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re: Ebola Nurse in Maine Takes a Bike Ride - Cops Follow
Posted on 10/30/14 at 7:34 pm to skeeter531
Posted on 10/30/14 at 7:34 pm to skeeter531
quote:
experts have also stated that 15% NEVER get a fever
I call bullshite.
1
Posted on 10/30/14 at 7:36 pm to skeeter531
quote:I think you are referring to a report from a previous outbreak where the person reported what was written on contact sheets. Since the doctors were dealing with a pandemic they may have skipped writing down a temperature for a given patient. The doctors and nurses coming back are also looking for signs of abdominal pain.
experts have also stated that 15% NEVER get a fever. So they won't know they're sick until they're sick...and hopefully that won't be sitting on a crowded subway and puking on someone or sneezing on someone.
Posted on 10/30/14 at 7:41 pm to mmcgrath
quote:
Notably, Duncan's family members who were living in the same household for days as he was at the start of his illness did not become infected.
Also pretty relevant from that article.
If Duncan's family can live with him when he first started to show symptoms and then its ridiculous to be concerned about picking it up on the street
Posted on 10/30/14 at 8:08 pm to Cockopotamus
Posted on 10/30/14 at 8:22 pm to mmcgrath
Strip her of her medical license
Posted on 10/30/14 at 8:37 pm to skeeter531
quote:
Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, underlined the importance of fever in discussing the case of Thomas E. Duncan
Referring to those who had close contact with Duncan, Frieden said a week ago: "The only thing we need to ensure is that their temperature is monitored, and if they develop a fever, that they are immediately assessed, isolated and if found to be positive, then appropriately cared for."
quote:
Dr. Anthony Fauci, who is helping to shape the U.S. response to Ebola as director of the National Institute of Allergy and Infectious Diseases, was asked by a CNN interviewer on Oct. 4 whether a person could be "contagious without having a fever."
Fauci replied that "the answer to that is no."
He continued: "You never say 100% but it's essentially 100%. … In biology nothing is 100%, but that's quite a reasonable conclusion to make."
Asked in the same interview about screening of air travelers, Fauci said, "Almost invariably, fever is the thing that signals the onset."
quote:
"To create the fullest possible picture of the unfolding epidemic," the authors said, they collected additional information from "informal case reports" and other sources.
The researchers described imperfections in some of the data. In a footnote, they wrote that "in practice, healthcare workers at the district level often do not have a medical thermometer and simply ask whether the person's body temperature is more elevated than usual."
Yea thats bullshite. I think most of that 13% are doctors in Africa not recording the temperature, not taking the temperature or guesstimating the temperature
Posted on 10/30/14 at 9:02 pm to Cockopotamus
You also have to take that 15% stat in context. Many people brought to the hospital in Africa are so close to dying their body is no longer capable of producing a fever.
Posted on 10/30/14 at 9:39 pm to Scoop
quote:
Everything else aside, at the end of the day she is an immature, petulant, narcissistic shite stirrer.
that's what exercisizing your freedom in the face of repression looks like you statist pussy.
Posted on 10/30/14 at 10:04 pm to mmcgrath
quote:
NC_Tigah:
quote:
Hickox was running an apparent fever on arrival, but her temp normalized.
Yeah, you totally never said anything of the sort.
quote:Correct. "Totally." Now that we've established correct context, once again we're back to the question at hand:
Again, the fact Ebola is non-contagious until symptoms appear gives us tremendous epidemiological advantages. The CDC has got to buck up and reinforce that meme. Prior to reporting to the hospital, Vinson and Spencer were asymptomatic and noncontagious. Hickox was running an apparent fever on arrival, but her temp normalized. She was symptom free X24hrs. Unless she becomes symptomatic, she will not be contagious.
Should a potential ebola carrier have been allowed to board an airliner after registering a temperature of 101° in customs?
