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Thread: Ebola - a nurse's perspective

  1. #1

    Ebola - a nurse's perspective

    HEALTH
    Ebola, A Nurse’s Perspective

    So a few months ago the country was enthralled with the idea of a few patients, infected with the Ebola virus, coming to the United States. Up until this point, we had been safe from Ebola due to the fact that bats can’t fly over the Atlantic. Some people were completely indifferent, while others had seen Outbreak one too many times. Most were a healthy mix, somewhere in between, but what bothered me the most was both the lack of education and the poor information that was spreading more virulently than the virus could ever hope to.

    First, I want to stress that I am a nurse, not a virologist, and hopefully throughout my post you will see that I am not pretending to be one. I have a Bachelor’s in Nursing and am currently a graduate student. I have worked extensively with Infectious Disease Specialists. I have been exposed to almost every infectious disease known to the modern world. I have taken courses in Biology, Microbiology, Anatomy, Physiology, Pathophysiology, Advanced Pathophysiology, Pharmacology, and an assortment of others. However, I am not and will not pretend to be an expert, just an experienced professional. When it comes to an epidemic of any sort, my first focus is on the patient, protecting and healing them, my second focus is on protecting the community. I don’t care about which strain does what, or what we can do with in lab. As a nurse, I concern myself with the current patient and future possible patients. I feel the first thing we should examine is Ebola itself. It is foreign to the US, both literally and figuratively. What it does to people and how it harmonizes with nature are both things that most westerners have little concept of. It is a virus, not a bacteria. This means that it is not its own organism. It is actually much smaller and basic than you can imagine. It is nothing more than a few pieces of DNA and some proteins. No cell wall, no cytoplasm, no metabolic functions. This is both their advantage and their downfall. Viruses require a host. For this example I will use the HIV virus. HIV gets into the human body and invades the host’s white blood cells, T4 cells to be exact but I won’t get that involved. The proteins help get the virus into the cell and those few small sequences of DNA write themselves into the host DNA. Now instead of the white blood cell attacking invaders, it is nothing more than an HIV factory. All of its metabolic functions are redirected at producing more of the virus, which pours out of the white blood cell like a sieve until eventually the host cell dies. This is why HIV infected patients have poor immune systems. The virus re-writes the DNA of the host cells. This is not something we can stop. New viruses are pouring out of the white blood cells at a rate of millions a day. We cannot filter them out. We cannot “kill” a little chunk of DNA and we don’t know enough about the human genome to correct the DNA sequences. This is why a lot of viral infections like HIV, Herpes, and Hepatitis are life long infections. HIV invades the white blood cells, Herpes invade the nerve roots, and Hepatitis invades the liver.

    Now that we have a better grasp of viruses, we will focus on Ebola a bit more. In tropical Africa, Ebola naturally lives in bats. It is nice to the bats and doesn’t cause them many issues. It is rumored that there are many viruses humans carry our entire lives and have no idea because they show zero symptoms. Therefore, they have never been studied. If this sounds crazy, just remember that it was in recent years the we discovered there was a virus behind cervical cancer. A virus that men can carry and spread without ever knowing they have it. Where the problem arises is that in tropical Africa, people like to eat bats. Sometimes they get infected with Ebola and it spreads. This process is called Zoonosis and can be true of bacteria or viruses. Canines carry Rabies, Armadillos carry Leprosy, Birds carry the Flu, Bats carry Ebola.

