I just realized that you were responding to post 2147. I thought you were responding to post 2178. My mistake.
I will be honest--your level of understanding of the subject that you have repeatedly communicated tells me very strongly that you do not have a PhD, nor do you have the scientific understanding that a PhD trained scientist gains from years of both reading papers and doing research in the lab. You have not demonstrated that you know anything about the basic structure of cells, how viruses replicate, shed, and spread, etc. So I choose a source written at what I perceive is your level of understanding.
Ah, the insult dodge. It won't work. Please provide a citation to support your assertion that Ebola cannot infect ciliated epithelial cells.
Odd, you've yet to dispute anything I've written or posted regarding the viral structure, function, etc. If I'm so woefully ignorant surely you can provide examples of my errors. Our first disagreement arose from my assertion that the epidemiological definition of "airborne" differs significantly from the general public's definition and the denial of any possibility of aerosol and droplet vectors is misleading the public, however well-intentioned or technically accurate.
If you are who you say you are (I have no way of verifying nor do I expect you to post personal information to do so), I'm not surprised that you cannot see outside your box to how the general public interprets what is coming out of the CDC/WHO/et al. Every scientist I've worked with has the same problem. That's why they hire people like me. They have the self-awareness to recognize their own blind spots and most aren't so supercilious they believe that anyone without their CV is automatically stupid.
The reason I am so fixated on the minute details of transmission is because only an accurate understanding of transmission characteristics allows for the proper infection control measures to be implemented. This outbreak is not going to be stopped by people becoming hysterical over supposed aerosol transmission--it will be stopped by understanding what DOES spread the virus, and taking steps to stop those chains of transmission.
Proven infection control measures aren't working. Some of that is due to the ignorance of the population, some due to the population densities of the infected areas, some due to the refusal to implement demonstrably effective yet politically unpopular controls like quarantines, some due to the unknowns regarding this particular pathogen. It is those unknowns that concern me and have since the beginning. There's nothing "hysterical" in my posts because I'm not hysterical. Concerned? Absolutely. I have no reason to believe that Ebola cannot spread throughout the world in very little time. In fact I have every reason to think it will. I vividly recall in the early days of HIV/AIDS claims by many authorities that GRID could not become a serious health issue in "developed countries." I recall the assertions that it was contained in the homosexual communities by definition so no quarantine was necessary. Of course the meme inverted to "everyone is at risk" once history demonstrated the errors of the early meme and the political element hit full stride. I see the same phenomenon occurring now. Given the specifics of the pathogen and the fact that one can be infected with Ebola without engaging in very specific sexual/drug activities, the recurring meme gives me pause.
As I wrote earlier, in a year we will have loads of data regarding transmission vectors. I think we'll see far easier H2H transmission than current dogma admits. Time will tell.
In an earlier post you defended the deflections performed by the scientists at the Congressional hearing by asserting that much is unknown about this virus and its transmission vectors, therefore the scientists couldn't provide the requested information and hence provided what little they could without admitting they just don't know. You then turn around and insist that you know enough to assure the world that only direct physical contact with blood/vomit/etc. will result in H2H Ebola viral transfer (though to give credit where due you did express some concern about the persistence of the virus in semen.) Which is it? Since you present yourself as the authority on the subject, please educate the rest of us on all possible transmission vectors. Perhaps you should offer to update the Congress since they didn't get the information regarding fomites from the scientists present.
Again, please provide a cite for your claim that Ebola cannot infect ciliated epithelial cells. Thanks in advance.
http://www.msf.org/article/liberia-boy-who-tricked-ebola
Excerpt:
When Mamadee was firstly admitted on 15 August, he tested negative for Ebola and was discharged. Staying overnight in the guesthouse as his village Sarkonedu was too far to travel to, he developed some signs and was readmitted the next day. He was displaying symptoms of nausea, fever, muscle pain, intense fatigue, abdominal pain and diarrhoea.
“He was a clear Ebola patient,” says Dr. Roberta Petrucci. “Only the jaundice made us doubt.” The doctors treated him with multivitamins, paracetamol, oral rehydration solution, antibiotics and with antimalarial pills, as Mamadee had also tested positive for malaria.
On 20 August, the second Ebola test result returned and it was as expected – positive. The only thing that didn’t fit into the picture was that young Mamadee in the meantime was already feeling good and running around.
“We couldn’t believe it,” says Dr. Petrucci. “We thought it must have been a mistake.” When the medical staff took another blood test a few days later, they realised that there had been no mistake. Mamadee still tested positive.
“The lab normally doesn’t make mistakes,” Dr. Petrucci continued. “And especially twice in a row with the same patient.” So, even though Mamadee was everything but symptomatic, he could theoretically infect others. “We had no other choice other than to keep him in the CMC as the result was still positive,” she says.
__________________
Well, so much for being too weak to go out and infect a bunch of people...
Really? You claimed previously that you have read a substantial amount of the pertinent medical literature. I guess you haven't, after all.
From a histology study of a chimp dead from the Taï Forest strain of Ebola (which used to be called "Ebola Côte d'Ivoire"): As described previously in experimental cases, lymphocytes and epithelial cells were apparently unaffected; the present case provides significant additional information confirming that the main target of viral infection is the macrophage system, which appears to be the most important site of viral replication.
