Thursday, November 27, 2014

Ebola From NEJM


Ebola From NEJM
In resource-limited areas, isolation of the sick from the population at large has been the cornerstone of control of Ebola virus disease (EVD) since the virus was discovered in 1976.1 Although this strategy by itself may be effective in controlling small outbreaks in remote settings, it has offered little hope to infected people and their families in the absence of medical care. In the current West African outbreak, infection control and clinical management efforts are necessarily being implemented on a larger scale than in any previous outbreak, and it is therefore appropriate to reassess traditional efforts at disease management.
Having cared for more than 700 patients with EVD between August 23 and October 4, 2014, in the largest Ebola treatment unit in Monrovia, Liberia, we believe that our cumulative clinical observations support a rational approach to EVD management in resource-limited settings.
Early symptoms of EVD include high fever (temperature of up to 40°C), malaise, fatigue, and body aches.
Clinical Features of Ebola Virus Disease.
The fever persists, and by day 3 to 5 of illness, gastrointestinal symptoms typically begin, with epigastric pain, nausea, vomiting, and diarrhea. Patients routinely presented to our facility after 2 or 3 days of severe vomiting or diarrhea, during which they posed a substantial risk to their communities and had a high probability of testing positive for Ebola virus in blood by polymerase chain reaction (PCR). Although some patients tested positive on PCR within 24 hours after symptom onset, we found that a negative test result could not be relied on to rule out disease until 72 hours after symptoms began. Of the patients who tested positive for Ebola, none that we were aware of had contracted disease from an infected contact during the early febrile phase of illness. No ancillary testing was available in our facility.
We observed that recurrent episodes of emesis resulted in an inability to tolerate oral intake. Large volumes of watery diarrhea estimated at 5 or more liters per day (a manifestation not unlike that of cholera) presented suddenly, persisted for up to 7 days or (rarely) longer, and gradually tapered off. Associated signs and symptoms included asthenia, headache, conjunctival injection, chest pain, abdominal pain, arthralgias, myalgias, and hiccups. Respiratory symptoms, such as cough, were rare. Commonly observed neurologic symptoms included delirium, both hypoactive and hyperactive, manifested by confusion, slowed cognition, or agitation, and less frequently, seizures. In the absence of adequate fluid and electrolyte replacement, severe lethargy and prostration developed.
In approximately 60% of the patients we cared for, the development of shock was manifested by diminished level of consciousness or coma, rapid thready pulses, oliguria or anuria, and tachypnea. The distal extremities were cold despite high ambient temperature, and peripheral vasoconstriction was apparent. In aggregate, these clinical findings suggested metabolic acidosis due to severe hypovolemic shock. Evidence of hyperdynamic or distributive shock was infrequently observed and if present was a late finding. Clinically significant hemorrhage from the upper or lower gastrointestinal tract or both occurred in less than 5% of patients before death. Sudden death occurred in a small fraction of patients who were in the recovery phase of their illness, possibly as the result of fatal arrhythmias. Most deaths occurred between days 7 and 12 of illness.
Symptoms began to improve in approximately 40% of patients around day 10 of illness. We observed the development of oral ulcers and thrush around this time, associated with throat pain and dysphagia. Nearly all patients who survived to day 13 ultimately lived. Our discharge criteria included 3 days without gastrointestinal symptoms and a negative PCR test for Ebola virus in blood. We noted that some patients with initial evidence of clinical improvement developed neck rigidity and diminished levels of consciousness. These symptoms were associated with a slight increase in late mortality. The role of central nervous system involvement by EVD, secondary infection, or aseptic processes could not be assessed.
Particularly vulnerable patient populations included children less than 5 years of age, the elderly, and pregnant women. Of the four women who presented with late second- or third-trimester pregnancies, three died shortly after miscarrying, and none successfully carried a fetus to term. Four Liberian staff members became infected with Ebola virus, and three of them died. According to individual investigations, these infections were not attributable to any known breaches in infection-control procedures in the Ebola treatment unit; instead they are thought to be possibly related to transmission in the community where the outbreak was active.
Health care workers in West Africa remain overwhelmed and challenged by the scarcity of resources that would be available in developed countries for improving the care of patients with EVD.4 When patients arrived at our facility, they were moderately to severely ill, and each physician was responsible for the care of 30 to 50 patients. Direct patient contact in the Ebola treatment center was typically limited to intervals of 45 to 60 minutes two to three times a day, owing to substantial heat exposure and fluid losses that providers experienced while wearing full personal protective equipment (PPE). Under these conditions, physicians had 1 to 2 minutes per patient to evaluate needs and establish a care plan.
Rapid clinical assessment required triage of patients into one of three categories: those who were clinically hypovolemic, not in shock, and able to provide self-care; those who were hypovolemic, not in shock, but unable to provide self-care; and those in shock with evidence of organ failure whose outcome would not be altered by any available medical intervention. The majority of patients we cared for were in the first category. We believe that this group had the highest likelihood of having a response to our limited available interventions.
We observed that patients who were hypovolemic, not in shock, and able to care for themselves had potential for recovery with oral antiemetics, antidiarrheal therapy, and adequate rehydration with oral electrolyte solutions. Given the massive fluid losses observed with EVD, oral antiemetics and antidiarrheal therapy appear to be important early interventions that may limit life-threatening dehydration and shock. In our experience, these regimens were successful at controlling symptoms, facilitated oral intake, reduced gastrointestinal fluid losses, and helped to reduce environmental contamination by body fluids. Health care workers with limited time in PPE were then able to direct their efforts toward encouraging and facilitating oral intake.
It was our impression that the cohort of patients who were hypovolemic and not in shock but unable to provide self-care would benefit the most from short-term intravenous fluid therapy and electrolyte replacement. Establishing intravenous access, delivering an adequate volume of fluid, and ensuring safe management of needles and devices required intensive individual-level patient care. Routine use of intravenous fluid therapy in our facility was prohibited by massive caseloads, limited number of health care workers, and limited time in PPE.
The central purpose of Ebola treatment units has historically been to isolate infected persons early in the course of disease — often soon after fever onset — in order to break the chain of disease transmission in the community. However, all efforts must be made to optimize the level of medical care provided within these facilities. Resistance by infected people to voluntary admission will persist unless the treatment facilities are seen as a place to go for treatment and recovery and not as a place to die isolated from loved ones and the community. Our observations support aggressive use of antiemetics, antidiarrheal medications, and rehydration solution to reduce massive gastrointestinal losses and the consequences of hypovolemic shock. Selective use of intravenous fluid therapy in the population that is most likely to benefit is a rational approach under the current circumstances. When possible, broader use of intravenous fluid therapy and electrolyte replacement, guided by point-of-service laboratory testing, is likely to significantly improve outcomes.

