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Old 10-16-2014, 10:09 AM   #261
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The Dallas County DA, who was going to charge Duncan for crimes, should consider charging this nurse if anyone else gets Ebola from her.

She should have been a professional and stayed home.
They should charge everyone infected with Ebola. Then they wouldn't be so darn careless endangering OUR lives.
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Old 10-16-2014, 10:21 AM   #262
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They should charge everyone infected with Ebola. Then they wouldn't be so darn careless endangering OUR lives.
She probably had a non-refundable ticket and Frontier wouldn't let her reschedule. If that was the case, they are probably kicking themselves now. I can see it now. The recorded conversation of the nurse telling the customer no-service agent that she's under observation for ebola. The agent says that no exceptions can be made. The rest is history. Just a WAG.
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Old 10-16-2014, 10:45 AM   #263
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The fact that this is not an airborne disease makes that unlikely IMHO, but Public awareness will be a major key.

One of the more interesting facts that is being generally ignored by the media scaremongers, is that the transmission history is that one person (historically) infects one or two others. The image of spreading infection is most commonly described by images of "Typhoid Mary". Not likely.

My two cents.
Let's examine what you mean by not an airborne disease. This disease will spread through the air via small droplets from, say, a sneeze for instance. In this regard the disease is very similar to the influenza virus, or the common cold. The reason that a sneeze of an ebola affected patient will contain the virus is because once the patient become significantly full of the virus, then the patient's cells begin to break down and the virus is released from the cells that are breaking down.

As for the Typhoid Mary scenario, I think there is reason to worry there as well. For instance let's say a person with an ebola fever comes into an emergency room and sneezes into their hand and uses the doorknob or a magazine in the waiting room. Then someone else in the emergency room picks up that magazine or uses that door knob. That person may not infect themselves by rubbing their eye or putting their fingers in their mouth but What if that person that has the virus on their hands but is not infected touches a toy in the waiting room that ends up in a child's mouth? So there might be a person, in that previous example, that transmits the virus yet never has the virus in their system.
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Old 10-16-2014, 11:00 AM   #264
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They should charge everyone infected with Ebola. Then they wouldn't be so darn careless endangering OUR lives.
+1

Ridiculous statement that the nurse should be arrested or criminally pursued. There are many screwups going on. But I don't see the nurses at fault for doing what they were told was safe by both the hospitals and the CDC. If anything, the nurses probably have a good suit against the hospitals and CDC. That is...IF THEY LIVE.

Strange the rush to blame the little guy (gal).

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Old 10-16-2014, 11:02 AM   #265
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Let's examine what you mean by not an airborne disease. This disease will spread through the air via small droplets from, say, a sneeze for instance. In this regard the disease is very similar to the influenza virus, or the common cold. The reason that a sneeze of an ebola affected patient will contain the virus is because once the patient become significantly full of the virus, then the patient's cells begin to break down and the virus is released from the cells that are breaking down.

As for the Typhoid Mary scenario, I think there is reason to worry there as well. For instance let's say a person with an ebola fever comes into an emergency room and sneezes into their hand and uses the doorknob or a magazine in the waiting room. Then someone else in the emergency room picks up that magazine or uses that door knob. That person may not infect themselves by rubbing their eye or putting their fingers in their mouth but What if that person that has the virus on their hands but is not infected touches a toy in the waiting room that ends up in a child's mouth? So there might be a person, in that previous example, that transmits the virus yet never has the virus in their system.
[my bolding]Not sure about the bolded part...several websites state ebola can be transmitted via eyes or mouth.

Or are you saying that the virus would not be on the doorknob or magazine from an ebola infected person who sneezes then touches those objects
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Old 10-16-2014, 11:08 AM   #266
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The person in charge of infection control at the Dallas hospital should be replaced immediately with someone who knows their stuff. Can you imagine sending an suspected Ebola patient's blood sample through the hospitals' pneumatic tube delivery system?

It seems to me that major hospitals can have 3-5 hazmat suits in inventory for immediate use where Ebola is suspected, borrow more from facilities nearby and backfill from a central warehouse. Each major hospital should have a plan for just such an emergency. They don't need to train every nurse how to care for such a patient but they should have a cadre of 20 (some will be on vacation or otherwise unavailable) trained and prepared to respond. These caregivers should be paid a premium when they are delivering care to such a patient.

