. Seventeen more people fled into the slum and the place was looted. People were carrying off blood-soaked sheets and mattresses.
So all of West Point was locked down in quarantine. Nobody gets out; it's surrounded by razor wire, patrol boats, and armed riot police. The World Food Programme said it would be delivering rations for 24,000 people, but even if the low end population estimate is correct that won't even cover half the people in there. There has been some limited food and water distribution, and also rioting, since everyone there is caught in a death trap. Honestly, I really can't help but think that it looks like they're being left in there to die, effectively being written off to try to maybe save the other million or so people in the city.
It's been a little over a week, and with the typical incubation period about 8-9 days, those people who physically carried off their infected relatives and blood-soaked sheets will be starting to get sick and infectious themselves right about now.
That's pretty much what it is, yeah, but at this point I don't see a better option so I can't really disagree with the plan.
In some ways it refreshing to see a government actually responding to the situation strongly.
Like with the whole funeral rights stuff. I can't imagine in the US that situation not being resolved via a bunch of cops/soldiers with with assault rifles at every hospital.
also this quote from the article.
With some of this stuff it is hard not to go "welp fuck it Darwin Award winners the lot of you".
They're not stealing blood-stained ebola-infected sheets because they're dumb jerks, and it isn't funny that they're going to die horribly.
So, part of me facepalms the looting, and other disease-spreading things they're doing, but the other part of me understands why they're doing it.
WoW
Dear Satan.....
Rereading the "outbreak" chapters of World War Z, they feel a lot more realistic now that local reaction to the Ebola outbreak has been surprisingly similar in some cases.
And a tremendous lack of education. Which is part of the deprivation thing.
Yeah, I have been watching this thing and it feel like, like that old quote,
"This the way the world ends, not with a bang but a whimper"
Or when the world ends. Probably the latter.
The strain in West Africa is supposed to be the same one that hits in the DRC though so I don't know how they'd be able to tell the difference.
Shitty Tumblr:lighthouse1138.tumblr.com
Reliable? No. That's one reason why there's a 50-90% mortality rate, depending on strain.
There's the new unlicensed treatment that might help shorten the course and severity of the disease if taken soon enough. But otherwise no, nothing at all beyond keeping you hydrated while you leak fluids from every orifice and hoping for the best.
It's eminently containable with simple practices. You aren't infectious until clearly ill and it only spreads by direct contact. It's a disease of poverty and ignorance which makes the whole situation that much more horrific. 99% of the fault for the spread lies not with the poor buggers getting the disease but the societal issues that have put them in the vulnerable situation they are in.
http://www.bbc.co.uk/news/magazine-28262541
It gives an interesting look into the methods used to try and control an unknown (at the time) disease.
Pretty much anything that will help you recover from the flu will help with ebola, but since nothing really helps that much with getting over the flu nothing helps that much with Ebola.
soundcloud link:
It's real (Ebola is here)
It's time to protect yourself(Ebola is here)
Protect your family(Ebola is here)
Protect your community(Ebola is here)
It's not a kid's book in the slightest, you just tend to grow up with a weird taste in reading material when your dad is a hospital lab tech and your mom used to do help do animal experimentation for the military.
Not a kid's book?
I read that book when I when in grade 7.
I may have been a bit of a weird kid.
Well, some of those religions with a mandate of cleanliness also prescribe the ritual washing of the body prior to burial, and I'm going to go out on a limb here and guess that in developing countries that generally means by hand, whether it's specifically called for or not.
And of course, regardless of one's belief system, it's a tall order to ask people to essentially shun the remains of their loved ones.
Speaking of bad information, according to the Christian Science Monitor four people have died from consuming large amounts of salt water to supposedly prevent Ebola. Four people died from Ebola in Nigeria; misinformation has killed as many as the disease.
At least by today's standards. It's not exactly shy about talking about how people's internals liquify and pour out of your every available orifice. I thought it was god damn neat, but, yanno, parents these days.
Virus Hunter sounds pretty cool, I'll have to get a copy and then send it to my parents.
To play devil's advocate,
not all ebolas
the "no true scotch man" fallacy.
I am in favor of rivers named Ebola.
Against viruses named Ebola.
So how about Canada donating experimental vaccine to affected areas in Africa?
If only we had some kind of man bat to test on.
But that's a really interesting question, I don't suppose we have any Ebolas in the audience that might want to lend a theory?
That shit got intentional weaponized. Erugh.
There was also rioting in Guinea after a rumor started going around that Red Cross workers there had for some reason deliberately sprayed markets with Ebola to make everyone sick, as if it wasn't bad enough that nearly 10% of the known cases and deaths have been health care workers.
Human trials of an Ebola vaccine could be starting as early as this month.
I saw mention from a few days ago that the quarantine on the West Point neighborhood/slum was being raised, but I've found no confirmation that it had actually happened or when it might happen.