Skip to main content

Ebola 2014 World Map with event descriptions.

This map updates with new events. It covers 1976 to 2015.

The 2014 outbreak of the Ebola virus was identified initially on March 14th by a software tool at Boston, some 7,000 kilometers from the infection locations. Normal medical services were provided in rural areas of Guinea from close to the start of the epidemic. They didn't know that quarantine was needed. Not for weeks.

What has happened and is happening to contain Ebola is predicated on models that were built to predict outbreaks in rural areas. The transfer rate is estimated to be between 1 and 2. This is not realistic for cities. As you will see, urban environments and urban dysfunctions can produce catastrophic impacts on public health efforts.

Advanced economies are atypical.

In wealthy countries the samples from hemorrhagic disease incidents go straight to a lab for tests. The victim or victims are quarantined. Investigations proceed to determine prior human contacts with victims to anticipate additional infections.

Out in the Guinea bush last March, these procedures went off slowly or ineffectively or not at all. Matters have gotten steadily worse. Ebola spread out to three additional countries so far and the system at Monrovia, Liberia, has been compromised through a criminal break in at an Ebola clinic.

World Health Organization does what it can. These experts rely on straight-line, hierarchical report systems to identify outbreaks. Up till this outbreak that system had worked well enough. Diseases had been slow enough to be controlled. Raise the R-zero transmission rate and the system fails.

There's nothing here that a quick $1-billion wouldn't help. Think of it as though it was a war.

Estimates for the R-zero transmission rates for Ebola outbreaks ran to 1.83 for Congo/1995 and 1.34 for Uganda/2000. (R-zero is the number of new infections per identified victim outside of quarantine.) In this 2014 incident the disease presents a higher R-zero, likely in the 2 to 3 range for rural African societies, outrunning the WHO system with ease.

Software called HealthMap takes a different approach from WHO at early detection of outbreaks:

HealthMap... uses algorithms to scour tens of thousands of social media sites, local news, government websites, infectious-disease physicians’ social networks, and other sources to detect and track disease outbreaks.

Sophisticated software filters irrelevant data, classifies the relevant information, identifies diseases and maps their locations with the help of experts. The site is run by a group of 45 researchers, epidemiologists, and software developers at [Boston College Hospital.]

-- from Public Health Watch,

At the same time the computer simulation community is making efforts to analyze a wide range of more-or-less-likely Ebola outbreak patterns. Here the focus is on transmission. These models start by building on lists of critical factors and then roll the dice at transmission level to see how many people get hit:
-- Societal responses that affect containment: availability of quarantine beds, openness to medical personnel on the part of the infected, education generally and of women as healthcare providers in particular, withdrawal/retreat by doctors and nurses, (commonly religious) barriers to public health measures.

-- The specific R-zero for this strain of Ebola. Recognize that R-zero varies with population density.

-- Incubation period, which has run to 6 days on average in prior outbreaks with a range of 1 to 21 days.

-- Specifics of urban environments. This is for Lagos, Nigeria and 20,000,000 residents in the region. On Western terms this is a borderline failed city.

-- Commercial and seasonal population movements. For example: AIDS was spread initially along the truck routes. Truck stop prostitution was a prime vector.

Lethality ranges 50% to 90% for Ebola. There are five major identified strains.

There is an additional problem in Nigeria. The country is sharply divided between its Muslim north and its Christian south. The north does little to educate women. Going backward toward the 7th Century is more like it. The Salafi ideal. A path you also see with the Boko Harum, Gulf States Salafi and ISIS.

Memorizing the Koran does not intersect modern biology. That is going to hurt them.

The worst of it for Nigeria's Muslims is that the men try to get together five times a day for prayers. They are good Sunnis. It is a time for peace and friendship. Inject the Ebola virus into this system and you get a transmission environment that combines aerial dispersal with hand contact. And the risks fire off at five times a day.

Christians meet once a week or for some, once a day. The traditional African religions meet for festivals and celebrations. With Ebola in the mix: the less frequently people congregate, the better.

Considering the impacts of social structure, will it be possible to quarantine new Ebola cases faster than new cases are generated? What are the right estimates for R-zero for rural, trading town and urban environments?

Results from unofficial Monte Carlo runs are not good. Go for projections based on secondary information and we're in new territory. More below the orange muffin........

At what point does a human population find itself unable to bury its dead ???

Europe went for Plague Pits during the 14th and 17th Centuries during years when three-quarters of all deaths are attributed to the one disease. Both London and Paris municipal governments issued plague orders. Bodies were picked up at night. Details for burial arrangements for most the corpses were left to the individual parishes -- even when London lost 69,000 in 1665. Public burial was used as a last resort.

About as fifth of London died from plague in 1665. At that time the city had an estimated 460,000 inhabitants.

When we look at the situation this week in Lagos, Nigeria, the outbreak targets twenty times the population for inner-city residents and forty times the population before you get out of built-up suburban districts. Population density runs to 20,000/sq.kilometer. for the main island of Lagos. That compares with 70,000 sq.kilometer for the multilevel island of Manhattan NYC.

By way of comparison the rural population density for Guinea runs to 40/sq.kilometer. In the area of the Congo around the Ebola River, population density runs below 10/sq.kilometer. No area that got hit before 2014 had population over 25/sq.kilometer.

All prior outbreaks were successfully limited to these rural areas. That's where the R-zero transmission ratios of 1.83 and 1.34 were recorded. No case of Ebola hemorrhagic fever had been recorded from an urban population.

Please bear with me:

Prior to 2014 no re-transmission of Ebola hemorrhagic fever had been recorded in an urban environment.
Not one case.

There are logical consequences that go with this difference. Low population densities match up with low counts for interpersonal contacts. Which means that an infected person gets a tiny fraction of the opportunities to infect a stranger that he would get in a city.

On top of the heightened contact counts, urban crime is observed to interfere with medical efforts. Over in Liberia, a news item out of @BBC:

"At least 20 suspected Ebola patients missing after quarantine center looted, [Monrovia,] Liberia police say."
Armed gangsters attacked that Ebola treatment and quartantine center. Lord only knows what they thought they were getting. Ebola starts like flu, ends like rabies. The rural R-zero estimates at 1.83 and 1.34 are pretty much irrelevant to what is happening with such social breakdowns at Lagos, Monrovia, and the cities in other outbreak countries.

