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The largest driver of this outbreak (and many ebola outbreaks) is the fear of healthcare and the way many cultures treat the deceased. These two issues are wha

by giarc 12y ago

The largest driver of this outbreak (and many ebola outbreaks) is the fear of healthcare and the way many cultures treat the deceased. These two issues are what would make transmission to NA or Europe very unlikely. Many people in African nations will stay away from hospitals because they believe they will get Ebola from the hospital. Therefore often people that are sick die of Ebola in the community and therefore spread the disease (symptoms of ebola are very similar to malaria in the first stages, and therefore does not always draw attention to people familiar with malaria) Secondly, when people die in many of these cultures, there is much more physical connection with the body, potentially spreading the disease more. In NA and Europe, people are much more likely to seek care and we also don't have as much contact with deceased person (and also have guidelines for handling of infectious bodies).

worldvoyageur 12y ago
Fear of healthcare might actually not be a bad way to reduce the risk of getting ebola as the easiest way to get it is as a result of poor hospital procedure. Here is a snippet from a moving article about a young microbiologist who investigated the first Ebola outbreak. " It quickly became clear that something was wrong at the hospital. Epidemiological detective work by our team confirmed the suspicions: people were being infected at the hospital through injections made using contaminated needles and syringes (only five syringes and needles were issued to the nurses each morning), and hospital staff and attendees at funerals were falling victim through exposure to body fluids infected with the virus. In addition there seemed to be transmission from mothers to babies. " The full article is a moving and rewarding read: http://www.ft.com/intl/cms/s/2/4c1711c2-d004-11e3-a2b7-00144feabdc0.html#axzz36XHDkoYz http://www.ft.com/intl/cms/s/2/4c1711c2-d004-11e3-a2b7-00144... As a tragic aside, it is the same poor hospital procedure that gave so many Africans AIDS back in the day. Sexual transmission is now the main vector, but it wasn't always the case.
- rwissmann 12y ago
  The problem regards people who already have Ebola. Of course, if you have just a less severe condition, staying a way form a hospital might during an epidemic might be a reasonable move. Treating those with Ebola at home is a recipe for catastrophe. Contrary to AIDS, Ebola is highly contagious and often leads to the infection of the whole family and visitors. So no, fear of healthcare is just about the worst possible mindset for those infected with Ebola and their families.
  - giarc 12y ago
    I agree with you. The first outbreak of Ebola was obviously handled incorrectly (5 needles per nurses) and may have been due to the unknown severity of the disease. Now each outbreak is handled by multiple agencies (WHO, Doctors without borders etc) and therefore the hospital is likely given access to proper infection control supplies. This is my conjecture, but likely a safe one.
sliverstorm 12y ago
Secondly, when people die in many of these cultures, there is much more physical connection with the body, potentially spreading the disease more. You would think this would have been selected against ages ago.
- emiliobumachar 12y ago
  Human culture changes way too fast for evolution to act.
  - nhaehnle 12y ago
    I have no idea why you were down-voted. It's true: even if, somehow, evolution had managed to at some point kill off all cultures with a certain trait, the same trait is likely to develop again in at most a few centuries. If somebody has solid arguments against emiliobumachar's point, I'd be interested to hear them.
    - marcosdumay 12y ago
      Maybe the downvote was because it isn't completely true. Nothing can be too fast, or too slow for evolution. It's only that culture evolves by different means than genotipes, and by those means fitting the norm more than compensates any unfitness caused by health problems. At least at the short term.
  - andrewflnr 12y ago
    On the contrary, I would say that evolution works pretty quickly to weed out cultural phenomena like, say, suicide cults, in much the same way that it works quickly to remove gross physical deformities.
- Fomite 12y ago
  It's hard to select against a cultural practice, generally, as there aren't large numbers of possible phenotypes in the area, and it only matters if that cultural practice results in less children. Dying isn't selected against on its own.
psychometry 12y ago
Those are all arguments as to why Ebola might not spread within Europe or the U.S. This article is about whether it could spread to those places.
- giarc 12y ago
  That's fairly incorrect since the answer to "Could Ebola spread to Europe or US" is an obvious 'yes'. An infected person from West Africa could get on a plane and be in Europe in a few hours. That's how Ebola could spread "to" somewhere. That article would be 2 sentences long. The obviously more important questions, and one that the original article is asking, is whether this person could be patient 0 for an outbreak within a westernized country?
- The_Pherocity 12y ago
  Yea, that's how conversation works. Someone posts an article, then clever people talk about it. Some agree, some give experiences, some add additional facts and resources, and other people offer counter arguments. This is a counter argument to the article. What you posted, besides being blatantly obvious, is simply noise and does not add to the conversation.
  - psychometry 12y ago
    I'm amazed you managed to misread a comment that was only two sentences long. The title of the article is--in case you missed that, too--"Could The Ebola Outbreak Spread To Europe Or The U.S.?" The previous comment did not address that question and instead answered a completely different question. What doesn't add to the conversation is obnoxious pedantry like your comment.
    - Throwaway618 12y ago
      What does add to the conversation, apparently, is continual snide assertions that parent didn't add to the conversation. (I actually don't have any problem with snide obnoxiousness. "I'm amazed you could [be so incredibly idiotic]" is upfront at least. What I do get tired of is a continual tree, like this one, of "You shouldn't have said that.")
ams6110 12y ago
A close family member who is an MD in the USA has on more than one occasion said "the hospital is the last place you want to be when you are sick" though more in reference to the higher liklihood of picking up antibiotic-resistant infections than other communicable diseases.
- Fomite 12y ago
  In fairness, unless you have to be there, hospitals are full of sick people. These are, by and large, places to be avoided. And this is as a epidemiologist working in hospital infection control.
mayneack 12y ago
In all fairness, in previous outbreaks, rural hospitals WERE methods for spreading Ebola.
- giarc 12y ago
  Yes, but this doesn't mean it isn't spread at home. If you have Ebola it will spread, full stop. It can be better controlled within a hospital than at your home.

