>>>EBOLA 2014-15 >> Latest News and Updates for MERS, Ebola and other spreading nasties<<<

Pixie comments:

There are supposed to be just a couple of categories for Ebola suspects/patients:

- positive patients are placed in isolation in a hospital environment

- suspect cases with definite contact with Ebola patients are placed under quarantine

- suspect cases with no definite contact are asked to self-monitor

But now a new category seems to be emerging in places like Newark, New Haven, and Paris. In this category we find individuals who meet the criteria for "Ebola suspect case" who have tested "negative" for the Ebola virus but who remain hospitalized with no alternate explanation given for their condition. It is then noted that these patients "remain under observation."

So are they being formally isolated? Has the category of "isolation" expanded to include "negative" patients they are a little unsure about? Are these people free to leave the hospital? How long does their suspended state last? What are the protocols for determining exactly when they can leave? Is there a firm protocol for re-testing "negative" suspect cases who demonstrate symptoms and seem to be at risk for Ebola, or is that protocol just sort of put together on the fly at the individual hospitals? Is there a communications plan for informing the public about the outcome of the case (further test results, patient release, etc.)? Is there a firm commitment to inform the public in the event that a formerly "negative" suspect case indeed turns positive? (Got "risk communications" protocols for that?). Or are some institutions deciding that they can "handle it" better on their own without the glare of the spotlight upon them so they've decided to proceed, perhaps on the down low, in caring for an Ebola patient? (HIPAA and all that..).

Call me skeptical. I don't much like this new, vague, category.

monotreme

Threat to break isolation in Liberia over food
[link to www.app.com]
October 23, 2014

Dozens of people quarantined for Ebola monitoring in western Liberia are threatening to break out of an isolation because they have no food, the West African nation’s state radio reported Thursday.

Forty-three people were put in quarantine after four people died of Ebola in Jennewende, a town in an impoverished corner of Grand Cape Mount County near the Sierra Leone border, the Liberia Broadcasting System said.

It quoted those quarantined as saying that the U.N. World Food Program apparently has stopped providing food to people affected by Ebola in the area. A WFP press officer said he is looking into the claim.

Thanks for the news dump NB some crazy stuff in there, It really sucks when there is no transparency and we are forced to read between the lines.

Pixie comments:

There are supposed to be just a couple of categories for Ebola suspects/patients:

- positive patients are placed in isolation in a hospital environment

- suspect cases with definite contact with Ebola patients are placed under quarantine

- suspect cases with no definite contact are asked to self-monitor

But now a new category seems to be emerging in places like Newark, New Haven, and Paris. In this category we find individuals who meet the criteria for "Ebola suspect case" who have tested "negative" for the Ebola virus but who remain hospitalized with no alternate explanation given for their condition. It is then noted that these patients "remain under observation."

So are they being formally isolated? Has the category of "isolation" expanded to include "negative" patients they are a little unsure about? Are these people free to leave the hospital? How long does their suspended state last? What are the protocols for determining exactly when they can leave? Is there a firm protocol for re-testing "negative" suspect cases who demonstrate symptoms and seem to be at risk for Ebola, or is that protocol just sort of put together on the fly at the individual hospitals? Is there a communications plan for informing the public about the outcome of the case (further test results, patient release, etc.)? Is there a firm commitment to inform the public in the event that a formerly "negative" suspect case indeed turns positive? (Got "risk communications" protocols for that?). Or are some institutions deciding that they can "handle it" better on their own without the glare of the spotlight upon them so they've decided to proceed, perhaps on the down low, in caring for an Ebola patient? (HIPAA and all that..).

Call me skeptical. I don't much like this new, vague, category.

monotreme


"These are children who had a normal course of illness...and had a clinical recovery, and both of these children became ill in a day or two," Dr Sprecher continued. "They came back and were found to be febrile and [PCR-]positive again. Both children had some neurologic signs. The feeling amongst the virologists is...the virus gets into some parts of the body with immunologic protection, like the central nervous system. The immune response clears the virus from the periphery, the patient has a clinical recovery, while the viral infection progresses in the [central nervous system] and eventually returns and reemerges as a renewed positivity. At least one of the children became negative again."

monotreme

Reinfection, Reemergence Unknown
[link to www.medscape.com]
Larry Hand October 23, 2014

In response to a question from a webcast participant, experts discussed the possibilities of reinfection and reemergence of disease after initial clearance.

"We know that patients who have survived do have specific antibodies in their blood," said Armand Sprecher, MD, from Médecins Sans Frontières. "Of course, what we don't know is the threshold at which antibodies give you a surrogate marker of protection. It's possible we may gather that over the course of this epidemic, as we hopefully move toward vaccination."

Paul Farmer, MD, PhD, from Partners in Health, Boston, Massachusetts, added, "In Monrovia, a couple of children under 5 who had negative [polymerase chain reactions (PCRs) after treatment] then returned some weeks later with positive PCR.

"These are children who had a normal course of illness...and had a clinical recovery, and both of these children became ill in a day or two," Dr Sprecher continued. "They came back and were found to be febrile and [PCR-]positive again. Both children had some neurologic signs. The feeling amongst the virologists is...the virus gets into some parts of the body with immunologic protection, like the central nervous system. The immune response clears the virus from the periphery, the patient has a clinical recovery, while the viral infection progresses in the [central nervous system] and eventually returns and reemerges as a renewed positivity. At least one of the children became negative again."

pixie

England:

NHS staff must take 'personal responsibility' for protecting themselves from Ebola

Dame Sally Davies says that Britain is not a 'paternalistic society' and doctors and nurses must listen to the training they are given to protect themselves from Ebola.

By Steven Swinford, and Matthew Holehouse6:00AM BST 23 Oct 2014
[link to www.telegraph.co.uk]

NHS staff should not expect to be "nannied" about how to protect themselves from Ebola and must take "personal responsibility", the Chief Medical Officer has warned.

Dame Sally Davies said that Britain is not a "paternalistic" society and that NHS staff must "choose to listen to the training" that they are given.
Her comments came after MPs said they had been informed by NHS staff that they have not been told where protective clothing is located in their hospitals.
Dame Sally told the health select committee: "I think we also need to get over to front line staff that they have a personal responsibility to make sure that they find out where their PPE [protective suit] is and they have learned to do this. We are not a paternalistic society and I am not a nanny. They must choose to listen to the training."

Comment: Ummm...ok.

The British government's way of putting the blame for infection on the HCW even before any infections have occurred. Typical…

Perchance I was speaking metaphorically, about those 2-legged deer whose time fast approaches...

I do not want to say too much, because this family member asked for complete anonymity.
We live in the western part of the US. This family member is a physician with additional duties at the teaching hospital where he is employed.
Earlier today he was identified as "Essential Support" whatever that means. With this ES moniker comes significant additional duties over and above patient care, administration activities, responsibility for residents in training, etc.
This family member has been required to remain at his facility 24/7, with no leave for trips home, for family and the like.
The facility operates under a standard Threat Level matrix used by many key facilities deemed to be of high importance to local/regional/national healthcare. The three level matrix has been moved to Level Three, hence my family members required commitment. No phone calls out, no trips outside the facility. Kind of like lock down. The facility even went so far as to preemptively release a statement to an unsuspecting press stating all hospital operations are moving forward normally, which seems very suspect.
With terrorism, Ebola and solar activity occurring all around us, this may be the final puzzle piece to fit neatly in order to derive a clear overall picture as to what the hell is going on in our country/world right now.
Please add any intel you may have encountered since 6 am PT today. It could be vital.