Ebola: Are We Ready?
“What do you think? Of course we are preparing for the possibility of the Ebola virus.” That was Randy Detrick last Tuesday.
Detrick is the PR Director for Lower Keys Medical Center. What The Blue Paper wanted to know was whether our local hospital has the necessary isolation units and whether it is stocked with the full protective gear which could have saved Dallas hospital nurses Nina Pham and Amber Vinson from contracting the Ebola virus.
Detrick promised a written statement but has yet to answer our questions [aside from the usual ‘fear not good people, we are totally in control’ response cited above.]
What are the chances?
We were surprised to learn that Key West, by some strange twist of fate, has historically been a chosen point of entry for African-based disease.
It was 1981. The U.S. medical community was officially recognizing the existence of a mysterious epidemic caused by what would later be called the HIV virus; the AIDS epidemic. Epidemiologists would take years to retrace the path of the disease. They discovered that some of the 30,000 Cuban soldiers sent to support Agostinho Neto in the war in Angola had contracted the HIV virus in the jungle. Back home they began infecting both Cubans and Haitians. Then came the 1980 Mariel Boatlift. In just a few months, over 125,000 Cubans came ashore from Key West to Miami, many of them had been released, by order of Fidel Castro, from prisons and hospitals. Many were HIV positive. The Mariel boatlift has since been infamously credited for having precipitated the tragic impacts of the disease in the US. more here
Last Monday Raul Castro announced that Cuba is again highly engaged in Africa. Cuba has 4,000 medical workers in 32 countries in Africa who are being tasked with trying to control the [Ebola] outbreak.
Despite WHO’s [World Health Organization’s] praise for Cuba’s commitment to the fight against Ebola, the news is received with some ambivalence by South Florida’s well informed politicians.
“There are Cuban doctors that are being sent to West Africa. They are treating Ebola victims,” US Congresswoman Ileana Ros-Lehtinen told CBS Miami, “What will happen to those doctors? Some of them may be coming here.”
Critics of the Castro regime say Cuba’s altruism has to be taken with a grain of salt. A Deutch Welle report claims the Cuban government runs a $7.6 Billion a year business leasing the approximately 50,000 doctors and healthcare assistants working in over 66 countries. Brazil, for instance, pays about $ 4,000 US per month to the Cuban government for each of its borrowed doctors.
According to WHO, Cuba has recently sent over 300 doctors to West Africa to fight the epidemic, and the Cuban Government claims that another 15,000 ‘volunteers’ have also signed up for duty to fight Ebola [Deutch Welle report]
Ros-Lehtinen’s concern is that while we are focusing on the larger international airports, the threat could enter our region from southern points where protocols may not be as stringent.
According to Customs and Border Patrol [CBP], Border Patrol officers will isolate those “travelers with overt signs of communicable disease of public health significance.”
But do BP officers have the medical expertise to sort out the variety of symptoms that could be observed in a group of exhausted Cuban rafters? The most significant precursor of the disease is a simple elevated temperature.
If history was to repeat itself, some Cuban men and women, tired of being “volunteered” to the glory of communism, could come back from West Africa with the virus [Ebola virus has been found in men’s semen for up to three months after recovery] get in a raft and wash ashore with the deadly virus somewhere in Key West.
Is our hospital ready to isolate the problem?
LKMC has so far been mute as to its patient isolation capabilities, personal protective gear, and waste handling procedures.
The latter issue could be particularly controversial in the Florida Keys. It concerns the daily disposal of some 440 gallons of contaminated material resulting from the treatment of just one Ebola patient [including up to 2.5 gallons a day of extremely infectious bodily fluids.]
According to CDC [Center for Disease Control] Ebola waste handling guidelines, “sanitary sewer may be used for the safe disposal of Ebola patient waste.”
How safe is this process, however, in a town like Key West where an aging sewer system, compromised by saltwater, is suspected of leaking into storm water lines and into the ocean? [See The Blue Paper report HERE showing that the volume of raw sewage entering the local sewer treatment plant mysteriously triples following strong rain events even though the storm water and sewer lines are supposed to be completely separate, that sewer contamination peaks in the harbor immediately following rainfall but not in the neighboring basin where no storm water outfall is present, and finally data also showing considerable amounts of saltwater infiltration into raw sewer lines.)
