Evening Ebola Update, Mon, 10/13: Emory’s choices for HCW/RT-PCR for arriving planes from Africa   Leave a comment

10/13/14

Dear Colleagues:

l.  Dr. Bruce Ribner, head of the Emory team which treated successfully two EBOV patients emailed last evening to say that Emory chose Alpha Pro Tech body suits for HCW.  Emory chose MaxAir 800 Portable Air-Purifying Respirators (PAPRs) over 3M PAPRs because the MaxAir units have disposable hoods.  Ribner doesn’t like disinfecting and reusing PPEs; there is too much possibility for contamination.  He encourages us to use disposable systems, but has no vested interest in MaxAir.  (Website listed in #7 below contains Dr. Ribner’s summary of EBOV care at Emory).

2.  Forbes just published an article with graphs showing the breakdown of cases and deaths for Guinea, Liberia, and Sierra Leone.  The article explains that the true case fatality rate for this current EBOV epidemic is 71%, not significantly different than prior epidemics. The lower figure of 50% frequently reported is not based on confirmed EBOV deaths.  See: http://www.forbes.com/sites/jvchamary/2014/10/13/ebola-trends/

3.  PLoS offers a great website for up-to-the-minute scientific information on EBOV for non-virologists titled: This Week in Virology (TWiV).  The site is maintained by V. Racniello, Ph.D., Professor of Microbiology at Columbia.  You may find all his archives at: http://www.virology.ws/archivepage/  His TWiV #305 and #306 are specific for EBOV.

4. NY Times carried an Op/Ed 10/12 by S. Mukherjee, author of ‘The Emperor of All Maladies’ on a reliable means of detecting EBOV patients on passengers to U.S.  His suggestion is to do RT-PCR on arriving passengers who have been to West Africa in the last 21 days (? by passport check).  He cites a report in The Lancet in 2000 in which PCR had very high sensitivity and specificity for people exposed to EBOV.  PCR takes only a small sample of blood, and results are available in 2-3 hours.  See: http://www.nytimes.com/2014/10/13/opinion/how-to-quarantine-against-ebola.html. 

5.  NY Times reports that CDC has doubled the number of contacts to follow re: the RN now infected in Dallas.  Apparently, HCW treating Mr. Duncan were not included in the initial contact group.  The specific ‘breakdown in protocol’ by the RN has not been announced by CDC.

6.  Several media sources reported that Dr. Chan, DG of WHO, stated that the current EBOV epidemic risks ‘state failure’ for several very poor states in West Africa.  Other quotes attributed to Dr. Chan may or may not be accurate.  If accurate, then Dr. Chan must be exhausted by all of her travels these last 6 weeks.  Everyone at WHO HQ and in the field in West Africa is going at 110% effort.  WHO should declare limits to working hours/day for staff in Geneva and in the field.  The mission to end this EBOV epidemic will take months; mandatory time off is necessary on long missions.

7.  Society of Healthcare Epidemiology in America  (SHEA) has issued an EBOV resource for all infectious disease workers.  It contains websites to answer all questions that have arisen to date.  See the site at: https://col128.mail.live.com/?tid=cmk36gKQlT5BGtSAAjfeSmVA2&fid=flinbox .  A link to Dr. Ribner’s summary is included at this site.

RGL, MD

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Posted October 14, 2014 by levittrg in Ebola

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