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Divernan

(15,480 posts)
Fri Aug 1, 2014, 09:47 AM Aug 2014

Pennsylvania doctors advised of deadly Ebola threat

(snippets from article)

The Pennsylvania Medical Society has alerted doctors to the threat of Ebola, even though the risk of the disease appearing in the United States is considered low.

The medical society, relaying advice from the U.S. Centers for Disease Control and Prevention, used its electronic newsletter to advise Pennsylvania doctors to learn the symptoms of Ebola, and be aware of patients who might have traveled recently to West Africa.

People who have been to areas where the outbreak is occurring are advised to watch for symptoms for ten days, and people who have had direct contact should be monitored for symptoms for 21 days.

Citing the Washington Post, the Pennsylvania Medical Society informed its members Connecticut-based Doctors Without Borders has more than 300 staff members responding to the epidemic.

http://www.pennlive.com/midstate/index.ssf/2014/07/ebola_virus_pennsylvania_cdc_w.html#incart_m-rpt-1

Reading the entire article, only snippets of which I posted per the 4 paragraph limitation, there are several internal contradictions in what the CDC is telling these docs.
First the CDC is saying it's unlikely someone could bring it back to the United States, since most flights from West Africa to the United States require stops in one or more countries. But in the next paragraph it talks about symptoms not appearing for 10 or 21 days.

Obviously people flying from Africa to the US would typically have no more than an overnight stop elsewhere - plenty of time for them to still be asymptomatic, regardless of how many stops/transfers in other countries.

The final inconsistency is regarding the time during which one should watch for symptoms to appear. Is it 10 days OR 21 days? Why such a difference? The standard medical decision rule is, "When in doubt, treat." That should be modified to "When in doubt, isolate."
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Pennsylvania doctors advised of deadly Ebola threat (Original Post) Divernan Aug 2014 OP
I think there will be a huge blizzard of CYA coming to America. djean111 Aug 2014 #1
I'm waiting for the what-me-worry crowd to ridicule the CDC for alerting docs. Divernan Aug 2014 #3
Um....no. jeff47 Aug 2014 #8
As far as I understand, Ebola can have incubation period ranging from 2 to 21 days. LisaL Aug 2014 #2
My point is,when in doubt, go with the maximum time period. Divernan Aug 2014 #4
I agree. LisaL Aug 2014 #5
The racists here are using this to hate. redstatebluegirl Aug 2014 #6
10 vs 21 days. jeff47 Aug 2014 #7
A friend just had a long planned medical mission to Guinea cancelled. bluedigger Aug 2014 #9
 

djean111

(14,255 posts)
1. I think there will be a huge blizzard of CYA coming to America.
Fri Aug 1, 2014, 09:58 AM
Aug 2014

I do not think the chances of Ebola showing up here are low at all. Too many people flying all over the place.

Divernan

(15,480 posts)
3. I'm waiting for the what-me-worry crowd to ridicule the CDC for alerting docs.
Fri Aug 1, 2014, 10:04 AM
Aug 2014

This is deadly serious - and I do mean deadly.

http://www.kcdc-phrp.org/article/S2210-9099%2811%2900002-6/abstract
(The Osong Public Health and Research Perspectives
Korea Centers for Disease Control and Prevention)

Incubation Period of Ebola Hemorrhagic Virus Subtype Zaire

Abstract
Objectives
Ebola hemorrhagic fever has killed over 1300 people, mostly in equatorial Africa. There is still uncertainty about the natural reservoir of the virus and about some of the factors involved in disease transmission. Until now, a maximum incubation period of 21 days has been assumed.
Methods
We analyzed data collected during the Ebola outbreak (subtype Zaire) in Kikwit, Democratic Republic of the Congo, in 1995 using maximum likelihood inference and assuming a log-normally distributed incubation period.
Results
The mean incubation period was estimated to be 12.7 days (standard deviation 4.31 days), indicating that about 4.1% of patients may have incubation periods longer than 21 days.
Conclusion

If the risk of new cases is to be reduced to 1% then 25 days should be used when investigating the source of an outbreak, when determining the duration of surveillance for contacts, and when declaring the end of an outbreak.

jeff47

(26,549 posts)
8. Um....no.
Fri Aug 1, 2014, 10:40 AM
Aug 2014

They're more-or-less assuming a perfectly balanced bell curve. Based on data where they don't even know when the exposure happened.

That paper has guesses upon guesses in order to create a mathematical model instead of just using the real-world statistics.

LisaL

(44,973 posts)
2. As far as I understand, Ebola can have incubation period ranging from 2 to 21 days.
Fri Aug 1, 2014, 10:00 AM
Aug 2014

Which is why there is an inconsistency regarding the time one should watch for symptoms to appear.

Divernan

(15,480 posts)
4. My point is,when in doubt, go with the maximum time period.
Fri Aug 1, 2014, 10:05 AM
Aug 2014

Which according to my post above is now estimated to be 25 days.

redstatebluegirl

(12,265 posts)
6. The racists here are using this to hate.
Fri Aug 1, 2014, 10:17 AM
Aug 2014

I heard an idiot yesterday in the grocery store say "if those "n" would stay in Africa that Ebola stuff would do our work for us". I turned around stared at him and said, "a mind is terrible thing to waste" and walked away. My husband said I was lucky he didn't whip out his gun and shoot me right there in the store. I can't stand by and listen to this stuff anymore. The assumption that only people of color are carrying this is a very troublesome idea.

Ebola is horrible, it is a terrible way for anyone to die. It will get here no doubt and we will have to deal with it. Of course if the Republicans have their way the CDC would be disbanded as well and any other health organizations that would have to deal with this and we would all be on ou

jeff47

(26,549 posts)
7. 10 vs 21 days.
Fri Aug 1, 2014, 10:33 AM
Aug 2014

The difference is the likelihood of Ebola taking 21 days to show symptoms. It almost never takes that long. It almost always takes 10 days or less.

So with someone who did not have direct exposure, no symptoms in 10 days indicates it is extremely unlikely they caught the disease.

With someone who did have direct exposure, you wait the full 21 days to rule out that slim chance of symptoms appearing in days 11-21. Because of the higher chance that they caught the disease to begin with.

bluedigger

(17,086 posts)
9. A friend just had a long planned medical mission to Guinea cancelled.
Fri Aug 1, 2014, 10:43 AM
Aug 2014

They were to leave this weekend I believe, but decided to call it off. They say it was not due to fear of ebola per se "not that contagious" but due to concerns over civil unrest resulting from the turmoil as well as worries of the students' families.

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