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Ebola, WHO - " incubation period that falls within the one to 42 day interval"

Amish Country

Well-known member
WHO: Ebola 'out of control' in West Africa
Admits some patients take longer than 21 days to show symptoms

by Jerome R. Corsi
October 14, 2014

Read more at http://www.wnd.com/2014/10/who-ebola-out-of-control-in-west-africa/#XQOdD86OK8ByG92Z.99

NEW YORK – The World Health Organization announced Tuesday that while the Ebola epidemic appears to have been stopped in Senegal and Nigeria, the disease remains “out of control” in Guinea, Sierra Leone and Liberia.

“In Guinea, Liberia and Sierra Leone, new cases continue to explode in areas that looked like they were coming under control,” WHO said in a newly released Ebola situation update.

“An unusual characteristic of this epidemic is a persistent cyclical pattern of gradual dips in the number of new cases, followed by sudden flare-ups,” the United Nations agency said.

“WHO epidemiologists see no signs that the outbreaks in any of these three countries are coming under control.”

WHO further disclosed that the incubation period for the current strain of Ebola could be longer than 21 days, meaning some people infected with the virus might not show symptoms until later than previously reported.

“Recent studies conducted in West Africa have demonstrated that 95 percent of confirmed cases have an incubation period in the range of one to 21 days; 98 percent have an incubation period that falls within the one to 42 day interval,” the WHO report disclosed.

WHO also reported being alarmed by “media reports of suspected Ebola cases imported into new countries that are said, by government officials or ministries of health, to be discarded as ‘negative’ within hours after the suspected case enters the country.”

The U.N. agency cautioned that rapid determination of infection status is impossible, casting grave doubts on some of the official information that is being communicated to the public and the media.

WHO recommended that the first 25 positive cases and 50 negative specimens detected by a country without a recognized national reference viral haemorrhagic fever laboratory be sent for secondary confirmatory testing to a WHO collaborating center. The centers are specialized in the safe detection – at biosafety level IV – of viral haemorrhagic fevers.

Similarly, for countries with a national reference laboratory for viral haemorrhagic fevers, WHO recommended that initial positive cases should also be sent to a WHO collaborating center for confirmation.

If results are concordant, laboratory results reported from the national reference laboratory would be accepted by WHO.

Read more at http://www.wnd.com/2014/10/who-ebola-out-of-control-in-west-africa/#XQOdD86OK8ByG92Z.99
 
Re: Ebola, WHO - " incubation period that falls within the one to 42 day interval"

WHO: Ebola 'out of control' in West Africa
Admits some patients take longer than 21 days to show symptoms

by Jerome R. Corsi
October 14, 2014

Read more at http://www.wnd.com/2014/10/who-ebola-out-of-control-in-west-africa/#XQOdD86OK8ByG92Z.99

NEW YORK ? ........

WHO also reported being alarmed by ?media reports of suspected Ebola cases imported into new countries that are said, by government officials or ministries of health, to be discarded as ?negative? within hours after the suspected case enters the country.?

The U.N. agency cautioned that rapid determination of infection status is impossible, casting grave doubts on some of the official information that is being communicated to the public and the media.

WHO recommended that the first 25 positive cases and 50 negative specimens detected by a country without a recognized national reference viral haemorrhagic fever laboratory be sent for secondary confirmatory testing to a WHO collaborating center. The centers are specialized in the safe detection ? at biosafety level IV ? of viral haemorrhagic fevers.

Similarly, for countries with a national reference laboratory for viral haemorrhagic fevers, WHO recommended that initial positive cases should also be sent to a WHO collaborating center for confirmation.

If results are concordant, laboratory results reported from the national reference laboratory would be accepted by WHO.

Read more at http://www.wnd.com/2014/10/who-ebola-out-of-control-in-west-africa/#XQOdD86OK8ByG92Z.99

Is this the full and comprehensive list of authorized laboratories?

Www.who.int/car/disease/ebola/PACE_outbreaks_Ebola_Marburg_en.pdf page 88 on.

If it is - there aren't many! And there are quite a few countries that you would assume have the facilities to test - who don't!
 
