Ebola, a thread for questions and answers.

[Stratter5]

Thought it might help if we had one thread running purely for Q&As; somewhere where the concerned, or curious, can ask and get a sensible answer. Keep it all together, so it's easier to see if someone's already addressed your Q.

I'll get the ball rolling with a Q about testing. The incubation period is up to 21 days; testing can only be done once symptomatic, and the viral load high enough. Are those who have been tested, and got a negative result, retested until the 21 days is up?

No idea.
But I do know that we need to keep things in proportion: about 3000 people worldwide have died from Ebola. Approx 500,000 people die from influenza each year, and many more from diarrhoea.

There's a thread somewhere, dating back to April-ish, at the beginning of the outbreak in Guinea. Everyone is very complacent, it burns out too fast to spread, it won't last. I think we've been too smug and assured it won't spread, it has, and it's like no other ebola outbreak we've seen.

This isn't a time to panic, we are still safe here, and the likelihood of a UK epidemic is negligible imo. But I think we've underestimated it, it's a relatively new disease in humans, and it's a horrible way to die. New is scary to most people, and a new, horrific virus is going to attract more attention, more fear, and more headlines than diarrohea.

Thank you Middleaged... You have just brought me back to reality after embarrassingly getting caught up in the media scaring hype.

I have a question please.

What do the healthcare workers use to disinfect their protective suits etc? Is it bleach or alcohol based?

I'm just wondering what can kill the virus when it's outside of the body.

Thanks.

HTH! I'm not saying we don't need to take precautions against Ebola, but if I was offered a choice of vaccination right now, I'd take the flu jab.

The spread of the disease in Africa is mostly due to incompetent management by the governments, due mostly to lack of funds.

So the logical question is; how did the nurse in Spain get it then, middleaged?

'What do the healthcare workers use to disinfect their protective suits etc?'

It's bleach (CDC website gives information on concentrations required and minimum soaking times).

'Are those who have been tested, and got a negative result, retested until the 21 days is up?'

Good question! I've been trying to find an answer from a reputable source, but can't. Tests are only considered reliable at 3 days symptomatic (viral load may be too low to be detectable before that), so test on admission (day 1) and again minimum 48 hours later is recommended. They will also test at same time for other common fever-inducing conditions (eg malaria and typhoid).

Whether/when they retest will, I think, depend on wider symptoms. So if someone has tested negative twice and appears to have an ordinary cold, they could be discharged from hospital, but returned to home quarantine with close monitoring until 21 is up an would only need re-testing if symptoms reappeared, worsened or changed.

Well, she obviously touched the patient. Its the only way the disease is transmitted.

Exactly. So with all the training and equipment here, it could still be spread. One patient, yet there's another case. Who's to say any other hcp's are more diligent?

Not arguing with you, by the way, just raising the point.

if I was offered a choice of vaccination right now, I'd take the flu

Me too. 100%. Ebola concerns me, not for my personal safety, but as a general concern. But flu, flu is the one that terrifies me, if I'm honest.

Ritzy turnip - chlorine kills it.

I recommend a book called The Hot Zone by Richard Preston, that someone on the April thread recommended. It gives the stories and anecdotes surrounding the discovery and early cases of Ebola, AIDS, Marburg etc. Really interesting.

Here's a CDC Infection Control guide for ebola which includes decontamination information.

I read the other day something about the Spanish nursing team only being given level 2 gear rather than level 4, and the nurse initially being curtained off from other patients rather than isolated.

This isn't the same article as I can't find it, but similar sentiments here

I read they use uv rays (sunshine) and chlorine to disinfect suits.

I have a question.

Why so they not burn / cremate Ebola corpses? Can the virus not transmit further to "soil dwelling creatures" like worms etc?

Artisan that's shocking. A so called first world country making such basic mistakes.

Why does the flu terrify you? It doesn't fill me with joy, and I do worry about elderly relatives. But terrify? Nope.

Whereas ebola is an extremely scary virus due to its rate of fatalities. I'm genuinely terrified what this virus will do in Africa. It could kill millions.

Thank you all.

Quint Maybe they don't have the equipment to cremate the bodies if traditionally most people are buried?

I'm sure I read somewhere a few weeks ago that 2 incinerators from UK had arrived to one of the worst hit places to help with cremating the bodies.

CDC recommends cremation (intense heat to reduce to ash) or burial in a hermetically sealed container.

I thought I'd read somewhere that cremation was now required, even though it is not the cultural norm. And of course it's low-tech, you just need fire hot enough. But if effective cremation cannot for any reason be carried out, then I suppose you just have to bury in a remote place bagged as well as possible.

It just does Rooner, probably irrationally, but flu scares me. But it's not the actual disease, because I'm quite comfortable about that as my family and I all get the flu jab. It's the thought of a bad pandemic that scares me, and the repercussions from that.

I know it's irrational, i know it is. Some people are terrified of clowns/snakes/dogs, I'm terrified of flu.

Given that 30% of people survive this, how far away are we from mass producing a vaccine from their anti bodies? Or doesn't it work like that?

Yes, I've read the BL2 instead of BL4 nursing in Spain, had to explain it to DD2 earlier.

"Given that 30% of people survive this, how far away are we from mass producing a vaccine from their anti bodies? Or doesn't it work like that?"

Here's an article about using serum to treat patients

All stocks of the experimental drug zmapp have now been used up.

As WHO has approved the use of unproven treatments, I think just about every retroviral drug could be tried.

Vaccine development has been underway for over a decade, according to this but none of the earlier attempts completed testing satisfactorily. The latest version has reached the stage of testing in humans (safety test, following successful animal trials, administered to people this September).

According to this article published in Nature earlier this year, there are no licensed therapeutic or vaccine products available to treat filoviruses. I think it is unlikely that antiretrovirals would work on a filovirus.

Quint if the victims are Muslim they cannot be cremated for religious reasons.

In Sierra Leone, for example, 71% of the population is Muslim.

I would also doubt that very poor countries can afford the luxury of a crematorium.