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#272009 - 10/04/14 12:58 AM Re: EBOV versus Pandemic Flu Preparedness [Re: Am_Fear_Liath_Mor]
AKSAR Offline
Old Hand

Registered: 08/31/11
Posts: 1195
Loc: Alaska
Originally Posted By: Am_Fear_Liath_Mor

Originally Posted By: AKSAR
The clinical study was a safety trial of an experimental drug to treat ebola
Yes it was! But did it all go terribly wrong in the Jungles of West Africa?

Did you even bother to read the article I linked?

Note that the drug apparently is not using the ebola virus itself. Rather, it uses small molecules which interfere with the ebola virus replicating itself. Think birth control for viruses. The trial was halted (note that this was before the current epidemic had blown up) because the FDA was concerned that the safety trials were initially using too high a dose. They were apparently concerned about possible toxic side effects of the drug, not that it would give people ebola. Drug trials usually start with a very small dose, then you wait awhile, then try a somewhat bigger dose, then you wait etc etc. That is why it can take decades to get new drug approved.

Since then, with the huge increase in ebola cases, the drug has been approved for emergency use.
Quote:
But Tekmira announced in July that the trial had hit a road block: The FDA asked the company to halt the trial until it could provide more data to ensure the safety of the healthy volunteers, some of whom were being dosed with as much TKM-Ebola as would be given to a lethally infected patient. The hold was partly lifted in August, allowing Tekmira to offer the drug on an emergency basis to Ebola patients, but the trial itself is still on hiatus.

Note that at least one ebola patient has been treated with the drug, and has recovered. Supplies of the drug are very limited, but apparently at least a few other patients are being treated with it.

If the test of the experimental drug did "..... all go terribly wrong in the Jungles of West Africa" as you suggest, then the FDA would hardly be approving it for use on other patients, now would they? Nor would they be fast tracking production of the drug for other patients.
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#272012 - 10/04/14 12:58 PM Re: EBOV versus Pandemic Flu Preparedness [Re: Meadowlark]
bws48 Offline
Old Hand

Registered: 08/18/07
Posts: 831
Loc: Anne Arundel County, Maryland
I found something that gives detailed guidance on cleaning and disinfection of Ebola contaminated objects by using bleach solutions published by the WHO. It includes specific instructions on how to prepare and use the solutions so that they are of the proper strength and effectiveness, which is what I was looking for when I found this document. Hope that it is informative and helps planning and prep. Also, hope no one has to use it. . .

http://www.who.int/csr/resources/publications/ebola/whoemcesr982sec5-6.pdf


Edited by bws48 (10/04/14 12:59 PM)
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#272013 - 10/04/14 01:58 PM Re: EBOV versus Pandemic Flu Preparedness [Re: bws48]
Russ Offline
Geezer

Registered: 06/02/06
Posts: 5338
Loc: SOCAL
There's another good read at: Interim Guidance for Environmental Infection Control in Hospitals for Ebola Virus
The FAQ section at the bottom is useful.

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#272015 - 10/04/14 02:41 PM Re: EBOV versus Pandemic Flu Preparedness [Re: Meadowlark]
Doug_Ritter Offline

Pooh-Bah

Registered: 01/28/01
Posts: 2048
Per Martin's point:

Boss, Coworkers of US Ebola Patient: He Knew He Had Ebola, US Trip Was 'Desperate Attempt to Survive'

http://www.breitbart.com/Big-Peace/2014/...empt-to-Survive
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#272016 - 10/04/14 02:44 PM Re: EBOV versus Pandemic Flu Preparedness [Re: bws48]
Russ Offline
Geezer

Registered: 06/02/06
Posts: 5338
Loc: SOCAL
In the WHO pdf above section 5.1 discusses preparation of bleach solutions. First they note that ordinary household bleach comes in 5%. Then the article notes that a 1:10 bleach solution is is strong and used to clean excreta and bodies. A 1:100 bleach solution is used to clean surfaces, equipment, bedding, reusable protective clothing...

Terminology question -- Household bleach is 5%, 1:10 is 10% (stronger) and 1:100 is 1% (way weaker). How do you get a 10% solution when starting with household bleach at 5%? ...or are they really saying 1:10 starting with household bleach and then cut that again to get the 1:100 solution? So 1:10 is really a .5% solution. Easy to get confued when terminology is mixed.

BTW, using the CDC guidelines, Dallas really messed up by using a pressure washer to clean up the hazardous waste site where their Ebola patient puked on the sidewalk. Sounds like a city bureaucrat told sanitation to clean "it" up and no one bothered to mention what "it" was. I wonder if those sanitation workers are on the list of peeps that need to be observed...