The nurse's association statement claims that the two infected nurses cared for Duncan before Ebola was fully diagnosed and cared for other patients concurrently. They wore normal hospital scrubs. Nurses group slams Dallas hospital for sloppy Ebola care
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Old 10-16-2014, 11:21 AM   #267
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+1

Strange the rush to blame the little guy (gal).
Have you ever seen the movie "The Paths of Glory"? Very good. And, IMHO, all to often what happens in real life when the Big Boys and Girls screw up.
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Old 10-16-2014, 11:22 AM   #268
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[my bolding]Not sure about the bolded part...several websites state ebola can be transmitted via eyes or mouth.

Or are you saying that the virus would not be on the doorknob or magazine from an ebola infected person who sneezes then touches those objects
From what I understand, the virus can be transmitted if absorbed through any mucus membrane. But what I was getting at in the bolded portion, was that an uninfected person could have the virus on their skin (only) and transmit the virus to an object and that object could infect someone else. So in other words the person with the virus on their skin could possibly remain uninfected , but could be a transmitter of the virus by simply moving a bodily fluid from an infected person to a third person. Not really a Typhoid Mary scenario, but it would make tracing the virus transmission more challenging, since the intermediate person was never infected ( only transmitted the virus on the outside of the body).
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Old 10-16-2014, 11:28 AM   #269
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Excerpt from the CDC on transmission:
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Because the natural reservoir host of Ebola viruses has not yet been identified, the manner in which the virus first appears in a human at the start of an outbreak is unknown. However, researchers believe that the first patient becomes infected through contact with an infected animal.

When an infection does occur in humans, the virus can be spread in several ways to others. Ebola is spread through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with
- blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola
-objects (like needles and syringes) that have been contaminated with the virus
-infected animals
Ebola is not spread through the air or by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. There is no evidence that mosquitos or other insects can transmit Ebola virus. Only mammals (for example, humans, bats, monkeys, and apes) have shown the ability to become infected with and spread Ebola virus.
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Old 10-16-2014, 11:34 AM   #270
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From what I understand, the virus can be transmitted if absorbed through any mucus membrane. But what I was getting at in the bolded portion, was that an uninfected person could have the virus on their skin (only) and transmit the virus to an object and that object could infect someone else. So in other words the person with the virus on their skin could possibly remain uninfected , but could be a transmitter of the virus by simply moving a bodily fluid from an infected person to a third person. Not really a Typhoid Mary scenario, but it would make tracing the virus transmission more challenging, since the intermediate person was never infected ( only transmitted the virus on the outside of the body).
Here's the website I found on how it can be transmitted
How Ebola spreads

From this, I read it that it would be possible for an infected person to sneeze or cough directly on or via covering with their hands and then touch some object, such as a doorknob or magazine, then as long as that object is still 'wet' (cuz according to the above link, once dry the virus 'dies') - someone else could then touch that object and infect themselves if they rub their eyes or put their fingers in their mouth.

That is what makes the thought of future air travel so worriesome...for me, at least.

Of all the objects touched as you make your way thru an airport or on a plane, the virus could have been laid down by someone infected and still 'alive' when you touch it.

Then, all it takes is a touch to your own eye, wipe your mouth and you've got it to.

(I must sound like Felix Unger......still....)
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Old 10-16-2014, 11:36 AM   #271
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Excerpt from the CDC on transmission:
It's unfortunate the way transmission is described when it comes to the quote "not spread through the air". Neither is influenza "spread through the air" but we don't want someone with influenza coughing on us and then having droplets with the virus enter our lungs. If I am wrong about this, I would be super grateful. Unfortunately though, I don't think I'm wrong.
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Old 10-16-2014, 11:37 AM   #272
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While not in the medical field, so much of this reminds me of disaster recovery exercises in IT. The first tests always failed, regardless of the amount of thought that was invested. Management was content to look the other way, as it was just a test.

The only way recovery was improved, was repeated failures and learning from those failures. Problem is, now we're learning with human lives. I'm sure there were DRs that had concerns, but were told they were just 'doom and gloomers, get a better attitude'.

