Ebola reaches Nigeria's largest city
July 29, 2014 10:25 AM Subscribe

A man has died in Lagos of Ebola virus. What's worrying is how he got there - by plane, with 100 other people.

"Since it claimed its first victims in Guinea last March, the Ebola virus epidemic has killed 660 people in three countries and infected nearly 1,100—more lethal than any other outbreak in the virus’s nearly 40-year history.

But last week’s developments could transform this outbreak from an unusually nasty regional epidemic to something much bigger. On Jul. 24, Nigerian authorities confirmed that a Liberian man, Patrick Sawyer, had collapsed in Lagos after flying there from the Liberian capital, Monrovia, and tested positive for Ebola; Sawyer died on the night of July 24-25."

Perhaps the most worrying quote from the article?

"The 35 Nigerian co-passengers took flight once word got out that the health ministry was supposed to have quarantined them"

Previously: Is Ebola so scary? Mapping the spread of Ebola.

posted by Happy Dave (259 comments total) 26 users marked this as a favorite

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posted by Iridic at 10:31 AM on July 29, 2014 [1 favorite]

"The 35 Nigerian co-passengers took flight once word got out that the health ministry was supposed to have quarantined them"

Jesus.

A Samaritan's Purse Doctor contracted it, and "patients have a better chance of survival if they receive treatment immediately after being infected, as Brantly did."
posted by dabitch at 10:38 AM on July 29, 2014 [5 favorites]

Many Africans believe Ebola is a government (or US) conspiracy and avoid doctors and clinics. Monkey Meat and the Ebola Outbreak in Liberia (Vice)
posted by stbalbach at 10:40 AM on July 29, 2014 [2 favorites]

WELL FUCKING HELL.

My coworker is going to Liberia in a week or two. She isn't worried at all. I, on the other hand, intend to not handle her stapler or breathe her air for at least two weeks after she gets back.
posted by showbiz_liz at 10:40 AM on July 29, 2014 [2 favorites]

I must admit that I'm feeling somewhat validated in my OCD, large-crowd anxiety, and fear of flying.
posted by Strange Interlude at 10:42 AM on July 29, 2014 [15 favorites]

The Atlantic has a decent piece discussing the underlying causes of the current outbreak. The big issue is there is a lot of distrust, especially regarding the handling of remains.
posted by NoxAeternum at 10:43 AM on July 29, 2014 [3 favorites]

Look at all those international departures from Lagos. If it shows up in the US, perhaps instead of appearing in NYC it will start in Texas or Georgia.
posted by crapmatic at 10:44 AM on July 29, 2014 [1 favorite]

Ugh why did I have to go see Rise of the Planet of the Apes last week
posted by showbiz_liz at 10:45 AM on July 29, 2014 [4 favorites]

"Ebola in Town", currently the most popular song in Liberia.
posted by stbalbach at 10:45 AM on July 29, 2014 [1 favorite]

Isn't it notoriously difficult to spread widely and rapidly due to the almost immediate death of the infected?

i mean whether or not this is factually true it is what i have chosen to believe, so there
posted by elizardbits at 10:46 AM on July 29, 2014 [8 favorites]

Damnit. Information is power and everyone fleeing is just leaving their power on the tarmac.
posted by Sophie1 at 10:47 AM on July 29, 2014

Ebola is spread through direct contact with body fluids of someone who is showing distinct symptoms of infection. It is not transmissible by air, it is not believed to be transmissible through aerosol methods (sneezing or coughing), it is most contagious at the later stages of the disease when the hemorrhaging is most acute.

I don't know what symptoms this man was exhibiting on the plane, but changes are if anyone was infected it would have been those seated directly next to him and possibly the flight crew if they were cleaning up his vomit and diarrhea. Not likely the entire planeload of people.
posted by hippybear at 10:48 AM on July 29, 2014 [5 favorites]

Ebola is spread through direct contact with body fluids of someone who is showing distinct symptoms of infection. It is not transmissible by air, it is not believed to be transmissible through aerosol methods (sneezing or coughing), it is most contagious at the later stages of the disease when the hemorrhaging is most acute.

On the other hand, something like 50 medical workers, who are essentially wearing full biohazard suits, have been infected this outbreak.
posted by OmieWise at 10:50 AM on July 29, 2014 [16 favorites]

"Ebola in Town", currently the most popular song in Liberia.

This is actually pretty catchy! And informative too. DO NOT WATCH THE VIDEO though ugh
posted by showbiz_liz at 10:51 AM on July 29, 2014 [2 favorites]

Ebola is a friendly virus. It just wants to hug you and cuddle you and share your fluids!
posted by blue_beetle at 10:52 AM on July 29, 2014 [5 favorites]

This is absolutely terrifying. The only reason that the 20th century's smallpox outbreaks were contained was because states did things like immediately investing millions in effective interventions and declaring martial law in areas with outbreaks to physically control the spread. It's really, really scary for these weak states to be so impotent right now. Situations like this cannot bow to local prejudices. Force must be used to stem the spread or things will get much, much worse, and then suddenly, precipitously, far worse even than that. And then it will be too late. There is no cure, no treatment for this disease.
posted by clockzero at 10:53 AM on July 29, 2014 [8 favorites]

On the other hand, something like 50 medical workers, who are essentially wearing full biohazard suits, have been infected this outbreak.

True, because the medical staff is being overwhelmed and despite having a strict protocol in place, it can be easy to have a small slip of procedure when you've been working for a zillion hours in a row dealing with dying people.

I listened to a very lengthy piece on BBC World radio last night that was quite informative about all this. Unfortunately, my cursory searching isn't finding any link to it that I can share.
posted by hippybear at 10:54 AM on July 29, 2014 [3 favorites]

I don't know what's worse, that the government was so inept that it so many exposed people run away, or that 35 people were so foolish that they'd bring a deadly disease home to their families and neighbors.

I'm can't say for certain that I'd be fully rational in that situation. "Quarantine" might sound a hell of a lot like, "indefinite exposure," if I didn't know anything more.
posted by Navelgazer at 10:54 AM on July 29, 2014 [1 favorite]

The running theme of this epidemic of people actively resisting the public health measures that might bring it under control - the co-passengers fleeing quarantine, mobs attacking hospitals and freeing patients from quarantine, people setting up roadblocks to block health workers from entering villages, etc. is not at all surprising in light of how much well-founded distrust there is of government and the health care systems in the affected countries in West Africa. It would be nice if one good thing that came out of this tragedy is the realization that the public health disaster of sub-Saharan Africa is a problem and risk for the whole world, but even if it does, it would take a lot to change the situation on the ground.

I still doubt that Ebola can gain much of a foothold in fully developed countries with effective public health systems who don't have the unfortunate coincidence of important funerary customs involving family members washing the corpse. Unless of course it becomes aerosol-transmissible, in which case would the last one out turn off the lights and shut down the nuclear power plants before you go, please?
posted by strangely stunted trees at 10:54 AM on July 29, 2014 [18 favorites]

Showbiz_liz, I think maybe you meant this NYT article?

"We don’t want any visitors," said their leader, Faya Iroundouno, 17, president of Kolo Bengou’s youth league. "We don’t want any contact with anyone." The others nodded in agreement and fiddled with their slingshots.

Singling out the international aid group Doctors Without Borders, Mr. Iroundouno continued, "Wherever those people have passed, the communities have been hit by illness."

And Doctors Without Borders has a similar piece up on their website:

Yeah, it's really important for us to understand why it's happening. In Guéckédougou, in Guinea, the people had a person die in their village. That happens. The next day, health workers show up in space suits and start spraying everything with disinfectant.

And then more people started dying. So it seems to them like after we showed up with the spray, more people died. And they say, "Oh, so you’re spraying Ebola in our village."

This was the line of reasoning. It's difficult to explain that there's something so small, you can't see it with your own eyes, but it's one of the deadliest things. We take for granted our basic level of education in the West.

posted by Ragini at 10:55 AM on July 29, 2014 [44 favorites]

I feel like a lot of the fear of Ebola is based on fiction that starts by assuming a mutation to an airborne transmissible form of the virus.
posted by smackfu at 10:57 AM on July 29, 2014 [4 favorites]

There was an article (posted here or elsewhere I don't know) about how a solid anthropological understanding of the local context was super important in cases like this, because if you arrogantly refuse to explain why you're doing what you're doing, it can wind up being perceived as "a bunch of big city folk/foreigners came and set up tents and almost everyone who goes into the tents winds up dead, wow fuck this."

They had a similar story on NPR this morning, discussing a polio outbreak in Pakistan - the Taliban have forbidden vaccination, and have threatened to kill not only medical teams trying to distribute vaccines but also families who seek vaccination for their kids. One of the reasons they had for their ban was that they feared it was a CIA plot.

They interviewed a Pakistani health official about this, who pointed out that the CIA actually had set up a fake hepatitis vaccination campaign several years ago, when they were trying to flush out Bin Laden. And now they figure that "if they can use hepatitis vaccinations to spy with, they can also use polio vaccinations to spy with, so fuck that."
posted by EmpressCallipygos at 10:58 AM on July 29, 2014 [40 favorites]

I don't know what symptoms this man was exhibiting on the plane, but changes are if anyone was infected it would have been those seated directly next to him and possibly the flight crew if they were cleaning up his vomit and diarrhea. Not likely the entire planeload of people.

What if a steward cleaned up after him, then neglected to wash their hands before preparing a flight load of shrimp cocktails
posted by Ray Walston, Luck Dragon at 10:58 AM on July 29, 2014 [3 favorites]

I think if we've learned anything from the past centuries of tracking epidemics it's that we usually aren't scared enough of them or their possible mutations.
posted by Lutoslawski at 11:00 AM on July 29, 2014 [3 favorites]

I feel like a lot of the fear of Ebola is based on fiction that starts by assuming a mutation to an airborne transmissible form of the virus.

Really? I feel like the fear is based on the fact that if you catch it you will likely die bleeding out of your eyeballs.
posted by OmieWise at 11:01 AM on July 29, 2014 [80 favorites]

Does anyone know how long Ebola virus lives outside the body?
posted by OmieWise at 11:01 AM on July 29, 2014 [1 favorite]

SURVIVAL OUTSIDE HOST: The virus can survive in liquid or dried material for a number of days (23). Infectivity is found to be stable at room temperature or at 4°C for several days, and indefinitely stable at -70°C (6, 20).
posted by showbiz_liz at 11:05 AM on July 29, 2014 [4 favorites]

I think if we've learned anything from the past centuries of tracking epidemics it's that we usually aren't scared enough of them or their possible mutations.

1. You think we have too little unactionable anxiety about non-realistic threats in modern western society?
2. What effect would widespread anxiety in the public have? Positive? Do you think it would prevent an epidemic, more effectively than sensible containment protocols?
posted by danny the boy at 11:06 AM on July 29, 2014 [4 favorites]

I feel like a lot of the fear of Ebola is based on fiction that starts by assuming a mutation to an airborne transmissible form of the virus.

How likely is this scenario?

Why isn't ebola currently capable of aerosol transmission? It is simply because it doesn't infect the respiratory tissues, and therefore doesn't get aerosolized? Because it can't survive in aerosolized form? Something more complicated?

If ebola did mutate into a form that infects respiratory tissue, is it likely to lose the ability to infect its currently preferred tissue? Wouldn't that change the symptomatology (and potentially the prognosis) of the disease?

Did you know that the word "tissue" loses all meaning if you say it a bunch?
posted by escape from the potato planet at 11:07 AM on July 29, 2014 [1 favorite]

props for adding Sakamoto to the thread!
posted by dabitch at 11:09 AM on July 29, 2014 [1 favorite]

I feel like a lot of the fear of Ebola is based on fiction that starts by assuming a mutation to an airborne transmissible form of the virus.

Is there no end to Tom Clancy's crimes?
posted by elizardbits at 11:11 AM on July 29, 2014 [18 favorites]

Marburg and Ebola viruses as aerosol threats: Although they are not naturally transmitted by aerosol, they are highly infectious as respirable particles under laboratory conditions. For these and other reasons, filoviruses are classified as category A biological weapons. However, there is very little data from animal studies with aerosolized filoviruses
posted by roomthreeseventeen at 11:12 AM on July 29, 2014 [3 favorites]

Ebola Reston has airborne transmission, which suggests other strains have the potential for a similar mutation. Fortunately, the Reston strain is not symptomatic in humans.
posted by tavella at 11:12 AM on July 29, 2014 [4 favorites]

1. You think we have too little unactionable anxiety about non-realistic threats in modern western society?

Er, non-realistic threat?
posted by Lutoslawski at 11:13 AM on July 29, 2014 [2 favorites]

Does anyone know how long Ebola virus lives outside the body?