R-zero, R-naught, Basic Reproduction Rate. Whatever. That's the number of people who get a disease from every person who contracts it -- excluding quarantine operations.

For Monrovia and Lagos, from what we see with local reports, there is no such thing as effective quarantine. Authorities are weak because government is weak. Taxes are low. Manpower for forceful health responses is non-existent. Education is available for a few. They are no more set up for Ebola than London and Paris were set up for plague.

Monrovia and Lagos are Libertarian Heavens.

A.k.a., Hell when confronted with Ebola.

Plus BBC and CBC have word of the criminal attack in Monrovia on an Ebola clinic.

PatSaw and R-zero at 8

"Lagos is big, it's crowded. It would make in many ways a perfect environment for the virus to spread," said Nigerian epidemiologist Chikwe Ihekweazu, who runs website Nigeria Health Watch and worked on Ebola in South Sudan a decade ago.

"In the heart of Lagos, people live on top of each other, sharing bedrooms and toilets. In densely populated communities infection control becomes almost impossible to do well."

When [Patrick] Sawyer landed at Murtala Mohammed airport on July 20, [2014] none of the bystanders, airport staff or health workers who rushed to help him understood the danger they were in.

No one had the full body protection of mask, suit and gloves that are essential to prevent contagion, so his ill advised journey gave the world's worst Ebola outbreak a foothold in Africa's most populous nation.

Sawyer died five days later, followed by one of the nurses who first treated him. Eight others are confirmed infected and receiving treatment, including a hospital doctor.

-- Tim Cocks at Reuters, August 12th

And now there are dozens of PatStaws running around in Monrovia and (more than 50:50) in Lagos and the other population centers of West Africa.

The first PatSaw generated a minimum R-zero of 8 in Lagos, Nigeria.

He did that without spending two or three days walking around half sick. He did that mostly hospitalized.

You want to understand the impact of high fatality and high R-zero, check out a copy of the movie "Contagion" from 2011. 84% rating at Rotten Tomatoes. All Star cast. Heavy CDC involvement.

Technically accurate. And the whole society goes down the tubes until a magic vaccine comes along, playing Deus ex machina.

And that's projecting a lower death rate and lower than an "8" for R-zero.

It can happen here.

Back in 1917 New York City peaked out losing 500 people a day to Spanish flu. That was from a population of 5,000,000. Today we've got 8,000,000 in the five boroughs and more than twice that in connected suburbs.

Other cities took big hits. They were clean and they had good medical systems.

Don't be afraid. There is no use to that. But learn to be careful. Learn what it will take to survive if this takes off.

You can do better than what happened with the PatSaw events. Adopting protective gear if Ebola gets here -- that can cut R-zero down by more than half. It also reduces morbidity by reducing the length of chains of invasive virus that get through. (Viruses travel in long chains, rarely individually.) The "R-100" masks with replaceable canisters and the best surgical masks are superior to alternatives.

The PatSaw prediction of "8" for the R-zero is from a sample size of one. Maybe we can dodge the bullet. For West Africa, the odds are worse than for us.

Do we really have to look at what an "8" looks like in Monte Carlo simulations ???

Watch the expansion through a poor, urban group of humans?

Watch every simulation run go nuts, unless a vaccine jumps in.

Tough problem.

Originally posted to waterstreet2008 on Mon Aug 18, 2014 at 06:37 AM PDT.

EMAIL TO A FRIEND X
Your Email has been sent.
You must add at least one tag to this diary before publishing it.

Add keywords that describe this diary. Separate multiple keywords with commas.
Tagging tips - Search For Tags - Browse For Tags

?

More Tagging tips:

A tag is a way to search for this diary. If someone is searching for "Barack Obama," is this a diary they'd be trying to find?

Use a person's full name, without any title. Senator Obama may become President Obama, and Michelle Obama might run for office.

If your diary covers an election or elected official, use election tags, which are generally the state abbreviation followed by the office. CA-01 is the first district House seat. CA-Sen covers both senate races. NY-GOV covers the New York governor's race.

Tags do not compound: that is, "education reform" is a completely different tag from "education". A tag like "reform" alone is probably not meaningful.

Consider if one or more of these tags fits your diary: Civil Rights, Community, Congress, Culture, Economy, Education, Elections, Energy, Environment, Health Care, International, Labor, Law, Media, Meta, National Security, Science, Transportation, or White House. If your diary is specific to a state, consider adding the state (California, Texas, etc). Keep in mind, though, that there are many wonderful and important diaries that don't fit in any of these tags. Don't worry if yours doesn't.

You can add a private note to this diary when hotlisting it:
Are you sure you want to remove this diary from your hotlist?
Are you sure you want to remove your recommendation? You can only recommend a diary once, so you will not be able to re-recommend it afterwards.
Rescue this diary, and add a note:
Are you sure you want to remove this diary from Rescue?
Choose where to republish this diary. The diary will be added to the queue for that group. Publish it from the queue to make it appear.

You must be a member of a group to use this feature.

Add a quick update to your diary without changing the diary itself:
Are you sure you want to remove this diary?
(The diary will be removed from the site and returned to your drafts for further editing.)
(The diary will be removed.)
Are you sure you want to save these changes to the published diary?

Comment Preferences

  •  Do you happen to know what parameters (3+ / 0-)
    Recommended by:
    waterstreet2008, G2geek, kfunk937

    (apart from R0) were changed during the Monte Carlo simulation?

    •  Series were run for rural, highway town, and (5+ / 0-)
      Recommended by:
      alx9090, DavidMS, G2geek, kfunk937, Teiresias70

      city.

      The main factors are listed above in the first section.

      There is no way for models to predict the behaviors of criminal gangs in such circumstances. It's like the rule book for tactical nuclear war simulations: "Soak board map in gasoline. Add lighted match."

      "The illiteracy of our children are appalling." #43

      by waterstreet2008 on Sun Aug 17, 2014 at 07:07:15 PM PDT

      [ Parent ]

      •  This is pushing the number of contacts up, too: (7+ / 0-)
        There are 40 beds at one treatment center that Doctors Without Borders recently took over in one quarantined county in Liberia. But 137 people have flocked there, packing the hallways until they can be sorted into those who are infected and those are not, said Joanne Liu, the group's international president.