Re: Ebola, WHO - " incubation period that falls within the one to 42 day interval"

Is this the full and comprehensive list of authorized laboratories?

Www.who.int/car/disease/ebola/PACE_outbreaks_Ebola_Marburg_en.pdf page 88 on.

If it is - there aren't many! And there are quite a few countries that you would assume have the facilities to test - who don't!
I suspect it depends on two factors--countries who have historically needed to test for hemorrhagic diseases (the African ones), and countries with level 4 research labs. I'm a bit surprised to see Canada in that list, but not surprised to see the US, France and Germany. When you think about what kind of things are typically studied in level 4 labs, there isn't much need for most nations to have them. France did a lot of the early research in HIV, which may explain why France is on the list.
 
Re: Ebola, WHO - " incubation period that falls within the one to 42 day interval"

The total number of operational laboratories in the three intense-transmission countries will increase to 13 in the coming weeks, as a Russian Mobile Laboratory becomes operational in Macenta, Guinea, and a Public Health England laboratory begins to provide diagnostic testing in the
Western Rural area of Sierra Leone. At present, overall testing capacity stands at 200 samples per day in Guinea, 470 in Liberia, and 300 in Sierra Leone
From today's WHO Roadmap update.
 
Re: Ebola, WHO - " incubation period that falls within the one to 42 day interval"

From today's WHO Roadmap update.

If we reach 10,000 cases per week in the next month, as suggested by WHO, they won't even be able to test one sample per patient at full capacity, much less a second confirmation sample and a sample to clear survivors.
 
Re: Ebola, WHO - " incubation period that falls within the one to 42 day interval"

Some drones would be useful. If labs are miles away over bad roads getting samples tested takes time and the suspect patient will need to be isolated or sent home, which waste resources or increases transmission. A blood sample postal service, via drones like Amazon were developing, would reduce strain on capacity.

Re the title of this thread if you follow the link and expand figure 3 you will see a graph for "Time between Exposure and Disease Onset" which peaks at 8 days and has a mean of 11. The interesting bit is the long tail.
small symptom onset.png
 
Re: Ebola, WHO - " incubation period that falls within the one to 42 day interval"

Here are the economics of deciding a 21 days quarantine: http://currents.plos.org/outbreaks/article/on-the-quarantine-period-for-ebola-virus/ (my emphasis) - Very detailed graphs and mathematical formulas. I am not sure that in the case of Ebola one should ask beancounters: "To make use of this approach, an acceptable residual risk needs to be set. To do this, one needs to balance out the costs and benefits of quarantine and risk reduction." I find this statement horrifying. Reading the whole article makes for more hair-raising fear.

ABSTRACT

Background:
21 days has been regarded as the appropriate quarantine period for holding individuals potentially exposed to Ebola Virus (EV) to reduce risk of contagion. There does not appear to be a systematic discussion of the basis for this period.

Methods:
The prior estimates for incubation time to EV were examined, along with data on the first 9 months of the current outbreak. These provided estimates of the distribution of incubation times.

Results:
A 21 day period for quarantine may result in the release of individuals with a 0.2 ? 12% risk of release prior to full opportunity for the incubation to proceed. It is suggested that a detailed cost-benefit assessment, including considering full transmission risks, needs to occur in order to determine the appropriate quarantine period for potentially exposed individuals.
 
Re: Ebola, WHO - " incubation period that falls within the one to 42 day interval"

Some drones would be useful. If labs are miles away over bad roads getting samples tested takes time and the suspect patient will need to be isolated or sent home, which waste resources or increases transmission. A blood sample postal service, via drones like Amazon were developing, would reduce strain on capacity.
....

Yes the drone idea is attractive. I like the idea. Then I got thinking of my late hubby's passion for model airplanes and boats, and my paranoid mind started waking up. You'd need also:

Good weather, no wind, no rain, a perfect drone with no technical fault likely to develop, no kids shooting at it, no buzzard mistaking the drone for prey, not overflying densely populated areas.
 
