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Ebola in danger of never going away? - Laurie Garrett

Re: Ebola in danger of never going away? - Laurie Garrett

The more I ponder this bit about a virus/host adaptation for ebola, I see an interesting parallel to influenza. The reservoirs are both creatures that fly, enabling the virus to spread. And in both cases, most of the hosts' immune systems can launch an effective defense. Out of all the mammals that ebola (& some other nasty pathgens) could use for reservoirs, it just had to choose (& fine tune it's genes to) one that can fly!

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Re: Ebola in danger of never going away? - Laurie Garrett

I wonder if being able to 'fly' mechanically (i.e. traveling with humans) gets the virus to different 'ecosystems' where that melting pot adaptability can really come into play. If hosts and infectious agents can settle into a detente or somewhat closed loop, there isn't any place for the virus to gain headway. But flight and groups of diverse hosts change all kinds of variables, and the outliers get to have a go.
 
Re: Ebola in danger of never going away? - Laurie Garrett

BestlaStormcrow said:
I wonder if being able to 'fly' mechanically (i.e. traveling with humans) gets the virus to different 'ecosystems' where that melting pot adaptability can really come into play. If hosts and infectious agents can settle into a detente or somewhat closed loop, there isn't any place for the virus to gain headway. But flight and groups of diverse hosts change all kinds of variables, and the outliers get to have a go.
Click to expand...

Or maybe they can be flown into extinction ... wiped off the face of the earth because they adapt to an ecosystem that doesn't let them multiply ...
 
Re: Ebola in danger of never going away? - Laurie Garrett

Public health awareness of emerging zoonotic viruses of bats: a European perspective

.....New zoonotic viruses may emerge from bat reservoirs and known ones may spread to a wider geographical range. To assess future threats posed by zoonotic viruses of bats, there is a need for accurate knowledge of the factors underlying disease emergence, for an effective surveillance programme, and for a rapid response system......

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The 1st part of the above paper describes how some viruses are confined to only one bat species, and may or may not have a single limited geographic location.

Whether that is due to limited geographic range of a particular bat species, I don't know. But clearly this area needs more study combined with better health care for people living in areas hit by severe bat-reservoir diseases.

I'm glad Laurie Garrett has raised the topic of considering the possibility of ebola being a long term global problem for a variety of reasons.

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Re: Ebola in danger of never going away? - Laurie Garrett

curiosity said:
....they adapt to an ecosystem that doesn't let them multiply ...
Click to expand...
Like bats in my state - there have been only a few cases of bat rabies in the part closer to Washington state. The bats that eat the mosquitos in most of the state aren't carrying any nasty virus. Perhaps there are other factors that keep the various bats and their diseases from expanding their range.

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Re: Ebola in danger of never going away? - Laurie Garrett

AlaskaDenise said:
Like bats in my state - there have been only a few cases of bat rabies in the part closer to Washington state. The bats that eat the mosquitos in most of the state aren't carrying any nasty virus. Perhaps there are other factors that keep the various bats and their diseases from expanding their range.

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Click to expand...


I'm in NW WA and the pine beetles and winters without freezing are a topic of discussion in my area. We had hummingbirds winter over for the first time last this year, but conversely, it looks like we'll lose our late summer guest, The Prince (A. augustus). Species are moving or being pushed out. Pests are changing. It's hard to guess what that could mean for our native bats should they somehow dip into a virus reservoir previously out of reach.

I feel bad though, because bats have had such a bap rap, and people seem to finally enjoy sharing habitat with them, and now this.
 
Re: Ebola in danger of never going away? - Laurie Garrett

As much as we recognize the role of a reservoir, the real problem here is not enough appropriate health care in urban areas of underdeveloped countries. For the moment we're worried about ebola arriving via jet-lagged humans to US, Europe, Canada, etc., but....what about when it arrives in Mumbai, Jakarta, Pakistan, Kabul, etc.? Unless there is an international coordinated very-large HCW response to an outbreak, it may become enemic in residents of many poor urban regions.

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Re: Ebola in danger of never going away? - Laurie Garrett

AlaskaDenise said:
As much as we recognize the role of a reservoir, the real problem here is not enough appropriate health care in urban areas of underdeveloped countries.
Click to expand...

Even when they are in-place, healthcare workers have been attacked and run-off, and people have stolen beds infected with the virus.

Cultural issues related to not believing that the disease exists at all, or that it's caused by sorcery, or that burial practices are more important than exposure risk, or not knowing about or accepting the germ theory of disease are much bigger issues in West Africa than not having enough appropriate healthcare.
 
Re: Ebola in danger of never going away? - Laurie Garrett

I believe the authors were referring to continuous accessiblity to some healthcare.

I've started reading that book, so we'll see what he says about cultural beliefs.

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Re: Ebola in danger of never going away? - Laurie Garrett

I was poking around for references to EVD without fever and found what looks to be taken from an older CDC high risk definition:

Testing is appropriate for the following patients:
•
Persons with onset of fever within 21 days of a high risk exposure to Ebola virus
•
Persons with a high risk exposure but without fever only if
1) other compatible symptoms are present and
2) blood test results are abnormal (i.e., thrombocytopenia <150,000 cells/μL
and/or elevated transaminases) or unknown
•
Persons with low risk exposures who develop fever and abnormal blood test results, or fever and compatible symptoms with blood test results abnormal
(as above)
or unknown http://www.doh.wa.gov/Portals/1/Documents/5100/420-002-epitrends2014-08.pdf

I saw the same verbiage quoted a few other places online, but it is no longer present in CDC information.

If fever is one of the main criteria, and people without a fever are not being tested further, might some cases make it through check points then? Was this just not practical?

Also, does anyone know what prompted the language change, from a technical/administrative standpoint?
 
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