Historically, very little in air, extended in liquid or dried liquid material. This is why Ebola has (historically) been very hard to catch, you basically needed fluid transfer to become infected. The primary means of transmission in previous epidemics has been either from poor medical practices or funerary practices that involved a great deal of contact with the recently deceased.

This is also why those epidemics tended to be self limiting. Once people stopped those practices, most of the infected died, the rest recovered, and the infection burned out. It's really hard for high-lethality infections to spread unless there's a mobile vector (airborne, or fleas, or the like.)

The worrisome thing about the current epidemic is how long it's run and how far it has spread, even with a 60% mortality rate.

Why isn't ebola currently capable of aerosol transmission?

It doesn't seem to attack lung tissue that much -- mostly endothelial, hepatic and phagocytes -- the liver, the lining of blood/lymph vessels and the uterus, the liver, and white blood cells.
posted by eriko at 11:14 AM on July 29, 2014 [3 favorites]

Don't miss the part where this guy's family has flown home to the US.

It says he wasn't symptomatic yet, and that they are being watched, but yikes, it's hard not to have a bad feeling about how easily this outbreak could get out of hand.
posted by OHenryPacey at 11:15 AM on July 29, 2014 [6 favorites]

full biohazard suits

An important thing we hammer into the students who take our PPE courses is that suits just reduce risk, they don't eliminate it. Nothing guarantees perfection. An innocuous mistake can almost completely nullify the protection too.

That's why it's so important to limit exposure as much as one can. Suits aren't magical protective talismans, but human-made, fallible, fragile tissues separating you from danger. Almost literally tissues, in some cases.

I don't envy folks who have to work long hours in a hot zone. It is a very high risk job.
posted by bonehead at 11:15 AM on July 29, 2014 [16 favorites]

AFAIK, aerosol is not the same as airborne either. Aerosol is bad but it's not going to infect the entire plane if you share a flight with someone who is infected.
posted by smackfu at 11:15 AM on July 29, 2014 [1 favorite]

Unless you are sitting next to them when they sneeze or cough wetly.
posted by elizardbits at 11:18 AM on July 29, 2014 [1 favorite]

"Ebola in Town", currently the most popular song in Liberia.

When dealing with Ebola, we must not fail to heed the lesson of the uncontrolled spread of autotune.
posted by TheWhiteSkull at 11:20 AM on July 29, 2014 [6 favorites]

Really? I feel like the fear is based on the fact that if you catch it you will likely die bleeding out of your eyeballs.

Exactly, it's fear based on that chapter from The Hot Zone, which was awesome to read but a little sensationalized. Ebola's not even categorized as a haemorrhagic fever any more.
posted by rewil at 11:21 AM on July 29, 2014 [1 favorite]

I don't think there's much to worry about as far as developed nations go. Just stick to good habits and we'll all be fine.
posted by ReeMonster at 11:22 AM on July 29, 2014

.
for Sheik Umar Khan, a true hero.
posted by tavella at 11:23 AM on July 29, 2014 [43 favorites]

A slightly more detailed article about Sheik Umar Khan, the doctor who recently died.
posted by elizardbits at 11:24 AM on July 29, 2014 [4 favorites]

Er, non-realistic threat?

Yes. You, and everyone else reading this comment in North America, Europe--basically anywhere that isn't Western Africa--have an insignificant chance of catching ebola. Seriously.

Scenarios where it reaches the western world are fantasies that depend on ebola basically not being ebola.
posted by danny the boy at 11:24 AM on July 29, 2014 [3 favorites]

Time to start seriously considering that vacation property I've been looking at in northwestern Nunavut.
posted by jimmythefish at 11:29 AM on July 29, 2014

There's some research that suggests that either airborne or fomite transmission is possible (at least in an experimental setting between pigs and monkeys, not necessarily between humans on an airplane).

You know, laboratory conditions: Sitting in a cylindrical chamber with recirculated air being breathed by an infected host.

Seriously, I get hella sick every time I take an extended flight...
posted by kaibutsu at 11:29 AM on July 29, 2014 [4 favorites]

I don't think there's much to worry about as far as developed nations go. Just stick to good habits and we'll all be fine.

Unless you are on the subway next to someone who hasn't been to the doctor because they have no health care and so they don't know they're a carrier. And they sneeze on you.
posted by EmpressCallipygos at 11:31 AM on July 29, 2014 [6 favorites]

Ebola's not even categorized as a haemorrhagic fever any more.

This is merely technical semantics on WHO's part, and not a reflection of any downgrading of Ebola's danger. Marburg isn't classified as a haemorrhagic fever anymore, either.
posted by Thorzdad at 11:32 AM on July 29, 2014 [4 favorites]

If it shows up in the US, perhaps instead of appearing in NYC it will start in Texas or Georgia.

There's a lot of petroleum production in Nigeria, specifically the Niger Delta. It's a significant component of their GDP; it's also the primary generator of revenue for their government.

Furthermore, about 10% of the US oil imports are from Nigeria.

The repercussions of an outbreak in Lagos, of even just this news, go far beyond the deaths of people. A mass evacuation of the region by oil companies, for example. Some kind of ruling by OPEC, of which Nigeria is a member. Travel restrictions to Nigeria by the US government. Or some kind of action by western governments (the cynical part of me says if we're willing to kill people for oil shouldn't we also be willing to save people? - not saying that a western oriented response would be a good thing, either). There's a variety of different scenarios that could play out, some good, some bad, some mixed.

I'm worried. I'm worried because prior to this, the Ebola outbreak hasn't really captured our interest yet, ridiculously! - but hey, if it were a missing jet! wow! - but now it may be seen as "threatening our interests." I'm worried someone is going to do something stupid, or cross-purposes with those who are legitimately trying to help. I'm worried about Nigeria's economy and government stability (other countries too, but Lagos is the largest city in Africa.) I'm worried about inappropriate, disproportionate responses that make the entire thing worse or concentrates on our own interests instead of the fact that people are actually dying.

I'm going to be watching the oil news and listening to the gossip very carefully over the new few days, and hoping like hell the biggest ripple effect of this news is that other countries start paying this outbreak the attention it deserves.
posted by barchan at 11:33 AM on July 29, 2014 [8 favorites]

danny the boy: “Scenarios where it reaches the western world are fantasies that depend on ebola basically not being ebola.”

Agreed, but my nightmare scenarios don't need that to happen. Nearly a billion people live in the developing parts of Sub-Saharan Africa.
posted by ob1quixote at 11:36 AM on July 29, 2014 [8 favorites]

Oh god the more I think about it the more I realize that yes, actually, there are a greater than usual number of top news stories in 2014 that are legitimately Tom Clancy novel major plot points.

someone please contact harrison ford
posted by elizardbits at 11:38 AM on July 29, 2014 [24 favorites]

21 million people live in Lagos. A proper outbreak in that city would be devastating, despite it not being "the western world".
posted by dabitch at 11:40 AM on July 29, 2014 [23 favorites]

elizardbits: "Oh god the more I think about it the more I realize that yes, actually, there are a greater than usual number of top news stories in 2014 that are legitimately Tom Clancy novel major plot points.

someone please contact harrison ford"

He's got a broken leg. Will Ben Affleck do?
posted by Strange Interlude at 11:41 AM on July 29, 2014 [1 favorite]

Would you settle for Chris Pine?
posted by entropicamericana at 11:45 AM on July 29, 2014 [8 favorites]

21 million people live in Lagos. A proper outbreak in that city would be devastating, despite it not being "the western world".

No shit.

Which is why getting into a panic about it as a person living in NYC, with even the most basic understanding of germ theory, is kind of silly. But people want to panic.
posted by danny the boy at 11:46 AM on July 29, 2014 [4 favorites]

Which is why getting into a panic about it as a person living in NYC, with even the most basic understanding of germ theory, is kind of silly.

It's silly to panic about Galactus. Considering the history of disease, it's merely premature to panic about pandemic.
posted by maxsparber at 11:50 AM on July 29, 2014 [28 favorites]

Screw 'Ebola in Town'. The best Ebola song is Ebolarama by Every Time I Die.
posted by MisantropicPainforest at 11:54 AM on July 29, 2014 [1 favorite]

Would you settle for Chris Pine?

I'm leading more towards some sort of Tom Hardy/Emily Blunt partnership.

Before the Ebola can get us, we will meet a more merciful end from the uncontrolled levels of sexy.
posted by TheWhiteSkull at 11:55 AM on July 29, 2014 [5 favorites]

Oh god the more I think about it the more I realize that yes, actually, there are a greater than usual number of top news stories in 2014 that are legitimately Tom Clancy novel major plot points.

I continue to believe my theory that reality did actually end on 12/21/12 and was replaced by Hollywood Screenwriter Reality.

It's the only thing that truly makes the last 20 months make any sense at all.
posted by hippybear at 11:56 AM on July 29, 2014 [52 favorites]

showbiz liz--You said "if you arrogantly refuse to explain"--do you know something I don't. I assume the vast majority of those working this epidemic (and prior outbreaks) are very aware of this--yet they are risking their lives to help manage this. These outbreaks are frightening to every one, breed conspiracies and traditional means of handling them probably won't work in a much more mobile world. If you know they have been arrogant, or ignored local traditions that would be helpful, I would appreciate the information--other than anecdotes. These are some of the most professional of all health care workers--I think they deserve respect rather than second guessing--unless there is evidence to the contrary.
posted by rmhsinc at 11:57 AM on July 29, 2014 [7 favorites]

I've kind of felt that way since November 7, 2000. It's been a long strange time since then.
posted by tavella at 11:59 AM on July 29, 2014 [11 favorites]

edeezy, I work in the oil biz. I've worked in the oil biz in Africa, including Nigeria. I have zero faith in certain countries and companies to not demonstrate a large degree of ignorance and either fail to act or act upon that ignorance. Furthermore, I'm quite aware of how certain policies and procedures changed in the aftermath of the revolutions/civil wars in northern Africa, how companies were woefully unprepared for what happened and perhaps have swung too far the other way. I'm hearing a ton of gossip already about evacuations - these companies are not the Peace Corps.

(And in light of recent allegations about the Peace Corps, are you sure you should be too comfortable? I really have no idea.)

I have no idea what's going to happen. All I know is that Ebola hitting Lagos is significant, and could be a turning point, and I'm concerned what it could mean.
posted by barchan at 12:01 PM on July 29, 2014 [4 favorites]

I always squicks me out when the narrative runs to "spacemen versus witch doctors" considering pharmaceutical companies, intelligence services and governments have been exploiting these same peoples using faux-public health programs for years. The distrust is not always borne out of ignorance, sometimes it is a natural reaction to Western malfeasance.

How many people would run from a similar outbreak when FEMA or the CDC turned up in an American town? Evil government scientists in Hazmat suits has become cliché in science fiction.

Or to put it another way, if Google gave you a house how long would it before before you stopped looking for cameras? If the Internet was created today, how many people would assume it was just an NSA spying program and avoid it?
posted by fullerine at 12:01 PM on July 29, 2014 [17 favorites]

No shit.

Which is why getting into a panic about it as a person living in NYC, with even the most basic understanding of germ theory, is kind of silly. But people want to panic.

Wow dude, never been sad or anxious about bad things happening to someone who wasn't you?
posted by Lutoslawski at 12:02 PM on July 29, 2014 [11 favorites]

entropicamericana: "Would you settle for Chris Pine?"

Honestly, I think the cool, level-headed resolve of Alec Baldwin is what's needed right now.
posted by Strange Interlude at 12:06 PM on July 29, 2014 [6 favorites]

showbiz liz--You said "if you arrogantly refuse to explain"--do you know something I don't.

Just because a person is a brilliant, selfless humanitarian, that doesn't mean they have ace PR skills, especially in a totally cultural new environment.

So, this is the article I was actually thinking of.

"Before the World Health Organization and Doctors Without Borders started bringing in anthropologists, medical staff often had a difficult time convincing families to bring their sick loved ones to clinics and isolation wards. In Uganda, Hewlett remembers, people were afraid of the international health care workers.

"The local people thought that the Europeans in control of the isolation units were in a body parts business," he says. "Their loved ones would go into the isolation units, and they would never see them come out.""
posted by showbiz_liz at 12:08 PM on July 29, 2014 [4 favorites]

How many people would run from a similar outbreak when FEMA or the CDC turned up in an American town?