Posted on 10/30/14 at 10:20 pm to NC_Tigah
quote:Can we call a truce on this? I won't even ask you to admit that you made mention of a fever on arrival. You seem above average intelligence although you clearly have a "dog in this hunt" so to speak.
Correct. "Totally." Now that we've established correct context, once again we're back to the question at hand:
quote:As a fig leaf, I will answer this question. If a passenger (who is a high potential Ebola carrier) looking to board an airplane shows a temperature of 101° in customs they should not be allowed to board. However, if a passenger indicates through a survey that they are a high potential carrier at customs and does not show a fever then the group of security / CDC / Port Authority employees should not immediately don personal protective gear and keep the person isolated for 4 hours. If in the event all of that happens, when a physician takes an oral temperature reading of 98.6 but realizes that their forehead has an elevated temperature they should be allowed to resume flight. At the very least they should not be locked in a forced quarantine.
Should a potential ebola carrier have been allowed to board an airliner after registering a temperature of 101° in customs?
Good enough?
Posted on 10/30/14 at 10:25 pm to LSUGrrrl
quote:Exactly! Some of the data was collected from death records. And a symptom for some of the patients was that they were in a coma.
You also have to take that 15% stat in context. Many people brought to the hospital in Africa are so close to dying their body is no longer capable of producing a fever.
This post was edited on 10/30/14 at 10:26 pm
Posted on 10/30/14 at 10:34 pm to mmcgrath
quote:Fever doesn't render one contagious. Fever is a physiologic harbinger. Ebola can progress very rapidly from outset of fever to onset of GI distress. That, my friend, is when Ebola becomes a dangerously contagious threat.
I have to admit that this was the first I heard of it and had, like NC_Tigah
Likewise, risk is of course situational.
If you plant an asymptomatic carrier on a 10-minute train ride adjacent to other passengers, those passengers stand no chance of infection.
If you plant an asymptomatic carrier on a 10-day cruise, there is likelihood that by cruise-end the Ebola carrier will have become contagious (emesis/diarrhea).
If you plant a febrile carrier on a 2-hr flight, there is likelihood that by flight-end the Ebola carrier will have become contagious (emesis/diarrhea).
Sort of basic stuff mmcgrath.
Posted on 10/30/14 at 10:55 pm to NC_Tigah
quote:I tried
Sort of basic stuff mmcgrath.
Posted on 10/31/14 at 2:26 am to skeeter531
quote:yes. Read.
The researchers described imperfections in some of the data. In a footnote, they wrote that "in practice, healthcare workers at the district level often do not have a medical thermometer and simply ask whether the person's body temperature is more elevated than usual."
Posted on 10/31/14 at 7:13 am to mmcgrath
quote:Exactly mmcgrath. Exactly.quote:Since the doctors were dealing with a pandemic they may have skipped writing down a temperature for a given patient
experts have also stated that 15% NEVER get a fever. So they won't know they're sick until they're sick...and hopefully that won't be sitting on a crowded subway and puking on someone or sneezing on someone.
Your reference may be to a different study, but the story is exactly the same.
Data is only as accurate as its input. Different study, but a very similar problem.
I'd be extremely surprised if Docs are either making or recording those temp measurements themselves. In some instances, RNs may be doing it, but more likely it's a function assigned to techs or screeners identical to those in the Monrovia Airport.
In other words, those insisting patients in the contagious phase of Viral Hemorrhagic Fever somehow have no fever, should consider the data source . . . . it's Liberia!
By its nature the good folks performing those measurements are often challenged by the instrumentation, the circumstances, the documentation, and the workload.
It's Liberia, where airport screeners send travelers off on international flights with registered temps of 32°C. FWIW, 32°C is more or less compatible with a slightly warm corpse. It is not just an erroneous reading. It is not recognized as erroneous by those involved.
Of course dubious data aside, the article skeeter531 linked also interprets Ebola infection and contagiousness as synonymous. I hope those here understand such an association to be misguided.