    When I said Westerners don’t really understand Ebola, the primary aspect that I am talking about is the patient. We don’t ever see what Ebola does. Our media is too censored, we hear how many died, and see people in haz-mat suits. Speaking of suits, we’ve all seen the pictures. Rubber gloves are adequate for AIDS and hepatitis, a simple mask stops Tuberculosis, but this requires space suits, just keep that in mind when you think its no big deal. So here is what happens when you catch Ebola, I figure you’re getting bored with reading right about now, so I’ll spice it up. First the virus gets into your system, I’ll elaborate on that later. Then, it hangs out for a few days, even up to 21, growing, multiplying at a rate of millions a day, and guess what, you’re infectious. Just like with the flu or hand foot and mouth disease, you can be spreading it to others before you show a symptom*. Remember, nurse mind set, protect the community. At first it’s not bad, little nausea, some sweating, diarrhea, much like a stomach bug. But then the virus really starts to build up in your liver and adrenal glands, after it has saturated your blood cells, the lining of your vessel, your skin, and bones. Hepatocellular necrosis occurs, which is fancy term for your liver starts to decompose.Your liver is what regulates blood clotting. This causes your blood either clot up and turn to jelly in your veins, stay liquid and bleed profusely, or a combo of both. The adrenal glands then do the same, causing your blood pressure to drop. This requires lots of IV fluids to keep your circulating volume up. At the same time inflammatory cytokines are released which causes vascular leakage. Cells don’t do a good job of holding things together so it all becomes a bloody goop. Anywhere in your body that blood vessels are shallow, like your nose, ears, gums, throat, GI tract, urethra, vagina, rectum, all start oozing fluids and bleeding because the tissues that normally keep it contained are disintegrating. So now you bleed from every orifice, including your eyeballs. Every time someone or something touches you, your tissue gets damaged which further the cycle, so a shot in the arm turn into a massive blood blister. Those who survive are left with massive scarring. Since the adrenals cannot keep your blood pressure up, and you are losing blood and fluids, we have to put IV fluids in to keep you out of hypovolemic shock. This in turn reduces your blood concentration, lowering your oxygen carrying capacity, which causes your heart to race. So you lay in bed, oozing fluids from everywhere, all while feeling like you just ran a marathon, with bloody diarrhea, oh and did I mention pain? Lots and lots of pain, but you can’t have any pain medicine because your liver and kidneys have failed. This why it pains me when I see this outbreak ONLY has a 50% death rate, when in Africa it is up to 90%…ONLY 50%. That is literally worse than cancer, and people are blowing it off. Imagine if cancer was infectious, and you lived in a country with zero cancer, and someone thought it would be a good idea to fly a few people in. I think there would be a different attitude.

    The biggest part of the discussion is how Ebola is spread. I will say two things on the topic, no, it is not airborne, and yes, basic hygiene plays a HUGE factor. But while on the topic of whether it is or is not airborne, the definition of an airborne contagion is one that can freely float in the air, survive lengths of time, and infect someone else. VERY few things fit in this category, most have been eradicated, Polio, Small Pox, Tuberculosis. Things that are also NOT airborne, are the flu and the cold. For the flu, you have to come into direct contact with the patients body fluids. How then, do you explain why people catch it and have no idea how. Well for one, people can spread it before they show symptoms, just like Ebola, and one other HUGE factor…droplets….let that word really sink in. The virus may not be airborne, but the droplets are. I’m going to digress for a second and get back to HIV and hepatitis, while I let droplets dwell in your mind. Everyone knows that HIV and Hepatitis are spread by blood contact, and sexual fluids, I don’t mean a drop of blood on the skin, or even a mucous membrane, it has to get INSIDE of you. This is why only gloves are required. HIV and hepatitis are not found in urine, stool (Some forms of hepatitis are, but you have to eat the stool to get infected) saliva, sweat, tears, or mucous. This is where some viruses are different. The flu gets into your mucous and other secretions, Ebola tends to stay in the blood, but remember, every one of your bodily fluids are full of blood now. So a person with the flu sneezes, and now millions of little droplets (remember those guys?) shoot out of their nose at nearly mach 1, all across the room, same for a cough, all it takes is a little microscopic droplet to land in your eye, nose, mouth, or the unlikely scenario of an open wound, and you’ve now been infected, because you came in CONTACT with their bodily fluids. I see the word contact thrown around a lot, but most people think of mass amounts of contact with blood, but what they don’t realize is that contact also includes microscopic mucous and saliva droplets, each one chock full of Ebola. Now to the second part of this, HIV only lives outside of the human body for a few seconds, maybe minutes if the quantity is high enough, Hepatitis a bit longer. That’s why you hear about the dirty needles at movie theaters and playgrounds, but never hear of an infection, before the perpetrator even leaves the theater, the HIV he left in that needle has already died. Ebola on the other hand survives quite well outside of the host, I can’t find my source again, but I believe its up to 4 days.