        Nyenswah described a similar situation in a treatment center in Liberia's capital of Monrovia: In one ward meant to accommodate up to 25 people, 80 are now crowded in. Another treatment center with 120 beds is expected to open Saturday outside Monrovia.

        "It's absolutely dangerous," said Liu, who recently returned from Guinea, Liberia and Sierra Leone. "With the massive influx of patients that we had over the last few days, we're not able to keep zones of patients anymore. Everybody is mixed."

        CBS News

        source

  •  This is frightening (10+ / 0-)

    Ebola clinic looted by Liberian slum residents

    Apparently they know what they are doing.

    Liberian officials fear Ebola could soon spread through the capital's largest slum after residents raided a quarantine centre for suspected patients and took items including bloody sheets and mattresses
    source

    Deliberate transmission will make model predictions nearly worthless, since no one is supposed to do that on purpose

    On the other hand (from the same article):

    Kenya bars entry to people travelling from or through Sierra Leone, Guinea, Liberia

    •  All I had was the BBC tweet. (5+ / 0-)
      Recommended by:
      alx9090, DavidMS, G2geek, kfunk937, highacidity

      The models predict that out-of-control Ebola can kill half of Monrovia. 20 to 160 to 1280 to whatever if the R-zero pegs at 8 cases per known infection.

      The PatStew example was hospitalized asap. These 20 people are ?????

      "The illiteracy of our children are appalling." #43

      by waterstreet2008 on Sun Aug 17, 2014 at 07:11:50 PM PDT

      [ Parent ]

    •  as you suggest, if they know what they are... (2+ / 1-)
      Recommended by:
      alx9090, waterstreet2008
      Hidden by:
      Mokurai

      ... doing, that means they're out to deliberately spread it.

      That's HUGE.  Bioterrorism with potential for mass casualties.

      Also relevant is the question of how long the virus remains infectious when it is on a cloth medium.  

      Reason being, I would not be surprised if Al Qaeda or ISIL has standing bids for acquiring Ebolavirus-infected materials.

      Now what?

      We got the future back. Uh-oh.

      by G2geek on Sun Aug 17, 2014 at 09:22:42 PM PDT

      [ Parent ]

      •  That is what I assume. Now, it could be (4+ / 0-)

        simply denial and destruction of evidence, since they supposedly said "there is no ebola here".

        •  Wilderness voice pointed this out earlier. (4+ / 0-)
          •  i read the linked item about... (5+ / 0-)

            ... Ebola denialism and think it's a credible hypothesis.  Probably more likely than Ebola terrorism in this instance,  though I've been making noise about Ebola terrorism for well over a decade.

            Ebola denialism is also consistent with the various denialisms we see in effect around the world, notably climate denialism.  The psychological mechanisms are probably similar.  

            We got the future back. Uh-oh.

            by G2geek on Mon Aug 18, 2014 at 12:16:12 AM PDT

            [ Parent ]

            •  I thought this at first, hearing that (4+ / 0-)

              the clinic was attacked and the ebola victims 'freed', but after reading that ebola contaminated items were also taken, I wasn't so sure. Why take live virus if you don't believe in it?

              •  good point, though.... (8+ / 0-)

                ... to play devil's advocate, people who are in denial may want to demonstrate bravado by nuzzling contaminated items to prove they aren't infectious?  

                Analogous to equivalent climate denialists who drive large diesel pickup trucks they call "coal rollers" that are modified to belch out lots of black smoke.

                Both are male and relatively uneducated compared to the norms for their societies.  (Too bad the "coal roller" guys don't get their karmic feedback as quickly as the Ebola guys, unless you count expensive engine repairs as karma.)

                So now we have two hypotheses:

                a)  Ebola terrorism of one kind or another, that may be purely local, or may be regional, or may play into other conflicts such as associated with Boko Haram or ISIL, or may be aimed at the global "market" pointing toward the US or Europe/UK.

                b)  Ebola denialism plus macho display.

                Either way, there should be some statistics before the month is over: increase in cases in a location where it would not otherwise be expected.

                We got the future back. Uh-oh.

                by G2geek on Mon Aug 18, 2014 at 03:27:05 AM PDT

                [ Parent ]

              •  Most of the people in this slum have almost (7+ / 0-)

                nothing.  No jobs, money, limited food/clothing/shelter.  Many commit crimes daily to survive.  To them, never having had a mattress, to get one, either for personal use or to sell, would be fantastic (bloodstains notwithstanding).  They stole other things from the clinic, as well. Chairs, tables anything that they could get their hands on.  No evidence that they specifically tried to get Ebola-contaminated supplies.

                There are many other bioterrorism weapons that are much cheaper and safer for the terrorists to use.  Ebola is not that easy to spread.  

                If a terrorist, infected with Ebola, tried to spread the disease, he would have to have extremely close contact with his victims, have to vomit or bleed on them or somehow otherwise contaminate them with virus. Can't be easily done unobtrusively. And, those that he spewed on would have to fail to clean themselves up properly.    Also, most Ebola patients are really sick when they're symptomatic.  Not easy for them to get around to spread virus.

                Also, rate of infection by Ebola is lower than other viruses.  Mrs. Writebol lived with Mr. Writebol after she had developed symptoms.  Her husband didn't get it.  Dozens of healthcare personnel have returned from Liberia and other affected areas since the outbreak began.  None of them got it.  

                How long Ebola can survive outside of a host varies.  UV light can inactivate it.  So sunlight exposure could do it.  Also washing with 10% bleach, using other chlorine-containing cleaners can kill the virus.  I've heard that out-of-host survival for Ebola could be about 3 days.

                A word to the wise is sufficient. Republicans need at least a paragraph.

                by d3clark on Mon Aug 18, 2014 at 07:13:53 AM PDT

                [ Parent ]

                •  Your fact base with respect to this cycle (2+ / 0-)
                  Recommended by:
                  kfunk937, d3clark

                  of the virus could be optimistic.

                  -- "Ebola is not that easy to spread."

                  -- "[Anyone infected with Ebola] would have to have extremely close contact with his victims, have to vomit or bleed on them or somehow otherwise contaminate them with virus."

