Why are so many ebola workers contracting the disease?
When I was young I read about Father Damien, the Belgian priest who went to care for lepers in Molokai, Hawaii, and after many years of work contracted the disease (which actually is not that easily caught) and died there of it. The story filled me with horror, and with awe for his dedication and courage.
The church called Father Damien a “martyr of charity.” And although these days we have much better ways of preventing the acquisition of disease by health workers, the truth is that they still assume a risk and are courageous people and potential martyrs of charity, although not necessarily saints and not always religious.
That brings us to ebola. The current outbreak is the largest ever—over 700 deaths so far—and it has also killed the most high-profile health care workers, at least to the best of my knowledge (I’ve had trouble finding any information on casualties of medical personnel in previous episodes). Not only is it the largest, it’s the largest by a factor of about 300% so far, with only a few others coming even to that previous level of one/third as large, as you can see from this chart. Perhaps that’s why this outbreak features the highest toll on health workers, too.
Ebola is not really all that easy to catch, unless you work with patients and become exposed to their body fluids. Medical workers caring for them must wear medical hazmat suits of a nature so thorough that no surface is exposed, and very strict procedures must be followed both in caring for patients and in removing the suits.
Several of the doctors and nurses who are currently contracting the disease are not unsophisticated workers living in the boonies, either. For example, one was Dr. Sheik Umar Khan, a top doctor in the Sierra Leone fight against the disease who died on Tuesday despite being given the best of care. Surely he knew how to protect himself from hazards, as did Dr. Kent Brantly, an American missionary doctor in Liberia who is still fighting for his life against the disease.
How could these men have been infected? Accidents happen; can one be vigilant all the time? A needle stick, a moment of infinitesimal carelessness while taking the protective gear off? Are people getting more careless in their haste to deal with an outbreak so large and overwhelming? Or is something about this outbreak a bit more contagious? Or is it just that where there are more sick people there will be more transmission to medical staff?
It was this statement about Brantly that caught my attention and made me wonder:
We’re trying to figure out what went wrong because he was always very careful,” said Tolbert Nyenswah, an assistant health minister in Monrovia.
Not all outbreaks are going to be the same, even of the same disease. There are strains of ebola with different virulence and death rates, although it is among the diseases with one of the highest death rates for certain strains (rabies is another). One thing appears to be the case, though, about ebola: although a frightening disease with a high fatality rate, it is not very easily caught under westernized and/or modern medical conditions, and so once an outbreak is contained it often dies out. But the animal reservoir in Africa remains, as does animal contact, and so it flares up again with time.
Outbreak with Dustin Hoffman:
“Don’t worry it’s not airborne.”
Hoffman: “It’s airborne.”
https://www.youtube.com/watch?v=2qAE-onz3Ys
The mutation rate of the AIDS virus was high. Maybe something’s kicking this one into high gear.
I just watched a Texas Hold-em Hand where two players had AA as their hands, which has a 96% chance of ending in a draw. However, one player hit the 4% 4-card flush on the board to win the hand and take the other person’s money. If you play 100 of those hands, that will happen to you (win or lose) about 4 times.
These doctors may have lowered their chance of contracting Ebola per patient interaction, but their number of contacts is still massive. Even if they can get the risk down to 1 exposure in 1000 interactions, if they then have 2000 interactions with patients, they’ve been exposed about twice.
The real miracle is that any of the first responders are living at all, much less that we’re getting as few cases as we are.
As someone who has worked in situations requiring hazmat rad-chem gear I can assure you it does not provide as much protection as you might think if someone gets careless due to fatigue via heat exhaustion. Those suits make you begin to sweat almost instantly. I can’t imagine how difficult it must be to use hazmat gear in equitorial Africa. Also, careless coworkers can nullify the efforts of the most careful worker. All it takes is one failure to observe all sterile procedures.
So I think someone has been careless and contaminated areas thought sterile or some patients have been infected with ebola that has managed to mutate and become airborne. I hope that this terrible disease has not become airborne as we are not prepared for the consequences.
sent in my institution after i have complained for years
people tend to be lax on protection and other things and not take them seriously.
which is intersting since we have a lab that can work with ebola and does… not to mention other interesting things.
This article at Foreign Policy offers some explanation for why health care workers are contracting the disease:
And here’s Sierra Leone’s top ebola doctor who has now died from the disease:
Ann,
The lack of training and proper equipment could easily account for the spread of ebola to heathcare workers. Given that we are discussing a situation in Africa, is it any wonder that the necessary equiptment and training are lacking? What is needed is a global ban of all air travel from the infection zone which now includes Nigeria, the most populous nation in Africa.
I was reading about this and also about Lassa fever, another hemorrhagic disease endemic in Africa. While the fatality rate once contacted isn’t as high, (it seems to be about 1%), it kills or completely incapacitates far more people every year. About 300-500,000 people contract it annually, and about 5000 people die. But Ebola has a fatality rate between 50% to 90%, depending on the strain. This seems like it’s the deadlier strain. It’s a scary thing–of it is aerosolized, it could go nuts. And thanks to easy air travel…
Ebola and Spanish flu are infamous because modern medicine has NEVER found a cure.
Instead of messing around, the only sane course of action is prompt quarantine, of which my Granduncle knew everything.
As previously recounted here, he was one of the two (2) survivors at Camp Riley in Kansas.
It may prove out that we need to select doctors and nurses that have Delta 32 in their genes. No-one else should be allowed to be directly involved.
Delta 32 is a White DNA mutation. (Only known race to have it, WHO has searched the entire human genome for it.)
It confers a unique protection for its carriers. It figures to be legacy mutation, hundreds of generations old.