If the government showed up to explain that, for public safety reasons, they needed to burn the dead body of my recently deceased relative who died from an incredibly virulent disease with up to a 90% kill rate I would light the pyre myself.
posted by elizardbits at 12:09 PM on July 29, 2014 [11 favorites]

someone please contact harrison ford

He's busy freaking out about a card trick.
posted by nzero at 12:12 PM on July 29, 2014 [3 favorites]

Wow dude, never been sad or anxious about bad things happening to someone who wasn't you?

You know I really resent that you and others are assuming some really shitty things about me, based on things I HAVEN'T written. Yes, I am concerned about people in west africa dying, because I am a human being and I care about other human beings. I'm just surprised about how much misinformation there is in this thread. People here are irrationally panicking (and that concern is for themselves, and not the people in Nigeria). I stand by my belief that no, ebola is not gonna get you.
posted by danny the boy at 12:13 PM on July 29, 2014 [18 favorites]

they needed to burn the dead body of my recently deceased relative who died from an incredibly virulent disease with up to a 90% kill rate I would light the pyre myself.

Depending on the relative, I might even haul the wood.
posted by TheWhiteSkull at 12:14 PM on July 29, 2014 [23 favorites]

How many people would run from a similar outbreak when FEMA or the CDC turned up in an American town?

A significant minority around here would be picking off quarantine workers with hunting rifles. Never mind anthropologists, you'd need the national guard.
posted by fshgrl at 12:15 PM on July 29, 2014 [12 favorites]

If the government showed up to explain that they needed to burn the dead body of my recently deceased relative who died from an incredibly virulent disease with up to a 90% kill rate I would light the pyre myself.

Just don't handle the body.

Look, it's pretty easy to sit in a developed Western country and make statements about how one might behave in the midst of an outbreak.

I don't really know much about what it is like to grow up acculturated into an African country, with it's melange of religious practices, varying levels of infrastructure, weak economy, multiple waves of historical imperial occupation and religious proselytization, perhaps not much exposure to modern medicine at all, and have little or no context clues for what is happening and why all these people from outside my village are coming in while people are dying and telling me that everything we've always done is no longer allowed and why my friends and relatives are disappearing without proper ritual burial even being possible.

I can try to project as to why there is distrust, and I believe the distrust is real. I don't know how to overcome that quickly or easily.
posted by hippybear at 12:16 PM on July 29, 2014 [5 favorites]

Isn't it notoriously difficult to spread widely and rapidly due to the almost immediate death of the infected?

I was coming here to say the same thing. Most of the transmissions is supposedly due to handling of human remains as part of burial rites. Doctors and nurses are obviously going to be susceptible as well. The disease apparently is difficult to transmit until the very final stages.

I believe the focus right now is not shutting down 21st Century necessities like air travel and trade, but instead on finding the local "reservoir" of the disease.
posted by KokuRyu at 12:20 PM on July 29, 2014

I don't really know much about what it is like to grow up acculturated into an African country

It's doesn't even need to be a West African country. I'm imagining the scene in various areas of Brooklyn or upstate in Kiryas Joel where devout Haredi are hypothetically told that the body of one of their religious leaders needs to be burned instead of buried reverently. It would be a disaster.
posted by elizardbits at 12:22 PM on July 29, 2014 [4 favorites]

A close relative used to be part of the animal disease control system when the BSE and then a hoof-and-mouth outbreaks occurred in the 90s. A few Vets were run off the land at gunpoint during those outbreaks.
posted by bonehead at 12:23 PM on July 29, 2014 [3 favorites]

All this just as I am recovering from a wicked cold imported from Europe by my wife that involved viral conjunctivitis. Not blood but I had pus-mucous coating my eyes. Not at all cool.

YES I CHECKED THE SYMPTOMS FOR EBOLA.
posted by srboisvert at 12:23 PM on July 29, 2014 [1 favorite]

showbiz liz--I would guess WHO, CDC and Drs. Without Borders have as much sensitivity and expertise as can be mustered. Old stories, conspiracies, etc. just do not cut it when discussing things of this magnitude. And for those who would not trust the CDC etc--good luck.
posted by rmhsinc at 12:23 PM on July 29, 2014

~If the government showed up to explain that, for public safety reasons, they needed to burn the dead body of my recently deceased relative who died from an incredibly virulent disease with up to a 90% kill rate I would light the pyre myself.

Meanwhile, your local talk-radio moron will start shouting "See? I told you!" warnings about the FEMA Death Camps being set-up in the area.
posted by Thorzdad at 12:24 PM on July 29, 2014 [6 favorites]

(I'm singling out these communities only because I know there are already issues with things like childhood vaccinations.)
posted by elizardbits at 12:24 PM on July 29, 2014

If the government showed up to explain that they needed to burn the dead body of my recently deceased relative who died from an incredibly virulent disease with up to a 90% kill rate I would light the pyre myself.

Do you honestly believe if they told everyone in your block/apartment/neighbourhood they had to stay indoors and took some of those neighbours away there wouldn't be some shit-fits thrown?

What if it was on the orders of the new head of the CDC, Dick Cheney*?

*As this is a comment about panic, I would like to stress that Dick Cheney is NOT the new head of the CDC.
posted by fullerine at 12:24 PM on July 29, 2014 [6 favorites]

If it shows up in the US, perhaps instead of appearing in NYC it will start in Texas or Georgia.

Which are obviously places well-known for their belief in the effectiveness of federal disease control and prevention, a firm grip on the reality of international relations with African countries and their populations, and a lack of paranoia about both.
posted by zombieflanders at 12:25 PM on July 29, 2014 [9 favorites]

Do you honestly believe if they told everyone in your block/apartment/neighbourhood they had to stay indoors and took some of those neighbours away there wouldn't be some shit-fits thrown?

I'm not sure what part of my comment, which you quoted in full, led you to the conclusion that I honestly believe this wholly different example you have given.
posted by elizardbits at 12:27 PM on July 29, 2014

I always squicks me out when the narrative runs to "spacemen versus witch doctors"

But it is a significant part of what's going on, as the articles link above note. It doesn't help to ignore the reality because you don't like it. It can be true both that there has been Western malfeasance and that local panic and ignorance is exacerbating the problem.

Do you honestly believe if they told everyone in your block/apartment/neighbourhood they had to stay indoors and took some of those neighbours away there wouldn't be some shit-fits thrown?

Then they'd need to be supressed by force. If we were facing a serious pandemic, it's not a time to dwell on sensitivities. If people were freaking out and preventing quarrantine or cure, martial law should be declared and the National Guard or military should be called in and force compliance.

Effort should be made to explain why things are being done need to be done, but if people aren't accepting the explanation there's no time to argue with them and assuage their fears while infection spreads and people die.
posted by Sangermaine at 12:29 PM on July 29, 2014

This is merely technical semantics on WHO's part, and not a reflection of any downgrading of Ebola's danger. Marburg isn't classified as a haemorrhagic fever anymore, either.

True, but people have the idea that everyone who gets Ebola turns into a bag of bloody slurry, liquifying out of their eyeballs and rectum, painting everything around them red and black.

It's deadly, but it's not a Guillermo del Toro-esque spectacle.
posted by rewil at 12:33 PM on July 29, 2014

I listened to a very lengthy piece on BBC World radio last night that was quite informative about all this. Unfortunately, my cursory searching isn't finding any link to it that I can share.

Perhaps this interview (mp3)? Justin Webb speaks to John Oxford, Professor of Virology at Queen Mary.
posted by Jahaza at 12:34 PM on July 29, 2014

Which are obviously places well-known for their belief in the effectiveness of federal disease control and prevention, a firm grip on the reality of international relations with African countries and their populations, and a lack of paranoia about both.

Here's the place I'd like to throw out how badly the CDC budget has been gutted, but due to all the budget shenanigans and presidential budget "filler funding" versus how congress passed it, I'm having trouble finding a real number; the most common number I'm running into is 20% since 2010, but there's all these different funding sources that play into it.

I guess the best way you could put it is that 50,000 CDC jobs have been cut since 2008. I'm still looking for what parts of the budget and jobs cuts apply to its international role.
posted by barchan at 12:34 PM on July 29, 2014 [4 favorites]

It's deadly, but it's not a Guillermo del Toro-esque spectacle.

As long as it doesn't do that eyeballs in the hands thing...
posted by Jahaza at 12:35 PM on July 29, 2014

Via NPR:

"The chance of Ebola spreading out of West Africa is very, very low," says infectious disease specialist Kamran Khan, with St. Michael's Hospital in Toronto. "But if it did spread, Paris is probably the first city on the list.... The volume of travel in the Conakry [Guinea] airport is low," Khan says. "Most of the flights are local. But 10 percent of the traffic goes to Paris." That would make Paris the likeliest place for Ebola to arrive.

And it is a possibility. After a person is infected with Ebola, symptoms could appear within two days — or take up to 21 days, Khan says. So a person infected in Guinea could hop on a plane and bring Ebola to, say, France or another international destination."

posted by argonauta at 12:36 PM on July 29, 2014 [4 favorites]

hippybear: “I continue to believe my theory that reality did actually end on 12/21/12 and was replaced by Hollywood Screenwriter Reality.

It's the only thing that truly makes the last 20 months make any sense at all.”

“People, we all died years ago.”—The Whelk, 21 November 2011
posted by ob1quixote at 12:40 PM on July 29, 2014 [2 favorites]

I'm sorry, but why does infectious disease specialist Kamran Khan think they know more about basic germ theory than the anonymous stranger on the Internet who just told us we're silly to panic about the spread of ebola?
posted by maxsparber at 12:41 PM on July 29, 2014 [5 favorites]

showbiz_liz: ""The local people thought that the Europeans in control of the isolation units were in a body parts business," he says. "Their loved ones would go into the isolation units, and they would never see them come out."""

hippybear: "I don't really know much about what it is like to grow up acculturated into an African country, with it's melange of religious practices, varying levels of infrastructure, weak economy, multiple waves of historical imperial occupation and religious proselytization, perhaps not much exposure to modern medicine at all, and have little or no context clues for what is happening and why all these people from outside my village are coming in while people are dying and telling me that everything we've always done is no longer allowed and why my friends and relatives are disappearing without proper ritual burial even being possible."

Tangentially related: Speaking with Vampires: Rumor and History in Colonial Africa is a fascinating book on contemporary African vampire myths.

An African politician recalled that in 1952, a man returned to his home area in central Kenya, much to the surprise of his neighbors: “He had been missing since 1927. We thought he had been slaughtered by the Nairobi Fire Brigade between 1930–1940 for his blood, which we believed was taken for use by the Medical Department for the treatment of Europeans with anaemic diseases.” [2] In 1986, however, a man in western Kenya told my assistant and I that it was the police, not the firemen, who captured Africans (“ordinary people” just “associated firemen with bloodsucking because of the color of their equipment”) and kept their victims in pits beneath the police station.[3]

What are historians to do with such evidence? To European officials, these stories were proof of African superstition, and of the disorder that superstition so often caused. It was yet another groundless African belief, the details of which were not worth the recall of officials and observers. But to young Africans growing up in Kenya—or Tanganyika or Northern Rhodesia—in the 1930s, such practices were terrible but matter-of-fact events, noteworthy, as in the quotations above, only when proven to be false or when the details of the story required correction. In this book, I want to study these stories both as colonial stories and for their mass of often contested details. I want to interrogate and contextualize these stories for what was in them: I want to contextualize all their power, all their loose ends, and all their complicated understandings of firemen and equipment and anemia, so that they might be used as a primary source with which to write, and sometimes rewrite, the history of colonial East and Central Africa. I argue that it is the very inaccurate jumble of events and details in these stories that makes them such accurate historical sources: it is through the convoluted array of overalls and anemia that Africans described colonial power.

posted by zamboni at 12:45 PM on July 29, 2014 [16 favorites]

I feel like a lot of the fear of Ebola is based on fiction that starts by assuming a mutation to an airborne transmissible form of the virus.

This has already happened. Ebola Reston is a mutation of Ebola that is highly contagious and transmissible via the air. Fortunately, it only appears to affect simians at this time and hasn't jumped species.

At the time the outbreak happened in Virginia, however, the US Army and the CDC were collectively freaking out because they were afraid that humans were susceptible.

It's no longer just the realm of fiction.
posted by DWRoelands at 12:45 PM on July 29, 2014 [1 favorite]

She says the chance is "very, very low."

That's what the old Scottish guy told Ian Malcolm about the odds of dinosaurs getting to San Francisco, and we all know how that turned out.
posted by maxsparber at 12:48 PM on July 29, 2014 [7 favorites]

Don't worry about Ebola, there's free ice cream for everyone.
posted by ob at 12:54 PM on July 29, 2014 [5 favorites]

Oh god the more I think about it the more I realize that yes, actually, there are a greater than usual number of top news stories in 2014 that are legitimately Tom Clancy novel major plot points.