                  -- "Most Ebola patients are really sick when they're symptomatic."

                  Out of host survival for Ebola is unknown for field materials. At least days but no tests have been done for survival in organic media. (Any volunteers to run these tests ???)

                  SECTION IV - STABILITY AND VIABILITY

                  DRUG SUSCEPTIBILITY: Unknown. S-adenosylhomocysteine hydrolase inhibitors have been found to have complete mortality protection in mice infected with a lethal dose of Ebola virus (30).

                  DRUG RESISTANCE: There are no known antiviral treatments available for human infections.

                  SUSCEPTIBILITY TO DISINFECTANTS: Ebola virus is susceptible to sodium hypochlorite, lipid solvents, phenolic disinfectants, peracetic acid, methyl alcohol, ether, sodium deoxycholate, 2% glutaraldehyde, 0.25% Triton X-100, β-propiolactone, 3% acetic acid (pH 2.5), formaldehyde and paraformaldehyde, and detergents such as SDS (20, 21, 31-34).

                  PHYSICAL INACTIVATION: Ebola are moderately thermolabile and can be inactivated by heating for 30 minutes to 60 minutes at 60ºC, boiling for 5 minutes, gamma irradiation (1.2 x106 rads to 1.27 x106 rads), and/or UV radiation.

                  Also:
                  COMMUNICABILITY: Communicable as long as blood, secretions, organs, or semen contain the virus. Ebola virus has been isolated from semen 61 days after the onset of illness, and transmission through semen has occurred 7 weeks after clinical recovery.

                  SURVIVAL OUTSIDE HOST: The virus can survive in liquid or dried material for a number of days. Infectivity is found to be stable at room temperature or at 4°C for several days, and indefinitely stable at -70°C (3, 4). Infectivity can be preserved by lyophilisation (= freezing and then warming in a vacuum so ice sublimes.)

                  Transmission at 1 to 10 virus bodies in aerisolized form is easily enough generated. Bleeding on people? No.

                  The practical isolation techniques used so far in Guinea and Liberia have failed to protect health workers. Liberia is down to 250 doctors for a population of 4,000,000. And 7 doctors have come down with Ebola.

                  Drs. Kent Brantly and Nancy Writebol are at Emory. Don't expect much of that level of care in Africa.

                  "The illiteracy of our children are appalling." #43

                  by waterstreet2008 on Mon Aug 18, 2014 at 07:52:14 AM PDT

                  [ Parent ]

                  •  A few things regarding your reply. (1+ / 0-)
                    Recommended by:
                    waterstreet2008

                    Ebola is not that easy to spread.  

                    Dr. Daniel Bausch is an MD with a specialty in tropical medicine.  He has done research on both Ebola and Lassa and fieldwork on outbreaks of filoviruses in Africa, among other places.
                    http://www.onthemedia.org/...

                    The CDC on Ebola: http://www.huffingtonpost.com/...

                    James Wilson, MD (pediatrician and infectious disease specialist) says that should Ebola reach the US, it would not cause a major outbreak and could be controlled relatively easily.  Wilson specializes in studying the course of infectious diseases and making predictions about their ability to spread.  He also has a background in US military intelligence. http://blog.sermo.com/...

                    The Ebola outbreak that didn't occur in South Africa in spite of no precautions taken around two patients who were symptomatic with Ebola and had contact with 300+ other people.  http://americablog.com/...

                    "There are no known antiviral treatments available for human infections."  Not true.  There are treatments available that have been successful in non-human primates.  They have not been tested in humans.  MApp, for example.  Though, since it has been given to Brantly and Writebol, among others, perhaps we can say that human studies are underway.  

                    I didn't mention the other methods of inactivating Ebola, because, most people won't have access to things like a gamma source, but can easily get bleach (hypochlorite.)

                    The two cases of transmission through semen, if I remember correctly, occurred post-intercourse.  The semen was not external to the host and subject to any environmental factors.  It was stored under physiologic conditions in the hosts.  We were talking about blood that is on mattresses and sheets, no longer in the vascular system, and now exposed to environmental factors like sunlight (UV radiation).  I seriously doubt that it would remain infections for 7 weeks.  But I can't say for sure.  

                    Temperature in Liberia is often li the low mid-80s to mid-90s.  "Room temperature" when used in the literature is often assumed to be room temperature in temperate climates and is usually considered to be about 68 degrees F to about  78 degrees F.  My guess would be that Ebola would be less stable in a hot sunny climate like Liberia.

                    I never contended that quarantine or treatment in Africa would be easy.  Outside of Monrovia, most of the rest of Liberia doesn't have electricity or running water.  They don't have the ability to decontaminate used biohazard equipment easily, if they even have biphazard equipment available.  To make an isolation ward at Brantly's hospital, they emptied out the chapel, strung up some ropes and let sheets hang over them.  Then they filled it with Ebola patients.  So, no, isolation/containment won't be easy at all.  But, in more developed countries, that would be much less of a problem.  Both Ebola patients brought to the US have survived.  No one at Emory has gotten the disease.

                    As I mentioned previously, dozens of medical personnel have returned from Liberia and other countries in the Ebola zone to the US and other countries.  None has developed Ebola.  Some of them lived at the hospitals and clinics.  Those that did could have easily been exposed to Ebola patients who were coming in while the medics were sleeping and eating.  Not wearing any kind of protective garb then.

                    A word to the wise is sufficient. Republicans need at least a paragraph.

                    by d3clark on Mon Aug 18, 2014 at 01:19:11 PM PDT

                    [ Parent ]

                    •  Ebola has five major identified strains. (1+ / 0-)
                      Recommended by:
                      d3clark

                      One strain is difficult to transmit.

                      This strain, today, is easy to transmit.

                      The Patrick Sawyer case, "PatSaw," ran up an "8" for re-transmittal at Lagos. And he was hospitalized and isolated asap.

                      "The illiteracy of our children are appalling." #43

                      by waterstreet2008 on Mon Aug 18, 2014 at 02:10:58 PM PDT

                      [ Parent ]

                      •  Sawyer was on a crowded plane, ill with Ebola (1+ / 0-)
                        Recommended by:
                        waterstreet2008

                        vomiting in an enclosed space, air being recirculated (not filtered).  Only 1 person in the plane got Ebola, Sawyer's personal assistant who had spent several days with him.  The other passengers, flight attendants, cleaning crew, none got Ebola.