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Old 10-16-2014, 11:42 AM   #273
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Then, all it takes is a touch to your own eye, wipe your mouth and you've got it to.

(I must sound like Felix Unger......still....)
We ALL could use a bit more Felix when in public!

I agree 100% with your assessment. A tray table even undetectibly coated with cough residue of an infected person gets touched by someone else, and that someone else rubs their eye...that's it...another infection!
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Old 10-16-2014, 12:06 PM   #274
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We ALL could use a bit more Felix when in public!
The trick to avoiding picking up germs in public seems to be:
- keep your hands away from your face. There's no avoiding touching all the surfaces we need to touch with our hands, so they are going to get germy.
- Wash hands frequently (or use a glob of the sanitizer stuff). Because eventually you >will< touch your face, or something that you eat, etc.
- Avoid being near people who are visibly sick. This isn't always possible.
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Old 10-16-2014, 12:16 PM   #275
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I remember the day when ladies wore gloves in public, you took them off to eat. I thought it was a style issue, now I wonder if it was the result of experience with the flu epidemic in my grandmother's day.
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Old 10-16-2014, 12:54 PM   #276
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They should charge everyone infected with Ebola. Then they wouldn't be so darn careless endangering OUR lives.
Maybe that is a solution...

If they are going to let people that have been in very close contact with Ebola victims travel anywhere they want, there is no sense in keeping anyone in any sort of quarantine.

Just let them take their own temperature, and if they think the temperature may be too high, check themselves in to the nearest hospital. When they are ready.

We are not stopping travel, either internally or externally to hot zone countries. We are not actually quarantining people at a central location. The more this gets out of Dallas, the less it even makes sense to monitor people. The US cannot handle 10,000 cases of a fever. And the more it gets out, who knows who is in contact with what.

It may be best to just let the virus take it's course, and work on a vaccine in the background.

Imagine if it ever takes a hold in a close country like Mexico. The health care is not as good as ours, and it would spread much faster.
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Old 10-16-2014, 12:54 PM   #277
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Don't blame the nurse. She actually contacted the CDC prior to her flight. She reported her fever at 99.5. They told her she was clear to fly since it wasn't a 100.5 fever. Per their 'protocol'. Apparently she called the CDC more than once and got the same answer.

The nurses keep getting tossed under the bus. They are the victims.

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Old 10-16-2014, 01:40 PM   #278
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Am watching the congressional hearing on Ebola...
Some of the more aggressive congressmen are suggesting that America should consider shutting down flights from other countries to prevent the spread.

Hmm... considering that there are an estimated 1.5 million flight passengers in a single day this might cause a bit of a problem.

I cannot believe the aggression on the part of some legislators questioning Dr. Frieden. For my money, he's a pretty smart guy. Great self control. If the "gentle lady from Colorado" talked to me like that... wellll.... ummmm....
The gestapo could not have been more overbearing.

Absolutely amazing that we have so many experts on the "panel"... some direct and indirect suggestions...

Stop all flights from Africa until the passenger went through a 21 day isolation period.
Full declarations from each passenger re: their activities during the past 21 days, followed by a lie detector test.
All passengers to wear virus protection while flying.

For people who were coming back from a 36 day vacation, when they could have helped, the congressmen and women were amazingly incisive about that which they had no clue.
Turned my stomach.

Update: Rep Scalise (Louisiana)... answer my questions YES or NO.. did you stop beating your wife?

No politics here... democrats and republicans were both exceedingly rude, and sounded like complete jerks.
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Old 10-16-2014, 02:41 PM   #279
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Sometimes less is more. Pierre Rollin, a CDC Ebola expert who is now reviewing the infection control practices in Dallas, has said that dialysis rarely saves Ebola patients and is contraindicated because it is associated with a very high risk of transmission to staff. Nina and Amber and their colleagues were unknowingly taking this risk. It has not escaped me that they are both in their 20s, low on the totem pole and probably afraid to object.

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Old 10-16-2014, 02:46 PM   #280
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No politics here... democrats and republicans were both exceedingly rude, and sounded like complete jerks.
Election year posturing...
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