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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

#71

Post by ianlevesque »

jrkatz wrote: post #36
ianlevesque wrote: post #28

Earlier quoted context omitted.

The injected flu shot has completely inactivated (colloquially, dead) virus and cannot cause flu like symptoms. Recent formulation removed the egg allergy restrictions as well. There's effectively no reason for anyone to avoid being vaccinated.

My understanding has always been that since the dead virus works by triggering an immune response, 'symptoms' (that are actually part of the immune response, e.g. fever, soreness) can still occur, though they end quickly, as the body easily 'beats' the non-reproducing virus. Is this not the case? Regardless, a person with nothing to fear from the flu getting the shot anyhow and having a fever for a few hours sounds l…

It's easiest to just go straight to the source for this info: http://www.cdc.gov/flu/professionals/vaccination/vaccine_saf...

The two key points:

1. "The most frequent reactions reported after vaccination in children and adults are pain and other injection-site reactions. Up to 64% of people vaccinated with IIV experience pain at the injection site, which usually resolves in 2. "Fever, malaise, myalgia, and other systemic symptoms that can occur after vaccination with IIV most often affect persons who have had no previous exposure to the influenza virus antigens in the vaccine (e.g., young children). In adults the rate of having these events is similar after IIV and after a placebo injection."

So other than your arm aching for <2 days where injected, the 'symptoms' are no more common than a placebo injection.

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

#72

Post by 13 »

jrkatz wrote: post #36
ianlevesque wrote: post #28

Earlier quoted context omitted.

The injected flu shot has completely inactivated (colloquially, dead) virus and cannot cause flu like symptoms. Recent formulation removed the egg allergy restrictions as well. There's effectively no reason for anyone to avoid being vaccinated.

My understanding has always been that since the dead virus works by triggering an immune response, 'symptoms' (that are actually part of the immune response, e.g. fever, soreness) can still occur, though they end quickly, as the body easily 'beats' the non-reproducing virus. Is this not the case? Regardless, a person with nothing to fear from the flu getting the shot anyhow and having a fever for a few hours sounds l…

The "symptoms" are a nocebo effect, or just that people usually get the shot around the same time that they got the flu anyway. The idea that you somehow get a weak version of the flu is a misconception.

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

#73

Post by hga »

yoshizar wrote: post #61
danieltillett wrote: post #29

Earlier quoted context omitted.

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.

I've read there was monkey to human to monkey contact, and it's acknowledged there's the possibility that was a route.

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

#74

Post by pdabbadabba »

Crito wrote: post #60
pdabbadabba wrote: post #54

Earlier quoted context omitted.

Most Ebola patients never bleed profusely the way we imagine them to (though, as it happened, this particular woman was bleeding from the mouth). It apparently is actually very hard to distinguish from other tropical diseases in most cases. http://www.who.int/mediacentre/factsheets/fs103/en/ In fact, that is why it took so long to identify and respond to the current outbreak. >Here, then, still in January, long befor…

Regardless, in this particular case it seems rather apparent that Duncan lied. If she was bleeding from the mouth and he was aware of it, in Liberia during an Ebola outbreak, then there at the very least he should have answered that "history of contact with ebola" question with a strong "maybe" . I am suspicious of the family being in denial, but I don't think that it is impossible. However for Duncan to also be in d…

Look, I don't say it was A-OK that Duncan checked "no" in the form. (Which, by the way, asks the question in several different forms, to try to capture cases where people were exposed to something, but don't know what to.) But I do wonder why people are so quick to demonize. He was not a highly educated person, he didn't know the woman he was helping and only saw her briefly, and was (or would have been, had he known) terrified of the consequences of checking "yes" on that box, both in terms of what the authorities would do down the line (quite possibly stick him in a decrepit hospital full of people dying of ebola) and what that would mean coming to grips with.

I'm also surprised that people so uncritically accept that his coming here was so terrible in any case. I would bet money that his dying in Dallas means he has infected far fewer people than if he had stayed in Liberia. It certainly serves our purposes to convince people that people with ebola should stay put but I've never heard it explained why, objectively, that is actually the case.

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

#75

Post by danieltillett »

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…

While I am firmly on the side that believes that Ebola is very serious and we need to do everything we can to stop it [1], it is possible the R0 could drop below 1 via changes in behaviour of the people in west Africa. Since we really have a poor idea of what factors are driving the spread of Ebola, it is possible that these factors could change spontaneously. For example, people might get so scared of Ebola in the affected countries that people just stop caring for the sick and throw them out on the street to die. This might be enough to get the R0 below 1 and the disease will burns itself out.

