[vox_mundi]

The Ebola virus seems to me stepping outside the R-naught boundary for the virus [R0 = 1-4] and approaching the R-naught of airborne viruses [R0 = 6-12+]

Background: Watch the movie "Contagion (synopsis: http://www.imdb.com/title/tt1598778/synopsis ) ," in it Winslet's character uses a concept known as "R0" -- pronounced "R-naught [ http://en.wikipedia.org/wiki/Basic_reproduction_number ]"--- to explain to skeptical public health officials that the new virus could be much more contagious than influenza or polio.

Ebola outbreak 'out of all proportion' and severity cannot be predicated
http://medicalxpress.com/news/2014-09-e ... cated.html

A mathematical model that replicates Ebola outbreaks can no longer be used to ascertain the eventual scale of the current epidemic, finds research conducted by the University of Warwick.

The research, titled Epidemiological Dynamics of Ebola Outbreaks and published by eLife, shows that when applying the available data from the ongoing 2014 outbreak to the model that it is, according to Dr House, "Out of All Proportion and on an Unprecedented Scale when compared to previous outbreaks".

Dr House commented: "If we analyse the data from past outbreaks we are able to design a model that works for the recorded cases of the virus spreading and can successfully replicate their eventual size. The current outbreak does not fit this previous pattern and, as a result, we are not in a position to provide an accurate prediction of the current outbreak".

The Warwick model successfully replicated the eventual scale of past outbreaks by analysing two key chance events: the initial number of people and the level of infectiousness once an epidemic is underway.

"With the current situation we are seeing something that defies this previous pattern of outbreak severity. As the current outbreak becomes more severe, it is less and less likely that it is a chance event and more likely that something more fundamental has changed", says Dr House.

... This could be as a result of a number of different factors: [i.e.]mutation of virus

Warwick Paper: http://elifesciences.org/content/elife/ ... 8.full.pdf

also If the Ebola Virus Goes Airborne, 1.2 million Will Die Expert Predicts
http://guardianlv.com/2014/09/if-ebola- ... -predicts/

Econometrics expert Francis Smart has predicted that if the Ebola virus does mutate into an airborne form, 1.2 million people will die from the disease. Smart, from the Michigan State University, published an article in Econometrics by Stimulation in which he outlined the mechanics of his prediction based on the research done by others.

Smart says that death toll numbers based on the more pessimistic opinion that the Ebola virus could mutate and go airborne are much greater. He believes that 20,000 is “vastly too small” and the prediction is “entirely based on effective and well-funded international relief mission..”He went on to predict that by Oct. 24 there will already be over 20,000 cases of the disease, a far shorter time period that the six months that the WHO predicted. Smart continues his analysis to conclude that as many as 4.7 million people will become infected and 1.2 million will die.

Nature does this from time to time

[westexas]

What We’re Afraid to Say About Ebola
http://www.nytimes.com/2014/09/12/opinion/what-were-afraid-to-say-about-ebola.html?emc=edit_tnt_20140911&nlid=745484&tntemail0=y&_r=1

By MICHAEL T. OSTERHOLMSEPT. 11, 2014
Michael T. Osterholm is the director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Excerpt:

The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air. You can now get Ebola only through direct contact with bodily fluids. But viruses like Ebola are notoriously sloppy in replicating, meaning the virus entering one person may be genetically different from the virus entering the next. The current Ebola virus’s hyper-evolution is unprecedented; there has been more human-to-human transmission in the past four months than most likely occurred in the last 500 to 1,000 years. Each new infection represents trillions of throws of the genetic dice.

If certain mutations occurred, it would mean that just breathing would put one at risk of contracting Ebola. Infections could spread quickly to every part of the globe, as the H1N1 influenza virus did in 2009, after its birth in Mexico. Why are public officials afraid to discuss this? They don’t want to be accused of screaming “Fire!” in a crowded theater — as I’m sure some will accuse me of doing. But the risk is real, and until we consider it, the world will not be prepared to do what is necessary to end the epidemic.

In 2012, a team of Canadian researchers proved that Ebola Zaire, the same virus that is causing the West Africa outbreak, could be transmitted by the respiratory route from pigs to monkeys, both of whose lungs are very similar to those of humans. Richard Preston’s 1994 best seller “The Hot Zone” chronicled a 1989 outbreak of a different strain, Ebola Reston virus, among monkeys at a quarantine station near Washington. The virus was transmitted through breathing, and the outbreak ended only when all the monkeys were euthanized. We must consider that such transmissions could happen between humans, if the virus mutates.

