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Old 10-18-2014, 12:48 PM   #341
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Until Ebola is brought under control in west Africa there is still the possibility of an infected person arriving in US. That infected person could have unknowingly contracted it in Europe, north or South Africa and not have ever traveled to west Africa
It's a question of degrees of risk. Someone coming directly from an infected area offers a significantly higher risk.
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Old 10-18-2014, 12:50 PM   #342
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did he have contact with any sick individuals
I suspect this question would be completely ineffective. They already did ask if he had any contact with Ebola affected individuals and he said NO. If you broaden the question to ANY sick individuals then either people will just say "no" regardless of who they have been in contact with, or you will get so many "yes" answers that the question is useless.

Every day at work, in an office not a medical setting, I encounter people with colds, sniffles, and other illnesses. I'm not taking their temperatures to know how sick but if you ask me have I been in contact with any sick person in the last week, I have to answer "yes" virtually every day. Imagine if half the travelers say yes, then this question would not be actionable.
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Old 10-18-2014, 12:58 PM   #343
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They already did ask if he had any contact with Ebola affected individuals and he said NO. If you broaden the question to ANY sick individuals then either people will just say "no" regardless of who they have been in contact with, or you will get so many "yes" answers that the question is useless.
I believe that question was asked in Brussels and upon departing Liberia, but nothing was asked when he entered the US. I am sure an improved script of questions can be developed for arrival in the US, but of course the individual could lie. Since the later is a possibility, I am in favor of travel bans for any individuals who originated from west africa.
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Old 10-18-2014, 01:16 PM   #344
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Quarantine Dallas? DS and his wife will have their new baby in Ebola Central USA Divisionthe Dallas Presbyterian Hospital in early spring.
I was born in that hospital myself! I managed not to catch anything.
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Old 10-18-2014, 01:22 PM   #345
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Burleson, Texas is just south of Ft. Worth, Texas. A relative there says they got automate phone calls and this info:

Letter from Burleson Independent School District

October 17, 2014

Dear Burleson ISD Parents and Guardians:

The health and safety of our students and staff is our most important consideration. We work diligently to keep you informed of important matters affecting our schools and district, and we have information to share with you.

It has been well publicized that a second health care worker was diagnosed with the Ebola virus and traveled on a flight from Cleveland to Dallas earlier this week.

District leaders confirmed today that a parent of a Centennial High School student was aboard that flight.

It is important to note that the parent, student and other family members are not exhibiting any symptoms and are not considered contagious. The parent and BISD have been in contact with the Centers for Disease Control and the Texas Department of State Health Services. Officials from these entities have confirmed the parent’s seating location aboard the flight was in a “low-risk” area. The family is following the Texas Department of State Health Services protocols and has chosen to keep the student at home as a precaution.

The family is cooperating entirely with Burleson ISD and other agencies. There are no other family members at any other BISD campus. Additionally, the district is working with the Centers for Disease Control, Texas Department of State Health Services, County Health & Human Services, and city officials from Burleson.

Our local, state and national health officials assure us there is no significant risk of possible transmission of the virus through indirect contact. The Centers for Disease Control has not recommended we perform additional cleaning or implement specific protocols at this time as they assure us this situation is very low risk. In an abundance of caution, district leaders have decided to proactively implement high-level disinfecting of Centennial High School, beginning this evening. BISD is taking additional measures at all campuses including increased cleaning throughout the weekend.
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Old 10-18-2014, 01:40 PM   #346
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For those wishing to impose a travel ban on all people who's flights originate in western Africa... a question:

- Do we allow our troops being deployed over there to return to the US?
- Do we allow journalists covering to return?
- Do we allow medical personel over there to return?
- Do we allow travelers from Nigeria to return - Nigeria was very effective in quarantining, and minimizing the spread - and is now Ebola free.

How long do we keep the travel ban in place?

Do we impose similar travel bans on people from Dallas?
Do we impose similar travel bans on people from Spain?
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Old 10-18-2014, 01:41 PM   #347
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It seems to me the original lapse in protocol happened when Duncan entered the country with no questions asked, even though he apparently showed no symptoms at that time. Who is responsible for that, CDC/Customs/TSA?
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The New York Times reported Thursday that Duncan had direct contact with a pregnant woman stricken with Ebola on September 15, days before he left for the United States. Citing the woman's parents and Duncan's neighbors in Monrovia, Liberia, the newspaper said Duncan had helped carry the ailing woman home after a hospital turned her away because there wasn't enough space in its Ebola treatment ward. [1]
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Days before he became the first person diagnosed with Ebola on American soil, Thomas Eric Duncan answered "no" to questions about whether he had cared for a patient with the deadly virus.