                        There are five species of ebolavirus.  The RNA from the ebolavirus isolated from this outbreak has a 97% homology with Zaire ebolavirus.  I've read nothing that says that this strain is any "easier" to transmit than Zaire ebolavirus.  If you have links that demonstrate that the ebolavirus in this outbreak is easier to transmit, please provide them.  I'd be interested in reading them.  Thanks

                        Please see the citations I gave, above, re: transmission, infectiousness.

                        A word to the wise is sufficient. Republicans need at least a paragraph.

                        by d3clark on Mon Aug 18, 2014 at 02:56:33 PM PDT

                        [ Parent ]

                        •  That's somewhat dated. (1+ / 0-)
                          Recommended by:
                          d3clark
                          Airborne transmission has not been documented during previous EVD outbreaks. They are, however, infectious as breathable 0.8– to 1.2-μm laboratory-generated droplets. Because of this potential route of infection, these viruses have been classified as Category A biological weapons.

                          Recently, the virus has been shown to travel without contact from pigs to nonhuman primates.

                          Nobody knows for sure.

                          Avoiding vomit comes naturally. 8 people died from some form of contact or another with this patient.

                          "The illiteracy of our children are appalling." #43

                          by waterstreet2008 on Mon Aug 18, 2014 at 04:05:54 PM PDT

                          [ Parent ]

                          •  Not dated. Information released since this event (1+ / 0-)
                            Recommended by:
                            waterstreet2008

                            began.  As indicated in the references I provided, except for the historical reference to the non-outbreak in S. Africa.

                            In the pigs-to-primates study: Pigs, for some reason have more Ebola virus present in their lungs than other species (primates, antelopes, etc.)  In the same study, primate-to-primate transmission was not achieved using the same experimental conditions.  Also, possibility exists that when the experimental area was cleaned daily by hosing the area down, bits of feces were sprayed on the primates.  

                            It's not always possible to avoid vomit if the infected person suddenly vomits on someone else.  Some animals not only don't avoid vomit, they eat it.

                            Again, people on the plane with Sawyer, with one exception, his personal assistant who had prolonged close contact with him for days,  didn't get it.  Mr. Writebol didn't get it.  Dozens of exposed healthcare workers from the area didn't get it.  If it were as easily transmissible as you claim, with even a 60% mortality, the number of cases and deaths in the areas affected would be huge.  

                            Example, the West Point section of Monrovia. People virtually living on top of each other.  Several to a room, many sharing toilets.  Poor sanitation. Some sharing eating utensils.  Ebola present in this area of a few hundred thousand people.  Yet few cases of Ebola.  If it could be transmitted easily, especially by droplet spread, would expect tens of thousands of cases by now, not a dozen.

                            Please show links that have information stating that virus in this outbreak is more easily transmitted than other, similar strains.  Thanks.

                            A word to the wise is sufficient. Republicans need at least a paragraph.

                            by d3clark on Mon Aug 18, 2014 at 09:13:21 PM PDT

                            [ Parent ]

                          •  You miss the obvious. (0+ / 0-)

                            "Please show links that have information stating that virus in this outbreak is more easily transmitted than other, similar strains."

                            Open your eyes.

                            This strain is killing medical personnel and primary care givers by the dozens. Dr. Sheik Umar Khan died in Sierra Leone and he certainly was not exposed to "bodily fluids" from his patients.

                            At end of July 700 had died. Today that looks to be 3,000 verified and nobody knows what is happening off the books.

                            Any research work that was done with earlier strains is loosely  connected to this strain. And a 97% match at the DNA is not even close for such match ups. We're closer overall to chimpanzees.

                            Finally, research that is quoted today is different from new research. D'oh.

                            "The illiteracy of our children are appalling." #43

                            by waterstreet2008 on Tue Aug 19, 2014 at 04:23:54 AM PDT

                            [ Parent ]

                          •  It's obvious that you are more into trying (0+ / 0-)

                            to sensationalize your hypothesis without providing evidence. You make unsupported claims as if they were facts, when they are not.  There's no point in attempting a reasonable discussion with you when you can't make any valid counterarguments (e.g. you've yet to show any evidence for your claim that this strain is highly infectious.)   You seem to only be interested in defending your untenable position and trying to fear monger.  Since that is the case there is no point in continuing.  

                            A word to the wise is sufficient. Republicans need at least a paragraph.

                            by d3clark on Tue Aug 19, 2014 at 05:12:40 AM PDT

                            [ Parent ]

                          •  And nonsense is nonsense. (0+ / 0-)

                            You present nothing to indicate that the R-zero of this strain and its transmittal characteristics match earlier outbreaks.

                            And nobody at WHO is making such claims.

                            "The illiteracy of our children are appalling." #43

                            by waterstreet2008 on Tue Aug 19, 2014 at 02:32:31 PM PDT

                            [ Parent ]

      •  HRed for CT eom (0+ / 0-)

        Back off, man. I'm a logician.—GOPBusters™

        by Mokurai on Mon Aug 18, 2014 at 12:43:21 PM PDT

        [ Parent ]

  •  I'd take R0=8 with a grain of salt... (6+ / 0-)
    The PatSaw prediction of "8" for the R-zero is from a sample size of one.
    Like the joke goes:
    The simplest way to deal with outliers is to always throw out the smallest and largest values from a sample set.

    If you only have two data points, throw them both out.

    If you have one data point, throw it out twice. ;)

    •  That's with Stewart going in hospital (4+ / 0-)
      Recommended by:
      DavidMS, dawnt, G2geek, alx9090

      first day in-country.

      pi-squared.

      Everything is either pi-squared, 5-cents, or 42.

      "The illiteracy of our children are appalling." #43

      by waterstreet2008 on Sun Aug 17, 2014 at 07:40:39 PM PDT

      [ Parent ]

    •  in which case we wait for more data... (4+ / 0-)

      .... such as will come in over the next few weeks when the people who looted that clinic start showing signs of infection.