[GHung]

Ebola: How bad can it get?

....But there are is also a fear being raised by some virologists that Ebola may never be contained.

Prof Jonathan Ball, a virologist at the University of Nottingham, describes the situation as "desperate".

His concern is that the virus is being given its first major opportunity to adapt to thrive in people, due to the large number of human-to-human transmissions of the virus during this outbreak of unprecedented scale.

http://www.bbc.com/news/health-29060239

Ebola outbreak: UN calls for $1bn to fight virus

"We requested about $100m a month ago and now it is $1bn, so our ask has gone up 10 times in a month," the UN's Ebola co-ordinator, David Nabarro, told a briefing in Geneva.

http://www.bbc.com/news/world-africa-29224752

[vox_mundi]

pstarr:

... An airborne mutation would need to be quite complex, a physical rewrite of the entire morphology, a rewrite of the genetic coding and expression.

Not necessarily. Ebola Reston may be airborne transmissible

http://www.cdc.gov/vhf/ebola/pdf/fact-sheet.pdf
CDC - Ebola Hemorrhagic Fever Fact Sheet

Ebola-Reston appeared in a primate research facility in Virginia, where it may have been transmitted from monkey to monkey through the air. While all Ebola virus species have displayed the ability to be spread through airborne particles (aerosols) under research conditions, this type of spread has not been documented among humans in a real-world setting, such as a hospital or household.

Growing concerns over 'In the Air' transmission of Ebola
http://www.bbc.com/news/science-environment-20341423

Canadian scientists have shown that the deadliest form of the Ebola virus could be transmitted by air between species. In experiments, they demonstrated that the virus was transmitted from pigs to monkeys without any direct contact between them.

In their experiments, the pigs carrying the virus were housed in pens with the monkeys in close proximity but separated by a wire barrier. After eight days, some of the macaques were showing clinical signs typical of ebola and were euthanised.

... The authors believe that more work needs to be done to clarify the role of wild and domestic pigs in spreading the virus. There have been anecdotal accounts of pigs dying at the start of human outbreaks.

http://www.nature.com/srep/2012/121115/ ... 00811.html
Transmission of Ebola virus from pigs to non-human primates

Pigs seem to give off more aerosolized viral particles than other species, says Derek Gatherer, a viral evolutionary biologist at Lancaster University in England. “If it’s going to spread by aerosols, then pigs are the species to do it,” he says.

https://www.sciencenews.org/article/air ... tudy-shows

[dohboi]

So this could go airborne...if pig[viruse]s could fly!?

Thanks for these important links, all.

There is another ebola thread, but I think it's time to have another one here, perhaps focused on what the outbreak suggests about our relationship with 'nature' (jumping off of vox's comment at the end of her opening post: "Nature does this from time to time").

This might, as the title suggests, be a good place for those who want to talk about preps.

Do feel free to post comments particularly regarding news of further spread of the disease at the other thread, too:
ebola-pandemic-pt-2-t70138-360.html

[GHung]

Preps? Good preps are generally the same for most situations. Everyone should be able to shelter reasonably comfortably in place (home) for at least a month; six months if you're a Mormon. If I'm forced to travel I carry my bugout (really 'bughome') bag. We keep months of food staples on hand, along with some luxuries; no sense in being homebound and miserable if a plague breaks out.

A good med kit and extra meds, and a means to disinfect things. We always have at least several gallons of household bleach in the store-room. I also keep a couple of gallons of concentrated 'kennel cleaner' that is essentially the equivalent to a surgery disinfectant for hospitals; kills about every pathogen known. I use it to disinfect the dog kennels, grooming room, hen house, and whelping/birthing areas periodically (http://www.petagree.net/store/p/1035-Ke ... allon.aspx - makes 64 gallons and smells nice). A couple of boxes of surgical masks/gloves; in case one needs to treat the sick/dead or venture out during a flu epidemic, etc., and a large roll (20'x100') of 6 mil plastic that could be used for isolation and body bags. Plenty of duct tape, of course.... and a good shovel.

Don't forget the pets have needs as well. Having to venture out for cat food isn't a good idea during disruption or an epidemic; your best strategy is isolation if you're not a first-responder or medical staff.

[dohboi]

Maybe some extra masks? Maybe some of those beaked ones?

[Newfie]

As opposed to "stock up" I would ask the question

"What is your strategy to survive should ebola strike your area?"

