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Ebola.....where Now?

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Sqad | 10:31 Wed 31st Dec 2014 | News
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http://www.dailymail.co.uk/news/article-2891870/How-did-miss-ebola-nurse-sick-complained-fever-Heathrow-asked-tested-SEVEN-TIMES-revealed-caught-disease-hug-church.html

I have mentioned on many threads on this subject that we need a scientific approach to the problem of Ebola in West Africa, mainly involving public Health preventative measures PLUS........that little bit of LUCK .
Up until now, we have had this commodity, but i fear it has run out.

Science versus anecdotal evidence.

The nurse new that she had a temperature and that she was a suspect for Ebola infection, but her temperature was normal.

Who should one believe....science OR the nurse?

My old teacher at med school impressed upon us....." In the vast majority of cases, the diagnosis will be made by talking and listening to the patient"

Modern medicine with it's "tick boxes" and links to various web sites, have forgotten that true and important maxim.

Is the incubation period 7-21 days?..............
Can one only catch Ebola by direct contact of body fluids?..........are you sure?

Should one isolate ALL travelers from West Africa, as suggested by many ABers, but kicked into touch by others?..........it looks a good move to isolate for 3 weeks.

Are you sure that the virus isn't airborne?

Sqad's views only, who is now a little more concerned about UK spread, than perhaps a week ago.

Still no need to panic, but the UK must "pull it's socks up."
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After much scoffing from the usual suspects, on this site, it looks like some form of quarantine is a must. The present system is obviously a disaster waiting to happen.
Both, Sqad, from what R4 was saying. Despite the Nurse having said that she felt a flush at Heathrow, they tested her 6 times in 30 minutes, her temp normal. However, perhaps they should have 'quarantined' her and PHE is reviewing their procedures as we speak, according to their CEO (forget her name). That perhaps is the learning point, particularly as the 'warning' came from an honest nurse who has been on the front line.

What amazes me though is that she isn't getting that wonder drug, rather it's a rapid hydration therapy - the Brit hospital in Sierra Leone is reporting a 50% recovery rate by this and they don't have the sophisticated facilities of the RFH.

The Cornish one has just been announced that it is negative, by the way.

As to infection, I would have thought that the routes to transmission would be more than well understood now - it's not the first outbreak there has been, just the most serious. And, after all, there is a screening test, a blood sample, that has been developed in the UK and in the process of being put into the market - this can detect Ebola when its dormant - that perhaps is the best route!
This latter development would allow for screening of health workers before departure and a minimal quarantine for those taken aside at our airports etc. I understand that the analysis work is also a quick process.
The problem is, what we should do and what we can do given constraints such as "human rights".

Personally I am all for a 3 week quarantine, as I have expressed on here before, but that, for some reason, does not bode well with some.

What I would be interested in is where the 'some' are. Are they even in the UK, and if they are, do they reside in cities or in rural areas. Is their chance of catching it so remote they can put principles before sense?

Like yo usay, no need to panic - yet. But it only needs for a case such as this where 3 planes were caught to also include the tube or another such crowded area for it to spiral beyond our control. Not everyone can go to the London hospital.
Clearly taking one's temperature is not sufficient checking to diagnose Ebola. Did they actually do anything else ?
In Science v. Anecdotal evidence, there's no real contest. Not that one is always right and the other wrong, but one is many times more likely to be right in general than the other. The occasions where some personal anecdote turns out to be correct are vastly outweighed by the many times it was just panic over nothing. That's empirically true, regardless of what some people may think.

Yes, we can be sure that Ebola is not airborne. By about now, if it were, then the infection rate in the three main countries would have spiralled out of control by easily an order of magnitude more cases than we're actually seeing.

Scoffing it is not, svejk. I'm not all that surprised that there are procedural issues -- there always are, sadly -- but the risk to the general UK public remains tiny.
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jim.

You first paragraph in your answer...............;-)

You second paragraph........I agree, but is one sure of the incubation period and convertibility only from bodily fluids during onset of symptoms?

I am not as confident as you in the final sentence of your final paragraph.

You have not mentioned 21 day isolation for ALL travelers from affected countries, for which i now totally support.
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"convertibility!.......should be contractability.
jim, you keep saying you'd be 'surprised' if we had an epidemic. Yeah, you could be a bit surprised and I could be a bit dead. I know which side of the safety line I'd rather err on.
Just an aside but did you realise that all returning medical staff are given 3 weeks paid leave upon returning?
I had understood that the disease was only infectious when symptoms came on. Even if this is no longer true, as is certainly possible (diseases can evolve after all), then it doesn't seem to be affecting the infection rate all that much. No, all the signs seem to point to the disease being very controllable when it comes to a new region such as the UK, and so I remain confident that the danger to the country is slight.

In terms of a mandatory incubation period. Hmm... it depends rather on the test carried out. The DM article implies that only her temperature was taken, and evidently that's not enough.
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Zac....thanks , i didn't know.

So that 3 weeks paid leave is a "bonus" to their monthly pay which wes continued whilst in West Africa?
This assumes health is a pure science which in my opinion it is not, there are far too many variables. How one person reacts to a particular cold virus, for example, may be totally different to someone else. As for the nurse, taking her temp repeatedly was clearly irrelevant (she could have taken paracetamol for example, as most do when they feel a bit off, which would have masked any fever.
I'm for quarantine I'm afraid, if you travel from there you need to accept the drawbacks.
I'd be more than surprised obviously, I'd also be bloody terrified. But it's bad risk assessment in this case to make it out like this is a real and imminent danger with a high probability of causing many hundreds or thousands of deaths. Realistically it's not even close to that, and there is no need whatsoever to imagine a doomsday scenario.

If the disease had arrived in the UK before places like Nigeria, Mali, Spain and the US, and we'd therefore not seen that the disease could be swiftly contained, then I would be less confident for sure. But it went to those places first, they dealt with it effectively, it barely spread beyond the first handful of cases, and the clear implication is that we can expect the same here.
Her temp was taken a further six times in 30 mins. Surely this isn't a long enough period?
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Prudie......exactly.
Sqad, I wouldn't call it a 'bonus' but I believe it's something which the taxpayers should be aware of.
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Zac......OK........but i would n't go to West Africa for just 3 weeks pay..............no way.
You were a surgeon. You wouldn't get out if bed for less than three weeks nurses pay. ;-)
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Zac....LOL.....depends upon with whom I was in bed.......;-)

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