Here is an abstract from a paper describing experimental infection of rhesis monkeys with Ebola Zaire (the paper is behind a paywall; I think it shows tissue sections):OBJECTIVE: The source of infection or mode of transmission of Ebola virus to human index cases of Ebola fever has not been established. Field observations in outbreaks of Ebola fever indicate that secondary transmission of Ebola virus is linked to improper needle hygiene, direct contact with infected tissue or fluid samples, and close contact with infected patients. While it is presumed that the virus infects through either breaks in the skin or contact with mucous membranes, the only two routes of exposure that have been experimentally validated are parenteral inoculation and aerosol inhalation. Epidemiologic evidence suggests that aerosol exposure is not an important means of virus transmission in natural outbreaks of human Ebola fever; this study was designed to verify that Ebola virus could be effectively transmitted by oral or conjunctival exposure in nonhuman primates. Please note the bolded section: this is important. This paper was published 18 years ago; the epidemiological evidence still shows that Ebola is not transmitted through airborne routes. Also, I have to point out that an experimentally generated aerosol, involving virus-laden liquid dispersed by an atomizer directly into an animal's face, has no equivalent within the natural context. It shows that inhalation of virus can cause disease--virus that can be inhaled in the form of droplets--but it does not show that humans aerosolize virus.
Here are some histopathology pictures: The top left picture shows the viral particles inside a lymph cell. The top right picture shows a section of lymph node. Various lymph cells show red in their cytoplasm, indicating that the virus has penetrated inside those cells. The big red crescent is a nodule of endothelial cells, many of which have been destroyed by virus. The picture at the bottom is a section of monkey lip containing epithelial cells on the top and endothelial and lymph cells on the bottom. Notice how the virus is oozing between the epithelial cells, but not penetrating them. You can be exposed to Ebola by physically touching someone; this could explain why. Of course, they could also be covered with drops of vomit or feces.
In order for a virus to infect a cell type, it must be able to bind receptors on the cell surface. Ebola does not recognize epithelial cell surface receptors.
Now, I could go on and on, linking to histopathology pictures and studies examining the tropism of Ebola virus, but the end result is the same. Ebola is not tropic for epithelial cells. It is tropic for fibroblasts, macrophages, and endothelial cells. The liver typically has a very high viral load, and from there, the virus enters the blood.
If you are who you say you are (I have no way of verifying nor do I expect you to post personal information to do so), I'm not surprised that you cannot see outside your box to how the general public interprets what is coming out of the CDC/WHO/et al. Every scientist I've worked with has the same problem. That's why they hire people like me. They have the self-awareness to recognize their own blind spots and most aren't so supercilious they believe that anyone without their CV is automatically stupid.
Of course, I am not about to publish my CV online. But the fact that I know what I am talking about should be pretty apparent, at least to people who are familiar enough with the scientific world to recognize the typical language use of an expert.
Unlike you, I do not assume the general public is too stupid to understand complex topics. They can understand, if the topic is explained adequately and at their level. This is why I take the trouble to explain these things, instead of just assuming that overwhelming stupidity among the general public prevents them from understanding. Public health officials have always tried to explain the mechanisms of disease transmission to the public--because public understanding is crucial to stopping those chains of transmission.
However, in your insistence that the public is incapable of understanding the nuances between droplet transmission and airborne transmission, what you are really telling me is that you do not/cannot understand the distinction. That does not mean that other members of the public cannot understand, however, so I will continue to explain.
The message from the CDC and the WHO is pretty consistent, and is solidly based on the current knowledge about Ebola. Obviously, both the CDC and the WHO assume that the public is educable in this matter.
BTW, claiming that scientists hire you means nothing. As far as I know, not a single administrative or IT person has ever become a scientist because they happen to work for us. I will say, however, that their services are critical to our ability to continue scientific work and I really do appreciate admin/IT support.
Proven infection control measures aren't working.
Infection control never works when it isn't used. That's the whole problem here.
There's nothing "hysterical" in my posts because I'm not hysterical. Concerned?
You have consistently insisted that Ebola must be airborne, and insinuated that the experts who actually read the scientific literature about it are either lying or do not know what they are talking about. Yet you cannot provide any data that would show that the experts are wrong. I believe that "hysterical" is an appropriate description of such behavior.
In an earlier post you defended the deflections performed by the scientists at the Congressional hearing by asserting that much is unknown about this virus and its transmission vectors, therefore the scientists couldn't provide the requested information and hence provided what little they could without admitting they just don't know. You then turn around and insist that you know enough to assure the world that only direct physical contact with blood/vomit/etc. will result in H2H Ebola viral transfer (though to give credit where due you did express some concern about the persistence of the virus in semen.) Which is it?
I know that you are looking for contradictions in what I have said, but there are none. Sorry to burst your bubble.
The epi data is pretty consistent: the virus is spread through direct contact with viremic patients or infected bodily fluids. This has been demonstrated multiple times and is not debatable. Spread by fomites is not a concern in the health-care setting, since surfaces are disinfected frequently, but the epi data on fomite transmission outside of the clinical setting is inconsistent. Could you catch Ebola by gathering up the wet bloody sheets of someone who just died of Ebola? You almost certainly will. Could you catch it by gathering up the dried-out sheets a week later? Probably not. Could you catch it by being in the room with someone who later turns out to have Ebola? Almost certainly not (unless they touched a surface with their vomit-covered hands and you touched the same surface minutes later). But there are clear gaps of knowledge, which have not been systematically studied. Epi studies are, by their nature, quite limited, and leave many questions unanswered.
Since you present yourself as the authority on the subject, please educate the rest of us on all possible transmission vectors. Perhaps you should offer to update the Congress since they didn't get the information regarding fomites from the scientists present.
I have been attempting to educate people. Some people refuse to learn, or want to believe that Ebola is more transmissible than it really is--I can't educate people like that. And I'm pretty sure that Dr. Friedan already told Congress everything that is known about transmission, and will continue to communicate the current knowledge about Ebola.