Woman saves three relatives from Ebola

CNN ^ | Sept. 26, 2014 | Elizabeth Cohen, Senior Medical Correspondent

[PA Engineer]

Epivir prices for your reference. The best I can tell, the treatment course is 300mg X ten days. Fauci I'm sure will let us know.

[Jane Long]

I’d like to know which meds she used for the IV drip.

[lulu16]

I wish you could see the video and how she dressed herself and the family she saved.

As for the supplies and medicine, my husband and I have been researching places to retire and good and cheap healthcare is a primary concern. In Panama it appears that you can ask for most meds without a prescription. I don’t know about equipment like the IV drips.

(You’ll have to read through the posts.)

http://bestplacesintheworldtoretire.com/questions-and-answers/1120-how-much-do-healthcare-and-medical-services-cost-in-panama

Another example of needing medical advice and getting the suggested meds over the counter.

” Another incident required medical attention and lab test. We walked into the lab, asked for the test, and left 15 minutes later with the typed report. Walked up the street a couple blocks to the doctor’s office. He suggested medication which he wrote on a piece of paper so we would know what to ask for (not a prescription). Doctor office visit, $10.
At the pharmacy they looked at the note, grabbed the medication from their stock, another $8. Many, not all, medications are available over the counter by request. Comparison prices to other meds we were familiar with were not greatly different than home.”

http://bestplacesintheworldtoretire.com/questions-and-answers/563-how-good-are-the-medical-centers-hospitals-and-health-clinics-in-boquete-panama-and-how-close-are-they#answer-1520

I have these thoughts of waiting out the pandemic there.

[yefragetuwrabrumuy]

A big breakthrough has come with the realization that one of the more lethal aspects of Ebola is from dehydration and electrolyte imbalance. So it is vital that patients get as much oral electrolyte solution in them as they can, while they can still swallow.

Being a nurse, she might have realized this intuitively, so along with her faith, she gave them the right kind of support as best she could.

And for the religious, guess where the inspiration to heal comes from.

[null and void]

Perhaps, but I’m not sure how we could use it.

[lulu16]

Thank-you so much for the link to the antiviral drug. It is so affordable. However, how do you know how much to give and for how long?

[null and void]

Local color please?

[lulu16]

What do you suggest for dehydration and electrolyte imbalance? I bought a couple of Pedialyte yesterday. They are not cheap. Can one use Gatorade?

I know from caring for dying pets, I used an eyedropper to give them water. How should be take care of humans, if we do not have access to an IV?

[lulu16]

Pardon me, what does local color mean?

[ProtectOurFreedom]

Ebola has been around for hundreds if not thousands of years before it was discovered by westerners (Whites) and given its name...I’m sure there are generations of African’s that have been born with a partial immunity to the disease.

That's an interesting thought, but I haven't seen any support for this theory in the literature I've read (but then I'm an amateur lay person). There is a lot of research on the initial outbreaks in Africa caused, it seems, by environmental and transportation changes, particularly railroads, which accelerated the spread of tropical diseases as well as re-use of contaminated needles in poor areas. There is also a lot of research regarding the main "reservoirs" of the disease in Africa. If outbreaks occurred hundreds or thousands of years ago, they must have been limited to small villages that probably didn't communicate with neighboring villages, limiting transmission. So I find it rather doubtful there would be wide-spread immunity in a fraction of the population.

Filoviruses in Bats: Current Knowledge and Future Directions

By Kevin J. Olival 1 and David T. S. Hayman
1 February 2014
Viruses 2014, 6(4), 1759-1788; doi:10.3390/v6041759

...Very diverse taxa have been suggested as potential reservoirs for filoviruses over the years, including bats, rodents, arthropods, and plants. In a massive field investigation to find the natural reservoir following the 1995 Kikwit, DRC outbreak over 3000 animals were collected primarily from forest areas near the home of the index case, but no evidence of Ebolavirus was found. The sampling included 78 mammal species, 51 bird species, and 22 reptiles and amphibians species were collected, and 18 species and approximately 1/5 of all the animals collected were bats. However sample sizes per species were low, with only 4 bat species having greater than 20 individuals collected. Swanepoel et al. demonstrated that plants, reptiles, invertebrates and some vertebrates were unlikely reservoirs, because experimentally they were refractory to infections. However the bats they tested were able to survive infection, support replication, and mount an adaptive immune response. Despite years of investigations, it took nearly forty years from the discovery of Marburgvirus in the late 1960s to identify fruit bats as (at least one of) the primary natural reservoir for this virus.

In just the past few years, antibody reactive with Reston ebolavirus and Zaire ebolavirus antigen have been detected in bats from the Philippines, China, Bangladesh, and orangutans from Indonesia (as previously mentioned). Though not conclusive evidence of the presence of these infections, the presence of these or related viruses are not entirely surprising considering the recent discoveries of Marburgvirus and Ebolavirus from congeneric species (Rousettus spp.) in Africa, and considering the large and overlapping geographic ranges for many of these bat species. Rousettus amplexicaudatus bats in the Philippines were found seropositive for Reston ebolavirus and implicating as the potential reservoir host for this virus in Asia.