    So with all this information, lets have some role play, so that you can see exactly what this means, to a nurse, in the real world. Imagine it as a cheesy PSA or lifetime movie. You go to see your doctor because its that time of year, you need some blood drawn and refills of your blood pressure med. You sit patiently in the waiting room, thumbing a magazine while your 2-year-old plays with her toys. Like all two year olds, she touches everything, and everything goes in her mouth, toys, pens, her own fingers. She is a 22 lb drool factory and you love her to pieces. You see the doctor, get your goodies, and go home. A week later your angel starts vomiting blood and within 3 days she dies because her heart raced so fast it finally gave up while trying to maintain a blood pressure. Her eyes are blood red and demonic, her skin falls off in sheets. What you don’t know is that 3 days before your visit, someone thought they had the flu. It is October you see and they sneezed while thumbing through that very same magazine you thumbed through. The same thumb you grabbed her pacifier out of your purse with in the waiting room. The people caring for Ebola patients wear space suits, and burn the bodies, yet it still spreads. Here in America, we have much better protocols, and much better hygiene. So if it spreads, it will be contained much better. Still, it spreads prior to symptoms and survives will outside the body, just like the flu. Despite vaccines and good hand washing, thousands still get the flu every year. But while the flu kills 1-2% of its victims, Ebola kills 50% on a good day, and spreads the same way. So please, do not write it off as hype. It is a real thing and it is here.

    The case in Dallas has been confirmed. The patient had contact with five children and adolescents prior to admission. Those five kids attend four of the largest schools in Dallas. One sneeze and we could already have thousands of people, who don’t know it yet, infected.

    Thank you for reading. Please feel free to comment.

    * I have had a lot of comments in regards to this. I picked my words carefully, but I never imagined getting thousands of views an hour, or my article getting picked apart, but I will try to elaborate now. I said spread, the virus, I did not say you were contagious. What I meant by this, was the summation of two concepts. To fully explain everything I could write a book, but this is meant to be short and sweet. The first concept is that of a fomite. We have established that the virus can survive for an unspecified amount of time outside the host, and we have established that sneezing/coughing is a perfectly logical method of transmission. So if patient A is infectious/contagious, they sneeze on patient B, but then patient B goes home and picks up their sisters 1 6 month old, who rubs his face, and licks all over your shoulder, he could very well have just orally consumed large quantities of the virus, therefore become patient C. Patient B never got sick, the virus never entered their system, yet they are responsible for spreading the virus to someone else. This is why the 5 exposed kids are so important, there may only be a 2% chance or whatever that they’ll get sick, but if they went to school, and each rubbed up against 500 kids in the hallways, you now have 2500 exposed kids, 50 of which will statistically become infected, 25 of which will probably die. No I do not have a source for the 2%, that is just an example number used to represent the relatively low likelihood of contracting the virus if exposed. Remember, heal the patient, PROTECT the community. The second concept of this is defining “symptom”. Lets assume it means anything other than your baseline condition. That means the first signs of being contagious, are also the more mild symptoms, sneezy, achy, nausea, flu-like symptoms. So who is going to wake up, feel a little under the weather, and think,crap, I have Ebola, better get quarantined, no, THAT’S how you start fear mongering and mass panic. Again, flu season is upon us, the initial stages of Ebola are like the flu, and its human nature to be in denial, so many people, if infected, would hope its just the flu and wait it out, they are not showing symptoms indicative of Ebola, but they ARE symptomatic of something, and therefore, by the CDC definition, would be contagious. Its also normal procedure for people to be symptomatic BEFORE seeking medical care, so technically, everyone will be contagious, BEFORE knowing they have Ebola. But like I said before, I omitted this lengthy explanation because I didn’t feel it was necessary for the point of the article.

