# Screening for Ebola...



## Gramm838 (Oct 15, 2014)

Has anyone else spotted the flaw in this proposal...whats the point of screening for Ebola on arrival in the UK - surely the screening should be done before anyone leaves the affected areas?

I suspect there is now going to be a massive outbreak centred on Texas now that an infected nurse has been on a flight, breaking the rules laid down


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## thaddeus6th (Oct 15, 2014)

I believe it is done on exit as well. Could be wrong, though.

Hopefully none of the 132 people the US is looking for prove infected. It is deeply worrying though, both that specific event and the wider spread of the disease, which is increasing at a rapid rate.


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## Dinosaur (Oct 15, 2014)

Just another act of security theatre.


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## Jo Zebedee (Oct 15, 2014)

I think screening is pretty pointless. The nurse in Texas wouldn't have been picked up anyway. 

Honestly, I think it's scary but should be kept in perspective (and be a reminder how priveleged and fortunate we in the developed world are). It does not spread easily - 2 infected for each person who has the illness and, looking at WHO's guidance today that is containable in a western society ( again, lucky us to be born in the 'right' place.) 

I just feel so sorry for the countries where it has devastated communities and taken so many lives and I hope we rich Westerners who buy our meat in Tescos and don't have to hunt bushmeat to survive ask the right questions about how equal this world. Perhaps this will push us to ask those questions. I certainly intend to give Medicine sans Frontiers (who were the first agency to pick it up being on the frontline with the appropriate knowledge) a good donation next payday.


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## thaddeus6th (Oct 15, 2014)

In practical terms you're probably right, Springs, but if it does help reassure people it may do some good that way, and help get staff more used to such procedures in case we need to really step them up.


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## Ray McCarthy (Oct 16, 2014)

Ebola : IF four weeks incubation... it seems to be exponential
Dec 10K
Jan 20K
Feb 40K
Mar 80K
Apr 160K
May 320K
Jun 640K
Jul  Over 1 Million

So far response is less than linear ... So much more needs done in Africa.


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## Ray McCarthy (Oct 16, 2014)

http://www.bbc.com/news/health-29060239
WHO seems to be assuming a peak of 20,000 cases. But this surely assumes that the outbreak is brought under control in next few weeks!


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## Vertigo (Oct 16, 2014)

I think a little perspective is needed with Ebola. It is not very infectious (Springs, I actually believe it is more like 1 to 1.6 new infections ratio rather than 1 to 2 but I may be wrong). I'm not saying it's not important to get it under control - once caught it is very serious - but it shouldn't be hard to contain with the proper facilities that we have in developed countries. The American nurse was almost certainly down to shoddy practice which is inexcusable and stupid; we had no such problems with the British nurse we brought back to the UK. To give a little of that perspective; the latest WHO figures for Ebola deaths stands at around 4500 but may be as high as 15000, whilst in comparison an estimated 670000 people died of malaria in 2012.

I'm not trying to belittle the Ebola deaths I just think that the media is scaring this up just as much as they possibly can. I reckon what we need to do is get adequate isolation facilities out to the affected places.

And more on topic, I think this screening is little more than a fear allaying PR exercise. Apart from anything else, last I heard it was only happening at Heathrow, Gatwick and Eurostar; as if they are the only routes into the country. Okay they might be the most likely routes from Africa but still this screening is really of little use.


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## Ray McCarthy (Oct 16, 2014)

I'd agree with all that. It seems the US staff didn't follow proper procedures.

I think it's not a problem if we put the resources in the right place. More Medical people, prefab buildings, resources etc in Africa, not spending money  "screening" in Europe or USA which is pointless given incubation period.


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## Jo Zebedee (Oct 16, 2014)

I read an interesting article earlier (some of the stuff around Ebola is touching on WIP research) from a virologist. His argument, basically,was that a virus doesn't want a huge fatality rate and that, as it adapts to its new host, its virulence should fall (he claimed this may already be happening).


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## Ray McCarthy (Oct 16, 2014)

Or only people not likely to be fatally affected breed. I don't think viruses are intelligent 
After all, we are often _*descended from survivors*_ of 1918 Spanish Flu, Scarlet fever (much more severe in Victorian era) and Black Death etc of mediaeval era.

It's certainly true that a less virulent virus is going to be more successful than the strain that kills most of the hosts. So adding surviving more robust hosts breeding and viruses with less fatal strains, certainly this may be why Scarlet fever today often seems no worse than a cold or mild flu.
Scarlet fever (Scarlatina) isn't a virus though. Black Death may have been more than one disease and some may have been Bacteria rather than a Virus.
I don't think it's just down to having antibiotics as Bacteria become antibiotic resistant. There is a suggestion that even apart from Antibiotics, Scarlet fever is less severe, though in the case of Scarlet fever the problem is the combination of a Bacteria and a bacteriophage. There are recent reports of antibiotic resistant strains. Vaccines (1900 and 1924)  were discontinued when antibiotics became available.

