Okay, at this point, it looks like you have a mental block against understanding the difference between airborne and droplet transmission.
Airborne is something that infects by particles suspended in the air. It is like smoke, but invisible. Think about how smoke fills a room and stays in the air until you open a window and let it out. If that smoke were an airborne virus like measles, anyone walking into that smoky room would get sick. If someone outside were close to the window when you opened it, that person could get sick.
Droplets are like a spritz of Windex from a spray bottle. You can stand at one end of the room and spritz Windex into the air all day long, and the most that will happen is that a big wet spot appears on the floor a short distance from where you are spritzing.
In the case of Ebola, the patient isn't even sneezing (analogous to spritzing the Windex). Since the virus is in the blood, not the epithelial cells of the respiratory system, even if the patient developed another illness (unlikely, given that he/she is in isolation where no exposure to a respiratory virus will happen), a sneeze or cough can't aerosolize virus or expel it into droplets. I've seen some reports that Ebola is highly susceptible to drying, meaning that even if it were shed into aerosols, it would not survive to infect someone else.
Almost all cases of Ebola can be traced to direct contact with a sick person. The few remaining cases either do not remember touching a sick person, or may have been infected through fomites. The transmissibility of Ebola in fomites, although recognized as a potential, has not been established through rigorous research.
Coughing and sneezing are not common Ebola symptoms but we are moving into cold and flu season. Do the authorities assume that Ebola is kept at bay by an adenovirus? I doubt that. Coinfection is an issue.
Colds and flus are not seasonal on the equator.
Fomites. That's the greatest omission to date. The authorities never list environmental contamination as a vector. Why is that? It's not amenable to the parsing done with the droplet vector. Then there is the droplet vector, which is parsed to be technically correct but still misleading in light of the general public's definition of the term.
Fomites are routinely mentioned as a potential vector, despite the fact that fomite transmission has not been established through rigorous research. Even if fomites exist, one reason that researchers won't find them is that surfaces in patient treatment areas are routinely sprayed with bleach. When a patient is removed from a house, the house is sprayed with bleach. No one is taking chances. It's pretty hard to establish that fomites can be vectors when everything is disinfected daily, if not more often.
I should point out that Africans refuse to enter houses where someone has had Ebola. They're refusing to pick up dead bodies. Not much of a chance of them getting Ebola like that, but they are subjected to the stench of rotting flesh.
Commission: telling people they are perfectly safe unless an Ebola patient is vomiting blood all over their shirts. That's so wildly inaccurate, one can only conclude that the authorities have something other than infection control as a focus. What that is I can only guess but none of the guesses are flattering.
You won't get Ebola by being in the same room or next room as an Ebola patient. You have to be within a few feet, or actually physically touch that patient.
Are you aware that there have been at least 25 outbreaks of Ebola prior to the two current outbreaks?
Think smoke. If Ebola were airborne, we would have seen a pandemic starting in 1976, at the time of the first outbreak. We cannot stop airborne viruses--have you never noticed that every year, influenza sweeps around the world in a few months, and we've never been able to prevent its spread?
Okay, we'll play it your way. By your own assertion you've laid out the authorities' dishonesy. I've yet to see, hear or read anyone talking about fomites or droplets. Not a single word. According to official pronouncements one must be vomited or bled upon by an infected individual to become ill. Is that not a lie by ommision?
I am utterly amazed that you know more about the spread of Ebola than the researchers and health care providers who work with it every day. I'm amazed that you know more about it than even the experts and authorities who read the medical literature about Ebola every day. How do you know so much that the experts don't?
So you're asserting that viral particles are not shed until the patient is in the last stage of illness. That is inaccurate. Viral shedding, according to the authorities, begins when the patient becomes febrile. One develops the fever days, in some cases many days, before the gastrointestinal lining begins to slough off.
