Ebola Outbreak Vastly Underestimated: WHO

CONAKRY (Reuters) - Staff with the World Health Organisation battling an Ebola outbreak in West Africa see evidence the numbers of reported cases and deaths vastly underestimates the scale of the outbreak, the U.N. agency said on its website on Thursday.

While we are witnessing a true watershed moment in America, specifically in Ferguson, MO, there is another potential danger facing our entire civilization.

Ebola.

The conventional wisdom had been that, as deadly as it is, its fairly hard to catch. I am going to say that has changed and that there is enough evidence in officially published material to make that case, from WHO:

Case identification and detection, contact tracing and patient clinical assessment and management are not the object of this Guidance document and instructions can be found elsewhere.1, 2 However, regarding IPC measures to be implemented during interviews for contact tracing and case finding in the community, the following principles should be kept in mind: 1) shaking hands should be avoided; 2) a distance of more than one metre (about 3 feet) should be maintained between interviewer and interviewee; 3) PPE is not required if this distance is assured and when interviewing asymptomatic individuals (e.g., neither fever, nor diarrhoea, bleeding or vomiting) and provided there will be no contact with the environment, potentially contaminated with a possible/probable case;] 4) it is advisable to provide workers undertaking contact tracing and case finding in the community with alcohol-based hand rub solutions and instructions to appropriately perform hand hygiene.

Interim Infection Prevention and Control Guidance for Care of Patients with Suspected or Confirmed Filovirus Haemorrhagic Fever in Health-Care Settings, with Focus on Ebola
August 2014

For more examples, look at my posts in the Facts, Opions, and Speculations thread.

It is known that the virus can live outside a host, in liquid or dried body fluids, up around 4 days.

This virus shows 3% genetic drift from its sequencing from the 70s, this is due to its mutating within whichever reservoir species it's been residing in since the last outbreak. As a result, it will have differences between many of its known processes.

See Quaratine, West Africa thread for more on this aspect.

There are many facets to how this diseasehas, will, and could further impact our entire society if it's not dealt with and truly contained soon. Please join the discussion here or in any of the many related threads.

I'm not going to suggest something like this could spread throughout the whole globe - I don't think it will - but it is not good news for underdeveloped nations and the humans living in those places. What's more disturbing is how we simply seem to look the other way - as if on command. But that particular tactic works with just about everything heh.

Certainly a horrible situation no matter how you look at it. :

Is it just a matter of containing and telling people to wash the hell up regularly? I'm very ignorant about it.

a reply to: Floydshayvious

Is it just a matter of containing and telling people to wash the hell up regularly? I'm very ignorant about it.

There's a bit more to it than that. There is so much that is still not known about the disease.

Regards to how underestimated it is, (educated) opinions vary:

There's no scientific way of knowing exactly how wrong the official numbers are, says Joseph Fair, an infectious disease doctor who has been acting as a special adviser to the health minister of Sierra Leone. "At a bare minimum, I would guess they're probably off by 20 percent," he says.

In the same article, another says:

"They think it's likely a bit underreported, but not substantially," Fauci says. The number of people affected is not likely to be "many, many, many-fold greater" than what the WHO has estimated, he added.

How much bigger is the Ebola outbreak than official reports show?

MSF said, in June:

"The scale of the current Ebola epidemic is unprecedented in terms of geographical distribution, people infected and deaths," MSF said in a statement yesterday.

The rapid spread of the disease, which is deadly in up to 90 per cent of cases, has overwhelmed aid agencies and health workers and terrified local communities.

"The epidemic is now out of control," said Bart Janssens, MSF director of operations. "With the appearance of new sites in Guinea, Sierra Leone and Liberia, there is a real risk of it spreading to other areas."

West Africa's ebola epidemic is 'out of control', death toll rises to 337


Make note of the numver of rrported deaths then and compare that to as of now:

Wiki:

18 Aug 2014 cases: 2,473 deaths: 1,350

Are we here who are posting about the potential danger this disease poses to our entire society fearmongers?

