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.
I questioned your claim regarding epithelial infection because the ZMAPP drug began as an effort to transport modified alleles to treat cystic fibrosis. The researcher used Ebola glycoproteins due to the virus' efficient transduction of lung tissue. Your claim doesn't jibe with the ZMAPP work.
On the epithelial issue:
Intracellular Events and Cell Fate in Filovirus Infection Viruses 2011 (PDF pg 4)Indeed, MARV or ZEBOV can be isolated from any organ or tissue. Besides the typical target cells for ZEBOV and MARV infection in non-human primates, additional target cells were occasionally found in individual animals. These cells included alveolar epithelial cells, bronchial epithelial cells and the cells of endocardial layer.
Ebola haemorrhagic fever Lancet March 2011Target cells and tissues
Ebola virus has a broad cell tropism, infecting a wide range of cell types. In-situ hybridisation and electron microscopic analyses of tissues from patients with fatal disease or from experimentally infected non-human primates show that monocytes, macrophages, dendritic cells, endothelial cells, fibroblasts, hepatocytes, adrenal cortical cells, and several types of epithelial cells all lend support to replication of these viruses.
Regarding the transmission vector issue:
Ebola Hemorrhagic Fever, Kikwit, Democratic Republic of the Congo, 1995: Risk Factors for Patients without a Reported Exposure JID 1999In 1995, 316 people became ill with Ebola hemorrhagic fever (EHF) in Kikwit, Democratic Republic of the Congo. The exposure source was not reported for 55 patients (17%) at the start of this investigation, and it remained unknown for 12 patients after extensive epidemiologic evaluation. Both admission to a hospital and visiting a person with fever and bleeding were risk factors associated with infection. Nineteen patients appeared to have been exposed while visiting someone with suspected EHF, although they did not provide care. Fourteen of the 19 reported touching the patient with suspected EHF; 5 reported that they had no physical contact. Although close contact while caring for an infected person was probably the major route of transmission in this and previous EHF outbreaks, the virus may have been transmitted by touch, droplet, airborne particle, or fomite; thus, expansion of the use of barrier techniques to include casual contacts might prevent or mitigate future epidemics.
If you go back to my first post to you in this thread, I agreed that it's unlikely that Ebola will mutate into the epidemiological definition of an airborne disease. Nor must it undergo such mutation. Fomite, contact, droplet and aerosol are more than sufficient to spread it far and wide, as we're seeing now in West Africa. Much will be learned from this outbreak and much previous work will be upended.
You seem to think that no one should be the least bit concerned about the spread of Ebola to the western hemisphere. That is your right, of course, but your continued insistence that you know all possible epidemiological factors is odd given that the researchers engaged with this virus will not say the same. Every statement I've heard and read regarding vectors is predicated with a statement that much is unknown regarding transmission and pathogenesis.
I suspect continued efforts to communicate with you will not prove fruitful. You appear hell-bent on sticking to your opinion and position, and cannot abide a hint of disagreement, divergence or doubt.
I plan to revisit this thread when this outbreak is over and compare events to predictions. It will be interesting to see how it ends.