Before leaving Liberia, Duncan also answered no to a question about whether he had touched the body of someone who died in an area affected by the disease, said Binyah Kesselly, board chairman of the Liberia Airport Authority. [2]
Providing false information would appear to be the initial failure. At the point of leaving Liberia for Brussels, Mr. Duncan did not have a fever. Remember that there is an incubation period between exposure and developing symptoms.


Quote:
Duncan was screened three times before he boarded his flight in Liberia to Brussels, Kesselly said.
"The first screening was at the gate, before you get to the parking lot. The second time is before you enter the terminal building and the third is before you board the flight. At every point your temperature is scanned."
His temperature at those checkpoints was a consistent 97.3 degrees Fahrenheit, Centers for Disease Control and Prevention chief Thomas Frieden told reporters Thursday. "Basically, he didn't have a fever," Frieden said, noting that the Ebola patient's temperature was taken by a trained CDC health care worker with a thermometer approved by the Food and Drug Administration. [2]

1. Travels, travails of Ebola patient Thomas Eric Duncan - CNN.com
2. Liberian President criticizes Ebola patient in Dallas - CNN.com
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Old 10-18-2014, 02:00 PM   #348
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Providing false information would appear to be the initial failure. At the point of leaving Liberia for Brussels, Mr. Duncan did not have a fever. Remember that there is an incubation period between exposure and developing symptoms.





1. Travels, travails of Ebola patient Thomas Eric Duncan - CNN.com
2. Liberian President criticizes Ebola patient in Dallas - CNN.com
Right, I was referring to lapses in the US. As to the Liberia end, I understand that Duncan's relatives said he didn't know the pregnant woman was stricken with ebola, but there is no way to know for sure.
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Old 10-18-2014, 02:09 PM   #349
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In many ways Duncan was similarly situated as the nurses who cared for him and contracted the disease, only he didn't know that the person he attempted to help had Ebola. He tried to get timely help when he got sick, even the physicians initially did not diagnose the condition - should he be held to a higher standard?
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Old 10-18-2014, 03:27 PM   #350
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There's obviously a problem with any self-reporting by travelers of their contacts, locations, etc. A person in West Africa traveling to the US may be signing his own death warrant by saying anything that stops him/her from getting on that plane to the US or Europe and the first-rate care that is there. Similarly, if a person has only a slight feeling of illness ("could be anything, I've felt this way hundreds of times . . . ") is he/she likely to say anything that totally disrupts travel plans--for "nothing"?
The info to date indicates people are generally not contagious yet if they don't have a fever. A fever is relatively fast and easy to determine. We should probably be screening, by temperature, everyone who enters the US after recent travel to a West African nation. It's not a huge number (compared to Europe or Asia). As to what to do with them: TBD. Visibly ill ones would be stopped from further travel until more is known, others might be allowed onward with some info about required reporting and symptoms to watch for, but at least we'd know who and where they likely went.
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Old 10-18-2014, 03:52 PM   #351
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Meanwhile, the Carnival ship carrying a lab worker who handled the samples from Duncan has been denied docking at Belize and Cozumel. It is destined to come back to port at Galveston tomorrow. One Web site talked about passengers getting screened before being admitted back on land. But what's the protocol?

It surely is an interesting time.
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Old 10-18-2014, 04:50 PM   #352
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Meanwhile, the Carnival ship carrying a lab worker who handled the samples from Duncan has been denied docking at Belize and Cozumel. It is destined to come back to port at Galveston tomorrow. One Web site talked about passengers getting screened before being admitted back on land. But what's the protocol?

It surely is an interesting time.
These cruise ships have always seemed to me to be disease incubation prisons, except less rape. Maybe more people will look at it this way given this recent trouble. I should look at the stock market reactions, though it would take a lot to make me consider an investment.

