Ebola part 3: FOR THE LOVE OF GOD DON'T PANIC!

[The Iceman of the North]

Iceman,

And had he been properly isolated at that point, perhaps, it would have stayed that way.

My original point was to point out that the Dallas Presbyterian did a worse job than the Lagos hospital after the diagnosis. What's your point?

[Ser Scot A Ellison]

Iceman,

That I agree?

[Cuellar]

Why can't it be both the Nurse and the CDC's fault?

[The Fallen]

Not panicking yet. Then again I don't know how fast this can go from being possibly contained to getting out of control.

[Swordfish]

Um, I wasn't in that part of the last thread at all. CDC screwed up--they know it, they've admitted it. I'm just pointing out that it was really bad judgment on the part of the nurse herself to even show up at the airport under the circumstances. Under any circumstances, really. Have some consideration for the other passengers.

I fail to see what's so difficult to understand about that.

You don't think she bears any responsibility here?

there's nothing difficult to understand about that.

Sure. She does. She was obviously concerned, that's why she called the CDC. They told her it was fine. She is not the expert here though.

the blaming iof the nurse is particularly amusing to me since when people question the information coming out of the CDC, you generally call them irrationally panicky.

So which is it? We are to trust the CDC or not?

I'll take a crack at that. Because it's the big bad gubmint and we have to blame everything on them?

I can't imagine the howls of rage if there was a total quarantine in place. Losing your personal freedoms and all that. They'd say the gubmint was overstepping its bounds.

Ah yes... The ultimate power of the strawman has been invoked. nicely played.

.

[Mudguard]

Yes. Like, seriously, there is a range for normal human body temps and a range for what is considered a fever. The very fact that your body temp can change and reflect the state of your health very much implies that there is a "magical" cutoff number. One temp indicates a fever, another doesn't.

I get the feeling you trying hard not to understand the whole concept of body temperature.

Since you believe in the magical cutoff number, which has been set at 100.4F, do you believe that a person infected with ebola at 100.3F is not infectious? They are below the cutoff so it's not considered a fever, by your definition.

[TrueMetis]

Is fever the only criteria? Cause it seems like there would be more to it than that.

[Ice Queen]

there's nothing difficult to understand about that.

Sure. She does. She was obviously concerned, that's why she called the CDC. They told her it was fine. She is not the expert here though.

the blaming iof the nurse is particularly amusing to me since when people question the information coming out of the CDC, you generally call them irrationally panicky.

So which is it? We are to trust the CDC or not?

Ah yes... The ultimate power of the strawman has been invoked. nicely played.

.

No, I wasn't creating a straw man, just making an observation.

Second, yes, trust CDC. It would be utter mass panic without them and they are acting in the best interest of the country. Just remember, it was always expected that we would have cases here. You also need to consider the role of hospitals in this. CDC can't do it all. The other factor is that it's all well and good to analyze from the safety of a keyboard, but we are dealing with something that's never been dealt with in this country before. AIDS comes closest to the media scrutiny and criticism we're seeing now.

[Shryke]

Is fever the only criteria? Cause it seems like there would be more to it than that.

Perhaps. But fever, or generally being sick, is the outward sign of an infection.

Body temp is the main criteria for a fever though afaik and it certainly seems to be the criteria the CDC uses to judge whether someone has a fever or not and thus what category they fall in to.

[Fez]

I read somewhere (can't link now as I'm on my phone) that you can catch Ebola 3 from meaningful eye contact with an infected person.

Stay safe and double-up on sunglasses, people.

This lady knows the score.

[Tears of Lys]

Dear Board:

Not panicking here.

Just thought you'd like to know.

[Fez]

So I don't know what this means yet (although I presume it relate to West Africa, not the US)...

The Associated Press ‏@AP 1m1 minute ago

BREAKING: Obama authorizes call-up of National Guard, reserves if needed to address Ebola.

But this whole saga is seriously following the zombie movie playbook step-by-step. If nothing else, I have even more respect for Max Brooks and others.

[Aemon Stark]

Aemon, from the previous thread you stated, in response to my post =:

I don't care if you want to call a temp of 99.5F a low grade temp, slightly elevated temp, or whatever, but on what basis do you assert that a person with a temp of 99.5F is not infectious for ebola, while a patient with a temp of 100.4F is infectious for ebola? There's some magical cutoff number? To be clear, you are saying that for a person infected with the ebola virus with a temp of 99.5F, you can safely come into contact with their blood, vomit, diarrhea and other bodily fluids because they aren't infectious?

Seriously?

Of course there's a cutoff number. That's what a fever is. I'm saying that a temp of 37.5/99.5 is not a fever and isolated without any other symptoms it is not indicative of anything, Ebola or otherwise. I'm just assuming, but I don't think this other nurse was having profuse diarrhea when she made that call.

[Mudguard]

Of course there's a cutoff number. That's what a fever is. I'm saying that a temp of 37.5/99.5 is not a fever and isolated without any other symptoms it is not indicative of anything, Ebola or otherwise. I'm just assuming, but I don't think this other nurse was having profuse diarrhea when she made that call.

