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POLL: Should the victims of Ebola have been brought back to Spain?
Wednesday, October 8, 2014 @ 10:29 AM

"Case 1" has just been diagnosed in Spain:The first contaminated vicitm of Ebola outside of Africa on record. 

Ebola, previously known as Ebola hemorrhagic fever, is a rare and deadly disease caused by infection with one of the Ebola virus strains. Ebola can cause disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzees). In past outbreaks the death percentage was 88% now it has been reduced to 53.8%, either by medical care or due to mutation. It is unclear.

The recent outbreak isn't just the worst single Ebola outbreak in history, it has now killed more than all the others combined.

Healthcare workers are visibly struggling, the response to the outbreak has been damned as "lethally inadequate" and the situation is showing signs of getting considerably worse.

The outbreak has been running all year, but the latest in a stream of worrying statistics shows 40% of all the deaths have been in just the past three weeks.

So what can we expect in the months, and possibly years, to come? The stories of healthcare workers being stretched beyond breaking point are countless. A lack of basic protective gear such as gloves has been widely reported.The charity "Medecins Sans Frontieres" has an isolation facility with 160 beds in Monrovia. But it says the queues are growing and they need another 800 beds to deal with the number of people who are already sick.This is not a scenario for containing an epidemic, but fuelling one.

Dr Dye's tentative forecasts are grim: "At the moment we're seeing about 500 new cases each week. Those numbers appear to be increasing. "I've just projected about five weeks into the future and if current trends persist we would be seeing not hundreds of cases per week, but thousands of cases per week and that is terribly disturbing.

"The situation is bad and we have to prepare for it getting worse."

The World Health Organization is using an educated guess of 20,000 cases before the end, in order to plan the scale of the response. It is also unclear when this outbreak will be over. Officially the World Health Organization is saying the outbreak can be contained in six to nine months. But that is based on getting the resources to tackle the outbreak, which are currently stretched too thinly to contain Ebola as it stands.

There have been nearly 4,000 cases so far, cases are increasing exponentially and there is a potentially vulnerable population in Sierra Leone, Liberia and Guinea in excess of 20 million.

there are is also a fear being raised by some virologists that Ebola may never be contained. Prof Jonathan Ball, a virologist at the University of Nottingham, describes the situation as "desperate". His concern is that the virus is being given its first major opportunity to adapt to thrive in people, due to the large number of human-to-human transmissions of the virus during this outbreak of unprecedented scale like HIV and influenza, Ebola's genetic code is a strand of RNA. Think of RNA as the less stable cousin of DNA, which is where we keep our genetic information.

It means Ebola virus has a high rate of mutation and with mutation comes the possibility of adapting. Prof Ball argues: "It is increasing exponentially and the fatality rate seems to be decreasing, but why?

"Is it better medical care, earlier intervention or is the virus adapting to humans and becoming less pathogenic? As a virologist that's what I think is happening."

There is a relationship between how deadly a virus is and how easily it spreads. Generally speaking if a virus is less likely to kill you, then you are more likely to spread it - although smallpox was a notable exception.
Prof Ball said "it really wouldn't surprise me" if Ebola adapted, the death rate fell to around 5% and the outbreak never really ended.

"It is like HIV, which has been knocking away at human-to-human transmission for hundreds of years before eventually finding the right combo of beneficial mutations to spread through human populations."


The Virus:

Ebola is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. There are five identified Ebola virus species, four of which are known to cause disease in humans: Ebola virus (Zaire ebolavirus); Sudan virus (Sudan ebolavirus); Taï Forest virus (Taï Forest ebolavirus, formerly Côte d’Ivoire ebolavirus); and Bundibugyo virus (Bundibugyo ebolavirus). The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates, but not in humans.

 

 

Ebola viruses are found in several African countries. Ebola was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Since then, outbreaks have appeared sporadically in Africa.

The natural reservoir host of Ebola virus remains unknown. However, on the basis of evidence and the nature of similar viruses, researchers believe that the virus is animal-borne and that bats are the most likely reservoir. Four of the five virus strains occur in an animal host native to Africa.

Up until now all cases of human illness or death from Ebola had occurred in Africa (with the exception of several laboratory contamination cases: one in England and two in Russia). On 9/30/2014, CDC confirmed, the first travel-associated case of Ebola to be diagnosed in the United States and now the recent contamination case in Madrid is the first non-travel assocaited contamination case on record.

Healthcare providers caring for Ebola patients and the family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in contact with the blood or body fluids of sick patients. People also can become sick with Ebola after coming in contact with infected wildlife. For example, in Africa, Ebola may spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. The virus also can be spread through contact with objects (like clothes, bedding, needles, syringes/sharps or medical equipment) that have been contaminated with the virus or with infected animals.

No FDA-approved vaccine or medicine (e.g., antiviral drug) is available for Ebola.

Symptoms of Ebola are treated as they appear. The following basic interventions, when used early, can significantly improve the chances of survival:

    •    Providing intravenous fluids (IV)and balancing electrolytes (body salts)
    •    Maintaining oxygen status and blood pressure
    •    Treating other infections if they occur
    
Experimental vaccines and treatments for Ebola are under development, but they have not yet been fully tested for safety or effectiveness.

Recovery from Ebola depends on good supportive care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years, possibly longer. It isn't known if people who recover are immune for life or if they can become infected with a different species of Ebola. Some people who have recovered from Ebola have developed long-term complications, such as joint and vision problems.
Symptoms of Ebola include

    •    Fever (greater than 38.6°C or 101.5°F)
    •    Severe headache
    •    Muscle pain
    •    Weakness
    •    Diarrhea
    •    Vomiting
    •    Abdominal (stomach) pain
    •    Unexplained hemorrhage (bleeding or bruising)

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days.
Recovery from Ebola depends on good supportive clinical care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years.