Wednesday, November 26, 2014

Pearl Linux User Name and Password

Here, I have reproduced a read me file of Pearl Linux since I could not find the user name and password.

It is an Ubuntu Derivative which has a Mac Os appearance and is 1.5 GiB.

At the login screen please type "custom" as the user name hit enter then for password lease that field blank and hit enter.

Found a small issue with the fonts not looking correct and I thought I deleted the .iso but I guess not.
All you have to do if you already downloaded Pearl is go into system settings and change the font from Veranda 9 (?) to Ubuntu 10 and this is important,

On Rendering check the box to left, Hinting change to slight and Sub-pixel order change to RGB. That is the only change that was made.

Their will be more of a README file coming soon. 

Monday, November 24, 2014

Garbage Characters for Sinhala Font


Garbage Characters for Sinhala Font

Certain elements affiliated with ruling coalition is distorting Sinhala Font in a enews page.
I do not use this site anyway but lot of my friends do.
Below is a email note I posted them.

It is not a big issue.
Kindergarten stuff.
Please go to UTUBE and watch “Rosa Natuwa” Song and Dance.
You see the same issue but song is played well in Sinhala
If the web browser does not have the Sinhala Font it reverts (assumes) Chinese characters.
Report it to Google, FireFox or Chrome Browser, what ever it is applicable.
I am trying Amazon to work on it for my writings (translate few of my books to Sinhala).

They do not understand that our alphabet has more than 50 characters.
If lot of people request (in millions) they would act on it.
In the mean time, they should drop the Sinhala Font and use English letters and use Google's Transliterate Format.
Or else they could use images with Sinhala Writings.

There was a time (I hated it) lot of dirty Sinhala words were circulated in emails and government knew it and took appropriate action.
Then the used images and that dirty habit died a natural death.

But this is more political and robust political action is mandatory.