You all know about the unidentified radio bursts from deep space, right? I mean, those shouldn't freak me out at all, right?
posted by shothotbot at 1:00 PM on July 29, 2014 [5 favorites]

I know! When the alien invaders show up, we can just sic the Ebola on them.
posted by Strange Interlude at 1:08 PM on July 29, 2014 [1 favorite]

For a moment, I thought the Dr. Khan saying it's not likely to spread out of West Africa and the Dr. Khan who recently died were the same person.
posted by ChuckRamone at 1:08 PM on July 29, 2014 [1 favorite]

Geez, who gives an answer like "well, that's not likely at all, but if it happens, sure, Paris is a goner."
posted by smackfu at 1:30 PM on July 29, 2014 [4 favorites]

smackfu: "Geez, who gives an answer like "well, that's not likely at all, but if it happens, sure, Paris is a goner.""

Scientists are rubbish at qualifying statements. (Mefi comment self-link).
posted by Happy Dave at 1:35 PM on July 29, 2014 [2 favorites]

God damn it, Patrick.
posted by kbanas at 1:46 PM on July 29, 2014

>> Oh god the more I think about it the more I realize that yes, actually, there are a greater than usual number of top news stories in 2014 that are legitimately Tom Clancy novel major plot points.

> You all know about the unidentified radio bursts from deep space, right? I mean, those shouldn't freak me out at all, right?

Much as I love this line of thought, I can assure you that the actual explanation for these radio bursts is very, very likely to be something much more mundane. (As long as you can classify last gasp flashes from (maybe) merging or disintegrating stellar corpses as "mundane", I guess.)
posted by RedOrGreen at 2:29 PM on July 29, 2014

Famous last words
posted by shothotbot at 2:42 PM on July 29, 2014 [1 favorite]

You all know about the unidentified radio bursts from deep space, right? I mean, those shouldn't freak me out at all, right?

The proper formulation is, "Of course, you know about the suppressed transmission."
posted by ricochet biscuit at 2:44 PM on July 29, 2014 [3 favorites]

How did Sawyer contract it? Was he near an outbreak area? He's in finance...not health care.... I've read the articles and no one comments on HOW he may have come into contact with the virus, or did I just miss it? You can see how mistakes can be made and those on the front line can get it, but a finance minister heading home from a conference?
posted by pearlybob at 3:22 PM on July 29, 2014

Scientists are rubbish at qualifying statements.

Sounds like scientists are quite good at qualifying statements—but journalists are rubbish at reporting what the scientists say with a sufficient level of accuracy and detail, and without giving into the temptation to write sensationalist clickbait.
posted by escape from the potato planet at 3:24 PM on July 29, 2014 [9 favorites]

Honestly this brings out the worst in everyone. I'm thinking "bring out the shock troops, time for Xe/BlackWater to prove their worth." It won't stop anything necessarily, but fuck this noise.
posted by aydeejones at 3:31 PM on July 29, 2014

I'm with danny the boy here. The thing about illnesses like ebola is that they burn out the host very quickly. It's a horrific, bleeding-from-the-eyes death, to be sure, and if you become symptomatic you are very very likely to die. But it happens so fast that you don't have the means to infect very many people. Thus far most ebola outbreaks have been very limited geographically and haven't lasted very long.

True, this is worrisome, that it's spread to a major city and that there are plausible transmission paths to the developed world. But I agree with danny the boy that this is a disease that tends to flare and dissipate rather than a Spanish flu that will spread around the world.

Really, regular flu kills up to hundreds of thousands of people every single year. And regular flu is something we joke about.
posted by dhartung at 3:47 PM on July 29, 2014

hundreds of thousands ?
posted by dabitch at 4:00 PM on July 29, 2014 [1 favorite]

According to the World Health Organization, up to 500,000 persons per year die due to seasonal influenza.

Source

On preview, The Whelk was faster on the draw.
posted by PROD_TPSL at 4:11 PM on July 29, 2014 [2 favorites]

I mean it's not worrisome because it's "spread to a major city and that there are plausible transmission paths to the developed world," it's worrisome because--Jesus Fucking Christ--more than 5 million people live in Lagos alone.

Considerably more than 5 million people live in Lagos. Over 20 million people live there, at a density of 20,000 people per square kilometre (51,820/sq mi).

It's really the worst possible place for ebola to break out. That short window of infectiousness is plenty of time to be catastrophic in a place so densely packed.
posted by Sys Rq at 4:33 PM on July 29, 2014 [3 favorites]

it's spread to a major city

Lagos is a major city, yes. But so are Conakry and Monrovia. The virus spread to major cities early on, and that's one of the reasons people have been worried about it. You can't exactly quarantine a city, and it is much harder to track who people have been in contact with.

I think that when people hear "Ebola" and "Africa" they imagine isolated rural villages, but we're talking about two capital cities. Lagos is much bigger, but would you be saying that it's "spread to a major city" now if it had been in Chicago or San Francisco for months?

So far it has been going on for months and it has not burned itself and it has not been contained. It's probably not going to kill hundreds of thousands of people, but it's already frightening and disruptive. Apart from the people who have died, borders are closed, airlines are stopping flights, etc. It's effecting far more people than who have caught the virus.

I feel like more than once in this thread there have been these casual statements about concerns of Ebola leaving Africa, with a pretty clear implication, intentional or not, that "as long as it doesn't leave the Dark Continent we'll be fine," and I think that's pretty fucked up.

Yeah. I mean, I get that whenever a topic like this comes up we're naturally going to think about how likely it is to effect us directly, but brushing off its seriousness because you think it's unlikely to escape Africa is... eh.

It reminds me a little of some initial coverage of the crashed AH1507 flight. Some of it listed the number of European victims, but not how many victims from African nations, despite all that information being available early on. Like they didn't matter as much.
posted by Kutsuwamushi at 4:37 PM on July 29, 2014 [9 favorites]

I mean it's not worrisome because it's "spread to a major city and that there are plausible transmission paths to the developed world," it's worrisome because--Jesus Fucking Christ--more than 5 million people live in Lagos alone.

One worry is about other people, and the other is about you personally.
posted by empath at 4:41 PM on July 29, 2014

I feel like more than once in this thread there have been these casual statements about concerns of Ebola leaving Africa, with a pretty clear implication, intentional or not, that "as long as it doesn't leave the Dark Continent we'll be fine," and I think that's pretty fucked up.

That's an incredibly uncharitable reading of what was a direct response to people in this thread (who are not in Africa) freaking out about getting ebola. Someone upthread was worried about getting sneezed on in the subway and catching it. Despite ebola not being anywhere near NYC, despite it not being transmissible via sneezing or coughing, despite it not actually infecting your respiratory system, etc., etc.

You're honestly saying that because I said ebola spreading to North America isn't a realistic scenario, I don't care about Africans.

You could also say I don't care about what happens to half of the world's population, since I didn't mention Asia anywhere. That would be equally weird.
posted by danny the boy at 5:02 PM on July 29, 2014 [5 favorites]

From the WHO on Seasonal Flu

Influenza occurs globally with an annual attack rate estimated at 5%–10% in adults and 20%–30% in children. Illnesses can result in hospitalization and death mainly among high-risk groups (the very young, elderly or chronically ill). Worldwide, these annual epidemics are estimated to result in about 3 to 5 million cases of severe illness, and about 250 000 to 500 000 deaths.

so yes, hundreds of thousands.

I do think this is a false comparison (whenever this statistic is brought up) because the majority of deaths are of people who are already immune compromised / close to death anyway. It's like when there's a heatwave that causes X number of deaths, statistically, those deaths were just pulled forward a few months, and after that you see a corresponding reduction in death rate in that population.

Ebola is scary because it's got a 50% chance to kill a perfectly healthy 25 year old who's reading about this on the internet even with the best medical treatment, while the regular flu has a pretty much 0% chance of doing so.
posted by xdvesper at 5:30 PM on July 29, 2014 [5 favorites]

Not necessarily- the 1918 Flu epidemic killed primarily young, healthy people, not children or the elderly. And even in "normal" years plenty of otherwise healthy people die from the flu.
posted by ambrosia at 5:37 PM on July 29, 2014 [4 favorites]

Thanks xdvesper for saying whet I was about to say, the (modern) flu doesn't decimate the population of perfectly healthy adults, it preys on the weak (which also makes it scary for those who have babies or care for their elderly family). Ebola can kill anyone.

Still I didn't realize that it was hundreds of thousands of deaths. My my, we are a lot of people these days aren't we?
posted by dabitch at 5:40 PM on July 29, 2014

Flu Outbreak Spreads Across US, Affects Young Adults

ignoring the 1.1B people who live in Africa

I said AND. AND. What does AND mean to you?

Lagos is a major city, yes. But so are Conakry and Monrovia.

Rank of Lagos among world cities: 25
Rank of Conakry: 248
Rank of Monrovia: 451

Like they didn't matter as much.

Oh, for pity's sake. I'm responding to people who are quaking in their boots about a worldwide pandemic. I am not diminishing the fact that this is a horrible disease that is going to continue to kill a whole bunch of people.

I don't think there is any particular value in hysteria or, say, people starting to walk around with face-masks when they are many thousands of miles from any actual diagnosed cases of Ebola. I said nothing to suggest that we shouldn't take Ebola seriously as a disease where it is happening, can we agree on that? The points that I'm making are about the focus on the visceral fear associated with Ebola rather than the relative risk. As a rule, humans are horrible at evaluating risk. I would hope we on the blue could strive to be a notch above the average when discussing it.
posted by dhartung at 6:07 PM on July 29, 2014 [5 favorites]

dhartung: “Flu Outbreak Spreads Across US, Affects Young Adults”

Yeah, I was going to say. My wife is a nurse. Last winter she called and told me, a robust man of middle years, to go get a flu shot because in the span of a week they had five cases of otherwise healthy people in their 30s and 40s die of the flu where she works. Of course, it takes two weeks for the vaccine to work, so I would have needed to go back in time for her warning to be of any use, but it's the thought that counts.
posted by ob1quixote at 6:24 PM on July 29, 2014 [1 favorite]

Rank of Lagos among world cities: 25
Rank of Conakry: 248
Rank of Monrovia: 451

Lagos is much bigger, yes, which I said. But the comparison wasn't Lagos--it was cities like Chicago and San Francisco, which are of comparable size.

It's hard to imagine that people would say "Ebola has spread to a major city" if it had been in either of those cities for months already, because they're usually considered major cities in their own right. These are major cities--they are national capitals and economic hubs--and shouldn't be overlooked.

I said nothing to suggest that we shouldn't take Ebola seriously as a disease where it is happening, can we agree on that?

I think so. The thing is that some of the comments on this thread (I am not singling you out) fit into a larger pattern of treating African casualties and African hardships as less important than European or American ones. There's not a lot of talk about what could happen in Lagos, or what next African city is most at risk, but there is a lot of talk about the risk of it escaping the continent. This stuff grates after a while.

That said, there are multiple conversations happening in this thread and your response will be shaped by what you're responding to so, shrug.
posted by Kutsuwamushi at 7:10 PM on July 29, 2014 [6 favorites]

fullerine: " If the Internet was created today, how many people would assume it was just an NSA spying program and avoid it?"

We assumed the internet was hooked up direct to the NSA server farms 30 years ago. Even salted our .sigs with likely sounding words of interest to provide camoflauge, plausible deniability and just straight up tweek the spooks.

elizardbits: "If the government showed up to explain that, for public safety reasons, they needed to burn the dead body of my recently deceased relative who died from an incredibly virulent disease with up to a 90% kill rate I would light the pyre myself."

It'd probably be less than a week before some religious extremist was successfully thwarting efforts via the courts.
posted by Mitheral at 7:19 PM on July 29, 2014

Considering that Patrick Sawyer, the man who died in Lagos, was an American citizen heading home to Minnesota, I think being concerned (for various definitions of concerned that do not include panic) about an international outbreak just got a little less sci-fi and a little more sci-fuck.
posted by lydhre at 7:22 PM on July 29, 2014 [4 favorites]

dhartung: "The thing about illnesses like ebola is that they burn out the host very quickly. It's a horrific, bleeding-from-the-eyes death, to be sure, and if you become symptomatic you are very very likely to die ... this is a disease that tends to flare and dissipate rather than a Spanish flu that will spread around the world."

