[Health] The Infectious Diseases Thread

[silverjon]

No, not at all. They're also dealing with many cases, not single incidents.

[Jeff V]

OTOH you also see a LOT more people wearing face masks there, so it's probably a cultural thing as well.

When you see people wearing face masks here, chance are, the face behind it is Japanese. I think they are just disgusted for having to breathe the same air as us.

[LawBeefaroni]

OTOH you also see a LOT more people wearing face masks there, so it's probably a cultural thing as well.

When you see people wearing face masks here, chance are, the face behind it is Japanese. I think they are just disgusted for having to breathe the same air as us.

Actually it's usually a generous gesture. Mostly they wear them because they're sick and they don't want to spread germs. Sometimes it's becasue they have allergies. And yes, some times, but not mostly, because it's flu season or whatever.

Think about how often you see someone coughing or sneezing in public. It's a lot. If they're Japanese nationals, they're probably wearing a mask. Which gives rise to the stereotype that they always wear masks in public.

[$iljanus]

OTOH you also see a LOT more people wearing face masks there, so it's probably a cultural thing as well.

When you see people wearing face masks here, chance are, the face behind it is Japanese. I think they are just disgusted for having to breathe the same air as us.

Actually it's usually a generous gesture. Mostly they wear them because they're sick and they don't want to spread germs. Sometimes it's becasue they have allergies. And yes, some times, but not mostly, because it's flu season or whatever.

Think about how often you see someone coughing or sneezing in public. It's a lot. If they're Japanese nationals, they're probably wearing a mask. Which gives rise to the stereotype that they always wear masks in public.

When I see masks in public here I think that the person just had a bone marrow transplant or is immunosuppressed.

[Holman]

At Target yesterday here in North Dallas, my wife reports seeing not one, not two, but three separate people in various degrees of protective gear-- all had breathing masks, two had gloves, and one had some sort of protective gown. Absolute craziness. I can only hope this gets nipped in the bud soon or this town may lose its collective mind.

Hopefully they were all from one nutty family. Did she get a read on them?

I would find it very difficult to resist sidling up nearby and suddenly coughing wetly and uncontrollably.

[RMC]

The spray is quite effective. Produces a quicker and stronger immune response.

Interesting - can adults get the spray form as well? I have only ever gotten the shot (and kids get spray).

Yes. There was even an approval granted earlier this year for a vaccine that doesn't contain egg allergens so people that were previously unable to be vaccinated now can do so. Info on the Live Attenuated ("Flu Mist") vaccine is here. Note, that because you're exposed to a living organism (as opposed the inactivated vaccine traditionally offered), the risk for some type of illness is higher (though still really, really low and not the flu regardless). In other words, the potential side effects will likely be more significant and systemic (though still rather limited). However, because it's a live organism, your immune system has a much stronger response to it.

Can the nasal spray flu vaccine give you the flu?

No. While the nasal spray flu vaccine does contain live viruses (unlike the flu shot), the viruses are attenuated (weakened) and cannot cause flu illness. The weakened viruses are cold-adapted, which means they are designed to only cause infection at the cooler temperatures found within the nose. The viruses cannot infect the lungs or other areas where warmer temperatures exist.

Science, bitches!

The stuff is on back order in our area with no info on when they will get some. Been that way since Sept 1 (my kids prefer it so my wife always inquires early). It's good if you can get it but you might as well get the shot if you have to wait into December for FluMist .

I get the shot, actually just got it today. But we got the mist in for a few staff that have allergies. My one staff member was so happy that she could actually get it even with her allergies.

Sometimes it is nice to work for a hospital so we can get these things. It's required to get the shot per terms of our employment, but I have never gotten sick from it, or if I did it was only a little, but I have gotten the flu and been miserable before.

[Smoove_B]

Sort of buried in the article where the government is considering putting medical staff on the "No Fly" list is the voluntary closure of two schools in Ohio:

Two schools in the Solon School District in suburban Cleveland are closed Thursday as a precaution because a staffer "traveled home from Dallas on Frontier Airlines Tuesday on a different flight, but perhaps the same aircraft," as Vinson, the school district said in a statement.

"Although we believe what the science community and public health officials are telling us about the low risk of possible transmission of the virus through indirect contact, we are nonetheless taking the unusual step of closing the dual school building for Thursday so that we can have the schools cleaned and disinfected," the statement said.

