Ebola death toll rises to at least 2,296: WHO | Hacker News Reader

Ebola death toll rises to at least 2,296: WHO

reuters.com

113 pointsanigbrowl38 comments

For what it is worth, if you wish to keep up on this topic (and candidly, you will want to keep up with this topic), then an excellent resource is the mailing list for the International Society for Infectious Diseases, called PROMED. The stories posted there are relevant and the list is mainly read by epidemiologists and other relevant medical professionals. It is a good resource for reporters trying to keep track of the stories (The Economist, for example references PROMED quite often), and occasionally features some very insightful commentary from people who are the leaders in these fields. http://promedmail.org

That's a great link, thank you.

I'm not sure I fully understand. This is fewer deaths than many seasonal influenza outbreaks (with more flu deaths in fewer months). How deadly is this, because so far, it hasn't had the impact I expected?

The impact is largely unknown and in the future. So far, there is unchecked exponential growth in infections and deaths. This is happening in large part due to local populations ignoring containment rules, which makes it exponentially more difficult to stop. As the virus infects more people, it's increasingly likely to mutate into something even more difficult to control. The geographical spread is also somewhat unknown, due to patients hiding from health workers.

Look at these graphs and extrapolate out a few months to see why this is scary: http://en.wikipedia.org/wiki/Ebola_virus_epidemic_in_West_Af...

Thank you, that was exactly what I was missing.

There appears to be a recurrent cycle in this graph[0], is it real, or am I reading too much into unfiltered data?

[0]http://en.wikipedia.org/wiki/File:Deseased_per_day_Ebola_201...

One should never differentiate a sampled signal without a low-pass filter (at least second order is preferred). The original cases/day plot was smooth, but also leveled off at the end. IDK if the people collecting the data are on any kind of weekly schedule, but that type of thing would certainly come through in the data with enough samples and Fourier analysis.

>>As the virus infects more people, it's increasingly likely to mutate into something even more difficult to control.

It has been a while since I learned about the topic, but I don't think ebola is very likely to mutate because it kills its host too quickly.

Ebola kills a relatively high proportion (~60%) of people infected with it compared to the flu, and we understand it less well than we do the flu. The key point of the story is that we're not very aware of the actual incidence, which suggests that existing containment strategies are not working well.

Infectious diseases tend to follow two paths:

1) Cull the herd, aka very old, very young, or very sick will die, but most will be fine. Like most flu seasons, but not all flu seasons. Not like ebola or rabies.

2) You get it, you're probably gonna die. Like rabies, or ebola, or once in a century or so flu seasons (the flu season right after WWI killed more people than WWI itself killed)

Last time on HN I suggested a mutation could affect transmission rates and it caused an epic flamefest or authoritarianism, so for the good of the site, we'll agree ahead of time that surely no mutations can occur, and the example of some flu seasons being much worse than others for genetic reasons is merely coincidence.

I missed that flamefest, and I know very little about the transmission of infectious disease, but there's a part of me that can't help but wonder how so many medical caregivers (both locals and westerners) who were supposedly experts in the transmission of the disease and who were reportedly taking every precaution managed to contract it.

I'm not losing sleep over it or anything but it does seem like there's something going on other than just the local population being ignorant about the disease this time.

The WHO put out a press release a couple weeks ago [1] talking about why so many doctors have been catching the disease. Basically, it's a lot bigger than prior outbreaks and is catching people off guard, doctors are working themselves to exhaustion, making themselves more likely to make mistakes, and it's hit urban areas, meaning it's exposing a lot of underequipped medical professionals to the disease. Knowing better doesn't always translate to being able to do better.

[1] http://www.who.int/mediacentre/news/ebola/25-august-2014/en/

Thanks! Very informative.

Under-equipped is nothing new. Mistakes are mostly nothing new. The larger size leading to increased fatigue amongst medical personnel and thus more mistakes is a good point - and a relief if that is genuinely the whole explanation.

In addition to the other god reply, there has been a simple shortage of gloves and other supplies.

I saw a segment on the TV where they stated that rioters were breaking into hospitals to save patients from the medical workers, based on rumors that the medical workers were trying to steal their blood.

I guess it was during a promotion for this episode of Frontline:

http://www.pbs.org/wgbh/pages/frontline/ebola-outbreak/

I just want to say, that was a fascinating video. I wish that I could join up with doctors without borders and help them in their fight.

You can, if slightly indirectly:

   1) Go to work.
   2) Receive paycheck.
   3) Donate a portion of it here: http://www.msf.org/donate

I love this comment for reminding me of what I often forget. I actually watched the Ebola Frontline last night and was fairly upset by it. The hopelessness of the ill, the lack of resources for the staff (they were out of ambulances, so they were using a hearse to transport patients to the MSF clinic), just a terrible situation. It felt especially terrible to waste brain cycles on Apple Watches while this is going on.

I briefly dreamed of dropping what I'm doing and flying to Africa to help, as if that would do anybody any good. For the price of a flight to West Africa, lodging, incidentals etc., I could easily spend $5K 'helping'. Liberia's GNI per Capita is only $800.

Donating $5K to MSF or another quality NGO could pay 15 Liberians' wages in full for 6 months. MSF would clearly be better off employing 15 Liberians to help with their outbreak than for me to give that money to an airline and a hotel and 'help' for a few weeks. The Liberians would be better off earning income that will be recycled through their communities, learning about public health, and taking collective agency over their country.