The bacteriophage were researched by USSR. Antibiotics may in the long term be doomed (it's a sort of an arms race) in which case the bacteriophage may hold hope.



They are like something out of SF and perhaps can be genetically engineered?


> Phages were discovered to be antibacterial agents and were used in Georgia and the United States during the 1920s and 1930s for treating bacterial infections. They had widespread use, including treatment of soldiers in the Red Army. However, they were abandoned for general use in the West for several reasons:
> 
> Medical trials were carried out, but a basic lack of understanding of phages made these invalid.
> Phage therapy was seen as untrustworthy, because many of the trials were conducted on totally unrelated diseases such as allergies and viral infections.
> ...


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## J Riff (Oct 17, 2014)

http://www.whitehouse.gov/blog/2014...utm_content=email382-text1&utm_campaign=ebola


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## BAYLOR (Oct 17, 2014)

Vertigo said:


> I think a little perspective is needed with Ebola. It is not very infectious (Springs, I actually believe it is more like 1 to 1.6 new infections ratio rather than 1 to 2 but I may be wrong). I'm not saying it's not important to get it under control - once caught it is very serious - but it shouldn't be hard to contain with the proper facilities that we have in developed countries. The American nurse was almost certainly down to shoddy practice which is inexcusable and stupid; we had no such problems with the British nurse we brought back to the UK. To give a little of that perspective; the latest WHO figures for Ebola deaths stands at around 4500 but may be as high as 15000, whilst in comparison an estimated 670000 people died of malaria in 2012.
> 
> I'm not trying to belittle the Ebola deaths I just think that the media is scaring this up just as much as they possibly can. I reckon what we need to do is get adequate isolation facilities out to the affected places.
> 
> And more on topic, I think this screening is little more than a fear allaying PR exercise. Apart from anything else, last I heard it was only happening at Heathrow, Gatwick and Eurostar; as if they are the only routes into the country. Okay they might be the most likely routes from Africa but still this screening is really of little use.



Could it become airborne?


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## Ray McCarthy (Oct 17, 2014)

Spittle maybe ... it seems to require a liquid. Any liquid.


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## Vertigo (Oct 17, 2014)

BAYLOR said:


> Could it become airborne?


My understanding at the moment is that it is very unlikely, though it could mutate as could any virus but by no means all do so. Many (most?) viruses are not airborne. Consider things like HIV which have never gone airborne.


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## AnyaKimlin (Oct 17, 2014)

I am a survivor of an old fashioned strain of Scarlet Fever (so only 36 years ago) - I caught it when I was two and it remains a mystery as I was the only one in the area with it.  The only reason I wasn't hospitalised was because my aunt was an experienced nurse and the GP visited twice a day.


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## Ray McCarthy (Oct 17, 2014)

Did they burn your cuddly toys?
I'm glad your aunt was available. It's bad enough to be so ill without having to be in hospital too. I was hospitalised three times as a child, so was when as an adult I was very Ill, I was glad they sent me home from A&E (after they decided I didn't have a collapsed lung, either I'd recovered a bit on the trolley or wasn't as bad as the GP thought). I guess apart from being unable to get out of bed for about 5 days I didn't need a huge amount of nursing. About 1991 I think. Some sort of chest infection? No-one was ever specific.

When we moved to Middle East we had to spend first week in a cheap hotel while the company looked for an Apartment. Three of the kids went down with chicken pox


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## AnyaKimlin (Oct 17, 2014)

Ray McCarthy said:


> Did they burn your cuddly toys?


Cuddly toys were burned, quarantined or a couple still bear the scars of a boil washing.  Books were also taken and destroyed.   One of my first memories is the daily penicillin injections.  I'd been left with the one family member who had, had no nursing training and was terrified of needles.  Me at 2 must have picked up on it and went nuts lol apparently I took the others fine.

I do know even with the penicillin it was close as to whether or not I pulled through.  It's interesting the family members who contracted scarlet or rheumatic fever are the ones later diagnosed with ME or a similar condition.


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## paranoid marvin (Oct 19, 2014)

In my opinion the reason for screening is to show that the government is doing something about it. I don't think anyone expects it to be particularly effective, but it means the government can say they're doing their best. It only takes one person with no apparent symptoms and who lies when questioned about their health or countries they have visited, and the screening process becomes ineffectual. But in reality because the world (travel wise) has shrunk to the size of a pea, short of banning all entry into the country there's no way to stop it from happening.