In Atlanta, a local sewer company expressed concerns about that procedure. There was some back-tracking on a claim by an Emory Hospital doctor that the sewer company had threatened to cut off the hospital. Nonetheless, Emory Hospital settled the dispute by agreeing to pre-treat Ebola patients’ toilet waste before flushing it into the public sewer system.
Issues about the integrity of the sewer lines, as well as the safety of public works employees, plumbers, and sewer plant operators have been raised, yet the CDC’s guidelines have not been amended, “United States sanitary sewer system handling processes (e.g., anaerobic digestion, composting, disinfection),” explains the CDC, “are designed to safely inactivate infectious agents.”
Could sewer rats become infected with Ebola?
What could result from the flushing of Ebola infested sewage into the bowels of American cities? New York’s population of rats is estimated to outnumber the human population by a near 2:1 ratio. [16 Million rats compared to 8.4 Million people]
In fact, there are claims of a second “golden age” for sewer rats. They have infiltrated miles of sewer lines tapping into the endless food supply created by the garbage grinders installed in modern kitchens.
The epidemic that has now infected over 13,700 people in West Africa is caused by the “Zaire” strain of the Ebola virus. The live “reservoir host” for the virus has not yet been identified. However in 1999 researchers from the Pasteur Institute in Paris found evidence that not only are rodents able to contract Ebola, they could possibly be a host for the virus. The Pasteur scientists did not find any live virus in the rodents collected at ground level, but using molecular biology techniques they were able to find Ebola viral sequences in the apparently healthy rodents. “The study should help research toward finding the natural reservoir of the Ebola virus,” they stated at the time.
Studies of Lassa Fever are illustrative. In a bulletin by WHO professor Melissa Leach, Lassa Fever is described as a viral hemorrhagic fever [like Ebola]. Lassa Fever is spread via contact with the feces of infected rats.
In this context, couldn’t contamination of the rat population become part of an apocalyptic Ebola scenario? It is questionable whether the CDC protocol on sanitary waste disposal takes into consideration the obscure underworld that connects every home and business with a network of questionable pipelines containing raw sewage that has not yet made its way to a treatment plant for proper neutralization. According to the CDC website, even on hard surfaces, the Ebola virus can survive up to six days.
In spite of the CDC’s reassuring guidance, some state health departments, like Wisconsin’s, now “recommend pre-treatment of Ebola patient waste in a toilet bowl with one cup of bleach for at least five minutes prior to flushing.”
With only 90 miles separating us from Cuba, the country most involved with the epidemic in West Africa, shouldn’t we be taking all possible precautions? Whether or not we are is still unclear.
Stay tuned.
Since the Carnival cruise line ship was denied by Belize to allow a passenger to disembark, who was quarantined due to an Ebola exposure prior to boarding the ship, a whole new scenario has concerned me. We have 3 million visitors a year to our little island. They are here one day and gone the next, how do we know if they are carriers of Ebola, and worse, what if they were – how could we ever track them down and are we ready to quarantine and handle what could be MANY cases? Seeing that a large hospital in Texas was not prepared to handle such an event, do we really believe Lower Keys Medical Center is prepared. In fairness to them I don’t think ANY hospital is truly prepared. So WHO is protecting us? Should our local government be asking these questions? Is not the safety of it’s citizens a primary purpose of local and bigger government? Just who specifically is looking after our well-being? The CDC? Are we to believe the CDC is investigating the readiness of all local hospitals? Are they conducting inspections to verify all hospitals are ready? There are not enough ‘man’ or woman hours to undertake such a mission. Am I worried? Well I would rather worry now and ask these questions urging those in authority to be prepared, than to look back in the middle of an epidemic and ask how this happened.
The Blue Paper article asking about how rats might carry the virus made me recall recent stories and deaths in Panama due to rat feces. It seems that simply sweeping and breathing rodent feces can infect a person and many died. This happened in poorer areas of Panama and rural areas where houses are open and rats are probably around, and not in the high rises of Panama City. Following is reference to a report done by the Navy in 2013. Though the research paper does acknowledge these diseases are ‘relatively uncommon’ they do have a ‘high mortality rate in the Americas’. The Hantavirus was not recognized as a threat until 1993 and this report states it will need to be revised, as there is more research and more is learned. We (CDC and government) seem to be learning as we go with Ebola and we the public need to know there is a plan in place to at lease detect Ebola and isolate any cases that might appear in Key West and the Florida Keys. Are we ready? I know my answer.