Maybe. But the thing about highly lethal, contagious viral diseases is they tend to mutate rapidly to progressively less lethal, more easily transmissible strains and then oscillate their lethality and transmissibility around a network of stable equilibria clades. And the beauty and terror of a widespread, fulminating outbreak is how it's basically running billions of adaptive iterations in parallel across hundreds or thousands or millions of different people at the same time. To take your example of Spanish Flu, in its initial waves of epidemic it appears to have been significantly less lethal, but highly transmissible. And in that form it spread widely. But the basically simultaneous emergence of the much more lethal strain in August 1918 across multiple continents seems likely a result of convergent evolution of dissimilar lower-lethality clades, probably inevitable given the large number of similar hosts it was adapting to.

Regarding the spread of ebola, one happy thought I don't see written in many of the articles about it is that it can also be a sexually transmissible illness:

Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery

The fact that in some areas of central Africa a surprisingly high proportion of the population test positive for ebola antibody titres indicates that this is already a continuum disease. We recognise and respond to the the lethal cases. But there's unidentified less lethal strains (at least in some people, possibly as a result of differences in innate and adaptive immune responses) causing probable sickness but not death and so go unrecognised.
posted by meehawl at 9:00 PM on July 29, 2014 [22 favorites]

How much would it spread in water?
Like what if an infected person got on a plane to India and decided that the Ganges would be the perfect cure for bleeding out of their eyes?
posted by Iax at 11:34 PM on July 29, 2014

A few comments deleted; jokes are really, really not a great way to kick off a discussion of horrific death and disease. Please take a moment to consider what you are posting? Also not that helpful to angrily direct attention back to the jokes once the conversation has recovered. Just contact us, if for any reason flagging doesn't seem to work.
posted by taz (staff) at 11:35 PM on July 29, 2014 [2 favorites]

Telegraph: "As the foreign secretary says Ebola is a 'very serious threat' to the UK... "
posted by PHINC at 5:58 AM on July 30, 2014

You know I really resent that you and others are assuming some really shitty things about me, based on things I HAVEN'T written.

Metafilter has an ugly habit of playing More-Empathetic-and-Humane-than-Thou in these threads.

This Ebola thing makes me realize how lucky I am to have been born and to live in a prosperous industrialized Western society with good sanitation, access to healthcare (relatively speaking), and fairly benign forms of superstition (again, relatively speaking).

.
posted by echocollate at 6:26 AM on July 30, 2014 [5 favorites]

So, wait... this whole global authorities on alert, and the quarantining of airline passengers from the region who have shown symptoms of the disease shouldn't have me a little concerned? What's the consensus?
posted by dabitch at 10:26 AM on July 30, 2014

We just heard that the Peace Corps is temporarily sending Guinea volunteers (including my brother) home, so scratch that?

Better sanitation in North America or not, wouldn't it make a hell of a lot more sense to quarantine them for three weeks first, just in case?

Because sanitation doesn't prevent transmission via shared needles, saliva, sex (? do semen/vaginal fluids transmit the virus?), etc etc.
posted by feckless fecal fear mongering at 12:09 PM on July 30, 2014

MoonOrb: I feel like more than once in this thread there have been these casual statements about concerns of Ebola leaving Africa, with a pretty clear implication, intentional or not, that "as long as it doesn't leave the Dark Continent we'll be fine," and I think that's pretty fucked up.

Experts: Ebola Vaccine At Least 50 White People Away
posted by tonycpsu at 1:11 PM on July 30, 2014 [2 favorites]

MonOrb--apparently you see something I don't. Mostly I see people saying they are glad it is as far away as possible and that they live in a country where sanitation, public health and isolation and quarantine measure are generally reliable and respected. These seem to me to be fairly human and understandable reactions. Perhaps it is not about indifference and the Dark Continent. This is not a site where I find people indifferent to the needs and plights of others regardless of race, ethnicity or nationality. Or perhaps I am only speaking for myself. I am glad I live where I do
posted by rmhsinc at 1:30 PM on July 30, 2014 [1 favorite]

A fine time to reread Laurie Garrett, and leave my favourite Poison Elves t-shirt in the closet.
posted by bouvin at 1:47 PM on July 30, 2014 [1 favorite]

I dunno, it seems to me that there's a lot of misreading of comments in the thread (intentional or not). Sure, don't panic, but at the same time there are news reports about emergency Cobra meetings to consider the threat from the disease's deadliest ever outbreak all the while doctors are warned that the outbreak is not under control. It's swell that a lot of people in this thread are where there's sanitation, healthcare and burial practices different than the situation in a lot of rural west Africa, but as pointed out upthread with religious practices that differ and rural armed folk that distrust the gubmint, some areas of the US might make perfect pockets for the spread of this virus. the Nigerian hospital where the victim died has been quarantined now.
posted by dabitch at 2:10 PM on July 30, 2014

"But if it did spread, Paris is probably the first city on the list.... The volume of travel in the Conakry [Guinea] airport is low," Khan says. "Most of the flights are local. But 10 percent of the traffic goes to Paris." That would make Paris the likeliest place for Ebola to arrive.

I don't know how likely it is or isn't to spread to the Western world, but I don't think Paris is particularly likely to be the first stop. True, Guinea is a francophone country with strong ties (and travel) to France. But the disease has since spread to Anglophone countries like Liberia (very strong ties to US), Sierra Leone, and Nigeria. So watch out ... Canada?

(None of this is a comment on how awful this is for West Africa regardless of what happens elsewhere in the world.)

I am still a little unclear how dangerous this is to people in West Africa. I read that it is only transmitted through contact with bodily fluids of someone in the throws of the infection - that sounds pretty easy to avoid. But it seems like maybe there's more to it than that?
posted by semacd at 3:10 PM on July 30, 2014

The more to it is that people aren't willing to avoid each other, yet.
posted by empath at 5:31 PM on July 30, 2014

some areas of the US might make perfect pockets for the spread of this virus

meh. There are pockets of under-served medical need and attention where someone could get "the flu" and spread it to others before anyone looked sideways, but these are actually poor minority neighborhoods. Of the pockets of anti-gubmint-health-care sentiment, either they are actually big-time hypocrites ("Keep your government hands off my Medicare!") or isolated off-grid survivalists who aren't likely to encounter many of these funny-looking people with the weird disease.

And let me just reiterate that quarantining and containment are the best way to handle any infectious disease happening anywhere. The fact that people are broadly hoping this disease is able to be contained are agreeing with medical protocol.

What's the consensus?

Personally? Discomfited. I believe, however, that the WHO and CDC and local authorities are doing all they can, under the circumstances. (There is a broader issue of underfunded medical systems that even a crunch operation like this can't fully overcome. These are among the 25 poorest countries in the world.) Is there a chance of spreading to non-African countries via air travel? Certainly, and I wouldn't be surprised if it does -- but in the manner that SARS did [wiki image, not a pdf], with hundreds of deaths in China and Hong Kong, a couple of places with tens of deaths, and very few anywhere else -- largely for the reasons that edeezy outlined above.

While nothing can be certain, as days pass there fails to be an indication of a real outbreak in Nigeria, despite that one unfortunate. Still, the number of diagnosed cases and confirmed deaths continues to rise without signs of leveling out (total cases doubling in each of the last two months). Here is where the disease having a limited asymptomatic period is in fact concerning, because that shows that people are still out there having contact with uninfected persons (or that other vectors have developed). It's hard to tell what the implications are, but at least for now it appears to still be almost wholly within these three affected countries. I saw a report of schools being closed; it will probably take a much broader general quarantine and economic pause to begin to have a serious effect at isolating the disease.

So this continues to be tragic for Guinea, Liberia, and Sierra Leone, three countries which have known their share of heartbreak and then some. I do think that diagnosed cases are not rising as quickly in Guinea as they first were, though, so there's that (some of this reflects the slowness of public health reporting, to be sure). If we're still doubling by the end of August, though (i.e. approaching 3000 cases, 1500 deaths), I'd loosen up my concern -- we're at a critical phase.
posted by dhartung at 7:04 PM on July 30, 2014 [2 favorites]

There are pockets of under-served medical need and attention where someone could get "the flu" and spread it to others before anyone looked sideways, but these are actually poor minority neighborhoods.

My very-late-at-night, very tired cursory Googling isn't finding what I'm looking for quickly, but I remember reading some articles in the not-too-distant past which talked about how most of the truly underserved communities when it comes to medical care in the US are white communities in Southern and Appalachian states which are not close to urban population centers. If I remember, the articles I was reading were about how entire teams of medical personnel of all flavors would swoop down into these areas and set up free or nearly-free one-stop clinics for a day or a weekend or something, providing everything from vaccinations to dental care to physicals to trauma center needs.

I'm not sure it's entirely fair to paint the picture of medically underserved communities with being all minorities. There are a lot of places which are mostly white and which lack sufficient local doctors and hospitals.
posted by hippybear at 12:40 AM on July 31, 2014 [3 favorites]

Experts: Ebola Vaccine At Least 50 White People Away

Vox.com: We have the science to build an Ebola vaccine. So why hasn't it happened?
posted by shothotbot at 9:34 AM on July 31, 2014

So if it's not transmitted through areosol such as sneezing, then when did you ever experience a dry sneeze? Sneezes have either nasal mucus or spit flying around--which to me, are body fluids.

And I'm waiting for the vaccine debate to strike big time--not in the sense of it's not profitable but the anti-vaccine people. A friend of my husband's is one of them and she actually posted that a vaccine is what caused all of this.

oy vey!
posted by stormpooper at 11:13 AM on July 31, 2014

There was an article (posted here or elsewhere I don't know) about how a solid anthropological understanding of the local context was super important in cases like this, because if you arrogantly refuse to explain why you're doing what you're doing, it can wind up being perceived as "a bunch of big city folk/foreigners came and set up tents and almost everyone who goes into the tents winds up dead, wow fuck this."

Very late to the thread, but I often show people this article from 2005 about a Marburg outbreak in Angola and the huge cultural cock-up that was the UN and WHO trying to respond. For example, white (like the Haz-mat suits) symbolized witchcraft in the worst-hit area of Angola.

Interestingly, I told an MPH friend about that article at the time and said something to the effect of, they should totally have someone whose job it is to know stuff like that and keep the doctors from doing it, and she said, "Yeah, that's an actual job that anthropologists do." I don't know why it isn't more widespread. (I mean, I do. But I don't.)
posted by Snarl Furillo at 11:34 AM on July 31, 2014 [5 favorites]

“Only Enough for One: Experimental Ebola Serum Used on U.S. Patient,” Maggie Fox, NBC News, 31 July 2014

A dose of “experimental serum” arrived in Liberia to be tried on a U.S. charity worker struggling for her life — but there was only enough for one of the two infected workers, so Dr. Kent Brantly asked that it be used on his colleague, the group Samaritan’s Purse said Thursday.

“U.S. doctor battling Ebola takes slight turn for worse,” Reuters, 31 Jul 2014

“Yesterday, an experimental serum arrived in the country, but there was only enough for one person. Dr. Brantly asked that it be given to Nancy Writebol,” [Samaritan's Purse leader Franklin] Graham said in a statement.

posted by ob1quixote at 11:47 AM on July 31, 2014 [5 favorites]

First Ebola Case Coming to Atlanta for Treatment, "Staff at the hospital have reportedly been “highly trained” as well and are aware of “unique protocols” that will be necessary to treat the patient. "

I sincerely hope that both Dr. Kent Brantly and Nancy Writebol pull trough. I hope too that the serum used on Nancy Writebol worked.
posted by dabitch at 4:05 PM on July 31, 2014

This is the headline of the local Atlanta paper. People aren't too happy, especially with all the CDC flubs lately. The news just hit... I'm sure the kerfuffle will build in the days ahead. Sigh.
posted by pearlybob at 4:28 PM on July 31, 2014

dabitch: “I sincerely hope that both Dr. Kent Brantly and Nancy Writebol pull trough.”

Indeed. Especially since if Dr. Brantly doesn't pull through, I'll never be able to buy him a drink.

They showed the isolation equipment on the charter flight they've sent to Liberia on the 7 o'clock news here. I think it's going to be fine.
posted by ob1quixote at 4:47 PM on July 31, 2014 [3 favorites]

People aren't too happy, especially with all the CDC flubs lately

I work within walking distance of Emory University Hospital and I can say that my office, at least, is pretty blasé about this. Although we have determined that one co-worker complaining about her headache almost certainly has ebola.

Emory has a page set up for press releases on the subject, but it does not have anything new at the moment.
posted by Panjandrum at 9:33 AM on August 1, 2014 [1 favorite]

Ebola outbreak 'moving faster than efforts to control it', says WHO chief
posted by adamvasco at 10:13 AM on August 1, 2014

Chan added that the longer the virus circulated, the more it became a public risk: "Constant mutation and adaptation are the survival mechanisms of viruses and other microbes. We must not give this virus opportunities to deliver more surprises."