If so, then the doctors are the forefront of the fight against it are too...

originally posted by: Floydshayvious
Is it just a matter of containing and telling people to wash the hell up regularly? I'm very ignorant about it.

we are not that good at washing either.

Only 5 Percent Of People Wash Their Hands Correctly
"Many people do not wash their hands when the behavior in which they engage would warrant it," begins a recent study from Michigan State University, and I'm sorry to say it only gets grosser from there. Researchers sneakily observed 3,749 people in public restrooms and found that nearly all of them—95 percent—didn't wash their hands long enough to kill germs.

Even scarier, 15 percent of men and 7 percent of women did not wash their hands at all. When they did bother to turn on a faucet, half of men and 22 percent of women neglected to use soap! (Or, as the researchers describe it: They "attempted to wash their hands," but failed.)
www.popsci.com...

Here is one thing that is contributing to the vast underestimation of the outbreak:

The scale of the world's worst Ebola outbreak has been concealed by families hiding infected loved ones in their homes and the existence of "shadow zones" that medics cannot enter, the World Health Organization (WHO) said on Friday.

The U.N. agency issued a statement detailing why the outbreak in West Africa had been underestimated, following criticism that it had moved too slowly to contain the killer virus, now spreading out of control.

World Health Organization warns of 'shadow zones' - hidden cases in Ebola outbreak

But don't worry, it's hard to catch an there is a new miracle cure...

a reply to: jadedANDcynical

Why else might the numbers be off?

One of her colleagues at the CDC who's worked in Liberia says preliminary data shows they could be missing 40 to 60% of the contacts of known Ebola patients.

Ebola patients lie to CDC

You don't say?

a reply to: jadedANDcynical

Posted elsewhere but works here too.

“It’s bad now, much worse than the numbers show. It’s going to get even worse in the very near future.”

CDC Director on Ebola Outbreak: “It’s going to get even worse”

(CNN) — The Ebola outbreak in West Africa is much worse than official figures show, and other countries are unintentionally making it harder to control, Centers for Disease Control and Prevention Director Tom Frieden told CNN Tuesday.

“We’ve seen outbreaks of Ebola before. This is the first epidemic spreading widely through many countries and it is spiraling out of control,” said Frieden, who recently returned from a trip to the region. “It’s bad now, much worse than the numbers show. It’s going to get even worse in the very near future.”

World Bank: Poor response to Ebola causing needless deaths

The world's "disastrously inadequate response" to West Africa's Ebola outbreak means many people are dying needlessly, the head of the World Bank said on Monday, as Nigeria confirmed another case of the virus. ….

……….Doctors Without Borders has warned about a worldwide shortage of the full-body protective suits worn by Ebola health-care workers. Sierra Leone’s Ebola emergency operations center said it faces a six-week wait for the specialized ambulances needed to transport Ebola patients.

Did the CDC drop the ball on Ebola? Did they assume it would burn out quickly?

On 8/1/14, the CDC director said:

Dr Frieden added: 'Ebola is a huge risk in Africa. It's not going to be a huge risk in the U.S.' - See more at: www.georgianewsday.com... ker-infected-with-the-horrific-disease-is-set-to-land-on-american-soil-tomorrow.html#sthash.CCX3EqBB.dpuf

Source: www.georgianewsday.com... ker-infected-with-the-horrific-disease-is-set-to-land-on-american-soil-tomorrow.html


Sept 2, 2014

"We can stop worrying about it here when it's controlled there," Frieden said. "I could not overstate the need for an urgent response."

Source: Read more: www.businessinsider.com...

www.businessinsider.com...

Reports today are beyond alarming.

Worldwide Ebola epidemic grows out of control

UNITED NATIONS (AP) - The international group Doctor Without Borders warned Tuesday that the world is losing the battle against Ebola and lamented that treatment centers in West Africa have been "reduced to places where people go to die alone."

In separate remarks after a United Nations meeting on the crisis, the World Health Organization chief said everyone involved had underestimated the outbreak, which has now killed more than 1,500 people in Guinea, Liberia, Sierra Leone and Nigeria. U.N. officials implored governments worldwide to send medical workers...