An Introduction to Ebola: The Virus and the Disease

C. J. Peters and J. W. Peters
Journal of Infectious Diseases. (1999) 179 (Supplement 1): ix-xvi. doi: 10.1086/514322

Filoviridae is the only known virus family about which we have such profound ignorance. We do not even understand the maintenance strategies employed in nature by the agents, and we know much less about the resulting diseases, their pathogenesis, and detailed virology.

Biomedical science first encountered the virus family Filoviridae when Marburg virus appeared in 1967. At that time, commercial laboratory workers with a severe and unusual disease were admitted to a hospital in Marburg, Germany.

In the late 1970s, the international community was again startled, this time by the discovery of Ebola virus as the causative agent of major outbreaks of hemorrhagic fever in the Democratic Republic of the Congo and Sudan. International scientific teams that arrived to deal with these highly virulent epidemics found that transmission had largely ceased; however, they could reconstruct considerable data from the survivors. Medical facilities had been closed because of the high death toll among the staff, thus eliminating major centers for dissemination of infection through the use of unsterilized needles and syringes and the lack of barrier-nursing techniques. In contrast, patients in the affected villages were segregated through traditional methods of quarantine, a step that controlled the situation outside the clinics.

After Ebola hemorrhagic fever (EHF) appeared in Africa in 1976–1979, it was not seen again until 1994. Was it “gone” during those 15 years? In one sense, certainly not—it was circulating in its natural reservoir. Was the virus causing sporadic human infections that remained undetected because the patients never contaminated hospitals to produce the savage nosocomial epidemics that brought Ebola virus to medical attention?

Of interest, there was an appreciable seroprevalence among the residents of Kikwit and those of surrounding villages, which was thought to represent temporally distant infections.

[null and void]

Gatún is in Panama, I thought he could answer your question regarding availability of IV equipment.

He’s a good man, and could be a great FRiend and resource should you relocate there.

[FredZarguna]

We have no idea how long Ebola has existed. In order for a statistically significant cohort to have a heritable immunity, a lot of Africans would have had to have died of Ebola before the first known outbreak in 1976. We have no modern record, nor any record during the colonial period that such epidemics occurred. Given current African mortality rates, and the epidemiological map there's no evidence of a resistant sub-population. The few cases of European survival we have would suggest that maybe Africans are actually more likely to succumb, but there isn't enough evidence either way.

[lulu16]

I have just decided what I shall be for the neighborhood Halloween party: Ms. Fatu Kekula in her makeshift nursing apparel. Then as my husband suggested, I give out links to this story.

This young lady is such a model and inspiration for me. She spent her own money to make sure she was safe as she treated her family around the clock ( not asking for a government handout). I wonder if someone has paid her last year’s tuition?

[lulu16]

Thank-you so much for the introduction. You are very kind. I loved kayaking through the jungles of the Panama Canal.

It would break my heart to leave the US, but my husband is quite fed up with the freedoms we are losing and the rampant corruption here since BO. I hear in Panama, they pretty much leave you alone.

[lulu16]

Jesus Christ and the apostles are our examples of the importance of healing and faith, the two are intertwined. And being saved is the outcome with both. Praise Jesus.

[PA Engineer]

Sort of a SWAG (and discussions with Wife MD). The drug treatment has to begin within the first 4 days based on Dr. Logan's work. All of his patients died when treatment was begun later. All of his patients were confirmed ebola. The 10 days is based on the "new ebola" course of infection.

Black Agnes has discussed the similarity between Epivir and Favipiravir, offered by the Japanese. Favipiravir was used to successfully treat the infection in a French nurse.

Doctor treats Ebola with HIV drug in Liberia — seemingly successfully

"Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases says that theoretically, Logan's approach has some merit. Lamivudine is a nucleocide analog, and other drugs in this class are being studied to treat Ebola."

Fauci was notified of this novel treatment back in September. I'll cut him just a little slack on this. The use of Epivir for Ebola is an off label treatment and forbidden by the FDA.

[null and void]

It would break my heart to leave the US,

Yeah. But it also breaks my heart to continue to live in a country I barely recognize.

[lulu16]

How to insert an IV:

http://www.wikihow.com/Insert-an-IV

This would be good to study and practice.

[FredZarguna]

If outbreaks occurred hundreds or thousands of years ago, they must have been limited to small villages that probably didn't communicate with neighboring villages, limiting transmission.

True, however, the OP is positing the existence of a sub-population with a heritable immunology. This cannot be an adaptive immune response, because specific immune responses are not heritable. It would [almost certainly] have to be a cytologic immunity. So necessarily -- if it exists -- the question of a resistant sub-population would have to be answered by the likelihood of the transmission of their genes and not the transmission of the virus. Did survivors leave their ravaged villages and reproduce elsewhere? Eh ... possible. But I agree with you that based on the history and mortality rates there isn't much reason to believe this happened.

[FredZarguna]

The trick seems to be to suppress the virus long enough or successfully treat the symptoms long enough for the organs producing adaptive immune cells to survive. Unlike HIV, once an adaptive immune response develops, the virus is destroyed. In all the survivors we have, no trace of Ebola has been found. Current theory is supportive care and virus suppression may allow the spleen and lymphatic system to survive long enough to start producing Ebola killers, absent that, the structures of the specific immune system are destroyed too quickly to kick in.