The problem is hoping for a spontaneous change in behaviour that gets the R0 below 1 is like have a small fire that has started in the corner of your living room. Sure the fire might go out on its own, but is wise to sit there doing nothing just because it might go out?

[1] http://www.tillett.info/2014/10/08/ebola-what-needs-to-be-do...

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

#76

Post by phkahler »

jrkatz wrote: post #36
ianlevesque wrote: post #28

Earlier quoted context omitted.

The injected flu shot has completely inactivated (colloquially, dead) virus and cannot cause flu like symptoms. Recent formulation removed the egg allergy restrictions as well. There's effectively no reason for anyone to avoid being vaccinated.

My understanding has always been that since the dead virus works by triggering an immune response, 'symptoms' (that are actually part of the immune response, e.g. fever, soreness) can still occur, though they end quickly, as the body easily 'beats' the non-reproducing virus. Is this not the case? Regardless, a person with nothing to fear from the flu getting the shot anyhow and having a fever for a few hours sounds l…

Asthma: Please look into Magnesium, Iodine, and if you're over weight do what you can about that too. These things did wonders for my asthma. YMMV of course.

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

#77

Post by fiatmoney »

MichaelGG wrote: post #51
simplemath wrote: post #2

I'm trying to remain calm about this, but its growing increasingly difficult. We're not far off pandemic territory. 10k new cases per week ? Very very alarming.

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

Malaria is mosquito-borne; effectively a condition of geography. One moves to a non-malaria zone and is no longer susceptible; or one can invest in some mosquito netting and dramatically cut their risk. Caring for the infected or burying the dead does not increase the risk.

Ebola is person-to-person and by all accounts highly infectious, particularly targeting caregivers. It's a recipe for a much more severe social breakdown.

It's also clear the number of malaria cases is bounded, at a level that is in some sense "livable". It is not clear at what level Ebola will top out at; it may not be compatible with maintaining a functioning society in particularly hard-hit areas.

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

#78

Post by jMyles »

danieltillett wrote: post #75
jewbacca wrote: post #59

Earlier quoted context omitted.

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…

While I am firmly on the side that believes that Ebola is very serious and we need to do everything we can to stop it [1], it is possible the R0 could drop below 1 via changes in behaviour of the people in west Africa. Since we really have a poor idea of what factors are driving the spread of Ebola, it is possible that these factors could change spontaneously. For example, people might get so scared of Ebola in the a…

In your piece, you advocate a military response. What do you want militaries to do to combat this problem? I'm terrified of this becoming a shooting war in which people suffering such horrible misery also become victims of violence intended to keep them "away."

I don't want tens of thousands in west Africa to die of ebola, but I certain don't want them to die lonely, thirsty, and ducking for cover. :-(

It seems like the most important tactic for reducing the R0 to <1 is building isolation treatment centers, yes?

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

#79

Post by ceejayoz »

baddox wrote: post #27
AmVess wrote: post #17

Earlier quoted context omitted.

It's impossible to get the flu from a flu shot.

ollysb didn't say that anyone got the flu from a flu shot.

Yes, they did. "Everyone that went for them came down with a mild flu after the shot."

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

#80

Post by ceejayoz »

ollysb wrote: post #8
Swizec wrote: post #6

Earlier quoted context omitted.

I have never gotten a flu shot in my life. The last time I remember having the flu was over 10 years ago ... actually, the last time I can remember actually being diagnosed with the flu was on the day before going to first grade. So make that 20 years ago. Do those shots really do anything much? edit: the last time I had a serious viral sickness it was a combination viral and bacterial angina (mononucleosis combined…

They handed them out at one of my previous jobs (corporate gig). Everyone that went for them came down with a mild flu after the shot and then proceeded to catch every other flu that came around during the winter. edit: I hadn't realised sharing experience was such a downvotable offence... note I observed this over 3 years. Obviously the flu jab targets specific strains of flu, if the jab you get doesn't target the s…

> then proceeded to catch every other flu that came around during the winter

There's generally only one or two flus in a season. Flu is often confused with colds and gastroenteritis by lay people - most of the time when someone says they got a "stomach flu" it's nothing of the sort.

This is why "sharing experience" is bullshit, especially when there's an entire global network of health organizations providing actual, data-driven analysis that shows your professed experiences to not be an accurate representation.

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