Posted on 10/31/14 at 7:49 am to NC_Tigah
quote:
If either one of them said, "Well its still ridiculously unlikely that the disease spreads even when a person is running a temp," then my pet ShihTzu knows more than they do.
We've actually learned since August, and backed it up with constant viral load testing at our facility, that during the initial stages of infection, even after the appearance of fever, an individual is not shedding enough virus to really be contagious. The majority of exposures likely come 6-10 days after onset of symptoms, when viral load is highest and the highest degree of health care worker interaction is needed.
But it's not like you're going to start trusting epidemiology today any more than yesterday.
Posted on 10/31/14 at 8:00 am to BamaAtl
quote:Wait!
We've actually learned since August, and backed it up with constant viral load testing at our facility
You've actually learned at your facility that as pertains to Ebola infection and >101.5°F fever, that nausea, vomiting, and or diarrhea is not a temporally associated symptom? Really?
I cannot wait to read that publication.
Please let us know when it's out.
Posted on 10/31/14 at 8:15 am to NC_Tigah
You're not reading. What we've learned is that in the early stages of symptoms the patient is largely not contagious. This is backed up by Duncan's family, Pham's fiancee, etc.
And publications (many) will be forthcoming!
And publications (many) will be forthcoming!
Posted on 10/31/14 at 8:52 am to BamaAtl
quote:No I am reading every word. "Early stages of symptoms" is a nonspecific qualifier under these circumstances.
You're not reading. What we've learned is that in the early stages of symptoms
So, assuming we both understand transmission is not d/t fever but rather body fluids, let's try again.
Have you actually learned at your facility that nausea, vomiting, and or diarrhea is a rare temporally associated symptom as pertains to Ebola infection and >101.5°F fever? Has your institution established that emesis, when it occurs early in presentation, does not present infective risk?
This is not really hypothetical.
We are talking here about specific risks of a potential ebola carrier being cleared to fly in a passenger jet when she's registered a 101° temp.
Based on what you've learned regarding transmissibility, is it your contention such a person should be boarding public transport?
Posted on 10/31/14 at 9:01 am to NC_Tigah
We have learned that in individuals that were asymptomatic in the recent past (say 12-36 hours), but are now symptomatic, onset of the symptoms you describe - nausea, vomiting, diarrhea, fever - are not AT THAT TIME indicative of an ability to infect other individuals.
That is, even though they are displaying symptoms, their infectivity toward other potential patients is very low.
To take your scenario specifically into account, since you seem stuck on it: A healthcare worker who initially registered a temp of 98, then a surface temp of 101 after a period of stress, who wasn't checked again with an oral thermometer with confirmation, and is not displaying any gastrointestinal symptoms, would be perfectly fine to fly from a standpoint of risk to other passengers. Especially since FEVER ALONE cannot transmit the virus, that requires direct contact with direct bodily fluids. Which I think even you will agree were not a risk in this instance.
And for everyone on this thread proclaiming how easy a 21-day vacation would be, try doing it when it's not your choice, when you may lose your job, and after doing critical volunteer work in a part of the world most people couldn't point to on a map. Not quite the same as what you're describing.
That is, even though they are displaying symptoms, their infectivity toward other potential patients is very low.
To take your scenario specifically into account, since you seem stuck on it: A healthcare worker who initially registered a temp of 98, then a surface temp of 101 after a period of stress, who wasn't checked again with an oral thermometer with confirmation, and is not displaying any gastrointestinal symptoms, would be perfectly fine to fly from a standpoint of risk to other passengers. Especially since FEVER ALONE cannot transmit the virus, that requires direct contact with direct bodily fluids. Which I think even you will agree were not a risk in this instance.
And for everyone on this thread proclaiming how easy a 21-day vacation would be, try doing it when it's not your choice, when you may lose your job, and after doing critical volunteer work in a part of the world most people couldn't point to on a map. Not quite the same as what you're describing.
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