In a statement published on August 8 the WHO said: “States should be prepared to facilitate the evacuation and repatriation of nationals (e.g. health workers) who have been exposed to ebola.” Both Manuel García Viejo, the 69-year-old priest who was infected in Sierra Leona, and Miguel Pajares, the other missionary who was infected in Liberia, were moved and admitted to the Carlos III hospital in Madrid, which is theoretically prepared to receive this type of patient. Nevertheless, staff have complained that the protective suits given to health workers did not comply with regulations, something the hospital itself denies.

Should Spain have brought what they are referring to as "Case 0" to Spain or should they have sent an emergency team, even a field hospital to treat the missionaries on site? 

 

(Source : CCD & BBC)



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13 Comments


Pilgrim said:
Wednesday, October 8, 2014 @ 8:57 PM

Those suits do NOT comply when compared to those worn by others with a complete head mask. Also, gloves should be attached to the sleeves of the suit, not separate.

To bring those patients back to Spain was a disasterous decisión!


GB45 said:
Thursday, October 9, 2014 @ 2:24 PM

Field hospitals would seem to be the way to go, to treat all nationalities. If that had been done initially the outbreak may have been contained. It may be too late now.


HR said:
Saturday, October 11, 2014 @ 8:27 AM

Only disasterous because the Spanish authorities did not take the threat seriously and were ill-prepared. One of these days, they'll think things through before acting.


catalanbrian said:
Saturday, October 11, 2014 @ 8:53 AM

Seeing the result of the poll with a significant majority voting 'no' makes me wonder whether the same result would have been the same before the nurse was infected and there had been a spike in the number of deaths in Africa. It is very easy to be wise after the event but I suspect that there may have been a very different result in the poll.

The major problem is that for too long we in the developed world have pretty much ignored African diseases, provided they posed no threat to us. It is only now, when we may be under threat, that we decide to take action, and that action may be too late - it is certainly too little.


jubilant said:
Saturday, October 11, 2014 @ 9:16 AM

One issue that is certain to arise in the near future is the transmission of the virus by people entering southern Europe on flimsy boats from Africa.


Brickwok said:
Saturday, October 11, 2014 @ 9:36 AM

You would't bring an atomic bomb back, so why a deadly virus?


Jools said:
Saturday, October 11, 2014 @ 10:33 AM

Nobody bothered about this virus before, again the poorer African countries were left to manage on their own or with charitable help.
But once an American citizen, and now a Spanish one are ill with the virus all hell breaks loose. I most certainly did not think it was necessary to kill the family pet, typical over reaction by the Spanish authorities.




felixcat said:
Saturday, October 11, 2014 @ 12:52 PM

The question is no longer "if" it has now happened, what needs to be thought about now is containment. The reason I say this is, when peoples civil liberties are affected with the introduction of "isolation areas" not units or wards I am talking outbreaks in a village say in Spain's case the whole village being isolated from the surrounding area. Don't be over dramatic I hear the calls, but like as already be pointed out these things need to be faced up to.

The is another scenario that really causes me concern. Not a million miles away there are terrorists who's whole mission in life is to cause terror, the thought of these people getting their hands on blood or other body fluids from Ebola victims and smuggling it back to the middle east and by what ever means launching it at the west is totally unthinkable.


Ralph said:
Saturday, October 11, 2014 @ 2:19 PM

Just think and watch, with real examples, how hypocritical human beings are... if the victim is brought back to his or her own country, in an attempt to help them in a place where they will have better care and means,.. then lots of people protests if something happens, most likely to get something out of it in terms of politics. However, if the victim was to left to suffer and die, and all heads were to turn the other way... then people will also protest, because the country did not do anything to help them.. what a bunch of F* (I wont say the F word), hypocrits, being from here or from any other country in the world..
NOW, this is the question that we should be asking ourselves instead of giving opinions on what should have been done... "What if it happens to you, what you had preferred it to happen, that my country had come to rescue me? Or would you have preferred to stay, so not to affect your country?" That is the question. I think the answer is obvious, and that is why the poll answers do not reflect the reality.. this is the perfect example to see how humanity´s hypocrisy comes to the surface...


GD said:
Saturday, October 11, 2014 @ 2:39 PM

Ebola is not caught from airborne contaminants. With the right kit, and right procedures, it will not spread. Thats the good news. The bad news is that it takes no prisoners if either of the the above are not 100% applied correctly. From what I have seen, everyone is loudly blaming everyone else which is pointless. Spain screwed up, admit it, and learn quickly. Hope she survives. No reason why nurse should NOT have been brought to Spain as a first world country well able to understand all the above. Someone has been careless.


David said:
Saturday, October 11, 2014 @ 4:45 PM

People surely have a right to die in their home country.


gb1 said:
Saturday, October 11, 2014 @ 5:00 PM

The British press reports today that soldiers are being sent to help in countries where the Ebola virus is prevalent, together with volunteers. The military are ordered to go: there may not be volunteers amongst them. The press also reports that if they contract the virus they may not be repatriated for treatment but be treated in a field hospital. This possible failure to repatriate seems quite wrong to me. Nationals who are ordered to go and help and volunteers must be brought back home for treatment.
It was quite correct for a Spaniard to be returned to Spain for treatment.


Michael Dowd said:
Saturday, October 11, 2014 @ 5:07 PM

I believe that bringing back people infected with Ebola to Spain is literally dicing with death.


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