I can sense panic is building and all it will take is another random case in some unconnected city for people to start losing their collective minds.

[RMC]

Sort of buried in the article where the government is considering putting medical staff on the "No Fly" list is the voluntary closure of two schools in Ohio:

Two schools in the Solon School District in suburban Cleveland are closed Thursday as a precaution because a staffer "traveled home from Dallas on Frontier Airlines Tuesday on a different flight, but perhaps the same aircraft," as Vinson, the school district said in a statement.

"Although we believe what the science community and public health officials are telling us about the low risk of possible transmission of the virus through indirect contact, we are nonetheless taking the unusual step of closing the dual school building for Thursday so that we can have the schools cleaned and disinfected," the statement said.

I can sense panic is building and all it will take is another random case in some unconnected city for people to start losing their collective minds.

There were more than just those two schools closed around Cleveland. It is causing a lot of stress, and I am trying to calm my family and friends as much as possible. But if a case surfaces here in Cleveland, than I can not imagine what will happen to the panic levels. It is insane what they are doing. There were nurses from some of our larger hospitals in the area on that plane as well, so not even sure what they are doing about them. <sigh>

[Blackhawk]

Sort of buried in the article where the government is considering putting medical staff on the "No Fly" list is the voluntary closure of two schools in Ohio:

Two schools in the Solon School District in suburban Cleveland are closed Thursday as a precaution because a staffer "traveled home from Dallas on Frontier Airlines Tuesday on a different flight, but perhaps the same aircraft," as Vinson, the school district said in a statement.

I can sense panic is building and all it will take is another random case in some unconnected city for people to start losing their collective minds.

'Perhaps the same aircraft?' It can't be that hard for a government agency to, you know, check.

/edit - or to look at a calendar and count.

[malchior]

I can sense panic is building and all it will take is another random case in some unconnected city for people to start losing their collective minds.

Yep - Yale student might be infected.

[Smoove_B]

Up next - cities will start cancelling Halloween because going do-to-door might spread Ebola. Wait for it.

I also just saw that the Texas nurse with Ebola is being transferred to the NIH for treatments. I fully expect this to become the standard if more cases develop -- assuming there aren't dozens.

[RMC]

Story about what else has been done in Cleveland

One business closed, and 7 people in quarantine. And maybe more on the way... Wow..

[$iljanus]

I can sense panic is building and all it will take is another random case in some unconnected city for people to start losing their collective minds.

Yep - Yale student might be infected.

The positive thing about this is that the person actually travelled from Liberia so if it does turn out to be Ebola it probably wasn't caught within the US meaning he probably didn't get it on a toilet seat at the local Denny's, at Target, etc. Also, the person monitored himself for symptoms since his return and seemed on top of things once he started having a fever. The hospital he was admitted to had been preparing for a possible Ebola patient "for weeks" so that's reassuring. And of course, it could certainly be something else since test results haven't come back.

[Jeff V]

I can sense panic is building and all it will take is another random case in some unconnected city for people to start losing their collective minds.

Yep - Yale student might be infected.

According to the mayor, “We hope this is not an Ebola case, and right now there is no reason to believe [that it is]"

No reason, huh. Researcher comes back from Liberia, but there is no reason to believe it could be ebola.

With this sort of attitude, it's surprising the disease hasn't made it all around the planet by now.

[godhugh]

I can sense panic is building and all it will take is another random case in some unconnected city for people to start losing their collective minds.

Yep - Yale student might be infected.

That's not really a random person though. That's a person who recently traveled back from Liberia and was self-monitoring and did the right thing. Why that would cause people to panic, I don't know.

The case you want to watch out for is the random person in Bumfuck, Arkansas who's never traveled to Western Africa and has no obvious connection to any of the existing cases. At that point, you've got an unknown vector out there.

Moving on...

The nursing community here in Dallas, at least at my hospital and among my friends, has been fairly professional, recognizing that the two additional cases are among the people you would hope (that's a bad word to use, but I can't think of a better one) would get infected. If some random person from Irving, with no obvious connection to the original patient, got infected then the level of concern would ratchet up pretty quickly. Any nurses out there fear-mongering or saying they wouldn't care for an Ebola patient are being shouted down pretty quickly.