The virus is shed in contaminated bodily fluids--blood, fluids derived from blood, and fluids which are contaminated with blood (for instance, sweat from an area next to a minor cut). Symptoms include vomiting and diarrhea--all it takes is for a little blood to get mixed in with those fluids for them to become contagious. BTW, not all patients become hemorrhagic, not even all those who die. They die of multiple organ failure.
My scenarios are those people who are unaware of their exposure, develop a fever, toss down some Tylenol and go on about their day. The next day they're nauseated but assume it's a stomach bug so take some more Tylenol and go about their day. Those people are the ticking time bombs, unknowingly spreading viral particles everywhere they go and exposing everyone they encounter--on mass transit, in the restaurant, at the office, etc. etc.
Highly unlikely. When symptoms appear, they hit hard. And if a person has a mild case, no vomiting, no diarrhea, they are unlikely to be shedding.
Which of your facts are known and which are assumptions? Recall that this is an entirely new strain that hasn't been studied like Zaire, Congo, Reston, etc. How much of what you're writing do you know is fact based on data? How much is assumption based upon the characteristics of Zaire?
My facts and statements are based entirely on extensive reading of the relevant medical literature about Ebola. This outbreak is Zaire, which is the most thoroughly characterized of all Ebola viruses.
Authorities have never once told the public, "there is much we don't know about how this new strain of Ebola spreads and behaves in the human body." That is an obscene lie by ommision. That's why I linked to the WHO communication document. Throughout that document they insist that the public be told that unknowns exist and officials should avoid making statemnts of fact that are not known to be fact. Once a "fact" has been disproven the effect upon the public's trust is severe.
Really? I watched a panel discussion of Ebola on CSpan yesterday. Everyone on that panel was very careful about what he said about Ebola. They stuck to what is known. One even referred obliquely to Donald Rumsfeld's "unknown unknowns." I have not seen a single instance in that panel or anywhere else of experts claiming that everything is known, or omitting to mention known facts.
I couldn't bring up the video you linked to, my firewall doesn't like it, but in the text it is noted that the patient was in shorts and a t-shirt. It isn't clear in the text but it seems the crowd developed when the PPE-clad followers were chasing the patient down. It's good that the people in the market have learned to keep their distance from someone known to be infected. That does nothing to stop the spread, however, since it's the unknown infected that are most dangerous.
Here is the youtube video. In case you cannot watch the youtube video, I will describe the scene. The man is clad only in t-shirt and shorts, no shoes. Any cuts on his feet can contaminate soil. There are a LOT of people at that market. Remember smoke, and how it penetrates everywhere? If that man were aerosolizing virus through the respiratory route, everyone in that sizeable crowd that gathered to watch would have been exposed, and there would already be a few cases. He is trying to escape four heavily clad health care workers, while another man in scrubs is following them, spraying the ground where the man walked with bleach. They finally corner him, talk to him, and wrestle him into a pick-up, while the crowd cheers.
The spread of Ebola is almost always through direct contact. The reason this outbreak continues is because we haven't managed to spread the message to everyone in the area about avoiding contact. Many of those people STILL do not believe Ebola is a real disease. We have to get on top of those two issues to stop the outbreak, and that is where we are having difficulty.
No, you are missing the distinction between the technical definition and layman's definition, and ignoring the misuse of the technical definition when communicating with laymen. When speaking among virologists or MDs, using the term "airborne" to mean individual viral particles independent of droplets (aka droplet nuclei) is fine since everyone understands the intended meaning. Using the term "airborne" among laymen, or rather using the phrase "it's not airborne" among laymen, is dishonest because you are intentionally misleading the audience. It's not a vague distinction.
Intelligent non-medical people are asking, "if it isn't airborne why are the doctors and nurses wearing positive-pressure spacesuits with protected air supplies?" How would you answer them?
You won't get Ebola by being in the same room or next room as an Ebola patient. You have to be within a few feet, or actually physically touch that patient.
Really? That's news to the CDC.
Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease ExposureSome Risk of Exposure
-- Household contact with an EVD patient
-- Other close contact with an EVD patient in health care facilities or community settings
Close contact
Close contact is defined as
a. being within approximately 3 feet (1 meter) of an EVD patient or within the patient’s room or care area for a prolonged period of time (e.g., health care personnel, household members) while not wearing recommended personal protective equipment (i.e., standard, droplet, and contact precautions; see Infection Prevention and Control Recommendations); or
b. having direct brief contact (e.g., shaking hands) with an EVD patient while not wearing recommended personal protective equipment.
Brief interactions, such as walking by a person or moving through a hospital, do not constitute close contact.
Also news to the WHO, which has reversed course considerably.
Ebola situation in Liberia: non-conventional interventions needed 8 SeptIn Monrovia, taxis filled with entire families, of whom some members are thought to be infected with the Ebola virus, crisscross the city, searching for a treatment bed. There are none. As WHO staff in Liberia confirm, no free beds for Ebola treatment exist anywhere in the country.
According to a WHO staff member who has been in Liberia for the past several weeks, motorbike-taxis and regular taxis are a hot source of potential Ebola virus transmission, as these vehicles are not disinfected at all, much less before new passengers are taken on board.
When patients are turned away at Ebola treatment centres, they have no choice but to return to their communities and homes, where they inevitably infect others, perpetuating constantly higher flare-ups in the number of cases.
This outbreak is Zaire, which is the most thoroughly characterized of all Ebola viruses.
Incorrect. There are three distinct Ebola clades at work right now, all of which derived from an ancestor virus in or about 2004.
Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak, Page 2In more pedestrian language:This suggests that the lineages of the three most recent outbreaks all diverged from a common ancestor at roughly the same time c. 2004 ( Fig. 2C and Fig. 3A ), supporting the hypothesis that each outbreak represents an independent zoonotic event from the same genetically diverse viral population in its natural reservoir.
Samples from 12 of the first EVD patients in Sierra Leone, all believed to have attended the funeral of an EVD case from Guinea, fall into two distinct clusters (clusters 1 and 2) ( Fig. 4A and fig. S8). Molecular dating places the divergence of these two lineages in late April ( Fig. 3B ), pre-dating their co-appearance in Sierra Leone in late May ( Fig. 4B ), suggesting the funeral attendees were most likely infected by two lineages then circulating in Guinea, possibly at the funeral (fig. S9).
(snip)
One iSNV (position 10,218) shared by twelve patients is later observed as fixed within 38 patients, becoming the majority allele in the population ( Fig. 4C ) and defining a third Sierra Leone cluster ( Fig. 4, A and D , and fig. S8). Repeated propagation at intermediate frequency suggests that transmission of multiple viral haplotypes may be common.
AAAS: Genomes reveal start of Ebola outbreakLook, I maintain that using a technically correct definition to mislead the general public regarding transmission vectors and risks is a gross injustice. It serves no good purpose, except perhaps to delay a public panic that will inevitably erupt if/when Ebola arrives in the continental US. I think it's when, not if, but I could be wrong. Even you, while denying it, admit that no physical contact is required because droplets are in fact a transmission vector. Why are you struggling so hard to deny your self-contradiction?The analysis reveals that the outbreak in Sierra Leone was sparked by at least two distinct viruses, introduced from Guinea at about the same time. It is unclear whether the herbalist was infected with both variants, or whether perhaps another funeral attendee was independently infected. One Ebola virus lineage disappears from patient samples taken later in the outbreak, while a third lineage appears. That lineage—tied to a nurse who was traveling to reach a hospital but died along the way—seems to have originated when one of the lineages present at the funeral gained a new mutation. This third lineage was spread, Garry says, via a truck driver who transported the nurse, as well as others who cared for her in the town where she died.
How do you know so much that the experts don't?
I know what the experts know because I get my information from research journals, not CSPAN. Perhaps you should expand your reading. Where are you getting your information, other than CSPAN? I note you post no links.