Officials rip world response to Ebola crisis

(CNN) - The Ebola outbreak is much worse than official figures show and is "spiraling out of control," a leading U.S. official said Tuesday -- due in part, he said, to some countries that inadvertently have made it harder to corral the deadly disease.

Centers for Disease Control and Prevention Director Dr. Tom Frieden offered his stark commentary to CNN a day after Ellen Johnson Sirleaf, the president of Liberia, voiced dissatisfaction with the world response so far.

And another American doctor with Ebola.

On Tuesday, a group called Serving in Mission announced that another American -- a doctor working in Liberia's capital --- had tested positive for Ebola.

The doctor, whose name was not released, was not treating Ebola patients and it's not known how he contracted the disease, SIM USA said. One of the other Americans infected with Ebola, Nancy Writebol, also was working on a SIM USA mission.

The unnamed American doctor immediately isolated himself upon the onset of symptoms, and is currently in an Ebola isolation unit, the group said.

source
source

Sounds like we are losing the battle...

I wonder if there has not been greater response because it is so large an area, and the people living there don't want to cooperate and they live under corrupt governments. Remember how we tried to help Haiti after the earthquake? It was virtually impossible.

Thank you, everyone, for your contributions!

I know there are probably some people with 'ebola fatigue' and I can't say I blame them, but the reality is that our options are becoming limited.

You know, one of the ways this disease could be underestimated is in its ability transmit itself.

Related to that aspect, present the following:

I posted this in the Ebola: Facts, Opinions, and Speculations thread, but I thought this warranted another mention.

Airborne or not had been hashed out in numerous threads, I know I've participated in many of those threads.

As we know:

In laboratory settings, non-human primates exposed to aerosolized ebolavirus from pigs have become infected, however, airborne transmission has not been demonstrated between non-human primates [1] [10] [15] [44] [45].

Viral shedding has been observed in nasopharyngeal secretions and rectal swabs of pigs following experimental inoculation [29] [30]

Ebola

PATHOGEN SAFETY DATA SHEET - INFECTIOUS SUBSTANCES

This page actually has been updated since I last linked to it. Which is good as this outbreak is moving so quickly I would hope world health authorities stay up to date on the most recent research into this deadly disease.

In that vein, I am contnually scouring google scholar for anything Ebola related. During one of my searches I came across this which was recently published.

Some microorganisms are transmitted by more than one route:
Chicken pox – Airborne and Contact
Ebola- Contact, Droplet and Airborne

Standard & Transmission- based Precautions
Part 9: Transmission-based precautions
Michelle Bergin
ADON Infection Prevention/Control-Midlands
Region September 2014
Standard & Transmission-base

It appears to be accompanying notes for a presentation, possivly related to the author's role as a continuing education teacher for health care professionals, I seriously doubt this is a typo or a misunderstanding because "she's just a nurse."

There's a great reddit thread with an MSF doctor, here that I am sure many would be interested in.

A few excerpts from the thread:

(this shows how understaffed they are)People still hide in the villages when they see the MSF ambulances arrive, and some of the ones who arrive at the treatment centers, cannot be admitted because we're so overwhelmed. We have started doing home-based treatment, but it's a difficult choice and we have to trust that the families will treat their relatives appropriately and not expose themselves to the disease

(This is good news)Thank you! No reason why Ebola should mutate to an airborne virus. It survives in body fluids, but not on dry surfaces due to it's lipid membrane.

(Secondary effects I've not seem mentioned elsewhere)The implications are huge. A deconstructed health system with half of the medical population decimated, a lack of trust in health facilities from the population, and apart from all of the Ebola cases and deaths, all of the non-Ebola cases and deaths that are not being managed, and that are probably in the 10s of thousands.

(This is bad news)[–]Schrodingers_Nachos 10 points an hour ago
Is there an end in sight?
permalink
[–]ELasry[S] 22 points an hour ago
Not if the response is not substantially upscaled

(Comments by me)

Tons more great stuff from someone on the literal front line of this fight at the link.