[Ibon]

Here at Mount Totumas we are 10km up a 4WD road and almost nobody wanders up here. We would stock up on 6 months food supply for us and our neighbors and wait it out. But what good is this for my wife and I, older, while we would watch our offspring and family members down in the masses suffering and dying. That would be worse than death. I could not get any of my children to willfully at this point pull up their lives and come here as a refugee until this would blow over. They have already heard me cry wolf one too many times.

The problem for all of us is that most would wait until the situation gets so undeniably bad that by then your options are restricted. Borders will be closed. Food rationed etc. etc.

WE have all been collectively numbed by The Boy Who Cried Wolf phenomenon . So many global threats that haven't materialized we could so easily get caught totally off guard.

This could get real and by then your options have closed.

But to go ahead and start now isolating yourself? Cancel trips? Change itineraries? Head for them there hills?

I think it is still very premature.

But the window between being premature and too late could be a very very small window.

Just saying.

[ritter]

I wonder, if ebola makes it to another continent, will it find a new/suitable reservoir? Hunkering down and waiting out a local flareup is a very different scenario than a disease with a local reservoir. It would no longer be African. It would be a world-wide background disease, just waiting for someone to eat under cooked pork (or whatever the reservoir host is) to spark the next outbreak.

[vox_mundi]

Hunkering down for the initial flare:-p may not be sufficient.

The 1918 Spanish flu pandemic repeatedly struck in 3 or 4 waves over 18 months, until the surviving population [herd] had built up enough immunity to support continuation of the epidemic.

The R0 had fallen below 1.0

Not sure if Ebola will follow a similar trajectory.

[Newfie]

Ibon,

We have a different strategy, and a similar problem. We have the boats with which we could transport our kids to relative safety in Newfoundland.

That said, the boys don't have any sailing experience, our daughter a little. They have wee ones, messy and troublesome.

But like you they don't want to know about it.

This past weekend I was talking to my wife about this very thing. If it comes to quarantine, and I am very hopeful it will NOT, it could be imposed quickly, without notice. One wonders if they would try to bar a sailboat from leaving the country, they might.

We have jobs we can't abandon on a whim, it occurs in February or so taking to the North Atlantic is no trivial decision. Judging when to bolt could be a real trick.

[careinke]

We have a guest cabin to use as an isolation unit if needed. But it is still way to early.

[Lore]

It looks like an Ebola vaccine is on the horizon. This is a case where nothing was previously developed because of the low incidence of the disease. Whether it comes in time before a wider spread is something we'll have to wait and see.

My concern is the greater the spread of Ebola the more opportunity for a harmful mutation.

[Subjectivist]

The problem is most vaccines have a .1% or so infection rate so if you give the vaccine to 300,000,000 Americans 30,000 of them will be infected from the vaccine. With a 90% death rate the vaccine itself would kill 27,000 people, so if the natural death toll would be lower then using the vaccine would be worse.

[ROCKMAN]

And then there's this reality check:

"Indeed during the presidency of George W. Bush, when the nation confronted an intentional attack with anthrax, Drs. Kenneth Bernard and Robert Kadlec served as Special Assistant to the President for Biodefense. Though the current Administration has no such position, the permanent presence of such a position, with the ability to cut across government agencies and act with authority during public health emergencies, has been advocated and endorsed by many in the public health emergency field as well as the Government Accounting Office .

Currently, amidst the many executive branch “czars”, only one infectious disease has its own specific “czar”. This disease, HIV/AIDS, is the leading killer amongst its fellow infectious diseases and the Office of National AIDS Policy serves to coordinate the efforts of the US government to control infections with this virus. Notably, there is no czar for other infectious diseases that, like HIV/AIDS, inflict a considerable amount of morbidity and mortality on the world and the US such as tuberculosis, malaria, bacterial meningitis, pneumonia or influenza—the last two of which comprise the leading infectious disease cause of death in the US. The appointment of a US Surgeon General with infectious disease expertise, a senior-level biosecurity/emerging infectious diseases coordinator and a prioritization of the WHO and CDC budgets and workforce to ensure the capability to perform core functions are the essential components of the path forward."

Note: "pneumonia or influenza—the last two of which comprise the leading infectious disease cause of death in the US": Together, pneumonia and influenza represented a cost to the U.S. economy in 2005 of $40.2 billion. Pneumonia and influenza together are ranked as the eighth leading cause of death in the United States. Pneumonia consistently accounts for the overwhelming majority of deaths between the two. In 2006, 55,477 people died of pneumonia.