There is a pretty decent amount of anger toward Texas Presby and the CDC for not being adequately prepared prior to the first infection and for continually screwing up since then (they gave the 2nd nurse permission to fly). I think there's going to be an even bigger backlash against them once everything settles down

I think at this point, folks just need to chill out and wait. There isn't anything anyone outside of the impacted hospitals can or need to do. The people who were originally exposed to Duncan are outside of the 21 day incubation period and none of them have tested positive. The two who are positive were nurses that weren't adequately protected and cared for him while he was heavily vomiting and having diarrhea. Given all that, it would have been a miracle if one of them hadn't gotten infected.

[Blackhawk]

I know I've said it before, but I'm still willing to give a little leniency to the CDC for screwing up. A lot of their policies and practices have been theoretical. They are experiencing first contact with the enemy - there are going to be things that don't work right and holes that weren't anticipated.

[Smoove_B]

I can tell you I've participated in theoretical exercises where this type of scenario occurs, and the assumptions made are that the system would identify the disease early enough that widespread panic and need for quarantine would be limited.

We (Federal Government) spent a butt-ton of money after 2001 on public health to bolster/raise/improve our surveillance systems - systems that were already (allegedly) improved back in 1998 after the IOM released their scathing review of public health in America. The fact that this happened after so much money and training was injected into public health infrastructure over the last decade really is telling.

[J.D.]

I think the tipping point right now is the nurse flying on the plane while showing symptoms. Nurses getting sick who were treating patients is unfortunate, but not unexpected in the public eye. Insufficient or lax hospital protocols for the first few cases are not unexpected since the system has to go through a learning process. People coming from overseas and showing symptoms is worrisome, but not unexpected either.

Exposed health care workers being allowed to board a commercial plane while feverish is so blatantly misguided that I almost don't believe that it actually happened.

[malchior]

The case you want to watch out for is the random person in Bumfuck, Arkansas who's never traveled to Western Africa and has no obvious connection to any of the existing cases. At that point, you've got an unknown vector out there.

Moving on...

I get what you are saying but any new infection on-shore in a new place ratchets up the public panic level unfortunately. Many people and shameless portions of the press seem to be looking past the facts.

[Smoove_B]

Exposed health care workers being allowed to board a commercial plane while feverish is so blatantly misguided that I almost don't believe that it actually happened.

It really does reinforce the issues I raised earlier. At no point should the nurse be calling the CDC and asking for guidance. She should have been part of a managed program set up by the State of Texas in conjunction with her local hospital where they both agreed (State and service provider) that medical staff working on Ebola patients shouldn't be getting on a plane, regardless of their own disease status. If the CDC stepped in last week and forced that issue, there would have been all kinds of other panic and outcry. What you're seeing here is failure on the state and local level. Did the CDC screw up? Absolutely. But just like with Hurricane Katrina, it was long after failures on the local and state level.

[malchior]

But just like with Hurricane Katrina, it was long after failures on the local and state level.

This is sort of another face of the issue. Local involvement/state management is seen as a feature in our system but might in this case end up instead hurting. 51 different processes for dealing with an infectious outbreak sounds like a recipe for disaster. At this point I have no faith that something more contagious wouldn't quickly overwhelm us.

[Isgrimnur]

Only 51?

I can assure you that the procedures at Baylor Medical in downtown Dallas has different procedures than Dallas Presbyterian.

Although I do give you credit for remembering DC.

[malchior]

Only 51?

I can assure you that the procedures at Baylor Medical in downtown Dallas has different procedures than Dallas Presbyterian.

Although I do give you credit for remembering DC.

I was talking high level here.

[Grifman]

All this means is that if we have a real epidemic with a flu like disease that is easily transmitted from person to person, we're screwed.

[$iljanus]

All this means is that if we have a real epidemic with a flu like disease that is easily transmitted from person to person, we're screwed.

I think most everyone in the world with international airports will be screwed...except maybe Cuba with their totalitarian government coupled with a robust health care system.

[RunningMn9]

All this means is that if we have a real epidemic with a flu like disease that is easily transmitted from person to person, we're screwed.

That was my takeaway from the swine flu incident. In the span of like a week, we went from one kid in a remote village in Mexico, to sick people on every continent. That's terrifying.