      If that occurrence was not fomented by a known terrorist group seeking to pay people for infectious samples, then it could be part of another dynamic I see occurring:

      Hypothesis (b):  

      Global "auto-immune response" to population overshoot of resources and pending ecological catastrophes, for example triggered by instinctive recognition of climate change impacts.  In other words:

      People in various regions across the globe are starting to feel it in their guts, that "something is up," that has to do with too many people competing for too few resources.  It may be recognition of "strange weather" as a sign of more and worse to come (climate impacts), or it may be in response to local conditions such as arise from localized population overshoot e.g. "water wars."

      In response to that, we see an increase in bizarre and seemingly irrational behaviors, that all have the effect of contributing to the deaths of large numbers of people.

      In some cases it appears to be "genetic warfare," competition between groups that are homogenous along one or more axes of measurement, such as the I/P conflict or arguably the spread of ISIL.  In some cases it appears to be "self-immolation" where groups act in ways that foment their own destruction, such as with African villagers attacking health care workers, or the present case of people without protective gear looting & handling infectious materials.

      I'm also inclined to think that certain dynamics in the US are related to this, such as the "grab" behaviors on the part of the Oligarchy, and the spread of overt racism and other "same-strata" group conflicts.  This suggests two things:  1)  Progressive strategy should focus on overcoming racism and other group conflicts between elements of the working-class strata, and 2)  Should also focus on creating conflict between factions of the Oligarchy along whatever axes of division can be exploited.

      Wondering what you think of this so far?

      We got the future back. Uh-oh.

      by G2geek on Sun Aug 17, 2014 at 09:44:25 PM PDT

      [ Parent ]

      •  The Monrovia event amounts to mass suicide. (0+ / 0-)

        What? Half of Monrovia before it's over?

        "The illiteracy of our children are appalling." #43

        by waterstreet2008 on Mon Aug 18, 2014 at 04:31:06 AM PDT

        [ Parent ]

        •  auto-immune self destruct. (3+ / 0-)

          This is going to sound terribly detached but none the less:  If conditions in Monrovia are particularly desperate as far as population competition for resources is concerned, then depopulation by 50% would alleviate those conditions.

          But at this point we have three hypotheses seeking data, so I can't think of anything else to do about this but wait for more data.  

          We too easily forget that we are animals, subject to all of the ecological hard limits that affect other animals.

          Sustainable condition for humans on Earth is a population of 3 - 4 billion, living at a mid-range European standard of living, such as in Poland.  

          We got the future back. Uh-oh.

          by G2geek on Mon Aug 18, 2014 at 05:45:20 AM PDT

          [ Parent ]

          •  Are you familiar with John Calhoun's work? (6+ / 0-)

            Starting in the late 1940s researcher John Calhoun studied what happens when population grows in otherwise ideal environments, mostly for the National Institutes of Health. He built rodent "utopias" with no predators and plenty of food, and watched what happened as population grew over time.

            Short version, in the beginning life was very good for the rodents as you might imagine in such an ideal environment, but when population became large it all went haywire. Social structure collapsed, aggressiveness and other antisocial behaviors came out in arbitrary-appearing ways, and eventually the rodents all died off.

            The issue in Calhoun's experiments wasn't Ehrlich's population bomb. The rodents had all the food they wanted. The only constraint was physical space, and the impacts on social structures that developed as the space-per-member declined.

            You suggest that "Sustainable condition for humans on Earth is a population of 3 - 4 billion". Currently we are at twice that level, but Calhoun's work may indicate that even your estimate is far too high.

            In Calhoun's experiments, after the population went over the edge into crazy land the inevitable outcome was complete extinction. After the colony got to the point where social structures collapsed, every rodent died.

            From Calhoun's wikipedia entry:

            Calhoun believed that his research provided clues to the future of mankind as well as ways to avoid a looming disaster. During the 1960s, he and Dr. Leaonard Duhl formed an informal group, the Space Cadets, which met to discuss the social uses of space. The members of this group came from as diverse professions as architecture, city planning, physics, and psychiatry. In Calhoun’s own words “Our success in being human has so far derived from our honoring deviance more than tradition. Template changing always has gained a slight, though often tenuous, lead over template obeying. Now we must search diligently for those creative deviants from which, alone, will come the conceptualization of an evolutionary designing process. This can assure us an open-ended future toward whose realization we can participate.”
            “Our success in being human has so far derived from our honoring deviance more than tradition." Unfortunately, this approach seems to be precisely the opposite of where our culture is currently headed.
      •  rec'd for such an interesting, if nihilistic, (2+ / 0-)
        Recommended by:
        waterstreet2008, highacidity

        hypothesis.

        Yet another I'd hope you're open to consider doing as a diary (or developing as a work of fiction: the human corpus going into auto-destruct, in oh-so-many ways).

        Based on historic/current events, I couldn't say it's not plausible, although I'm beggared if I can come up with a mechanism to explain it.

        And I'd rather see the glass half-full, despite the toll that the willing suspension of disbelief requires (pushing rocks uphill, while evidence sits on them). Mostly because to do otherwise is just not acceptable. I like the view from this side of the grass...

        So now that I've mixed all my metaphors, please carry on.

  •  Thank you for your analisys. (5+ / 0-)

    What do you think of the Germ Theory of Democracy?

    I'd imagine that it would apply in these cases with a vengeance because the disease is transmitted via human contact or contact with infected material.  

    I can only hope that the disease burns itself out sooner than latter.  

    I'm a 4 Freedoms Democrat.

    by DavidMS on Sun Aug 17, 2014 at 08:45:29 PM PDT

  •  death dealing delusions (9+ / 0-)

    The mob that looted the Ebola clinic in Monrovia were under the delusion that Ebola is a fiction
    http://www.theguardian.com/...

    Wesseh said she heard the assailants shouting that President Ellen Johnson Sirleaf "is broke", adding: "She wants money. There's no Ebola" in Liberia.
    Others were saying Ebola is a fiction so that big pharma can make money selling cures.
    •  stupid fools. (8+ / 0-)

      They will soon discover that Ebola is not a fiction.

      But lest we think ourselves superior to an illiterate mob, keep this in mind:  climate denialism.

      Yes it can happen here.