    ADDENDUM: Sadly, I feel the need to point out that the title of this blog is “Ebola, A Nurse’s Perspective”, not “A Nurse’s Guide to Surviving the Apocalypse”, or “How to Become an Ebola Expert in 15 minutes”. It could just as well be “Hamburgers, A Chef’s Perspective” and no one would be hounding me over grammar, a misplaced comma, or wanting citations as to why I say it should be on the grill 5 minutes per side of 7 minutes per side. The point is those things are irrelevant to the goal of the article, this is MY perspective (a particular attitude toward or way of regarding something; a point of view.) I don’t have to prove anything, the point of my article is to take what the uneducated (in a medical sense) journalists say, what the talking heads on TV say, and then let you know what the people say who are on the front lines. That’s like discrediting your grandads account of what happened when he stormed Normandy beach, because its not what your history teacher told you. Have I experienced Ebola first hand? Nope, have I experienced a WHOLE lot of other things that the majority of the population has not? You bet your ass I have, and I felt the need to take the time to hopefully help other people out a little. So please keep that in mind, I’m not perfect, but my experiences are my experiences, and I wanted to share them with you, to let you inside the head of a nurse for a minute

    https://dtolar.wordpress.com/2014/10...s-perspective/



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  3. #2
    The biggest part of the discussion is how Ebola is spread. I will say two things on the topic, no, it is not airborne, and yes, basic hygiene plays a HUGE factor. But while on the topic of whether it is or is not airborne, the definition of an airborne contagion is one that can freely float in the air, survive lengths of time, and infect someone else. VERY few things fit in this category, most have been eradicated, Polio, Small Pox, Tuberculosis. Things that are also NOT airborne, are the flu and the cold. For the flu, you have to come into direct contact with the patients body fluids. How then, do you explain why people catch it and have no idea how. Well for one, people can spread it before they show symptoms, just like Ebola, and one other HUGE factor…droplets….let that word really sink in. The virus may not be airborne, but the droplets are. I’m going to digress for a second and get back to HIV and hepatitis, while I let droplets dwell in your mind.
    Hmmm. I have never heard this before. Colds and flus are not considered airborne, yet you can catch them from the air? If true, they have been manipulating the language for a long time...
    Last edited by Brian4Liberty; 10-13-2014 at 02:52 PM.
    "Foreign aid is taking money from the poor people of a rich country, and giving it to the rich people of a poor country." - Ron Paul
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  4. #3
    This nurse's posts have been making the rounds too.

    http://www.theamericanconservative.c...e-culture-war/
    Someone sent me last night this sarcastic blog post from an emergency room nurse, questioning the US capacity to care for even a small Ebola epidemic here. Excerpt:

    Exactly as predicted, now that the horse is some distance down the road, the government officials paid to prepare for emergencies, after being caught in their usual pants-around-their-ankles condition, are busily trying to find a lock for the barn door, and assuring all and sundry that “We’ve got this.”

    And also as I noted going back weeks and even years, no, they don’t.

    But still we get the unicorn-farted happygas from the Dutiful Minions:

    At the White House Friday, federal officials sought to reassure the public that the nation’s health-care system was well-equipped to treat the virus and stop it from spreading.

    “It’s very important to remind the American people that the United States has the most capable infrastructure and the best doctors in the world, bar none,” said Lisa Monaco, assistant to the president for homeland security and counterterrorism. “The United States is prepared to deal with this crisis.”
    Okay, yes we do have the best infrastructure and the best doctors in the world, bar none.

    But unless we know how high that bar is, that’s like saying you have the world’s largest unicorn. It sounds like a lot, but it’s not as impressive if you find out it’ll fit in your shirt pocket, is it?