[LawBeefaroni]

All this means is that if we have a real epidemic with a flu like disease that is easily transmitted from person to person, we're screwed.

That was my takeaway from the swine flu incident. In the span of like a week, we went from one kid in a remote village in Mexico, to sick people on every continent. That's terrifying.

1918 all over again. Except not.

We are still far more vulnerable than we like to think but modern medicine deserves some credit.

[Carpet_pissr]

All this means is that if we have a real epidemic with a flu like disease that is easily transmitted from person to person, we're screwed.

That was my takeaway from the swine flu incident. In the span of like a week, we went from one kid in a remote village in Mexico, to sick people on every continent. That's terrifying.

[Holman]

I think at this point, folks just need to chill out and wait. There isn't anything anyone outside of the impacted hospitals can or need to do. The people who were originally exposed to Duncan are outside of the 21 day incubation period and none of them have tested positive. The two who are positive were nurses that weren't adequately protected and cared for him while he was heavily vomiting and having diarrhea. Given all that, it would have been a miracle if one of them hadn't gotten infected.

This is the kind of reassurance I'm trying to pass around. Right now, the only U.S. cases of Ebola are two health-care workers who were up to their elbows in the known Liberian patient's fluids. While this obviously calls for professional hand-wringing, it's nothing like a wild spread of the disease.

[Smoove_B]

This is the kind of reassurance I'm trying to pass around. Right now, the only U.S. cases of Ebola are two health-care workers who were up to their elbows in the known Liberian patient's fluids. While this obviously calls for professional hand-wringing, it's nothing like a wild spread of the disease.

Unlike EEE which has killed two people in New Hampshire. Not for anything, but for the average person, contact with a mosquito is more likely than a random stranger's diarrhea.

[Smoove_B]

If you had your money on cruise ship, come on down:

A Texas health worker who may have had contact with specimens from the first patient diagnosed with Ebola in the United States has been isolated on a cruise ship despite showing no symptoms of the disease, the Department of State said on Friday.

...

The employee has been self-monitoring since last Monday and has yet to develop a fever or show any other symptom of Ebola, the statement said. The worker and a companion voluntarily isolated themselves in their cabin, and U.S. officials are arranging for the ship to return to the country.

[J.D.]

Wait, what?

Why isolate yourself if you don't have symptoms? Unless you're just being overly cautious. But if you're being overly cautious, why get on a cruise ship?

[Smoove_B]

As a pet peeve, the chronic misuse of quarantine and isolation by the media really, really irritates me. You isolate people that have an illness. You quarantine a person that was exposed to someone with an illness but has not yet developed the illness (and might not).

[Smoove_B]

Why isolate yourself if you don't have symptoms? Unless you're just being overly cautious. But if you're being overly cautious, why get on a cruise ship?

I'm guessing they've been following the news while on the ship and realized under the new protocol they never should have boarded. However, similar to the nurse that traveled to Ohio to plan her wedding, it could have also been a "I do what I want" scenario that perhaps they reconsidered after seeing two colleagues now have the disease.

[RMC]

Why isolate yourself if you don't have symptoms? Unless you're just being overly cautious. But if you're being overly cautious, why get on a cruise ship?

I'm guessing they've been following the news while on the ship and realized under the new protocol they never should have boarded. However, similar to the nurse that traveled to Ohio to plan her wedding, it could have also been a "I do what I want" scenario that perhaps they reconsidered after seeing two colleagues now have the disease.

This sounds like a Lab Tech, what kind of exposure would they have. The new labs there is very little contact with any fluids in the lab. Hell our lab is almost all automated. They load the tubes and off it goes( for most blood tests). I know there are other test that require getting some of the sample out and doing other stuff, but I was pretty sure that was very limited.

Hell, some of the volunteers at our hospital carry test tubes, etc.. Should they be looked at as well? <sigh>

[Moliere]

[Blackhawk]

"Hey, Frank - what should we do with all these rain suits that didn't sell last spring?"

[Captain Caveman]

Woman pukes on flight and is locked in the bathroom the remainder of the trip.

People are fucking insane.

[$iljanus]

I see skin where the cuff meets the glove so that person is obviously doomed.

[Blackhawk]

Woman pukes on flight and is locked in the bathroom the remainder of the trip.

People are fucking insane.

Wow. Someone gets a free false imprisonment lawsuit.