      We got the future back. Uh-oh.

      by G2geek on Sun Aug 17, 2014 at 10:32:00 PM PDT

      [ Parent ]

    •  On second thought: (5+ / 0-)

      The fact that large groups of uneducated youth are so cynical about government & corporations, that they would rampage through a hot zone like that, points to something else:

      There is substantial unrest and conflict around the globe that is driven by the reactions of various peoples to their local oligarchies.  In general these reactions have tended to be:

      a)  Cynicism and resignation such as we see occasionally on DK.  
      b)  Right wing politics including real overt Naziism such as in Greece.
      c)  Criminality ranging from loosely-organized groups to the rise of highly-organized gangs.
      d)  Terrorism generally.
      e)  Tribalism and tribal conflicts generally.

      It may become possible, using the internet and other tools, to organize this into some kind of worldwide rebellion against The Oligarchy generally.

      What all of those reactions (a) through (e) have in common is that they are ignorant of class issues: that the Oligarchy as a whole consists of the top .0001% mercilessly exploiting the bottom 90% while seeking to co-opt the remainder of the top 10%.  

      In Marxist terms (and I'm not a Marxist, but find this language fits the situation):  the Ownership is attempting to co-opt the Bourgeoisie, split the Petty Bourgeoisie against itself, split the Proletariat against itself, and use the Lumpenproletariat against the Proletariat.

      There is probably a Marxist prescription for dealing with those type of dynamics.  But what comes readily to mind, is that a range of successful solutions could be based on strategies that seek to a) unite the Proletariat against the Ownership, and b) build solidarity between the Proletariat and the sympathetic elements of the Petty Bourgeoisie.  

      Comments?

      We got the future back. Uh-oh.

      by G2geek on Sun Aug 17, 2014 at 10:59:22 PM PDT

      [ Parent ]

    •  This form of denialism is quite common (2+ / 0-)

      in the face of health disasters where there appears to be no hope. I have seen it back when cancer mostly couldn't be treated, and quack remedies proliferated. I have seen it in AIDS before any treatment was available, continuing as long as available treatments were unaffordable. I see it now among anti-vaxxers, because we cannot predict or effectively treat autism.

      I have had Nigerian friends who were quite certain that AIDS was created by the CIA to kill Africans.

      It can happen at the point where hope first appears, if there has been enough helplessness before. This is the case with polio in northern Nigeria, Afghanistan, and Pakistan, all areas where health workers risk death at the best of times, and the popular CT is that the polio vaccine is actually meant to sterilize Muslims. If Muslims in these areas could meet Muslims who were vaccinated and now have children, or see them frequently enough on TV, we could disperse this nonsense. But these are exactly the regions where that is not possible.

      The several forms of Ebola CT (It doesn't exist, health workers are deliberately infecting people, it's the CIA) are not surprising if you know anything about other disease CTs.

      I learned about this from my parents, converts to Christian Science. It took a long time to kill them, but it succeeded. (Mostly untreated diabetes with extensive neuropathy, non-healing sores, and eventually heart failure, and mostly untreated congestive heart failure)

      Back off, man. I'm a logician.—GOPBusters™

      by Mokurai on Mon Aug 18, 2014 at 01:10:48 PM PDT

      [ Parent ]

  •  update a few minutes ago (4+ / 0-)
    Beautifully done diary, waterstreet2008. And some really thoughtful commentary. Wow.

    BTW, when I first typed that last, I typoed "Woe." Maybe I shoulda left it that way.

    And Laurie Garrett is well worth following, if you/others don't already know her. Although she's getting some pushback for "fearmongering," perhaps for good reason (considering direct-transmission) from other scientists/science communicators, based in-part on headlines indicating we're not scared nearly enough . . .

  •  Is there any evidence of ebola (1+ / 0-)
    Recommended by:
    waterstreet2008

    being communicated successfully outside of the afflicted areas?
    What I am wondering is if the virus can propagate outside of Africa.

    Another issue, MSF has been saying that cases are doubling every month. If the transmission rate is increasing due to greater population density/contact, we should be seeing those numbers spike strongly. Sawyer arrived in Lagos nearly a month ago, figure an average of say ten days for incubation, and we're onto our third generation of cases in Lagos.

    This is a bad outbreak, but I don't think the numbers suggest that it's going to be a global pandemic.

    … the NSA takes significant care to prevent any abuses and that there is a substantial oversight system in place,” Sen. Dianne Feinstein (D-California), said August 23.

    by mosesfreeman on Mon Aug 18, 2014 at 07:49:58 AM PDT

    •  Italy is possible. (0+ / 0-)

      Abu Dhabi reports a Nigerian woman dying at their airport. Not clear whether they isolated the passengers/crew on her plane.

      Albania has five Africans quarantined. Circumstances not clear.

      Senegal and Ghana are in the mix with WHO reported cases.

      Here we go.

      "The illiteracy of our children are appalling." #43

      by waterstreet2008 on Mon Aug 18, 2014 at 07:59:19 AM PDT

      [ Parent ]

      •  A Saudi national is dead as well (3+ / 0-)

        but I haven't seen any evidence of a case wherein a person acquires the disease outside of Africa. That would be a game-changer.

        … the NSA takes significant care to prevent any abuses and that there is a substantial oversight system in place,” Sen. Dianne Feinstein (D-California), said August 23.

        by mosesfreeman on Mon Aug 18, 2014 at 08:02:43 AM PDT

        [ Parent ]

        •  Senegal and Ghana are the game changers. (1+ / 0-)
          Recommended by:
          mosesfreeman

          Expansion out of Africa is inevitable.

          What's the R-zero in environments outside of Africa? When that question presents, we'll get an idea where this outbreak is going.

          "The illiteracy of our children are appalling." #43

          by waterstreet2008 on Mon Aug 18, 2014 at 08:45:23 AM PDT

          [ Parent ]

          •  Expansion out of Africa isn't inevitable (1+ / 0-)
            Recommended by:
            waterstreet2008

            Infected persons will inevitably leave Africa, though hopefully not in large numbers. What I doubt is that the disease will spread much from the entry points. It's a "dumb" virus, and apparently requires prolonged contact to transmit. We should have seen evidence of communicability outside of Africa already, if it was going to occur.