US death toll for 2014 so far: pneumonia - about 35,000. Ebola -o-. Always good to keep matters in perspective IMHO.

[vox_mundi]

Subjectivist:

.... The problem is most vaccines have a .1% or so infection rate so if you give the vaccine to 300,000,000 Americans 30,000 of them will be infected from the vaccine. With a 90% death rate the vaccine itself would kill 27,000 people, so if the natural death toll would be lower then using the vaccine would be worse.

Sorry, but I've got to call bull-shit when I see it.

First. The statement ...

... most vaccines have a .1% or so infection rate ...

has no basis in fact - ZERO! Not one single study supports that statement.

Second. All current vaccines are using Ebola surface protein fragments - not dead or attenuated virus. You can't get the disease if the vaccine doesn't even contain any of the virus RNA.

Third. If 300,000,000 Merikans contract a disease with a 50% Case Fatality Rate (CFR), then 150,000,000 will be needing body bags which happens to be a WAY BIGGER number than 27,000 which is the number you pulled out of thin air.

Other than that, have a nice day.

[vox_mundi]

Ebola vaccine: Little and Late
http://news.sciencemag.org/africa/2014/ ... late?rss=1

Good News: The scientific hurdles are not particularly high. Companies have made similar vaccines at high volume, and animal studies have shown that Ebola virus is fairly easy to defeat with the proper immune response. “Although Ebola is a very scary, hemorrhagic virus, all you need is fairly modest neutralizing antibody response and you’re protected,”

Bad News: An Ebola vaccine made by GlaxoSmithKline (GSK) in Rixensart, Belgium, is the furthest along, having entered phase I human trials on 2 September. GSK has committed to manufacturing up to 10,000 doses of the vaccine … But hundreds of thousands of doses would be needed to put a dent in the outbreak. That “would take one-and-a-half years at the scale we’re working at,” says Ripley Ballou, who heads the Ebola vaccine program for GSK. - most optimistic timeline for 100,000 to 500,000 doses - 9 months

How deadly is Ebola? Statistical challenges may be inflating survival rate
http://news.sciencemag.org/africa/2014/ ... vival-rate

… actual CFR (Case Fatality Rate) > 70%

Rock - Currently Ebola fatalities are doubling about every 21 days which works out to:
15-Sep-14 - 2,500
6-Oct-14 - 5,000
27-Oct-14 - 10,000
17-Nov-14 - 20,000
8-Dec-14 - 40,000
29-Dec-14 - 80,000
19-Jan-15 - 160,000
9-Feb-15 - 320,000
2-Mar-15 - 640,000
23-Mar-15 - 1,280,000
13-Apr-15 - 2,560,000
4-May-15 - 5,120,000
25-May-15 - 10,240,000
15-Jun-15 - 20,480,000
6-Jul-15 - 40,960,000
27-Jul-15 - 81,920,000
17-Aug-15 - 163,840,000
7-Sep-15 - 327,680,000
28-Sep-15 - 655,360,000

It could surpass global deaths from malaria by springtime

Special Power During a State of Health Emergency
http://www.publichealthlaw.net/MSEHPA/MSEHPA2.pdf

pg 24 Rationing, Priority (Who goes to the front of the line)

Legal Authorities for Isolation and Quarantine
Executive Order 13295

Based upon the recommendation of the Secretary of Health and Human Services (the “Secretary”), in consultation with the Surgeon General, and for the purpose of specifying certain communicable diseases for regulations providing for the apprehension, detention, or conditional release of individuals to prevent the introduction, transmission, or spread of suspected communicable diseases, the following communicable diseases are hereby specified pursuant to section 361(b) of the Public Health Service Act:

(a) Cholera; Diphtheria; infectious Tuberculosis; Plague; Smallpox; Yellow Fever; and Viral Hemorrhagic Fevers (Lassa, Marburg, Ebola, Crimean-Congo, South American, and others not yet isolated or named).
(b) Severe Acute Respiratory Syndrome (SARS)

http://www.cdc.gov/quarantine/aboutlaws ... ation.html

In addition to serving as medical functions, isolation and quarantine also are “police power” functions, derived from the right of the state to take action affecting individuals for the benefit of society.

U.S. Customs and Border Protection and U.S. Coast Guard officers are authorized to help enforce federal quarantine orders.

Ebola Science Resource: http://www.sciencemag.org/site/extra/ebola/