Well fuck you too, lady
posted by showbiz_liz at 11:30 AM on August 1, 2014

Just got wind of this interesting journal of a UNC doc working on the ebola outbreak with Doctors Without Borders in Guinea.
posted by Stewriffic at 1:10 PM on August 1, 2014 [3 favorites]

> if people aren't accepting the explanation there's no time to argue with them and assuage their fears while infection spreads and people die.

It strikes me that this sounds very much like the argument that drug warriors use about the epidemic of hard drugs vs. the 4th amendment. I agree with extreme measures needed for containment, but anthropologists are also needed in the western world to foster understanding and assuage panic. Obedience at gunpoint isn't the only tool to enforce/encourage quarantines, anywhere. I'm reading an attitude that finesse is needed in Nigeria to understand local views, but fearful conservative Texans (in a hypothetical stateside ebola arrival) can just go fuck themselves (or be shot). Unpack your ~~adjectives~~ attitudes.
posted by morganw at 2:04 PM on August 1, 2014

Unpack your ~~adjectives~~ ~~attitudes~~ knapsack.
posted by hippybear at 2:22 PM on August 1, 2014

The journal from the UNC doc is heartbreaking, especially the story of the little boy and his mother. What makes it such a terribly punishing disease is that it is the people who *don't* turn into savages who take the toll. The ones who try to care for their family, care for patients. Like this father:

I’m concerned it’s only a matter of time as the father walked 25km [to the treatment center] with one of the children tied to his back exposing him to potentially infectious sweat.
posted by tavella at 3:05 PM on August 1, 2014 [1 favorite]

So they quite literally broadcast the entire journey of the ambulance from Dobbins Air Reserve Base to Emory. I think every news helo in Atlanta was following turn by turn. At the end, it looks like Dr. Brantly walked into the hospital under his own power.
posted by ob1quixote at 9:45 AM on August 2, 2014 [3 favorites]

Yeay! That means he's doing quite well, right?

Must have been like a surreal weird white ford bronco chase to watch.
posted by dabitch at 10:17 AM on August 2, 2014 [1 favorite]

I don't know that I'd say quite well, but I think it at least means he's not at death's door.

Yeah, it was crazy. One channel tweeted every turn the ambulance made. MSNBC broadcast the whole thing live. J. Elvis Weinstein, the original Tom Servo and Dr. Erhardt on MST3K, tweeted, ”Watching coverage of Al Cowlings driving the Ebola patient to the hospital.”

“Ebola patient Dr. Kent Brantly walks into Emory Hospital”—WXIA TV 11
posted by ob1quixote at 10:54 AM on August 2, 2014 [4 favorites]

Huh. I am surprised if they allowed him to walk in even if he was feeling better, easier to control the shedding of virus with an immobile patient I'd think. Ebola patients do apparently recover quite quickly once they pass the crisis point, though.
posted by tavella at 11:00 AM on August 2, 2014

Is it me or is kind of invasive to film a patient like that? I mean, sheesh, bad enough you're sick like that with a life-threatening disease - but you have to worry about being filmed every move you make?
posted by joseph conrad is fully awesome at 11:00 AM on August 2, 2014 [4 favorites]

I am surprised if they allowed him to walk in even if he was feeling better, easier to control the shedding of virus with an immobile patient I'd think.

The virus is not capable of becoming airborne. It is transmitted via contact with body fluids. Unless he's leaving a trail of diarrhea or vomit or blood, he's not shedding the virus.
posted by hippybear at 11:05 AM on August 2, 2014

Yes, but it's transmitted by sweat, among many other things. Lot easier to avoid touching anything or anyone or dripping anything, plus you can put them in an isolation stretcher. But I assume that the people involved knew what they were doing.
posted by tavella at 11:41 AM on August 2, 2014

joseph conrad is fully awesome: “Is it me or is kind of invasive to film a patient like that? I mean, sheesh, bad enough you're sick like that with a life-threatening disease - but you have to worry about being filmed every move you make?”

It is a little distasteful, but I guess the media felt justified because of the high level of interest, especially in the Atlanta area. Judging by my Facebook feed, many Atlantans think this is going to be the Walking Dead, so they're anxious. As with much else, the superstitious can't be swayed by appeals to reason, so I've largely given up even trying.

Given the breathless reporting here, you'd have though there would be a fully armed convoy with air cover to transport Dr. Brantly, not a Grady Hospital ambulance and a few SUVs for the support personnel. Not to mention the streets lined with people taking photo and video with their cameras. At one point the MSNBC anchor started asking the doctors who they had phoned to comment on the transport about a rumor she'd heard that the virus had become airborne. It was all they could do not to shout at her.

tavella: “Yes, but it's transmitted by sweat, among many other things. Lot easier to avoid touching anything or anyone or dripping anything, plus you can put them in an isolation stretcher. But I assume that the people involved knew what they were doing.”

Dr. Brantly and the person who helped him through the door were both wearing full containment. The attendant was also wearing a SCBA or a PAPR.
posted by ob1quixote at 12:00 PM on August 2, 2014 [1 favorite]

Ah, okay, that makes more sense, I hadn't seen a picture.
posted by tavella at 12:18 PM on August 2, 2014

The virus is not capable of becoming airborne.

That's not necessarily true. What we know is that it hasn't become airborne yet. I've never heard of a single scientist saying it cannot become so.

Especially since there's evidence for airborne transmission between animals in lab settings... hermetically (basically) sealed labs with recirculating air. Like an airplane. (links about this are above, I'm too lazy to dig for them.)
posted by feckless fecal fear mongering at 2:17 PM on August 2, 2014 [3 favorites]

The virus we are currently dealing with is not capable of airborne transmission. Dealing with speculative possibilities will only lead to madness.
posted by hippybear at 3:44 PM on August 2, 2014 [3 favorites]

I'm not 100% convinced that it isn't transmitted by air in some form. The official "story" is that a colleague came into a clean room without going though the proper procedures. Dr. Brantley and Ms Writebol aren't stupid. They knew proper protocol. Even if they were at the tail end of a 48 hour shift...they knew what to do to remain safe. They weren't licking the floor or anything but they still got it. How? What happened? I'm 100% sure that they were being as safe as they could be but they contracted this awful virus anyway. My house is within a geographical mile of the CDC and Emory....I'm confidant that everything is being done for these folks and I don't need to worry for myself or my children... BUT..... The question still lingers....how did they contract the virus. I think many, many questions still need to be answered. At least to me.
posted by pearlybob at 4:46 PM on August 2, 2014 [3 favorites]

hippybear, I adore your brain from afar so I don't want to get fighty about this. But there is evidence that the human-deadly variant of Ebola is, in fact, transmissible in an airborne way (again, links above to studies involving animals in labs). That isn't madness, it seems to be proven scientific fact. That's something worth considering in the light of the flight that landed in Nairobi, for example, given that airplanes and labs working with that kind of virus (biosafety 4?) are indistinguishable in terms of hermetic sealing and recirculation of air.

So, yeah, the virus we're talking about actually does seem capable of airborne transmission (absent serious breakdowns in handling protocols in the lab(s) studied).

I'm not saying that Ebola is obviously airborne. Just saying there's evidence that it can be airborne in circumstances that are physically very, very similar to airplanes, and that's something worth considering, but perhaps not outright worrying about.
posted by feckless fecal fear mongering at 7:49 PM on August 2, 2014 [2 favorites]

>"Ebola in Town", currently the most popular song in Liberia.

Here's a better version of "Ebola in Town" on the SoundCloud page of one of the artists that doesn't cut off the end and doesn't have any disturbing imagery. It's really quite catchy.
posted by Small Dollar at 8:32 PM on August 2, 2014 [2 favorites]

As international medics are withdrawn it is still a mysery why so many Ebola health care workers are dying.
As well as this as noted up thread Many Sierra Leoneans refuse to take the advice of medical experts on Ebola.
posted by adamvasco at 10:47 AM on August 3, 2014 [2 favorites]

A mystery? Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced. This has always been the case. Is Vox seen a real paper one should trust now?
posted by dabitch at 12:47 AM on August 4, 2014 [1 favorite]

Health workers struggle to separate myth from reality of Ebola as residents say abandoning tradition is out of the question.
From Nigeria Daily Post : Lagos State Government visits Prophet T.B Joshua.
As to whether Vox is real paper or not I have no idea but the question they asked is valid.
posted by adamvasco at 5:42 AM on August 4, 2014

Hit post too soon
WHO Director-General Margaret Chan
"It is a social problem. Deep-seated beliefs and cultural practices are a significant cause of further spread and a significant barrier to rapid and effective containment."
posted by adamvasco at 5:46 AM on August 4, 2014

Steven Hoffman and Julia Belluz: The Ebola outbreak's real cause: Letting industry drive the research agenda

Ebola will continue to move through Africa—this time, and again in the future—not only because of the viral reservoirs and broken health systems specific to the continent. There are much larger issues at play here. Namely, the global institutions we designed to promote health innovation, trade, and investment perpetuate its spread and prevent its resolution.

This shouldn't be news. Most all of the money for research and development in health comes from the private sector. They naturally have a singular focus—making money—and they do that by selling patent-protected products to many people who can and are willing to pay very high monopoly prices. Not by developing medicines and vaccines for the world's poorest people, like those suffering with Ebola.

Right now, more money goes into fighting baldness and erectile dysfunction than hemorrhagic fevers like dengue or Ebola[...]Neglected diseases (ie., Ebola) got hardly any of the share of funding. These illnesses primarily grip people in developing countries and rely on investment from the public sector, which funds only a small fraction of total health R&D compared to industry. (In 2009, for example, $240 billion US was invested in health R&D. Of that, $214 billion went to high-income countries, and of that 60 percent came from industry, 30 percent from the public sector, and 10 percent from other sources.)

When a virus like Ebola does attract money, it's mainly from department of defense and not traditional disease research structures since Ebola is considered a potential bioterrorism weapon.

The result of this architecture of investments is that most health products that hit the market don't focus on sicknesses of the poor. Of the 850 health products approved by regulators between 2000 and 2011, only 37 focused on neglected diseases.

So we can't be surprised about the current Ebola outbreak. We can't lament the fact that there's no cure or that it's an unstoppable and violent virus when remedies could be expedited; we just don't prioritize them over other, more potentially profitable health problems.

As long as we perpetuate this global system of R&D funding, outbreaks of neglected diseases like Ebola will keep happening. Sadly, it's a cause shared by many more diseases of the poor, some of which affect multiple times more people than the one that's currently making headlines.

posted by zombieflanders at 11:32 AM on August 4, 2014 [6 favorites]

One of the doctors who treated Patrick Sawyer in Lagos has tested positive for Ebola.

Three others who also treated Sawyer now show symptoms of Ebola and their test results are pending, according to Nigerian Health Minister Onyebuchi Chukwu.
posted by argonauta at 12:42 PM on August 4, 2014

Oh dear.
posted by feckless fecal fear mongering at 12:54 PM on August 4, 2014

That is terrifying
posted by Ray Walston, Luck Dragon at 12:57 PM on August 4, 2014 [1 favorite]

Yep....damn
posted by pearlybob at 12:59 PM on August 4, 2014

Right, retreating to my underground bunker in an undisclosed location, it's been a pleasure snarking with you my friends, goodbye.
posted by elizardbits at 1:01 PM on August 4, 2014 [3 favorites]

For the record, Vox is part of Vox Media, which owns several sites including The Verge and SB Nation. Ezra Klein left the Washington Post to take over as Editor-in-Chief of Vox.com.

Meanwhile some people in the U.S. have gone Full Stupid: "Essential Oils & More to Combat Ebola Virus"
posted by ob1quixote at 1:08 PM on August 4, 2014

Well to be fair the article did note that the healthcare infrastructure in Lagos isn't great. So maybe the doctor wasn't able to take full biohazard precautions?