Ha
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Old 10-18-2014, 05:37 PM   #353
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For those wishing to impose a travel ban on all people who's flights originate in western Africa... a question:

- Do we allow our troops being deployed over there to return to the US?
- Do we allow journalists covering to return?
- Do we allow medical personel over there to return?
- Do we allow travelers from Nigeria to return - Nigeria was very effective in quarantining, and minimizing the spread - and is now Ebola free.

How long do we keep the travel ban in place?

Do we impose similar travel bans on people from Dallas?
Do we impose similar travel bans on people from Spain?
These are all great question. Dr. Freiden pointed out the difficulties and expense of relying on charter flights resulting a several day delay of getting a team in from a European country. It is big burden for our troops and public health official to help out in Liberia. It would be simply awful if we make it virtually impossible for them to get home, in the event of a family illness, or injury (example breaking a leg).

The best probably the only way to prevent 100 case of Ebola in the USA is to prevent a 1 million cases of Ebola in Africa, anything we do to hamper that goal is counterproductive.
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Internet Crazy Index for ebola rising...
Old 10-18-2014, 05:44 PM   #354
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Internet Crazy Index for ebola rising...

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Meanwhile, the Carnival ship carrying a lab worker who handled the samples from Duncan has been denied docking at Belize and Cozumel. It is destined to come back to port at Galveston tomorrow. One Web site talked about passengers getting screened before being admitted back on land. But what's the protocol?

It surely is an interesting time.
Oh, just hold them all for 21 days. We know we can't trust people to self-monitor and refrain from travel, and even though it will have been 21 days since the lab supervisor had seen that sample from Mr. Duncan, you just can't be too careful, right?

Well, maybe not. A person isn't capable of transmitting ebola unless they have symptoms from the virus replicating and demolishing their tissues. And even then, it really does take direct contact with the person or their bodily fluids. A person capable of transmitting the disease is going to be fairly ill feeling.

That's OK, though. There's plenty for everyone to fret, worry, and bloviate over. No, really. Here's a sampler from the Intertubes today (Caution - links contain Crazy):

A Senator recently expressed his concerns that Islamic State militants in Iraq and Syria might intentionally infect themselves with Ebola and then hop a plane to the United States to infect us all. One news network has decided we should all worry about this threat.

The FBI and Department of Homeland Security expressed their views on this. And don't forget, when a headline ends in a question mark, the answer is No.

Hrmph! We all know these diseases Don't Just Happen. They've obviously been planned by someone for nefarious purposes, or are the result of our own inattention. Or zombie apocalypse!

Meanwhile, the cranks have kicked things up a notch. Need an Ebola Cure? Homeopathy! Just dilute away until less than one molecule of 'cure' is in solution, and the 'memory' of the cure will make everything better, no side effects! *

OK, maybe not that. But, Vitamin C! It cures colds in 7-10 days. Colds are caused by a virus. Ebola is caused by a virus! We have a cure! *

Well... How about magical nano-silver? That cures everything. Ebola is a thing. Therefore... *



* May cause death. Some bleeding from the eyes, nose, and mouth are normal. Liquefaction of the intestines is a sign the medicine is working.

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Old 10-18-2014, 06:04 PM   #355
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Hrmph! We all know these diseases Don't Just Happen. They've obviously been planned by someone for nefarious purposes, or are the result of our own inattention. Or zombie apocalypse!



* May cause death. Some bleeding from the eyes, nose, and mouth are normal. Liquefaction of the intestines is a sign the medicine is working.

The last book I read in my Kindle Lending Library (free books for Amazon prime customers) was Wired. A techno thriller the main plot being an Al-Qaeda like group was working with a brilliant but troubled biochemist. She develops a strain of Ebola which is only triggered after you eat Pork. Thus prevent good Muslim from catching the disease and ironically good Jews. It was written a couple of years ago before this outbreak by a molecular biochemist. Part of me always wonders about this outbreak..
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Old 10-18-2014, 06:47 PM   #356
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...
A Senator recently expressed his concerns that Islamic State militants in Iraq and Syria might intentionally infect themselves with Ebola and then hop a plane to the United States to infect us all. One news network has decided we should all worry about this threat.
I have little doubt that ISIS would be thinking about this. The question is what is the chance of their success? Why get infected themselves then enter the US, if they could collect body fluid of patients (which is a dime a liter - pardon the bad pun) for a low-tech dissemination, à la Rajneeshee method. See this for a description of this crude and disgusting propagation method.