Needless to say, I dropped my pipedreams of flying anywhere and loaded up http://www.msf.org/donate.

Liberia does not deserve your assistance.

"Since 2003, the international community has poured billions of dollars of aid into the country." (https://www.devex.com/news/a-decade-of-aid-dependence-in-lib...)

"Liberia receives an estimated $449 million in annual off-budget foreign assistance. And this estimate of off-budget aid excludes unknown amounts of funding from UNMIL, China, private foundations, and several bilateral and UN agencies." (http://aiddata.org/blog/the-elusive-quest-for-effective-aid-...)

After all this, if a country in the world's oldest continent still can't manage (because of corruption, apathy, whatever) it's certainly not your responsibility to step in and perpetuate such incompetence. If it takes a substantial reduction in population to finally affect change, then so be it.

Blunt, controversial, I don't care. 'Africa' needs to step up and take responsibility for its own destiny.

More reading: http://www.spectator.co.uk/features/9121361/why-aid-fails/

Limiting the spread of contagious and lethal diseases is not purely humanitarian. He's not donating dollars to Liberia, he's donating them to MSF.

here's a more comprehensive, recent (10/8/14) study with plots showing exponential growth in transmission. They have projections out to january 2015

http://currents.plos.org/outbreaks/article/obk-14-0036-early...

Btw, reddit.com/r/ebola is doing a fine job collecting relevant news on the outbreak.

This study seems to be overly optimistic about the ability to control the outbreak... thus projecting 25K cases by the end of 2014 yet only projecting 140K cases overall.

That's assuming the virus does not mutate over that many generations which may affect one of several crucial parameters governing how large the outbreak will be when we look back at it from the lens of 2020.

Further to the 2 excellent answers you have already received, it is also important to know that we have been attempting to create a vaccine or even effective treatment for Ebola for a relatively long time (it was first encountered in 1976). Compare this to the common flu that we prepare a reliable vaccine for every single year.

In the event of a truly global Ebola pandemic, we would be unlikely to be able to develop an effective vaccine in anything near a reasonable length of time. It is so much so the stuff of nightmares that an Ebola pandemic is the premise for a number of fictional works.

The fact that there are a monoclonal antibody, an RNA-i drug and an experimental vaccine available three months after is became clear that the West Africa outbreak is out of control tells me that our friends at Fort Detrick and their colleagues at Biopreparat took precautions, in case it would be used against them.

For a bioweapon, Ebola has the disadvantage that there is person-to-person transmission. On the other hand, the experience in Uganda shows that with proper medical facilities, an outbreak can be brought under control, Uganda is a reasonably developed nation, and the disease never spun out of control there. On the other hand, Sierra Leone and Liberia never recovered from the civil wars in both countries, which is why the epidemic is spreading like wildfire over there. On the battlefield, it would do just that.

My understanding is the mutation rate of ebola is significant. Current person-to-person transmission can be brought under control as you mentioned. However, if it mutated to something more transmissive (is that a word?? I declare it so!), plenty of sci-fi's will turn in to prophecy.

According to this paper here (http://mbe.oxfordjournals.org/content/14/8/800.full.pdf) the mutation rate in the Ebolavirus is comparatively low for an RNA virus, two orders of magnitude less than in influenza or HIV.

We have brought highly transmissive diseases, like measles and rubella, under control with vaccination; both of these happen to be caused by RNA viruses. There will be a doomsday epidemic in the future, but Ebola won't be it, at least not for the West. Ever-more common antibiotic resistance in common bacteria is much, much more reason for concern.

It's quite deadly when you actually get it, but as far as I understand the transmission rate is not very high. That's why the death toll is not increasing at a faster rate. Yet it should be closely watched. It's definitely more worrying that any of the previous H1N1 media panics.

Reported death toll. The biggest cause for concern is that every story that comes out immediately starts talking about how we don't really know how many people are infected or have died, due to the distrust of the local population in medicine.

The second paragraph in this story states that recorded cases of infection are now over 4000. With a 90% mortality rate, the known death toll will double in the next few weeks.

I don't think this is likely to become pandemic, but it must be a very scary situation in Africa.

> I don't think this is likely to become pandemic, but it must be a very scary situation in Africa.

I don't think we should undermine Ebola, but hey, AIDS kill way more people in Sub-saharan Africa every year. In 2011 there were 1.2 millions of AIDS related death there. That's more than 3000 people dying every single day.

I've fount the TWIV podcast to be very helpful to see through the fear mongering. They do a special on ebola , risks and treatments under way http://www.twiv.tv/2014/08/10/twiv-297/

You know how at the start of disaster movies you see odd clips of the news with reports of whatever's going to cause the disaster being reported in the background while they establish your empathy with the characters?

That's how I feel whenever a report on the Ebola epidemic pops up. Like here.

Good VICE segment on the current epidemic in Africa:

https://www.youtube.com/watch?v=XasTcDsDfMg

A really good book that predicted this outbreak back in 1994 is called "The Coming Plague: Newly Emerging Diseases in a World Out of Balance" by Laurie Garrett. She actually has an excellent chapter on the Ebola virus and explained how this disease is so virulent. Ebola mutates very rapidly.

Good book, but no, the mutation rate isn't particularly high for Ebola.

I believe this refutes your statement:

http://www.ibtimes.com/origin-ebola-outbreak-may-be-bat-viru...

300 mutations since May?

I thought this was a link to a list of all the names of the people who had died.

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