Which then makes me worry about how many other people may have come into contact.
posted by feckless fecal fear mongering at 1:21 PM on August 4, 2014

These new cases in Lagos are troubling but I'm not activating World Watch Two just yet.
posted by ob1quixote at 1:23 PM on August 4, 2014

Very much hoping for the best here: Patient at Mount Sinai Has Ebola-Like Symptoms, Hospital Says
posted by argonauta at 1:38 PM on August 4, 2014

Very much hoping for the best here: Patient at Mount Sinai Has Ebola-Like Symptoms, Hospital Says

This could very well be malaria, right?
posted by showbiz_liz at 1:49 PM on August 4, 2014

I dunno, maybe it's just me, but it seems like a hospital putting out a release like that is really, really not a good idea. Wait until you're sure, doesn't that seem like a more responsible approach?
posted by feckless fecal fear mongering at 1:50 PM on August 4, 2014 [1 favorite]

I would guess that unless Sawyer was immediately diagnosed with Ebola, the medical personnel in question weren't wearing much beyond mask and gloves, so some infected would not be a surprise, though tragic.
posted by tavella at 1:59 PM on August 4, 2014 [1 favorite]

It's going to be a really long couple of weeks if we all freak out every time anyone checks into any hospital with "ebola-like symptoms."
posted by ArbitraryAndCapricious at 2:00 PM on August 4, 2014 [1 favorite]

Especially since they are so generic. I am assuming that the patient in question was recently in one of the infection zones, thus the suspicion of a zebra, but it still seems like an odd thing to do a press release on before confirmation.
posted by tavella at 2:01 PM on August 4, 2014

I need to stop reading this thread. I'm pretty close to just taking my sleeping bag into my closet and staying there.
posted by Ray Walston, Luck Dragon at 2:10 PM on August 4, 2014 [1 favorite]

The only explanation I can come up with is they were unsuccessful at contacting everyone who may have come into contact with the guy. So sending out a soft release like this would, I'd imagine, prompt people to call the hospital if they haven't already been contacted, without inciting the fear that would come from "if you were at the hospital CALL US NOW." And/or rumours had already started flying about because of trying to contact people, so they're trying to get in front of it?
posted by feckless fecal fear mongering at 2:12 PM on August 4, 2014 [2 favorites]

Yeah, my best bet is that they want to get in front of any rumors, because incomplete information (or a seeming lack of transparency) is more likely to cause panic than complete information.
posted by ArbitraryAndCapricious at 2:19 PM on August 4, 2014 [1 favorite]

So, if the doctors who received that experimental serum both recover, what are the odds that there could be an emergency "who gives a shit that it hasn't been tested" distribution of the stuff? Is there a precedent for that?
posted by showbiz_liz at 2:24 PM on August 4, 2014

How much of the serum actually exists though? I don't think this is like Outbreak where USAMRIID is suddenly going to go "Oh uh we totally have freezers stocked to the brim with an antidote."
posted by feckless fecal fear mongering at 2:27 PM on August 4, 2014

Oh, well sure. I don't have much idea of how long it takes to make such a thing.
posted by showbiz_liz at 2:28 PM on August 4, 2014

That explanation does make sense, fffm. My personal spidey-sense hypothesis was that they would only issue a press release like that if they had significant reason to believe that he does have it, even if the official test results weren't/aren't available yet. I figure a hospital otherwise has just as much (if not more) of a reason to minimize speculation and fear-mongering, y'know?

(Of course I sincerely hope I'm proven wrong. And soon.)
posted by argonauta at 2:29 PM on August 4, 2014

Monoclonal antibodies are serious shit and often have very scary side effects up to and including death. So passing it out without testing is a very risky proposition. When the alternative is death by blood pouring out of all your orifices, though, I'd probably take that stuff without a second thought.
posted by Justinian at 2:36 PM on August 4, 2014

(I just want to say I hope to fuck that he's not infected, and that no new cases will pop up in the USA. The shitstorm that'll happen if/when the National Guard needs to be brought in to enforce quarantines...can you even imagine trying to enforce a quarantine in NYC?)
posted by feckless fecal fear mongering at 2:38 PM on August 4, 2014

Justinian, just for curiosity's sake, can you expand on the side effects?
posted by feckless fecal fear mongering at 2:46 PM on August 4, 2014

Nobody knows about the side effects of this particular monoclonal antibody. But to pick one example the side effects of Infliximab are:

serious and sometimes fatal blood disorders
serious infections
lymphoma and solid tissue cancers
reports of serious liver injury
reactivation of hepatitis B
reactivation of tuberculosis[18]
lethal hepatosplenic T-cell lymphoma (generally only when combined with 6-mercaptopurine)
drug-induced lupus
demyelinating central nervous system disorders
psoriasis and psoriasiform skin lesions
new-onset vitiligo

posted by Justinian at 3:10 PM on August 4, 2014 [1 favorite]

Remember that in this case those have to be weighed against "bleeding out your eyeballs until you die" though!
posted by Justinian at 3:18 PM on August 4, 2014 [3 favorites]

Whoa.
posted by feckless fecal fear mongering at 3:20 PM on August 4, 2014

which death is quickest, i will take that death
posted by elizardbits at 3:22 PM on August 4, 2014 [1 favorite]

To be clear, those side effects aren't exactly super-common. It's not like you have a 50% of dying from them. They do occur though.
posted by Justinian at 3:27 PM on August 4, 2014

Heck yeah: A man who was tested for Ebola at New York’s Mount Sinai Hospital on Monday is “unlikely” to have the virus, the city’s health department said.
posted by argonauta at 3:32 PM on August 4, 2014 [1 favorite]

It seems to me that those side effects are unlikely to be close to the side effects of this monoclonal antibody, too. Because Infliximab acts to suppress your immune system (it is used to treat things like ulcerative colitis). While this monoclonal antibody is being used to attack a disease and so is almost certainly not suppressing your immune system. But that's why you're supposed to test these things before using them; the effects can be wild.
posted by Justinian at 3:38 PM on August 4, 2014

Y'all keep talking. Being on the front line (literally), having the running knowledge of metafilter is actually very comforting. I'm good, just love to read what y'all find......keep it coming please.
posted by pearlybob at 3:49 PM on August 4, 2014 [1 favorite]

God's Minions are not helping.
Allegations of the Ebola virus at the Synagogue Church of All Nations .
But TB Joshua whose church attracts 50,000 worshippers a week, is now asking victims to stay in their own countries.
Also Last week, Ituah Ighodalo, the Founder of Trinity House, sparked outrage on his Facebook page after he said that “the Name of Jesus” will cause the viral spread to stop. The pastor had since come out to clarify that his Facebook post was merely a “message of hope and faith reminding us of the ever living words of our Lord and Saviour Jesus Christ.”
posted by adamvasco at 3:59 PM on August 4, 2014

it's a small company, but they might just have cracked it! The patients are improving! The experimental Ebola treatment administered to two Americans who contracted the virus in Africa was a medical cocktail called ZMapp, derived in part from tobacco plants, that has shown promise in tests on monkeys.
posted by dabitch at 6:17 PM on August 4, 2014 [1 favorite]

I confess that the news of Ebola is terrifying to me. Partly because it can be a horrifying death, it has a high mortality rate, and even people who are quite cautious are contracting it. I have some masks in my 1st Aid kit, and since I'm going on a Road/Camping Trip, I have some stored water and food. When I get to my destination, I'll make sure we have a month or 2 supply of food and critical supplies. There are some disasters I'd cheerfully volunteer to serve at, but my fear of Ebola is visceral. Also, the things you do to prepare for any emergency apply here, and it's smart to prepare for emergencies as a general rule.

So, yeah, I understand the concerns of people outside of Africa who are panicking, and the terrors of people in the infected areas. I don't believe the US, Russia, China or any big country is intentionally spreading it, but the logic of a villager who experiences strangers arriving and behaving bizarrely makes quite a bit of sense. I'm cynical enough to fear that a terrorist would intentionally spread it because it would, in fact, create terror very effectively.

The people who calmly, or not so calmly, I suppose, go to infected areas to help are such huge heroes. I am in awe of every one of them. Guess it's time to write a check to Medecin San Frontieres. This thread is a terrific resource. Thanks, y'all.
posted by theora55 at 9:32 AM on August 5, 2014 [2 favorites]

Via BBCAfrica: Saudi Arabia says it will not be issuing visas for the annual Hajj pilgrimage to visitors from Liberia, Guinea and Sierra Leone.

British Airways has now suspended all flights to Liberia and Sierra Leone through the end of August. White House spokesman Josh Earnest outlined yesterday why the U.S. sees no need to block flights from outbreak-stricken African nations.

(Meanwhile, Medecins sans Frontieres has some great content, including details about their Ebola clinics and protocols, plus interviews with volunteers and survivors. Their donation page is here.)
posted by argonauta at 10:29 AM on August 5, 2014 [2 favorites]

Nigeria announced that eight health workers who had contact with Ebola victim Patrick Sawyer are now in isolation with symptoms of the disease. They are among 14 people who had "serious direct contact" with Sawyer, most of them at the hospital, [Lagos state health commissioner Jide] Idris said. Nigerian health authorities acknowledged on Tuesday that they did not immediately quarantine the sick passenger.

"This cluster of cases in Lagos, Nigeria is very concerning," said Dr. Tom Frieden, director of the U.S. Centers for Disease Controls and Prevention, which is dispatching 50 experienced disease control specialists to West Africa. "It shows what happens if meticulous infection control, contact tracing, and proper isolation of patients with suspected Ebola is not done. Stopping the spread in Lagos will be difficult but it can be done," he said.

Three missionaries in Liberia have also now tested positive for the virus, including Spanish priest Miguel Pajares, age 75, and Sisters Chantal Pascaline Mutwamene, from the Congo, and Paciencia Melgar, from Equatorial Guinea.
posted by argonauta at 2:16 PM on August 5, 2014

A Saudi man suspected of being infected with Ebola died in an isolation ward at a hospital in Jeddah on Wednesday morning. The Saudi health ministry said that the 40 year-old, who had recently been on a business trip to Sierra Leone, was admitted to the hospital on Monday night after showing symptoms of viral hemorrhagic fever. Samples from the man have been sent to laboratories in the United States and Germany to confirm if this is the first Ebola-related death outside of Africa.

The World Health Organization has convened an Emergency Committee of global health experts for a two-day meeting in Geneva to determine if criteria have been met to issue a Public Health Emergency of International Concern (PHEIC) about the virus. A summary of the meeting will be made public and a press briefing will be held on Friday, 8 August.

Lola Okolosie: Ebola has infected public discourse with a new xenophobia
posted by argonauta at 7:22 AM on August 6, 2014

Some good news for a change: The patient at Mount Sinai Hospital in Manhattan has tested negative for Ebola.
posted by argonauta at 3:06 PM on August 6, 2014 [1 favorite]

why do two white americans get the ebola serum while hundreds of africans die?
posted by yeoz at 3:19 PM on August 6, 2014

A response to that article-

"Let me just pose an alternative headline which could very well had been used if this situation were reversed:

Why were Africans used as guinea pigs for Ebola ‘test’ drug? The resulting story would be sure to point out how the drug had only been tested on primates but was used on Africans before the requisite FDA testing and trials because African lives aren’t valuable, and then there’d be vague references to the lingering racist associations between Black people and monkeys. That’s the story we’d be seeing right now if this drug had been used and caused adverse effects.

Aside from that, only two people were given the drug. Imagine if the drug was mass produced and distributed in this densely populated area, the appearance of symptoms went down for a time…and then they reappeared. What kind of epidemic would we have on our hands if we released hundreds of people from under observation only to learn that they get sick again later?"
posted by showbiz_liz at 3:32 PM on August 6, 2014 [5 favorites]

I'm not sure whether the reverse -- testing an unapproved serum on black non-Americans -- would be any better. Especially since most of them would be very poor and have little basis for informed consent.

But mainly it happened because their organization really pushed for it, and I'm not going to criticize them for trying to help their employees. Especially since those employees had been risking their lives in very dangerous conditions to try to save other people.
posted by tavella at 3:37 PM on August 6, 2014 [1 favorite]

WHO to convene ethical review of experimental treatments for Ebola
posted by argonauta at 3:40 PM on August 6, 2014 [2 favorites]

That article yeoz posted is a good summary. You really can't test this kind of drug in field conditions like those in Africa.
posted by Justinian at 4:48 PM on August 6, 2014

Libya has declared a State of Emergency over Ebola outbreak there. The CDC has raised Ebola to "Level 1" status.

The illness and deaths are horrible. However in addition to that great cost, there are going to be a number of domino effects that will mean a great economic impact, as well, as people "hunker down" in various ways.

Let's just say that I would be very nervous if my job involved cleaning aircraft these days.
posted by spock at 5:39 PM on August 6, 2014 [2 favorites]

~~Libya~~ Liberia has declared a State of Emergency over Ebola outbreak there.

FTFY.

(Don't feel bad. You were only off by three thousand kilometres.)
posted by Sys Rq at 8:44 PM on August 6, 2014 [2 favorites]

Only looks like about 6mm to me, YFMV.
posted by Mitheral at 9:40 PM on August 6, 2014

So much for containment.
First to Atlanta and now to Madrid.
Knowing the Spanish health system, this does not me me feel any easier.
This is political posturing on a grand and dangerous scale.
posted by adamvasco at 8:46 AM on August 7, 2014

How can idiots like this even have a Radio Show.?
Christian Radio Host Hopes Ebola Will 'Solve America's Problems Of Atheism And Homosexuality'
posted by adamvasco at 11:37 AM on August 7, 2014 [1 favorite]

How can idiots like this even have a Radio Show.?