Of course it will be contained and unlikely to affect the majority of first-world inhabitants, but it's at this time that we need to take a good long look at ourselves. Allowing over two thirds of the world to live in squalor with unsanitary conditions, with people dying through lack of clean water and scarcity of food, whilst the minority have that much that much of it gets thrown away is morally reprehensible. We only have ourselves to blame for an epidemic becoming a pandemic.


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## Karn Maeshalanadae (Oct 20, 2014)

And not only that, PM, but going on without any education about very important matters, either. Teaching them basic hygiene like handwashing, showering/bathing, proper disposal of bodily wastes. Cleansing of clothing.


My brother and mother are worried about this. I'm not. It can be contained, and I believe anyone developing substances to combat its spread and deaths can get something going. Something. Zmapp was a start, and it appears blood transfusions from survivors could be as well.


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## Foxbat (Oct 20, 2014)

A bit of good news.
http://www.bbc.co.uk/news/world-africa-29685127


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## Karn Maeshalanadae (Oct 21, 2014)

Good news indeed.


Ebola is one of the deadliest diseases our species has ever faced. Last night I said I'm not worried about it, and honestly, I am not. It would be foolish in the extreme to say the virus itself isn't a threat when the opportunity to get infected is present, but to be honest, I don't think that opportunity will come about for most of this country.


That being said, mistakes have been made, serious ones. The first of which was allowing Duncan on the plane out of Liberia. The second of which was Duncan not being immediately hospitalized when symptoms started appearing.


And mistakes even on the national level. Dr. Gupta gave a demonstration of CDC regulation in donning and removal of hazmat suits using some form of sticky liquid-I believe it was chocolate sauce, I can't remember exactly which-to represent Ebola contamination-and wound up getting that "contamination" upon himself, if I remember correctly, three times, one of which was along his head/neck area, where men shave in the morning.


But at the same time, since this disease if left unchecked would have the potential to collapse society, it IS being checked. Experiments in treatment and vaccination, review of all medical protocols in eliminating exposure risk...I don't think it'll have a big foothold here in the United States or Europe.


And there is the pre-bedtime babbling for the night. Hehe. I really shouldn't be allowed to post after 10 p.m. PST.


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## Brian G Turner (Nov 1, 2014)

IMO it's backwards to refuse to quarantine health workers exposed to ebola, and allow them to wander freely - until they show symptoms:
http://www.bbc.co.uk/news/world-us-canada-29858689

Such an attitude seems overly complacent, rather than reasonable? Especially when we're talking about a virus that has no known cure, and has such a high kill rate?


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## thaddeus6th (Nov 1, 2014)

I agree. I'm also perplexed by the nurse and others who seem to view it as unfair. It's three weeks of confinement, but not imprisonment, to try and limit an extremely dangerous disease.


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## Jo Zebedee (Nov 1, 2014)

I'm on the other side of the argument on this one - we need health workers out there. It's hard to catch and only in the symptom-showing stage. Provided the health worker is prepared to follow some guidelines - temperature checking before going out, maybe limiting travel and attendance at large scale events, then I don't see what is to be gained by keeping them in a house for three weeks other than scaremongering and putting off others who might have been brave enough to volunterre.


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## thaddeus6th (Nov 1, 2014)

It minimises the risk of contagion in places that (in the West) often have high population densities. Given how many flights criss-cross countries and continents, if it got a foothold in the US, Europe, India or China then we could be in serious trouble.

Of course, Nigeria managed to eliminate ebola, so an infection doesn't equal a full-blown (national) epidemic, but better safe than sorry when dealing with something that has an over 70% kill rate.


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## Jo Zebedee (Nov 1, 2014)

I'm not saying there should be no checks (nor are the health workers in question, as far as I can see), but just as a blanket 'go anywhere you want, take ten flights' approach raises risk (more in terms of the logistics of finding everyone in potential contact than in terms of the disease spreading - Thomas Duncan infected the nurses, not the general public who came into random contact with him - this is a difficult disease to catch until it's very end stages) a 'don't leave your house for three weeks' approach is too narrow. It's about finding a sensible balance - eg if you had no temperature and chose to go for dinner at your friends, where is the risk in that? It's so mimimal that any risk assessment would deem it low enough to take (even with calculating the high death rate in).

I think the governments need to apply a risk rating sensibly to all this and stop knee jerking, because that knee jerking is in danger of leaving us more exposed if trained people won't go to the infected countries.


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