by giarc 12y ago

worldvoyageur 12y ago

Fear of healthcare might actually not be a bad way to reduce the risk of getting ebola as the easiest way to get it is as a result of poor hospital procedure. Here is a snippet from a moving article about a young microbiologist who investigated the first Ebola outbreak. " It quickly became clear that something was wrong at the hospital. Epidemiological detective work by our team confirmed the suspicions: people were being infected at the hospital through injections made using contaminated needles and syringes (only five syringes and needles were issued to the nurses each morning), and hospital staff and attendees at funerals were falling victim through exposure to body fluids infected with the virus. In addition there seemed to be transmission from mothers to babies. " The full article is a moving and rewarding read: http://www.ft.com/intl/cms/s/2/4c1711c2-d004-11e3-a2b7-00144feabdc0.html#axzz36XHDkoYz http://www.ft.com/intl/cms/s/2/4c1711c2-d004-11e3-a2b7-00144... As a tragic aside, it is the same poor hospital procedure that gave so many Africans AIDS back in the day. Sexual transmission is now the main vector, but it wasn't always the case.

rwissmann 12y ago
The problem regards people who already have Ebola. Of course, if you have just a less severe condition, staying a way form a hospital might during an epidemic might be a reasonable move. Treating those with Ebola at home is a recipe for catastrophe. Contrary to AIDS, Ebola is highly contagious and often leads to the infection of the whole family and visitors. So no, fear of healthcare is just about the worst possible mindset for those infected with Ebola and their families.
- giarc 12y ago
  I agree with you. The first outbreak of Ebola was obviously handled incorrectly (5 needles per nurses) and may have been due to the unknown severity of the disease. Now each outbreak is handled by multiple agencies (WHO, Doctors without borders etc) and therefore the hospital is likely given access to proper infection control supplies. This is my conjecture, but likely a safe one.

sliverstorm 12y ago

Secondly, when people die in many of these cultures, there is much more physical connection with the body, potentially spreading the disease more. You would think this would have been selected against ages ago.

emiliobumachar 12y ago
Human culture changes way too fast for evolution to act.
- nhaehnle 12y ago
  I have no idea why you were down-voted. It's true: even if, somehow, evolution had managed to at some point kill off all cultures with a certain trait, the same trait is likely to develop again in at most a few centuries. If somebody has solid arguments against emiliobumachar's point, I'd be interested to hear them.
  - marcosdumay 12y ago
    Maybe the downvote was because it isn't completely true. Nothing can be too fast, or too slow for evolution. It's only that culture evolves by different means than genotipes, and by those means fitting the norm more than compensates any unfitness caused by health problems. At least at the short term.
- andrewflnr 12y ago
  On the contrary, I would say that evolution works pretty quickly to weed out cultural phenomena like, say, suicide cults, in much the same way that it works quickly to remove gross physical deformities.
Fomite 12y ago
It's hard to select against a cultural practice, generally, as there aren't large numbers of possible phenotypes in the area, and it only matters if that cultural practice results in less children. Dying isn't selected against on its own.

psychometry 12y ago

Those are all arguments as to why Ebola might not spread within Europe or the U.S. This article is about whether it could spread to those places.

giarc 12y ago
That's fairly incorrect since the answer to "Could Ebola spread to Europe or US" is an obvious 'yes'. An infected person from West Africa could get on a plane and be in Europe in a few hours. That's how Ebola could spread "to" somewhere. That article would be 2 sentences long. The obviously more important questions, and one that the original article is asking, is whether this person could be patient 0 for an outbreak within a westernized country?
The_Pherocity 12y ago
Yea, that's how conversation works. Someone posts an article, then clever people talk about it. Some agree, some give experiences, some add additional facts and resources, and other people offer counter arguments. This is a counter argument to the article. What you posted, besides being blatantly obvious, is simply noise and does not add to the conversation.
- psychometry 12y ago
  I'm amazed you managed to misread a comment that was only two sentences long. The title of the article is--in case you missed that, too--"Could The Ebola Outbreak Spread To Europe Or The U.S.?" The previous comment did not address that question and instead answered a completely different question. What doesn't add to the conversation is obnoxious pedantry like your comment.
  - Throwaway618 12y ago
    What does add to the conversation, apparently, is continual snide assertions that parent didn't add to the conversation. (I actually don't have any problem with snide obnoxiousness. "I'm amazed you could [be so incredibly idiotic]" is upfront at least. What I do get tired of is a continual tree, like this one, of "You shouldn't have said that.")

ams6110 12y ago

A close family member who is an MD in the USA has on more than one occasion said "the hospital is the last place you want to be when you are sick" though more in reference to the higher liklihood of picking up antibiotic-resistant infections than other communicable diseases.

Fomite 12y ago
In fairness, unless you have to be there, hospitals are full of sick people. These are, by and large, places to be avoided. And this is as a epidemiologist working in hospital infection control.

mayneack 12y ago

In all fairness, in previous outbreaks, rural hospitals WERE methods for spreading Ebola.

giarc 12y ago
Yes, but this doesn't mean it isn't spread at home. If you have Ebola it will spread, full stop. It can be better controlled within a hospital than at your home.