Community Chat

[pitdakota]

On 11/1/2014 Lynnj said:

On 11/1/2014 pitdakota said:

On 11/1/2014 MomTo2Dogs said:

It's my understanding that Spencer felt ill after he went out in public. The first symptoms of Ebola are cold/flu like. Fever, fatigue, muscle pain, headache, sore throat. My impression from what I read is Spencer felt fine when he was out and did not feel sick until after he got home. So he would not have been contagious when he was out bowling and in the Uber taxi.

Maybe someone else can chime in on this.

Yes, while Dr. Spencer was out and about was before his temp went up. When his temp elevated he called just as he was supposed to, the system kicked in and worked just like it should. He was following the protocols of MSF. The same ones these health care workers have been following since March of this year with this specific outbreak, not to mention the previous outbreaks of ebola to which MSF has responded.

Okay, so what if someone who is self monitoring is out and about when the temp first begins to go up? The person may be taking temp 2-3 times/day. Let's say on day 10, they take temp in the morning and it is normal. Then they leave and go run errands for most of the day. At some point, the temp starts to rise while they are still out. They may start to feel fatigued also (not sure how quickly that comes on in relation to temp spiking). So they think, one more stop at grocery store to pick a few things up for dinner, then head home. At this point they do not know the temp is up, since they have been out all day, and haven't taken temp. Would they be contagious now? What about if they sneezed during this time, and droplets got on things that others touched shortly after they landed?

People with ebola don't go from having no ebola in their blood stream and having no symptoms to being horribly infectious within a matter of hours.

The temp going up is a sign of the body's defense mechanism because the viral load is starting to build. The immune system is responding to fight the virus. If someone is just feeling fatigued, the viral load is not such that these individuals would be extremely contagious. Other symptoms will soon develop. Profound weakness, GI symptoms, rash, etc. As the viral load continues to build, they are more than fatigued. And the vast majority of patients do run a temperature.

In all honesty, the last thing anyone in the public should worry about with with ebola is coughing or sneezing. Theoretically when the viral load is high enough in the body can have the virus in salvia and mucous, but those people aren't out and about grocery shopping for the most part. They are sick. And respiratory symptoms such as a cold with coughing and sneezing are not routine symptoms by any means.

Droplet precautions are more in store for health care workers when these individuals are in the hospital and doctors and nurses are around the patient intubating them, suctioning the ET tube, providing aersol treatments, etc. And needless to say, health care workers might be positioned to be right down by the patient's face while providing that care.

It is not casual contact that exposes someone to ebola. It is very close contact with body fluids of someone that has symptoms.

Same with HIV. We know how HIV is transmitted. HIV is also present in tears. But I don't think there is a documented case to date of someone getting HIV because an HIV person cried all over them and there were no other exposures.

[Lynnj]

Thanks, Pitdakota, for making explanation so easy to understand. So someone who just starts to spike a temp doesn't have symptoms and is not contagious? Why do they put these people recently taken to the hospital into immediate isolation? My understanding is that hospitals have set up special rooms now while a test for Ebola is being confirmed. So if someone wouldn't be contagious until it's built up into the system why are they taking such precautions?

[pitdakota]

Lynnj, when the temp starts to elevate they are in the period of the onset of symptoms. Incubation period is over and the onset of symptoms have started, and the viral load will continue to climb. That is why the goal is to quickly get them to the hospital in isolation and start treatment immediately. The EMTs and paramedics that respond would wear full personal protective gear. But that is not for coughing and sneezing. That is in the case of exposure to vomiting, diarrhea, and/or any bleeding that might occur. Remember that these individuals would be having to start an IV, so they would be exposed to the blood.

ETA: that is also why the want to move quickly. They want to get the individual into isolation and away from any community contacts at that point. The health dept then steps in to start contact tracing. Based on history of development of symptoms, etc. they then take actions with any known contacts. There are different levels of monitoring and based on that exposure they rate the risk & advise accordingly.

[Lynnj]

Thanks,Pitdakota.

[pitdakota]

Your welcome Lynnj!

I need to watch the webcast, I would love to see it. Since we fall back an hour...maybe I will start now!!

[focksie]

Lynnj, this is what I found on the WHO website. What I'm reading from this is that a person can be infectious once symptoms appear (i.e., once they have a fever), although I understand they are not as infectious as when the viral load is much greater in advanced disease. I'll keep researching for more specific info but I have to get to bed now.

http://www.who.int/csr/disease/ebola/faq-ebola/en/

What are typical signs and symptoms of infection?

Sudden onset of fever, intense weakness, muscle pain, headache and sore throat are typical signs and symptoms. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding.

Laboratory findings include low white blood cell and platelet counts, and elevated liver enzymes.

The incubation period, or the time interval from infection to onset of symptoms, is from 2 to 21 days. The patients become contagious once they begin to show symptoms.

[Lynnj]

Thanks, Focksie. I am headed to bed right behind you. Good night. I was starting to think that it would be okay for someone who is under self monitoring, with no symptoms and no temp, to be out and about in stores. But now I am not so sure. A temp could spike at any time. Maybe even being more active could help to bring it on too? For the few that we know about in the US recently, they were out, and didn't spike a temp until the next morning. I wonder what might have happened had they spiked a temp while they were out, sort of like my scenario in the post above.

[Lynnj]

I started to watch the video, but I am too tired to take it in. I want to be awake when I listen to this. Thanks for posting the link, Gato. I've saved it as a favorite.

[pitdakota]

On 11/1/2014 Lynnj said: Thanks, Focksie. I am headed to bed right behind you. Good night. I was starting to think that it would be okay for someone who is under self monitoring, with no symptoms and no temp, to be out and about in stores. But now I am not so sure. A temp could spike at any time. Maybe even being more active could help to bring it on too? For the few that we know about in the US recently, they were out, and didn't spike a temp until the next morning. I wonder what might have happened had they spiked a temp while they were out, sort of like my scenario in the post above.

Lynnj, hope you had an opportunity to watch the webcast.

GATO, thanks for the link. I finally had time to watch it up through the question and answer part. Great information. This organization is so special.

Loved the story about the little 22 month old escaping the ETC. Too cute.

You can tell these people are passionate about what they do. A big kudos to them!

[hckynut]

Haven't a clue what MFS means.