    So let’s look at that infrastructure.

    There are, in fact, a total of four medical isolation units in the entire United States, as we noted yesterday, that are capable of handling infected Ebola patients near endlessly.

    Where are they, and what can they handle?

    Emory University’s Serious Communicable Disease Unit is in Atlanta, GA. That’s where Brantly and Writebol were treated. It has three beds.
    St. Patrick Hospital’s ICU Isolation Unit is in Missoula MT. It has three beds.
    The National Institute of Health’s Special Clinical Studies Unit is in Bethesda MD. It has seven beds.
    And the biggest, the Nebraska Medical Center’s Biocontainment Unit is in Omaha NE. It has ten beds.

    3+3+7+10=23 beds, coast to coast.

    So, for the entire country, all 316,100,000+ of us, we’re fully prepared to treat 23 Ebola patients at the same time. (For reference, that’s how many Ebola patients Liberia had last April. It hasn’t gone well.)

    But the 316M-person question is, what happens when we have 24?

    More happygas, anyone?
    The nurse goes on to quote the CDC’s website advising people who don’t wish to contract Ebola to avoid hospitals where Ebola patients are being treated. What does this guideline mean in real life? More:

    So, you can either have an Ebola hospital, or a regular one. Personally I work at a hospital with +/- 10 negative airflow rooms, in the entire building. So that’s how many Ebola patients we could care for, max. But 6 of those rooms are in the ER. Let me be more specific: 6 of those rooms are in the ER that sees 300-500 patients a day 24/7/365, 110,000+ patients a year, and of whom 99-and-change% of them go home alive. So we can care for them, or we can take in 6 Ebola patients, of whom 0-3 will likely survive. While all those other patients go somewhere else. Or nowhere else. And we can multiply that times every city that gets an Ebola patient, if we try to use existing facilities. Sorry, if my choice is the entire community, or a handful of individuals of whom 50-90% will certainly die anyways, “Best wishes with your Ebola, we have a bus waiting outside to take you to the treatment center in BFE.”

    Not even close to a tough call. And it’s a choice we’ll have to start making if ever the patients coming in overtop our ability to deal with them. And if you’re in a one-hospital locale, that’ll be the choice on Day One. I can’t imagine the community that’ll rather see everybody with a heart attack(stroke/asthma attack/diabetic emergency/car accident…you get the idea) die, just to save a few of the Ebola patients. Call me when the head of the CDC, or the local hospital CMO talks about that on the news, and they’re ready for it.
    Read the whole thing.
    Related, the medical community is "bristling" at the CDC for blaming that TX nurse for getting it.

    http://www.zerohedge.com/news/2014-1...rotocol-breach

    Do not panic. Ebola is not very contagious at all. That remains the mantra from health and political officials in America.. and as far as the nurse who was treating now-dead Dallas Ebola patient Thomas Eric Duncan, it was user error, according to CDC Director Frieden. As Reuters reports, some healthcare experts are bristling at the assertion by a top U.S. health official that a “protocol breach” caused the Dallas nurse to be infected with Ebola while caring for a dying patient, saying the case instead shows how far the nation’s hospitals are from adequately training staff to deal with the deadly virus, "you don't scapegoat and blame when you have a disease outbreak... We have a system failure. That is what we have to correct."
    http://www.zerohedge.com/news/2014-1...bola-live-feed

    With three out of four nurses say their hospital hasn't provided sufficient education for them on Ebola, according to a survey by the largest professional association of registered nurses in the United States, it seems the Centers for Disease Control and Prevention (CDC) has decided its time to tamp down some more public fears over the contagiousness of this deadly disease... The CDC will provide an update on the response to the second U.S. Ebola diagnosis - the Dallas nurse who was infected while caring for a Liberian national in her hospital (supposedly due to her 'protocol breach')...

