Comment by masnick | Hacker News Reader

Comment by masnick | Hacker News Reader

This blog post provides some good, straight-forward information about epidemiology, clinical characteristics, and infection control recommendations for Ebola: http://haicontroversies.blogspot.com/2014/07/ebola-hemorrhag... (It's written by an infectious disease physician.)

"Contact and airborne precautions are indicated for suspected and confirmed cases" refers to:

- Contact: wearing disposable gowns and gloves to interact with the patient

- Airborne: putting the patient in a negative pressure room (to avoid spreading air from the room around the hospital), and wearing a N-95 respirator or PAPR (http://www.3m.com/Product/information/Powered-Air-Purifying-...) in addition to the contact precaution stuff.

Source: http://www.cdc.gov/HAI/settings/outpatient/basic-infection-c...

That gives you a sense of what you'd need to do to safely interact/care for someone with Ebola. However, remember that several doctors treating Ebola have come down with the disease during the current epidemic. Hopefully (for the rest of us), there was some sort of infection control lapse that lead to their infection, rather than these infection control measures not being sufficient.

"rather than these infection control measures not being sufficient."

Per my understanding of things, that seems frighteningly unlikely[1]. As I understand it, there are a substantially greater portion of health workers getting sick than in previous outbreaks, and those health workers are not tied to a particular location. If that's the case (and mind you, this is all very much Nth hand what-I-got-from-the-radio stuff - either of those could certainly not be the case) then it seems to follow that probably this strain of ebola has some attribute that makes the recommended countermeasures inadequate (at least the countermeasures recommended for deployment in the field, which may or may not be this set of countermeasures).

[1]: That isn't to say "tremendously unlikely", just "unlikely enough to be frightening."

The problem is that contact + airborne precautions are the highest level of infection control precautions that hospitals in the US usually do. The blog post I linked to above indicates that there are additional recommendations on top of contact + airborne that are unusual in the US.

Infection control practices are assumed to be effective when adhered to. With a disease like Ebola, it's almost guaranteed that health care providers will follow the rules to the letter, at least in the US (and hopefully everywhere).

So: scary.

I doubt that all, and maybe any, of those recommendations can be followed by the medical staff currently responding to the outbreak in Africa. We're talking about an area of the world that struggles to provide any clean water to humans at all, and where many rural residents are actively hostile toward medical staff.

I know they're following some set of protocols, as it was reported at least one of the infected doctors claimed to have abided by them. I have no idea the degree to which they match the linked recommendations. Previous outbreaks have been in the same areas, though, so more infections with (we hope) the same or better protocols followed (presumably) comparably well is still worrisome.

I found this comment to have an undertone of ignorance.

1) Implying a cluster of 54 countries are all homogeneous, have poor health standard, etc

2) "Struggles to provide any clean water to humans at all" - this is much more heresy than fact. Please rely on statistics

African countries by no means are world superpowers, but this comment is pretty ignorant. Please think twice about such comments, they can be interpreted as offensive

Guinea, Liberia, and Sierra Leone are all poor countries with limited access to health care.

Additionally, http://en.wikipedia.org/wiki/Water_supply_in_Sierra_Leone opens with "Water supply in Sierra Leone is characterized by limited access to safe drinking water."

The parent made no statement that all of Africa is so limited, only that the outbreak was in Africa. The countries most affected by the outbreak were correctly described.

I did not mean to imply that all of Africa lacks clean water and is hostile to doctors--just the areas of the current outbreak. Sorry for the imprecise language.

I think it is instructive that ebola has not spread to the more developed areas of Africa in 30 years. Compare to AIDS, which also originated in Africa and rapidly spread into cities worldwide.

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