Because in America, around 27% of the population will always believe the stupidest or the most most horrible *ist and *phobic thing someone can come up with, and funnel millions of dollars and their votes supporting it.
posted by zombieflanders at 12:28 PM on August 7, 2014 [4 favorites]

You KNOW I meant to type Liberia. :/

Nice WebMD article explaining the probable reasons that experienced medical personnel, knowledgable about fighting infectious disease, could still become infected.
posted by spock at 8:07 PM on August 7, 2014 [1 favorite]

Ebola crisis in Liberia brings rumours, hygiene lessons and hunger.
As aid workers offer health advice on the streets, residents fear emergency measures are starving the capital of supplies.
posted by adamvasco at 4:35 PM on August 9, 2014

Researchers believe that a two year-old boy in Guinea was Patient Zero of the current Ebola outbreak.

Patient Zero in the Ebola outbreak, researchers suspect, was a 2-year-old boy who died on December 6, just a few days after falling ill in a village in Gueckedou, in southeastern Guinea. Bordering Sierra Leone and Liberia, Gueckedou is at the intersection of the three nations, where the disease found an easy entry point to the region.

A week later, it killed the boy's mother, then his 3-year-old sister, then his grandmother.... Two mourners at the grandmother's funeral took the virus home to their village. A health worker carried it to still another, where he died, as did his doctor. They both infected relatives from other towns.

By the time Ebola was recognized, in March, dozens of people had died in eight Guinean communities, and suspected cases were popping up in Liberia and Sierra Leone.

posted by argonauta at 7:03 AM on August 10, 2014

Ebola Outbreaks 1976 - 2014 Interactive Map
posted by adamvasco at 6:46 PM on August 13, 2014

Armed men claiming that "there's no Ebola" in Liberia raided a quarantine centre for the deadly disease in Monrovia overnight, prompting at least 20 patients infected with the deadly virus to flee.
posted by adamvasco at 8:52 AM on August 17, 2014 [3 favorites]

*headdesk*
*headdesk*
*headdesk*
*headdesk*
*headdesk*
posted by feckless fecal fear mongering at 9:12 AM on August 17, 2014 [2 favorites]

Health officials are concerned that blood-stained bedsheets stolen from the clinic could pose an infection risk.

> Blood-stained bedsheets
> stolen from
> ebola patients

Smart move.
posted by mrbigmuscles at 2:48 PM on August 17, 2014

Liberia, population four million, has fewer than 250 doctors left in the entire country, according to the Liberia Medical and Dental Council. Seven doctors there have contracted Ebola, and two of them have died.

Christ
posted by crayz at 4:44 PM on August 17, 2014

Attention, World: You just don't get it.
You are not nearly scared enough about Ebola. (paywalled click on the print icon in the middle and you will be ok).
A little more from Liberia and the West Point holding centre in Monrovia
Mob Destroys Ebola Center In Liberia Two Days After It Opens.
posted by adamvasco at 6:03 PM on August 17, 2014 [1 favorite]

Wow, buried in that first link of yours, adamvasco, is that one of the nurses who treated Patrick Sawyer has escaped from quarantine and gone back to her home province, along with mention of a case in Johannesburg.

Eep.
posted by Happy Dave at 5:00 AM on August 18, 2014

one of the nurses who treated Patrick Sawyer has escaped from quarantine

WHAT

She is, presumably, a trained medical professional. What the actual fuck is she doing breaking quarantine? She knows better.
posted by feckless fecal fear mongering at 8:09 AM on August 18, 2014 [1 favorite]

adamvasco your second link is borked
posted by feckless fecal fear mongering at 8:11 AM on August 18, 2014

She is, presumably, a trained medical professional. What the actual fuck is she doing breaking quarantine? She knows better.

She's a human being, terrified of dying separated from the people she loves. This isn't Hollywood, nor are people acting in accordance with logical costs and benefits like in some economics textbook. Humans are going to do all kinds of fucked up shit they shouldn't do. From where I sit I'd really like to think is be more noble, but in actuality I know that I don't know.
posted by OmieWise at 9:12 AM on August 18, 2014 [5 favorites]

I understand she's afraid, OmieWise, I'm not an idiot.

But she is knowingly putting enormous numbers of people at risk when she knows full well exactly what the risks are and how dangerous it is. She knows better, and is betraying every precept she was trained to believe in.

As for me? Yeah, actually, I can pretty confidently say I would stay in quarantine rather than risking untold numbers of other people and potentially exposing them to a horrific, terrible death.
posted by feckless fecal fear mongering at 10:11 AM on August 18, 2014

From the borked link
West Point, located on a peninsula which juts out into the Atlantic between the Mesurado and St. Paul Rivers serves as a home to approximately 75,000 people and is easily one of Monrovia's most densely populated neighborhoods hampered by overpopulation and a host of diseases. More.
posted by adamvasco at 10:37 AM on August 18, 2014

I understand she's afraid, OmieWise, I'm not an idiot.

Sorry, just responding to the comment as written.
posted by OmieWise at 3:25 PM on August 18, 2014

Liberia battles Ebola epidemic - The Atlantic. Warning, there are some shots of corpses and distressing imagery in this article.
posted by Happy Dave at 12:01 AM on August 20, 2014 [2 favorites]

Liberian medical student Gondah Lekpeh gives us his perspective from the front lines of the Ebola outbreak (via io9):

There are two ambulances to transfer suspect cases to isolation center and two burial teams for Monrovia. These teams are overwhelmed and it takes about two to three days to respond to calls from communities. The relatives of suspected cases end up transporting the patient in a commercial vehicle, thereby contaminating themselves. The remains of suspected cases who died at homes spend days before the burial team can arrive. Moreover, there is only one treatment center in Monrovia. The isolation center is full to capacity and suspected cases are reportedly turned away. When will the spread and death of Ebola stop in the wake of limited resources? I do not know. But I know for sure that contact tracing is not possible and we are overstretched and exhausted.
posted by rory at 2:27 PM on August 22, 2014

WHO warns of Shadow zones and unreported Ebola cases.
Ebola has caused Liberia's cauldron of disatisfaction to boil over.
posted by adamvasco at 5:43 PM on August 22, 2014 [2 favorites]

Shadow zones…terrifying.
posted by OmieWise at 6:57 PM on August 22, 2014

dhartung on July 30:

If we're still doubling by the end of August, though (i.e. approaching 3000 cases, 1500 deaths), I'd loosen up my concern -- we're at a critical phase.

WHO on Aug 22:

Some 1,427 people have died among 2,615 known cases of the deadly virus in West Africa since the outbreak was first identified in March, according to new figures released by the WHO on Friday.

This is not an optimism-inspiring graph
posted by crayz at 9:39 AM on August 23, 2014 [3 favorites]

A slow motion nightmare. Somewhere I heard they(WHO) figure another six months before it's under control.
The social component, the infected patients being 'liberated', is perhaps the most heartbreaking. This kind of communication breakdown shouldn't be so so very hard to solve - should it? You tailor your message, hell the crap they convince people to buy everyday, you'd think someone would be tackling this aspect, in the interest of being better able to do their job.
posted by From Bklyn at 2:07 PM on August 23, 2014

I'm surprised that the situation in West Point isn't getting more play in the world media. 75,000 increasingly malnourished people penned into a shantytown with no sanitation, the health system collapsed, and, judging by the photos in the Atlantic, possibly hundreds of people exposed just during the sacking of the isolation clinic. You have to figure that graph is about to get a lot steeper in the next month - like a lot steeper. Even if the quarantine holds, it seems like the result would still be Ebola running through West Point like wildfire.
posted by strangely stunted trees at 5:03 PM on August 23, 2014

Well, as if there weren't enough bad news already, the BBC is now reporting that two cases of Ebola have been confirmed in northwestern DR Congo.
posted by strangely stunted trees at 10:54 AM on August 24, 2014

Some experimental treatments aren't working. Dr. Abraham Borbor has died, it's possible that priest Miguel Pajares who flew to Spain and died was treated with zmapp as well.

Meanwhile in the UK William Pooley is still OK and his family is praising the care he receives.
posted by dabitch at 10:40 AM on August 25, 2014

You know digging into these numbers they actually look significantly worse. In the month from Jul 20 -> Aug 20, cases went:

Nigeria: 0 -> 16
Sierra Leone: 454 -> 910
Liberia: 224 -> 1082
Guinea: 415 -> 607

Guinea looks like the only bright spot there, but the outbreak in Guinea had been slowing down - it had crossed the 300 mark back in May, so it's now adding new cases over twice as fast as it had been for months.

Would it be irresponsible to speculate that the virus has already mutated into a more dangerous form, if the outbreak is expanding this fast and heating back up in areas that had previously been thought under control?
posted by crayz at 2:01 PM on August 25, 2014

Would it be irresponsible to speculate that the virus has already mutated into a more dangerous form, if the outbreak is expanding this fast and heating back up in areas that had previously been thought under control?

I wouldn't say so, necessarily. The more people get infected, the more people those people will infect. Just the fact that this happened in a more populated area than previous outbreaks could account for a lot.
posted by showbiz_liz at 2:06 PM on August 25, 2014

Would it be irresponsible to speculate that the virus has already mutated into a more dangerous form, if the outbreak is expanding this fast and heating back up in areas that had previously been thought under control?

Yeah, I'm not sure what your evidence for that would be. In addition to what showbiz_liz points out above, you have to keep in mind that at a certain point the health systems in places where things were slowing down may just get completely overwhelmed. This is especially true as more healthcare workers die.
posted by OmieWise at 7:35 AM on August 26, 2014

WHO says Ebola could afflict over 20,000 (NYT)
posted by OmieWise at 4:55 AM on August 28, 2014 [1 favorite]

It's shown up in an oil hub now, Port Harcourt.
posted by Happy Dave at 5:00 AM on August 28, 2014 [1 favorite]

WHO's August 28 Disease Outbreak News update now puts the the total number of probable and confirmed cases, through August 26, at 3069, with 1552 deaths (also noted in the NYT article). WHO says, "The outbreak continues to accelerate. More than 40% of the total number of cases have occurred within the past 21 days. However, most cases are concentrated in only a few localities."

To update crayz's by-nation count, now with July 20 -> August 20 -> August 26:

Nigeria: 0 -> 16 -> 17*
Sierra Leone: 454 -> 910 -> 1026
Liberia: 224 -> 1082 -> 1378
Guinea: 415 -> 607 -> 648

*+1 in Port Harcourt announced today. The totals do not include cases in the DRC. (Still very encouraging re: Guinea.)

dhartung, I'm curious about your take on this as well, now that we've officially crossed the 3000/1500 levels. I was very much hoping we would not have reached them by now.
posted by argonauta at 6:58 AM on August 28, 2014

Well, it's not good. I see that the goal the WHO set today is to "stop ongoing Ebola transmission worldwide within 6–9 months", which isn't especially ambitious given the alarm with which authorities treat it. "Nearly 40% of the total number of reported cases have occurred within the past three weeks" really is pretty bad news.

Would it be irresponsible to speculate that the virus has already mutated into a more dangerous form, if the outbreak is expanding this fast and heating back up in areas that had previously been thought under control?

A major factor in disease reporting is the level of awareness and speed of diagnosis including lab work by local health authorities. Ebola, once it gets into the final stages, is pretty impossible to miss, but some of this acceleration may easily reflect getting medical teams into remote areas and catching cases sooner. It's actually unlikely that the disease would mutate in that direction now given that it's spreading just fine as it is. Obviously it doesn't have actual volition, but the evolutionary pressure on the virus isn't very great right now.
posted by dhartung at 2:51 AM on August 29, 2014 [1 favorite]

And now Senegal
posted by adamvasco at 10:13 AM on August 29, 2014

Now scientists are starting to get some answers. In a new paper in Science, researchers reveal that they have sequenced the genomes of Ebola from 78 patients in Sierra Leone who contracted the disease in May and June. Those sequences revealed some 300 mutations specific to this outbreak.
posted by adamvasco at 10:15 AM on August 29, 2014

Following up on Adamvasco: note the "in memoriam" at the end of the paper in Science (possible paywall, sorry, but the abstract should be public) - 5 of the co-authors died of Ebola over the course of the work. (And kudos to Science for getting it published as fast as they did - just over two weeks from start to finish.)
posted by RedOrGreen at 10:22 AM on August 29, 2014 [2 favorites]

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