However, the link provided by Paquette assured us that it would not be so easy. Indeed, the girlfriend of Duncan and three more persons in close contact with Duncan have not been infected. Yet, the nurses were infected despite their precaution. Do we really know how the virus is spread?

However, the close friends of Duncan have been stigmatized and are having trouble looking for a place to live. Their pastor said “They are physically well, but we are working feverishly, no pun intended, on their transition,” he said. See: http://www.bloomberg.com/news/2014-1...in-dallas.html.
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Old 10-18-2014, 07:20 PM   #357
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IIndeed, the girlfriend of Duncan and three more persons in close contact with Duncan have not been infected. Yet, the nurses were infected despite their precaution. Do we really know how the virus is spread?
Bear in mind that the nurses were tending to a patient in the most severe stages of the disease, and were directly exposed to body fluids containing live virus, with the vomiting, diarrhea, and dialysis setup (bleeding with port installation and setup).

The disease is very infectious, with only 1-10 live virii needed to infect someone. It's not particularly contagious, with R0 of about 2 (compare to measles at R0 of 18), and only transmissible when a patient shows symptoms.

The nurses may have been contaminated through problems in the design or implementation of the protocol. The exterior of their protective gear was almost certainly contaminated with the live virus while working with the patient.
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Old 10-18-2014, 08:28 PM   #358
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I have little doubt that ISIS would be thinking about this. The question is what is the chance of their success? Why get infected themselves then enter the US, if they could collect body fluid of patients (which is a dime a liter - pardon the bad pun) for a low-tech dissemination, à la Rajneeshee method. See this for a description of this crude and disgusting propagation method.

However, the link provided by Paquette assured us that it would not be so easy. Indeed, the girlfriend of Duncan and three more persons in close contact with Duncan have not been infected. Yet, the nurses were infected despite their precaution. Do we really know how the virus is spread?

However, the close friends of Duncan have been stigmatized and are having trouble looking for a place to live. Their pastor said “They are physically well, but we are working feverishly, no pun intended, on their transition,” he said. See: Ebola Fears Stymie Home Quest for Quarantined in Dallas - Bloomberg.
The problem with scooping stuff up is that left outside an animal over a few hours the virus dies. Its not like anthrax where the bacteria goes to a spore state and can live in the wild for 100 years. Now if you want to smuggle fruit bats ...
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Old 10-18-2014, 08:42 PM   #359
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Burleson, Texas is just south of Ft. Worth, Texas. A relative there says they got automate phone calls and this info:

Letter from Burleson Independent School District

October 17, 2014

Dear Burleson ISD Parents and Guardians:

The health and safety of our students and staff is our most important consideration. We work diligently to keep you informed of important matters affecting our schools and district, and we have information to share with you.

It has been well publicized that a second health care worker was diagnosed with the Ebola virus and traveled on a flight from Cleveland to Dallas earlier this week.

District leaders confirmed today that a parent of a Centennial High School student was aboard that flight.

It is important to note that the parent, student and other family members are not exhibiting any symptoms and are not considered contagious. The parent and BISD have been in contact with the Centers for Disease Control and the Texas Department of State Health Services. Officials from these entities have confirmed the parent’s seating location aboard the flight was in a “low-risk” area. The family is following the Texas Department of State Health Services protocols and has chosen to keep the student at home as a precaution.

The family is cooperating entirely with Burleson ISD and other agencies. There are no other family members at any other BISD campus. Additionally, the district is working with the Centers for Disease Control, Texas Department of State Health Services, County Health & Human Services, and city officials from Burleson.

Our local, state and national health officials assure us there is no significant risk of possible transmission of the virus through indirect contact. The Centers for Disease Control has not recommended we perform additional cleaning or implement specific protocols at this time as they assure us this situation is very low risk. In an abundance of caution, district leaders have decided to proactively implement high-level disinfecting of Centennial High School, beginning this evening. BISD is taking additional measures at all campuses including increased cleaning throughout the weekend.

I bet there will be a lot of empty classrooms there Monday.
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Old 10-18-2014, 08:49 PM   #360
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apparently we have a de-facto quarantine of Dallas. Maine school board puts teacher on leave after she traveled to Dallas - The Portland Press Herald / Maine Sunday Telegram
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