Ebola has mutated. Asymptomatic carriers.

From the BBC, January 29, 2015

Scientists tracking the Ebola outbreak in Guinea say the virus has mutated.

Researchers at the Institut Pasteur in France, which first identified the outbreak last March, are investigating whether it could have become more contagious.

[snip]

“We’ve now seen several cases that don’t have any symptoms at all, asymptomatic cases,” said Anavaj Sakuntabhai.

“These people may be the people who can spread the virus better, but we still don’t know that yet. A virus can change itself to less deadly, but more contagious and that’s something we are afraid of.”

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H7N9 Flies from China to Canada – On a Plane

From SCMP, January 27, 2015

North America’s first case of bird flu in humans has been identified in a Vancouver-area woman who returned to the city on a flight from Hong Kong this month.

Canadian health authorities said the patient, who tested positive to the H7N9 strain of avian flu on Monday morning, is not gravely ill.

[snip]

The Globe and Mail newspaper reported that the patient and her husband, both aged in their 50s, had travelled together and both were now sick at home. Tests have not yet confirmed the man’s suspected H7N9 infection.

The newspaper quoted Bonnie Henry, BC’s deputy provincial health officer, as saying the couple “did some touring of areas and villages in China where poultry are seen throughout the village, but there was not a particularly high-risk exposure that we were able to identify.

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H5N1 in the US

From NBC News, January 22, 2015:

A green-winged teal shot by a hunter in northern Washington state has tested positive for H5N1 bird flu — a relative of the virus that’s infected nearly 700 people globally and killed 400 of them.

[snip]

To make matters more complicated, this strain of H5N1 found in the teal appears to be a mix of H5N1 and the H5N8 found in Washington state and elsewhere in the U.S. as well as in Europe, South Korea, Japan and Taiwan.

The pandemic potential of this version of H5N1 is unknown.

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Ebola Myths vs Facts (with references!)

Myth: New Ebola has not shown any significant mutations.

Fact: New Ebola is accumulating mutations at twice the rate of previous outbreaks. Further, sequence analysis shows that it appears to be under “incomplete purifying selection” (Gire et al. 2014). This suggests that the New Ebola is in the process of adapting to the human host.

Myth: New Ebola is not very contagious. It is hard to get.

Fact: Ebola is now transmitting to people at the same rate as the flu. R0 for seasonal influenza is about 1.3 (Cobum et al 2009). R0 for Ebola is currently calculated to be 1.4 to 1.8 (WHO Ebola response team, 2014).

Myth: The new Ebola hasn’t become more transmissible.

Fact: One of the top experts on Ebola, Dr. Peter Jahrling, has reported: ‘We are using tests now that weren’t using in the past, but there seems to be a belief that the virus load is higher in these patients [today] than what we have seen before. If true, that’s a very different bug.

‘I have a field team in Monrovia. They are running [tests]. They are telling me that viral loads are coming up very quickly and really high, higher than they are used to seeing.

‘It may be that the virus burns hotter and quicker.’ Daily Mail, October 18, 2014.

Myth: Quarantines don’t work.

Fact: Quarantines work very well if they are strictly enforced (McLeod et al. 2007).

References

Coburn BJ, Wagner BG, Blower S. Modeling influenza epidemics and pandemics: insights into the future of swine flu (H1N1). (2009) BMC Med. 7:30.

Gire SK et al (2014) Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak. Science 345: 1369-1372.

McLeod MA, Baker M, Wilson N, Kelly H, Kiedrzynski T, Kool JL (2008) Protective effect of maritime quarantine in South Pacific jurisdictions, 1918-19 influenza pandemic.Emerg Infect Dis. 14:468-70

WHO Ebola Response Team (2014) Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections. N Engl J Med 371:1481-1495.

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Expellamis Ebolis Scientia! The use of the word “Science” as an incantation to silence different opinions

In Harry Potter world, people with recessive mutations in the Magic gene can point a stick, enunciate some pseudo-Latin and make cool stuff happen.

In Science world, one must observe reality closely, formulate reasonable hypotheses and then test them with carefully designed experiments. A scientist must then make his results and conclusions public so that they can be scrutinized by other scientists. Quite a chore compared to Harry Potter world. But that’s the way it is.

Lately, I’ve noticed that politicians have been using the word science as a sort of magical incantation with which to silence those who disagree with them. They provide no data or even simple logic. They just say “the Science shows”. This is a perversion of the scientific method. And it is time for real scientists to call bullshit on this tactic.

More to come.

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Open thread

For those unable to participate on PFI Forum as commentors, I offer this thread. If I am unable to comment on PFI Forum, for whatever reason, I will attempt to post on this thread.

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Temporal and quantitative framework for intervention in the Ebola pandemic

The following projection involves estimates based on media accounts of reported cases as well as estimates of unreported cases.

First some assumptions:

1 HCW is needed for every 10 Ebola patients
There are 10,000 to 20,000 patients not receiving care currently.
By mid-November, this number will jump to 100,000-200,000, without immediate intervention.
By some time in January, this number will reach 1-2 million.

Second, some math:

1,000 to 2,000 additional HCWs are needed immediately, as in, on this very day. This number could be reasonably be acheived if it was made a priority.

If additional HCWs are delayed until mid-November, 10,000 to 20,000 HCWs will be required. Although technically possible, it is unlikely that this number could be mobilised.

If additional HCWs are delayed until January, 100,000 – 200,000 will be needed. This number almost certainly will not be acheived.

Conclusion

Plans to plan, plans to meet to plan, speeches about plannning, speeches about potential deployments, promises to deploy at some point in the future are all equally useless. Either HCWs deploy within the next few weeks or Africa is doomed. Plan B will be to let the virus burn through the continent and attempt to limit it to there while more developed countries develop vaccine for their own populations.

That is all.

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