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#272017 - 10/04/14 03:19 PM Re: EBOV versus Pandemic Flu Preparedness [Re: Russ]
bws48 Offline
Old Hand

Registered: 08/18/07
Posts: 831
Loc: Anne Arundel County, Maryland
Originally Posted By: Russ
Easy to get confused when terminology is mixed.


I'm a bit confused also; I think they are talking about diluting the normal "bleach" in the standard bottle (5%).

And as to the story quoted by Doug:

I take it with a grain of salt. As Martin said, the news outlets have a big incentive to hype anything, verified or not, as long as it sells:

If he was so afraid, I would think on his first visit to the ER he would have made it very clear that he thought he might have Ebola. Instead, if the other reports are true, he only said he had been in Liberia (or words to that effect). IMO, contradictory and inexplicable behavior for someone who fled when he "knew he had Ebola" and knew "he was going to surely die,. ."
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#272018 - 10/04/14 03:52 PM Re: EBOV versus Pandemic Flu Preparedness [Re: bws48]
Russ Offline
Geezer

Registered: 06/02/06
Posts: 5338
Loc: SOCAL
Been thinking about this and only Mr Duncan knows the truth and he seems to be keeping the truth to himself. However ... he fled Liberia knowing he had been exposed to Ebola and then went to stay with friends/relatives in Dallas. I'm quite sure he didn't tell them he had Ebola and probably didn't want to admit to anyone that he knew he had Ebola because that would mean that deliberately put friends/relatives to a high risk of exposure. He started lying about his exposure with that CDC form at the airport when he departed Liberia and he never changed his story. Just my opinion, but it seems to be corroborated with the reports out of Liberia and the fact that the folks in Dallas let him stay. Desperate people lie.

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#272019 - 10/04/14 04:15 PM Re: EBOV versus Pandemic Flu Preparedness [Re: bws48]
Russ Offline
Geezer

Registered: 06/02/06
Posts: 5338
Loc: SOCAL
I think the reason for the terminology shift was to use 5% bleach concentrate to reference a starting point for their 1:10 and 1:100 (dilution) mixtures.

After reading the WHO info I checked the bargain store laundry bleach we have here and it does not specify a concentration, but it is lavender scented wink I'll be picking up a couple gallons of "name brand" bleach to use as a starting point. The lavender stuff is fine for laundry.

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#272020 - 10/04/14 05:25 PM Re: EBOV versus Pandemic Flu Preparedness [Re: Russ]
bws48 Offline
Old Hand

Registered: 08/18/07
Posts: 831
Loc: Anne Arundel County, Maryland
Our local Home Depot carries a "Germicidal" bleach that is listed as 8.3% sodium hypochlorite yielding "7.9% available chlorine". A little extra can't hurt.
_________________________
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#272021 - 10/04/14 05:48 PM Re: EBOV versus Pandemic Flu Preparedness [Re: Russ]
Arney Offline
Pooh-Bah

Registered: 09/15/05
Posts: 2485
Loc: California
If one reads an article like this one, it makes you realize the complexity of human psychology and the desire to believe what you want to believe in the face of a desperate situation. Also, how much trust do we put in what neighbors, friends, and people in authority tell us?

For one thing, the preganant landlord's daughter that Mr Duncan helped was reportedly diagnosed earlier at a clinic with malaria. I also read elsewhere a couple days ago (can't find that article again) that he was told by the family that the daughter was suffering from complications of her pregnancy when they sought his help to find medical help.

And if we believe stories that he was going to hop on a plane to marry his girlfriend in Texas in a matter of days, would he so willingly come into direct contact with someone he believed was gravely ill with Ebola? That doesn't add up.

I also agree with bws48's point that if he was so desperate to live and start his new life with his wife-to-be and he really thought he had Ebola, wouldn't he be more assertive at his first ER visit to Texas Presby? Would he let those people in the apartment tend to him like they did if he really thought he had Ebola? I would imagine that he realized the gravity of his situation at some point in this saga, whether back in Liberia or in Dallas, but perhaps he could not face that grim reality by that point.

On a related note, the news that the Dallas DA may prosecute Mr Duncan could be the wrong thing to do from a public health perspective. I think that will simply serve to stigmatize the sick (perhaps even Americans who get infected) and could drive infected people underground and that's the last thing you want. I don't think prosecution is a deterrant at all to keeping infected people out of the US but it may change people's behavior in undesirable ways once they are here.

The priority should be to find everyone who is infected or potentially infected, ideally, before they become infectious. Facing punishment just delays that discovery process, making it more likely an infected person becomes infectious out in public.

I said it before, but I think scrutinizing the Dallas case is important, and not just some morbid fascination, because it gives us an idea of how future cases will be handled across the country.

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