That's not the question. I'll even tweak it to exclude other symptoms. Are you saying that for a person infected with the ebola virus with a temp of 99.5F and not showing any other symptoms, you can safely come into contact with their blood, vomit, diarrhea and other bodily fluids because they aren't infectious?

ETA: and how about 100.3F with no other symptoms? 100% not infectious?

[Aemon Stark]

No I'm saying that someone who has no symptoms and reports a temp of 37.5 is showing no evidence of infection.

I'm also not talking about whether someone would be infectious at this or that temp. Even in the presence of possible Ebola exposure, someone with no symptoms and no fever is not infectious, but that changes with the emergence of any symptom, including fever (>38). But at the same time, these symptoms are also non-specific and their presence is not, in itself, evidence of Ebola infection.

As for this case, the nurse reported a normal temp and no other symptoms. Not infectious. Certainly not necessarily infected with Ebola.

(And it should be capitalized by the way.)

[TerraPrime]

Fever is one of the many signs used in diagnosing Ebola infection. It is not the only sign. Patients will need to present other symptoms, such as muscle pain, headache, vomitting, diarrhea. Each of these symptoms are non-specific and even as a group, is not exclusively associated with Ebola virus disease. However, fever is one of the more consistent features of Ebola infection and the severity can be monitored objectively and noninvasively, so it's become a good tracking tag in identifying potential patients of EVD.

As for the temperature cut-off, it's about statistics and percent confident interval. 101.5F is the cut-off for consideration of EVD diagnosis because statistically speaking, temperatures that do not reach this limit are much more likely to be associated with non-EVD. The "magic" is in the statistics and pathogenicity of the virus. I don't know why this becomes such a sticking point. The second infected nurse, Ms. Vinson, had a temperature that was borderline above normal body temperature and not close enough to the diagnostic cut-off for Ebola.

As we approach the regular flu season, we are going to see a large number of people with fever and muscle ache, and by coincidence, some of them could probably trace contact by 2 to 3 steps to someone who might have possibly been exposed to Ebola. The strain on our quarantine system and public healtmanagement system will be immense if we classify every temperature of 99.5F as worthy of quarantine. On a personal level, I am ok with this and I am also ok with a much aggressive and forceful quarantine protocol, but on a pragmatic angle, I don't think the U.S. public will accept this or that it would be feasible in terms of our capacity to handle a more stringent level of quarantine.

[Mudguard]

No I'm saying that someone who has no symptoms and reports a temp of 37.5 is showing no evidence of infection.

Well, that makes sense but doesn't at all answer my question.

[Mudguard]

Fever is one of the many signs used in diagnosing Ebola infection. It is not the only sign. Patients will need to present other symptoms, such as muscle pain, headache, vomitting, diarrhea. Each of these symptoms are non-specific and even as a group, is not exclusively associated with Ebola virus disease. However, fever is one of the more consistent features of Ebola infection and the severity can be monitored objectively and noninvasively, so it's become a good tracking tag in identifying potential patients of EVD.

As for the temperature cut-off, it's about statistics and percent confident interval. 101.5F is the cut-off for consideration of EVD diagnosis because statistically speaking, temperatures that do not reach this limit are much more likely to be associated with non-EVD. The "magic" is in the statistics and pathogenicity of the virus. I don't know why this becomes such a sticking point. The second infected nurse, Ms. Vinson, had a temperature that was borderline above normal body temperature and not close enough to the diagnostic cut-off for Ebola.

As we approach the regular flu season, we are going to see a large number of people with fever and muscle ache, and by coincidence, some of them could probably trace contact by 2 to 3 steps to someone who might have possibly been exposed to Ebola. The strain on our quarantine system and public healtmanagement system will be immense if we classify every temperature of 99.5F as worthy of quarantine. On a personal level, I am ok with this and I am also ok with a much aggressive and forceful quarantine protocol, but on a pragmatic angle, I don't think the U.S. public will accept this or that it would be feasible in terms of our capacity to handle a more stringent level of quarantine.

I agree with all this. A specific cutoff must be chosen as a practical matter to enable screening. Sure. But that's a separate issue than the question I was posing.

[TerraPrime]

And I addressed that - it's about statistics. There is no 100% gurantee because we cannot preclude all possibilities a priori. We can only measure the risk based on past data.

So, is someone with 99.8F fever capable of shedding Ebola virus? Possible, but very improbable. Another person with fever at 100.1F? Still improbable, but more likely than at 99.8F.

Is that the answer you're seeking?

[Mudguard]

And I addressed that - it's about statistics. There is no 100% gurantee because we cannot preclude all possibilities a priori. We can only measure the risk based on past data.

So, is someone with 99.8F fever capable of shedding Ebola virus? Possible, but very improbable. Another person with fever at 100.1F? Still improbable, but more likely than at 99.8F.

Is that the answer you're seeking?

Like I said, I agree with you. And yes, that's more or less the answer I was looking for. There's enough evidence that low grade fever or elevated temperature or whatever you want to call it, is one of the early symptoms, and absent any other symptoms like diarrhea or vomiting, probably means that there's a low risk of transmission. I would classify both 100.4F and 99.5F in the low risk of transmission category. My only point, and it's clear that there are people who disagree, is that it doesn't make sense to claim that there is zero risk at 99.5F while maintaining that there is a risk at 100.4F.