Tuesday, October 21, 2014

Is This A New, More Virulent Ebola?

The West Africa Ebola mortality rate with treatment is very high. Normally, mortality drops when doctors gain experience with new diseases and learn how best to care for patients. This seems not to be the case with this Ebola.

West African Ebola may be spreading more easily than other Ebola outbreaks.  [Thanks to Washington's Blog for alerting me to Michael Osterholm's speech on C-SPAN2.]

Two very knowledgeable scientists have suggested as much.  Peter Jahrling, PhD, of NIAID (formerly USAMRIID) who has worked with Ebola for 25 years, said that the concentration of virus in patients seemed to be twice as high as in earlier epidemics.
Yes. I have a field team in Monrovia. They are running [tests]. They are telling me that viral loads are coming up very quickly and really high, higher than they are used to seeing. It turns out that in limited studies with the evacuated patients, they continued to express virus in blood and semen. What does that mean? Right now, we just don't know.
Michael Osterholm, PhD, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, is a prominent public health scientist and a nationally recognized biosecurity expert.  In a speech at Johns Hopkins on October 14, he said he had just been given permission to say that Canada's Gary Kobinger found that the pathological lesions in the lungs from macaques infected with west African Ebola were "much much more severe" than expected. "It was unlike any of the [earlier] ebola viruses they have seen in monkeys." [at 20 minutes]
He warned the audience to expect the unexpected as the epidemic continues: "Do not expect that anything carved in stone today won't be blown up by some stick of dynamite."
... In other comments, Osterholm said an international Ebola research agenda is urgently needed to answer a number of questions. For example, more virus isolates are needed for genetic studies, and information on clinical virology is sorely lacking. 
Government experts and the media tell us that Ebola can only be spread by direct contact, and is easily killed with diluted bleach.  Why, then, have virtually all the belongings of nurses Nina Pham and Amber Vinson been removed from their apartments?  Everything removed has been burned.

From San Antonio Eyewitness News:

... TCEQ photos of nurse Nina Pham's home after decontamination tell the story. The apartment looks practically back to the way it was before she moved in. The refrigerator and cabinets are empty, and only a few large items remain. They are proof of her life before the virus, and another symbol of how Ebola has turned it upside down.
In all, the TCEQ said it filled 53 barrels with Vinson's belongings, 21 from Pham and five from the City of Dallas. All were driven to a Port Arthur Texas facility, where they were incinerated.

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