    CDC Press Conference is due to start at 1200ET...
    Based on the idea of natural rights, government secures those rights to the individual by strictly negative intervention, making justice costless and easy of access; and beyond that it does not go. The State, on the other hand, both in its genesis and by its primary intention, is purely anti-social. It is not based on the idea of natural rights, but on the idea that the individual has no rights except those that the State may provisionally grant him. It has always made justice costly and difficult of access, and has invariably held itself above justice and common morality whenever it could advantage itself by so doing.
    --Albert J. Nock

  5. #4
    It does not require a majority to prevail, but rather an irate, tireless minority keen to set brush fires in people's minds. -Samuel Adams

  6. #5
    Quote Originally Posted by Brian4Liberty View Post
    Hmmm. I have never heard this before. Colds and flus are not considered airborne, yet you can catch then from the air? If true, they have been manipulating the language for a long time...

    Ever see a sneeze caught in high-def slow motion?

    Check out this link from Mythbusters, all the while keeping in mind that every single droplet is potentially infectious and recent studies have determined that sneeze droplets can travel much greater distances than previously thought:

    http://www.discovery.com/tv-shows/my...on-sneezes.htm

    Even disregarding the "not airborne" debate, consider how easy it would be for an infectious person (who may not even know he has the virus) to pass it along in any number of ways.

    He covers his mouth while sneezing, getting a nice handful of gunk. Wipes hand on pants (leaving infectious reside) opens a door by the handle (leaving infectious reside) walks inside McDonald's just barely in front of a bus carrying a junior high basketball team. No time to wash hands - hell with it! Goes up, leans on counter to contemplate the menu (leaving infectious reside) pulls out his wallet, grabs a couple of fives (leaving infectious reside) to pay for his meal. Eats at a table (leaving infectious reside) finishes, opens the door to the restroom with a broad push of his palm (leaving infectious reside) and finally gets to wash that nasty fish grease (and hopefully a lot of Ebola virus) off his fingers.

    In the meantime, the next two kids at the counter each gets one of those fives in their change. One of them sits at the same table as our earlier Ebola spreader. The table hasn't been wiped down because hey - it's dinner rush. Of course, all of the kids have grabbed the door handle on the way in....

    Now... add this to the mix: We're about a month away from the start of flu season, which usually starts in the fall and continues through the winter. In that same month's time, we'll have just passed the potential outside incubation period of Ebola for all the dozens of people who are already suspected of having contact with the Ebola patient(s) in Dallas.

    The early onset symptoms of Ebola and the flu are virtually identical. The flu's no big deal. But by the time symptoms are showing, the Ebola patient is highly infectious. And in order to effectively quarantine an Ebola patient, (as pointed out in the OP article) the facility needs negative air pressure rooms. (pressure is lower in the room so air is always flowing IN rather than OUT. This keeps any airborne particles from sneaking out.

    As the OP pointed out, most hospitals only have a few of these rooms. Single digits at best.

    If you are managing an emergency room and look out and see forty cases of people exhibiting classic cases of the flu - or Ebola - what do you do?

    Yeah. I'm guessing it's gonna be a wild ride.

  7. #6
    Quote Originally Posted by KCIndy View Post
    Even disregarding the "not airborne" debate, consider how easy it would be for an infectious person (who may not even know he has the virus) to pass it along in any number of ways.

    He covers his mouth while sneezing, getting a nice handful of gunk. Wipes hand on pants (leaving infectious reside) opens a door by the handle (leaving infectious reside) walks inside McDonald's just barely in front of a bus carrying a junior high basketball team. No time to wash hands - hell with it! Goes up, leans on counter to contemplate the menu (leaving infectious reside) pulls out his wallet, grabs a couple of fives (leaving infectious reside) to pay for his meal. Eats at a table (leaving infectious reside) finishes, opens the door to the restroom with a broad push of his palm (leaving infectious reside) and finally gets to wash that nasty fish grease (and hopefully a lot of Ebola virus) off his fingers.