Armed Forces Pest Management Board TECHNICAL GUIDE NO. 41
PROTECTION FROM RODENT-BORNE DISEASES WITH SPECIAL EMPHASIS ON OCCUPATIONAL EXPOSURE TO HANTAVIRUS
Published and Distributed by the Defense Pest Management Information Analysis Center Forest Glen Section Walter Reed Army Medical Center Washington,DC 20307-5001
Office of the Deputy Under Secretary of Defense (Environmental Security)
December 2013
FOREWORD
This document provides guidance on the protection of individuals from rodent-borne diseases. Information on diseases associated with rodents is presented in tabular form. Rodents may serve as reservoirs for diseases that are transmitted though contact with contaminated food and water by arthropods. Rodents may also transmit diseases through direct contact with humans, such as through bites, or though aerosolization of excreta and body fluids. Prevention of these diseases involves vector control and good sanitation practices. A great amount of literature has been devoted to protection against rodent-associated diseases that are transmitted by vectors or unsanitary conditions. The contents of this manual address the prevention of diseases caused by hantaviruses, which are spread through inhalation or ingestion of materials contaminated with rodent saliva, urine, or feces. Although these diseases are relatively uncommon, the high fatality rate of hantaviruses in the Americas, and the inability to determine from visual observation infected from noninfected rodents, heighten the awareness that must accompany rodents. Because the hantavirus threat was not recognized in 1993, information on rodent hosts and disease distribution, as well as prevention strategies aimed at reducing the incidence of hantavirus pulmonary syndrome, has been limited by time and available technologies. Personal protection measures against hantaviruses are presented for a variety of military situations involving contact with rodents or rodent contamination. Since individuals on military installations may not be able to determine the presence or absence of hantaviruses in every situation involving rodents, the universal use of the precautions in this manual should afford adequate protection.
In light of the current pace of research on rodent-borne diseases, I fully expect that our Board will need to revise this TG in a relatively short time. Your constructive comments are most welcome and will be given full consideration in the updating of this document.
Stanton E. Cope, PhD Captain, Medical Service Corps, US Navy Director Armed Forces Pest Management Board
Very sobering stats and facts on the disease and it’s potential apocalypse. Having said that here are some other stats worth looking at.
Number of Ebola cases in the US: 3, 1 death.
Number of senior citizens in danger of starvation in the US as of 2012: 8,000,000.
Number of Americans who have contracted Ebola in the US: 3, 1 death.
Number of women killed by domestic violence in a five year period: 54,000.
Number of Americans who have contracted Ebola in the US: 3. Deaths, 1.
Number of Americans killed by guns (averaged) every day: 342.
“Hunger kills much more than Ebola, but is not considered a significant problem because rich people don’t die from it.” – author unknown
Total number of Ebola deaths in US hospitals to date: 1
Total number of deaths from other infections in US hospitals in 2011 (latest year info is available): 75,000
(Source: CDC)
Ebola is not the worry. It is a right-wing fear tool of immense effectiveness. There are MANY MANY MANY other things the local health care and sewer folks could be doing to improve and protect our lives and health, focusing on ebola is the most expensive and least likely to provide any real results.
Sorry, but this article is pandering to and fueling irrational fears.
I imagine whether or not Ebola is the worry, I don’t see President Obama, CDC, the Surgeon General (do we even have a Surgeon General?) doing anything intelligent about Ebola, so far. Imagine Ebola being weaponized. Instead of bodies strapped with explosives, or big airplanes hijacked and flown into tall buildings, a person intentionally is infected with Ebola and put on a ship or on an airplane headed for New York City. On arrival, after symptoms break out, the weapon starts walking the streets of New York, eating in restaurants, going to movies, riding subways, going to pro baseball, football, basketball or hockey games. Or imagine the traveler coming to Key West and walking up and down Duval Street and eating in Duval Street restaurants and drinking in Duval Street bars. Imagine, instead of being infected overseas, the traveler has a vial of Ebola, which, on arriving at the destination, New York, Key West, the travel consumes and, after symptoms begin, starts hanging out in crowded places. I don’t see the US has any defense to Ebola breaking out here big time. I hope it doesn’t happen, but if it does, the statistics on other causes of death in the US might seem like good news compared to the Ebola statistics. I think it’s bizarre than anyone might believe, or say, the hospital on Stock Island, or Key West, is prepared to deal with Ebola. CDC wasn’t prepared, and still isn’t. The hospital in Dallas wasn’t prepared.