            If we do see isolated cases of that, it still isn't definitive unless they are widespread and shown to be easily transmissible. I predict that this will fizzle out over the course of months, and while it may spread to Senegal and other regional countries, I don't think it will go global.

            … the NSA takes significant care to prevent any abuses and that there is a substantial oversight system in place,” Sen. Dianne Feinstein (D-California), said August 23.

            by mosesfreeman on Mon Aug 18, 2014 at 09:37:31 AM PDT

            [ Parent ]

            •  Again, here's the known transmission profile: (0+ / 0-)
              Transmission occurs at 1 to 10 virus bodies in aerisolized form.
              And:
              COMMUNICABILITY: Communicable as long as blood, secretions, organs, or semen contain the virus. Ebola virus has been isolated from semen 61 days after the onset of illness, and transmission through semen has occurred 7 weeks after clinical recovery.

              SURVIVAL OUTSIDE HOST: The virus can survive in liquid or dried material for a number of days. Infectivity is found to be stable at room temperature or at 4°C for several days, and indefinitely stable at -70°C (3, 4). Infectivity can be preserved by lyophilisation (= freezing and then warming in a vacuum so ice sublimes.)

              Note that non-symptomatic transmission is well established.

              I don't know where the "prolonged contact" concept got into this discussion. That is not the case. Passing "1 to 10" virus nodes can happen with any form of physical contact I know of.

              There's way too much wishful thinking going on. Possibly reflecting corporate MSM pipe dreams.

              "The illiteracy of our children are appalling." #43

              by waterstreet2008 on Mon Aug 18, 2014 at 09:50:01 AM PDT

              [ Parent ]

            •  Ebola is coming out of Africa. (1+ / 0-)
              Recommended by:
              mosesfreeman

              And when it hits one of the anti-science countries, it will run like a train down the tracks.

              "The illiteracy of our children are appalling." #43

              by waterstreet2008 on Mon Aug 18, 2014 at 09:53:11 AM PDT

              [ Parent ]

              •  See me in November (1+ / 0-)
                Recommended by:
                waterstreet2008

                I predict that ebola will have played hell with west Africa by then, but that cases won't exceed 30,000, and that the disease will be confined to west Africa.

                Just my two cents.

                … the NSA takes significant care to prevent any abuses and that there is a substantial oversight system in place,” Sen. Dianne Feinstein (D-California), said August 23.

                by mosesfreeman on Mon Aug 18, 2014 at 10:02:37 AM PDT

                [ Parent ]

                •  What's you pick for the Urban R-Zero number ? (1+ / 0-)
                  Recommended by:
                  mosesfreeman

                  You get two: for the big cities in West Africa and for Europe.

                  "The illiteracy of our children are appalling." #43

                  by waterstreet2008 on Mon Aug 18, 2014 at 10:09:32 AM PDT

                  [ Parent ]

                  •  This is just a guess (1+ / 0-)
                    Recommended by:
                    waterstreet2008

                    but I would say 3 for Lagos et al, and 0.1 or less for Europe.

                    … the NSA takes significant care to prevent any abuses and that there is a substantial oversight system in place,” Sen. Dianne Feinstein (D-California), said August 23.

                    by mosesfreeman on Mon Aug 18, 2014 at 12:01:39 PM PDT

                    [ Parent ]

                    •  For the first 5 days of infection on average (0+ / 0-)

                      the R-zero is determined almost solely by population density.

                      The sixth day is when the victim shows symptoms, again that's as a average.

                      Ebola don't know no White European "privilege." And it's a miracle that earlier cycles didn't make it to Europe.

                      Cleanliness and education are irrelevant. As a guess an indoor dance club and a commuter train car would compete to be the perfect site for multiple transfers.

                      R-zero = 50 is readily doable for an evening.

                      "The illiteracy of our children are appalling." #43

                      by waterstreet2008 on Mon Aug 18, 2014 at 01:52:25 PM PDT

                      [ Parent ]

                      •  You're not going to see transfer of secretions (1+ / 0-)
                        Recommended by:
                        waterstreet2008

                        in the latter, remember, it's not airborne. All bets are off for the former.

                        So if I'm right, and we see 30k cases or less by November, with no significant breakout beyond Africa, you're buying the drinks right?

                        … the NSA takes significant care to prevent any abuses and that there is a substantial oversight system in place,” Sen. Dianne Feinstein (D-California), said August 23.

                        by mosesfreeman on Mon Aug 18, 2014 at 02:07:03 PM PDT

                        [ Parent ]

                        •  Earlier outbreaks presented high death rates with (1+ / 0-)
                          Recommended by:
                          mosesfreeman

                          low transfer rates.

                          This outbreak is different. The death rate is still sky high and the transfer rate is almost certainly not in the 1-to-2 range -- more like 5 to 10 in urban environments.

                          WHO restated today that "bodily fluids" are the only means of transfer. However, does coughing count? The viability goes a couple of days in saliva -- how much saliva is necessary?

                          Consider behavior when people go into Ebola.

                          Sure thing, we get to November and it's only 30,000 cases and nothing in Europe, I'm good for drinks. Joe's Pub NYC and tickets to what's on stage. And a free surgical mask for jollies.

                          Because otherwise, if this thing isn't stopped before it gets to 10,000 cases: this strain of Ebola could kill 50,000,000 in Africa over a decade. Its robustness looks to be capable of sending it out in wave after wave.

                          Europe? Try Asia. And with what happened in Lagos, we know that transfer is relatively easy. A new strain of Ebola -- you betcha. A Poisson distribution with mean at 1.5 and a 25 event count has less than 1 chance in 100 of throwing off an 8.

                          That PatSaw event killed one nurse wearing full protective gear and anticipating Ebola. And it's killing medical personnel and caretakers by the hundreds.

                          "The illiteracy of our children are appalling." #43

                          by waterstreet2008 on Mon Aug 18, 2014 at 03:54:07 PM PDT

                          [ Parent ]

  •  US Ebola patient to be release today from Emory (0+ / 0-)

    I guess they feel he ias no threat to general public,will he have traces of the virus , no one  know , even money can be a way Ebola can be transmitted if it is contaminated with the virus

Subscribe or Donate to support Daily Kos.

Click here for the mobile view of the site