    In the meantime, the next two kids at the counter each gets one of those fives in their change. One of them sits at the same table as our earlier Ebola spreader. The table hasn't been wiped down because hey - it's dinner rush. Of course, all of the kids have grabbed the door handle on the way in....
    And another fact that makes that scenario a little more "scary" is that one reason that Ebola is so contagious is that all it takes as few as one single virus to infect someone. Most diseases take far more than that. IIRC, this is called "Virus quantification". For example, if it takes 50 viruses on average to become infected with some specific cold or flu, it might take 5 on average to contract Ebola. This probably why care-givers catch it despite being cautious.
    "Foreign aid is taking money from the poor people of a rich country, and giving it to the rich people of a poor country." - Ron Paul
    "Beware the Military-Industrial-Financial-Pharma-Corporate-Internet-Media-Government Complex." - B4L update of General Dwight D. Eisenhower
    "Debt is the drug, Wall St. Banksters are the dealers, and politicians are the addicts." - B4L
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    The views and opinions expressed here are solely my own, and do not represent this forum or any other entities or persons.

  8. #7
    Quote Originally Posted by Lucille View Post
    This nurse's posts have been making the rounds too.

    http://www.theamericanconservative.c...e-culture-war/
    That nurse has a very colorful style.

    Exactly as predicted, now that the horse is some distance down the road, the government officials paid to prepare for emergencies, after being caught in their usual pants-around-their-ankles condition, are busily trying to find a lock for the barn door, and assuring all and sundry that “We’ve got this.”
    "Foreign aid is taking money from the poor people of a rich country, and giving it to the rich people of a poor country." - Ron Paul
    "Beware the Military-Industrial-Financial-Pharma-Corporate-Internet-Media-Government Complex." - B4L update of General Dwight D. Eisenhower
    "Debt is the drug, Wall St. Banksters are the dealers, and politicians are the addicts." - B4L
    "Totally free immigration? I've never taken that position. I believe in national sovereignty." - Ron Paul

    Proponent of real science.
    The views and opinions expressed here are solely my own, and do not represent this forum or any other entities or persons.

  9. #8
    Quote Originally Posted by Brian4Liberty View Post
    Hmmm. I have never heard this before. Colds and flus are not considered airborne, yet you can catch them from the air? If true, they have been manipulating the language for a long time...
    I think it has to do with airborne vs droplet (and contact) transmission. TB is airborne, so it just floats thru the air for a long time. So if you were on a jumbo jet and someone sneezed some TB into the air at the back of the plane, you might contract it (or have it land on your skin/clothing, where you could later contract it or spread it for someone else to become either infectious or infected) even if you're at the front of the plane. With infectious agents that are in droplet form, those droplets weigh more than air and don't travel like the airborne contagions do. Generally speaking, droplets do not remain in the air for very long and seldom travel more than 3 feet. Some droplet agents like smallpox and SARS may travel 6 or more feet. However, a variety of sources are reporting that Ebola might become aerosolized in certain cases, like flushing a toilet that has infected diarrhea or vomit in it. This would make spreading/contracting Ebola substantially easier/more likely. Here is a quote from an informative article:

    And a second quote from the same article:
    The potential for transmission via inhalation of aerosols, therefore, cannot be ruled out by the observed risk factors or our knowledge of the infection process. Many body fluids, such as vomit, diarrhea, blood, and saliva, are capable of creating inhalable aerosol particles in the immediate vicinity of an infected person.



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  11. #9
    She held my interest until she said that TB had been eradicated.

    In 2013, a total of 9,588 new tuberculosis (TB) cases were reported in the United States, with an incidence rate of 3.0 cases per 100,000 population.
    And these are reported cases, even though TB is notoriously more concentrated in populations unlikely to report it.