It may entirely explain why White (global) populations are so low. (contrast with the Yellow race) One might conjecture that some horrific pandemic occurred in the ancient past. Delta 32 survivors became a ‘founder population.’ This DNA fraction becomes ever larger as successive pandemics (the Black Death) overtake humanity.
Ebola has every prospect of becoming a pandemic — and at lightening speed in the era of jet travel.
The folly of bringing victims to America is epic. We can’t treat them either. They should be quarantined in place.
I expect that the lid will come down after the horses are entirely out of the barn.
If this contagion conforms to priors, expect that it will run absolutely wild for years on end — probably five to twenty-five.
Plainly, it does not respond to modern antibiotics.
Think about that.
The victims are not patients — they are lab rats.
My Granduncle had much to say about such a status.
&&&
As these first evidences show, Ebola is able to get around all of our protective technology — as a practical matter.
If we keep messing around with it, expect more fatalities than all of those during the 20th Century.
We can only hope that a pool of Delta 32 physicians exists — and that this mutation provides protection from Ebola.
{ It’s been established that Delta 32 frustrates Black Death, HIV/AIDS and Spanish flu. That’s something remarkable, no? }
http://en.wikipedia.org/wiki/CCR5
&&&
Just to cheer you up: Avian flu is a trivial variation of Spanish flu. So, if you’ve wondered why the CDC has been going ape about Avian flu — now you know why.
Again, all such researchers MUST have Delta 32 should they ever be allowed to mess around with Avian flu.
Period, stop.
So what do we have? A Japanese researcher messing around with Spanish flu — up in Wisconsin — the original source of the Spanish flu pandemic — at least as far as the US Army medical corps could determine.
He’s playing with fire in an ammo bunker — and yet is not being stopped by the authorities. !!!
Madness. Arrogance. Folly.
S**t:
http://www.businessinsider.com/report-at-least-one-ebola-patient-is-headed-to-atlanta-hospital-2014-7
@blert,
Genetic testing is racist. (epitaph on a tombstone)
That’ll happen right up until a violent outbreak that consumes an entire region. After that, the mask of civilization will slip off.
But seriously, I would love to have such secret knowledge in my possession. If I don’t have Delta 32, I wouldn’t go anywhere near infected people.
You know if you can be tested for such genes? Where/What company?
This is caused by a virus, crafting a vaccine from the
survivors immune system is essential.
As we know anti biotics are useless.
Matt…
“Several commercial testing companies offer tests for CCR5-Δ32.[27]”
[27] http://www.afao.org.au/__data/assets/pdf_file/0014/4460/BP0607_Delta_32.pdf
And, within:
“In 2006 a company called Syquip Pty Ltd began promoting a service offering to test individuals for the Delta 32 mutation. Promotion of the testing service included high profile advertising targeting gay men, along with posts to consumer forums on the Internet.
The press release, and their website, offered an international testing service using a buccal swab (swabbing the inside of the mouth) to test for the delta 32 mutation. The test was [first Ed} offered at a cost of $US160 for each individual… ”
“Information contained on companies website http://www.delta32.com.au claims that homozygotes are “virtually immune” to HIV infection,…”
%%%
Then there’s:
http://www.delta-32.com/
“Find Out If You Are Resistant To HIV “NOW ONLY $199.00”
I thought you’d want to know.
Cheers.
Molly…
All of the work needs to be done outside the USA.
The convenience of the researchers is secondary to containment.
Ebola has been around for DECADES.
Do note the total lack of progress to date.
Just what is going to be so special in the next few months?
Lee, I used to live in the area of northern Liberia that’s just across the border from southeastern Guinea where the outbreak started. Ebola had never appeared in West Africa at the time but they did warn us about Lassa fever, of which there had been a serious outbreak in Liberia about 13 years before I was there. A (locally) famous missionary nurse down the road from where I lived had died in that outbreak. It was definitely a sobering idea to contemplate since Lassa has very similar symptoms to Ebola. Lassa fever virus is known to be carried by rats and people get infected when rats are living in houses with thatch roofs, for instance. We were required to have a metal roof where we lived.
At the time, from what they told us, it seemed like Lassa was like Ebola, in that it broke out in isolated outbreaks from time to time and then disappeared for years before appearing again. And the death rate was very high, like Ebola, in the 50% – 90% range. But recently I went back to read up on it and was shocked that apparently they now believe it’s much, much more common. Like you said, they estimate there might be 500,000 cases a year and “only” 5000 deaths (i.e. a 1% death rate). So I guess they’ve learned a lot in the intervening years. Perhaps Ebola is the same and there are more under-the-radar cases than they’re currently aware of. In the case of Lassa, from what I read, there are lots of cases where the disease is mild enough that people don’t have recognizable symptoms.
Here’s information about the missionary nurse, who was named Esther Bacon.
And here’s a link about Aniru Conteh, another Sierra Leonean doctor, who dedicated his life to fighting Lassa fever and who died of that disease in 2004 due to an accidental needle stick while treating a patient.
Blert, I thought they are bringing those victims to the US because of the high mortality rate & that they want their families to essentially get to say “good bye”.
Plus the medical/hospital community wants the
*experience* & prestige * of treating an Ebola victim.
I would presume they’re trying to save their lives. People do survive Ebola. And I’m speaking as someone who lives a few miles from where it’s said they’ll be treated.
I vividly remember watching Nightline with Ted Koppel and seeing a villager who was wearing scrubs being interviewed and being asked how he stayed there. He said he wanted to leave and heard Jesus in a voice asking him to stay. This man was telling the TRUTH. And he did stay. I too, read in awe, the story of Fr. Damian and the lepers. Another rarely acknowledged white martyr (no blood) was Nostradamus. He lost his whole family and yet stayed to tend the sick as a physician.
Nostradamus lost his family to the black plague. And he still took care of the sick.