Re: Ebola, WHO - " incubation period that falls within the one to 42 day interval"

98% of patients develop Ebola within 42 days of Ebola, not 100% in 21 days? Are they sure that the small percentage that develop infection after the 21 day period that has been widely accepted weren't infected from a latent or other source than they are assuming?
 
Re: Ebola, WHO - " incubation period that falls within the one to 42 day interval"

This one would do. 20Kg, 4Kg payload, satnav/auto pilot, 100km/hr, 7hrs endurance and can land in a grass field. It is probably fairly rugged as they market it for boarder patrol work with a camera payload.
http://www.barnardmicrosystems.com/inview/features.html

Google has a drone delivery system that is quite developed - question is, is it ready enough for use? Would be one heck of a field test..

http://www.cio-today.com/article/index.php?story_id=01300000Q6DO
 
Re: Ebola, WHO - " incubation period that falls within the one to 42 day interval"

98% of patients develop Ebola within 42 days of Ebola, not 100% in 21 days? Are they sure that the small percentage that develop infection after the 21 day period that has been widely accepted weren't infected from a latent or other source than they are assuming?

There's some evidence for up to 25 days, and there's always a very long tail for these things: "If the risk of new cases is to be reduced to 1% then 25 days should be used when investigating the source of an outbreak, when determining the duration of surveillance for contacts, and when declaring the end of an outbreak."

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766904/

The difference between 42 (2*21) and 50 (2*25) days is massive in terms of surveillance/quarantine efforts....
 
Re: Ebola, WHO - " incubation period that falls within the one to 42 day interval"

98% of patients develop Ebola within 42 days of Ebola, not 100% in 21 days? Are they sure that the small percentage that develop infection after the 21 day period that has been widely accepted weren't infected from a latent or other source than they are assuming?

The PLOS study explains the infections beyond the 21 days...."although this may vary with the presence of asymptomatic cases and R0."...

.
 
Re: Ebola, WHO - " incubation period that falls within the one to 42 day interval"

.....Re the title of this thread if you follow the link and expand figure 3 you will see a graph for "Time between Exposure and Disease Onset" which peaks at 8 days and has a mean of 11. The interesting bit is the long tail.
View attachment 18283

the tail in Figure 3, Panel E, surprises me more. It shows the number of infected people from a single index case - with disease onset starting after 21 days for 11 people. Some as long as over 40 days!

.
 
Re: Ebola, WHO - " incubation period that falls within the one to 42 day interval"

?Recent studies conducted in West Africa have demonstrated that 95 percent of confirmed cases have an incubation period in the range of one to 21 days; 98 percent have an incubation period that falls within the one to 42 day interval?

In other words, 3% have an incubation period of 22 to 42 days. What about the remaining 2% that are apparently even longer??
 
Re: Ebola, WHO - " incubation period that falls within the one to 42 day interval"

The plos study highlights that shorter incubation periods are observed where there has been needlestick exposures or blood exposures, but that longer incubation periods are observed from direct contact.

What if an individual exposed to a low level of virus has an immune system that recognises the virus sufficiently to fight it early in the infection, but not clear it from their systems, so are carrying virus at low levels in their blood for a protracted period.

If a seperate health issue then occurs e.g. malaria, that further challenges their immune system, ebola then gets the upper hand and develops into full blown disease, leading to an abnormally long incubation period?

More information is needed on these outlier cases to get beyond speculation.
 
Re: Ebola, WHO - " incubation period that falls within the one to 42 day interval"

If a seperate health issue then occurs e.g. malaria, that further challenges their immune system, ebola then gets the upper hand and develops into full blown disease, leading to an abnormally long incubation period?

There was the case of a nurse in Nigeria, who contracted a case of Malaria in addition to Ebola. She recovered from both diseases.

http://graphic.com.gh/features/feat...ada-igonoh-who-survived-ebola-in-nigeria.html

I suspect the secondary infection may cause the release of additional cytokines and other danger signals that allow the immune system to recover enough to fight the virus. Malariotherapy on its own has been used in this way to fight other infectious diseases, including considerable success with spirochetes and limited success with HIV.
 
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