    Eradication is the reduction of an infectious disease's prevalence in the global host population to zero.
    Tuberculosis (TB) remains a major global health problem.
    In 2012, an estimated 8.6 million people developed TB and
    1.3 million died from the disease (including 320 000 deaths
    among HIV-positive people).
    Genuine, willful, aggressive ignorance is the one sure way to tick me off. I wish I could say you were trolling. I know better, and it's just sad.

  12. #10
    Quote Originally Posted by youngbuck View Post
    Generally speaking, droplets do not remain in the air for very long and seldom travel more than 3 feet. Some droplet agents like smallpox and SARS may travel 6 or more feet.

    Adam and Jamie on Mythbusters can hit around 17-20 feet!

    They claim this as a "busted" myth because the "myth" they were testing was the "urban legend" regarding flu that said droplets from a sneeze travel at 100 mph and can go as far as 30 feet. But as far as I'm concerned, if they can show definitively that many human sneezes can send droplets flying as far as fifteen feet, it's a scary thing.

    Think of how close people sit on an airplane. Or a bus or train. Or in a movie theater. Or in church.

    http://www.discovery.com/tv-shows/my...el-100-mph.htm
    The duo each sniffed some snuff to muster up strong sneezes, but even those gargantuan gesundheits clocked in at less than 100 mph. Make that way less than 100 mph. Adam's achoo erupted at 35 mph, and Jamie barely beat him at 39 mph.

    As for whether a sneeze can go the distance, neither MythBuster could break the 20-foot mark. Instead, Adam's and Jamie's flying phlegm landed 17 and 13 feet away, respectively.

    So while sneezes still spew snot fast and far, the busted myth proves their much-advertised speed and distance stats are full of hot air.

  13. #11
    Quote Originally Posted by KCIndy View Post
    Ever see a sneeze caught in high-def slow motion?

    Check out this link from Mythbusters, all the while keeping in mind that every single droplet is potentially infectious and recent studies have determined that sneeze droplets can travel much greater distances than previously thought:

    http://www.discovery.com/tv-shows/my...on-sneezes.htm

    Even disregarding the "not airborne" debate, consider how easy it would be for an infectious person (who may not even know he has the virus) to pass it along in any number of ways.

    He covers his mouth while sneezing, getting a nice handful of gunk. Wipes hand on pants (leaving infectious reside) opens a door by the handle (leaving infectious reside) walks inside McDonald's just barely in front of a bus carrying a junior high basketball team. No time to wash hands - hell with it! Goes up, leans on counter to contemplate the menu (leaving infectious reside) pulls out his wallet, grabs a couple of fives (leaving infectious reside) to pay for his meal. Eats at a table (leaving infectious reside) finishes, opens the door to the restroom with a broad push of his palm (leaving infectious reside) and finally gets to wash that nasty fish grease (and hopefully a lot of Ebola virus) off his fingers.

    In the meantime, the next two kids at the counter each gets one of those fives in their change. One of them sits at the same table as our earlier Ebola spreader. The table hasn't been wiped down because hey - it's dinner rush. Of course, all of the kids have grabbed the door handle on the way in....

    Now... add this to the mix: We're about a month away from the start of flu season, which usually starts in the fall and continues through the winter. In that same month's time, we'll have just passed the potential outside incubation period of Ebola for all the dozens of people who are already suspected of having contact with the Ebola patient(s) in Dallas.

    The early onset symptoms of Ebola and the flu are virtually identical. The flu's no big deal. But by the time symptoms are showing, the Ebola patient is highly infectious. And in order to effectively quarantine an Ebola patient, (as pointed out in the OP article) the facility needs negative air pressure rooms. (pressure is lower in the room so air is always flowing IN rather than OUT. This keeps any airborne particles from sneaking out.

    As the OP pointed out, most hospitals only have a few of these rooms. Single digits at best.

    If you are managing an emergency room and look out and see forty cases of people exhibiting classic cases of the flu - or Ebola - what do you do?

    Yeah. I'm guessing it's gonna be a wild ride.
    BAN TWEENS!

    -t



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