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W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

nytimes.com

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Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#61

Post by yoshizar »

danieltillett wrote: post #29
simplemath wrote: post #18

Earlier quoted context omitted.

There's already limited evidence that some transmission is occurring via atomized saliva/mucous. A truly airbone variant could cause a "get in your bunker and ride it out" kind of event.

Yes Ebola can be transmitted that way, but it is an unlikely route. The way Ebola is constructed it is very unlikely to become airborne [1], but it could increase in natural reproductive efficiency (R0). We really have no idea of the R0 for Ebola right now as we don’t have the people on the ground recording what is happening in the community. Ebola does not have to become airborne for it to be a problem. Polio is not…

Wasn't there strong circumstantial evidence that the Ebola Reston strain was spreading without any bodily contact? It was discovered in lab monkeys in Virgina and spread from room to room of monkeys without any direct contact between the monkeys. It's possible caretakers were spreading it, but it seemed more likely that the strain had gone airborne.

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#62

Post by jMyles »

jewbacca wrote: post #59
danieltillett wrote: post #14

Not stopping this outbreak with all the resources we have is running a massive natural experiment in how well adapted Ebola can become for efficient human-to-human transmission. As a zoonotic virus Ebola in its wild state is very unlikely to be optimised for human-to-human transmission. Every new case is increasing the chance that a new strain will arise that will be efficiently transmitted between people. I am not t…

My total layman's impression of this has been that it doesn't matter if the virus mutates to something "worse" -- that, short of some currently politically impossible action several orders of magnitude beyond what is currently being done, there is no really solid, non-magical-thinking, reason to believe this outbreak won't kill tens/hundreds of millions of people and threaten world civilization as we know it, even wi…

I am bouncing back and forth between the positions you describe. At the end of the day, though, if the "R-naught" is less than 2 in uncontrolled situations, and something like 1 in a hospital, it seems like it can be reduced to As I understand it, the most dangerous type of "worse" is ebola becoming less deadly.

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#64

Post by danieltillett »

thret wrote: post #53
danieltillett wrote: post #41

Earlier quoted context omitted.

Firstly, this might happen over millions of years, but this is unlikely to occur anytime in the short term. Many viruses that have been in the human population for a long time have quite high death rates in immune naive populations (think of small pox as an example). Secondly, the mechanism of transmission of Ebola is quite closely tied to the cause of death. To be transmitted it needs to turn you into a massive vira…

http://en.wikipedia.org/wiki/History_of_syphilis "The first well-recorded European outbreak of what is now known as syphilis occurred in 1495 among French troops besieging Naples, Italy.[3] From this centre, the disease swept across Europe. As Jared Diamond describes it, "[W]hen syphilis was first definitely recorded in Europe in 1495, its pustules often covered the body from the head to the knees, caused flesh to fa…

Of course is doesn’t always take millions of years, but it can take millions of years and it is not something you should expect will happen quickly. Even in the case of syphilis it still took 50 years. The evolution of syphilis (to a slower disease course) is exactly what we should be most worried about happening with Ebola as it will then be more effectively spread - just because syphilis is not as quickly lethal as it once was it is not something that you want to catch and leave untreated.

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#65

Post by yoshizar »

danieltillett wrote: post #14

Not stopping this outbreak with all the resources we have is running a massive natural experiment in how well adapted Ebola can become for efficient human-to-human transmission. As a zoonotic virus Ebola in its wild state is very unlikely to be optimised for human-to-human transmission. Every new case is increasing the chance that a new strain will arise that will be efficiently transmitted between people. I am not t…

Very few articles about airborne mutation seem to bring up that ebola is an RNA-based virus, which means that it mutates at a faster rate and is less genetically stable than DNA-based viruses, bacteria, or most other pathogens. I wrote an explanation about the significance of RNA here: http://www.thinkhardly.com/think-hardly/ebola-for-entreprene...

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#66

Post by pdabbadabba »

sigmar wrote: post #57
MichaelGG wrote: post #51

Earlier quoted context omitted.

Malaria kills over half a million people a year, out of over 200M cases. Why is ebola so much more alarming?

You pretty much answered your own question- .5M deaths out of 200M. Ebola kills 50-90%

I think the answer can be summarized: "human-to-human" transmission. Malaria, to be sure, has been a much more significant public health problem historically, but with ebola you have the possibility of human-to-human transmission and, thus, geometric growth. You also have the possibility that it will spread elsewhere in the world. And we're not just talking about the western world here either (though that surely drives more than its fair share of the panic). Imagine, for instance, ebola in Mumbai or Mexico City.

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#67

Post by krschultz »

jMyles wrote: post #5
nostromo wrote: post #4

I'm worried about the coming flu season. Many people will have the early symptoms shared by both flu and ebola (a fever and a headache). The medical establishment will need to find needles in the haystack. Don't skip the flu shot this (or any) year, folks.

I've never gotten the flu shot, and hadn't planned to this year. I'm in great health; my immune system seems to be functioning extremely well. I never get sick. However, I am concerned about the needle-haystack phenomenon with ebola. Can you link me to a reasonable, digestible abstract about the real pros-and-cons of flu shot?

http://theincidentaleconomist.com/wordpress/healthcare-triag...

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#68

Post by jMyles »

atiffany wrote: post #43

Donation link: http://www.doctorswithoutborders.org/our-work/medical-issues...

I've been following this organization for a few years now. Its blogs and 'field news' have informed me about places in the world I didn't realize even exist - places with unique cultures that are threatened by lack of medical care and all the ways in which war and capricious borders create shortages in supply of medical care.

I've given what I can - please do the same everyone!

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#69

Post by ericwhyne »

There are a lot of great perspectives and threads in this discussion. If you're interested and want to develop them further, a few of us have stood up ebola-wiki.com to share data sources and information. It's a place to build on these ideas, cite your sources, and refine them. I'd welcome feedback. Also, if you are a mediawiki admin please contact me. We could use more help and advice as this scales.

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#70

Post by krschultz »

Swizec wrote: post #47
pdabbadabba wrote: post #34

Earlier quoted context omitted.

Well, define "suffice." The methods you list are certainly good things to do, but you you really think that would make it impossible (or even very unlikely) for you to infect someone else? When you sneeze into your elbow, no droplets at all escape into the air? Do you always wash your hands after sneezing or touching your face before touching any other surface? I seriously doubt it. Meanwhile, what are the risks of g…

> Meanwhile, what are the risks of getting a flu shot? Effectively zero. To be perfectly honest, it's not about risk. It's about the nuisance of yet another errand to run. Unfortunately that small-ish barrier is often enough to prevent me from doing things that don't feel absolutely essential. Hell, I wonder where I would even go to get a flu shot ... my general physician? I don't even know where their offices are ..…

At least in NYC, you can walk into any pharmacy at any hour of the day and get it for free in under 5 minutes. I know because I walked into the Duane Reade next to my building at 10pm on a Saturday and got it. It takes longer to buy a 6 pack of beer, then you at least have to take out ID.
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