Thursday, November 20, 2014

Preparation for Concentration / Focus for Moment Meditation


Preparation for Concentration / Focus for Moment Meditation

1. Do not Think of the Past ( I have not finished my work)

2. Do not Think of the Future ( I have lot of things to do)

3. Do not let the mind drift ( a mosquito hovering)

4. Do not say it is warm (dress appropriately but do not look for a fan)

5. Do not say it is cold ( dress appropriately but do not look for a heater)

6. Do not be lazy

7. Avoid company (If one cannot avoid not more than five for a group)

8. Do not look for solitude

9. Be aware of the current setting (if you are in a bus find a corner and pretend you read a book/note)

10. Be aware of the current physical need (voiding, hunger, physical disability)

If there is a hindrance (as you may perceive it), do not react to it but accept it as a fickle and passing episode like quicksilver.

Then any place is good for moment meditation.

If you are not meditating, just focus and do what you have to do in the present moment to the best of your capability.

In a sense your mind is in a Moment Mediation Mode (3M).

If one practices these few principles with diligence and awareness, getting into moment meditation becomes just a habit not a “result seeking work” endeavor.

One's productivity in what ever one does goes up by the minute.

It is not easy but one has to practice and become adept at it.

Then you do not need a guru and become a master and not a slave of a rigid protocol dispensed by an unprepared master.

Friday, November 14, 2014

Update on Mahela and Sanga.


Update on Mahela and Sanga.


I pity these two players now having decided to play till the world cup is over in 2015.

They will have a bad taste in their mouth at the end of their cricketing saga.


My wishful thinking was that they could have retired before the tournament but I still respect their enthusiasm and sacrifice to cricket.


My gut feeling is that they will burn out even (if that has not happened already) before the tournament commences.


It is already seen in Dilshan.


Then we can see the real Sri-Lankan cricket talent without the old guard worst than Zimbabwe and Bangladesh.


Sri-Lankan cricket management run by politicians, wheeler dealers in business and old cricketing cronies (I think they wet their pants when a female Indian Cricket Board secretary gives them  an order to play in India by their own command; it is given by either by a telephone call or by an email) are ruining our old talents, while young ones who represent Sri-Lankan cricket is a collection of "rag tag of players".

In any are case I do not watch cricket now and won't revise my predictions already made.


I hope either South Africa or West Indies could lift the cup, this time round (unless of course, they do a silly mistake in a vital match).

 

Below is a reproduction.

I hope above blog post done in only ten minutes before I went to sleep needed, another 25 minutes of editing and looking for typos.

I was I was listening to BBC radio and listening to cricket and I had to give up editing and went down to my son's room and peo TV was blocked for (cricket from UK) cricket and then I had to make my wife to move out to answer a call to get to the digital TV (Capture card) and tune into Eye Channel and was able see to Mahela's mastery.


Take my word, they are the modern version of Rohan Kanhaie and Kallicherran of yesteryear West Indies. 
This I said long time ago when they were young.

I will not miss a match when Mahela is on song.


Sanga should learn a lesson or two from Mahela.


West Indies cricketers who are young and never seen the two classy players mentioned above should watch Mahela and Sanga play limited over games and believe that they can produce high class players (their problem is batting once Lara was gone).


The differences in the above two players as opposed to Sri-Lankan players were they always played like that every time they came to the crease, limited or not.

I never missed them when they came to Colombo on short visits (including great Westly Hall, Greenich and Griffith and I think Lance Gibbs the spinner).


Sorbers I have not seen playing live.



Vivian Richard is a class of his own and there is nobody currently to match him.
 
Brian Lara is the epitome of style.

 
There is a documentary on West Indian cricket of yesteryear produced by a cricket loving Englishman. 

 

Everybody who is a cricket lover should see that documentary including West Indians.

Without them cricket will be dead the way Indians cronies (not players) not West Indian who are marketing cricket like tooth paste and soap opera (Bollywood style).

I hope west Indies stop fighting and play gentleman cricket and beat India who has become too big for comfort for any cricket (IPL included.)

They actually gave Indian a wake up call and scare.


If not for Dravid, the Wall (a real mature cricketer of class, whom I like very much) I would be rubbing salt on their wounds.


Dravid was one player who was very badly treated by Indian Cricket Selectors, who thinks that any Indian who can play soft ball cricket can represent India.


Now that Kersten is gone like in Sri-lanka (political involvement) all the cronies will get in to ruin Indian Cricket Board and ICC.

On a finer note my daughter, my wife and the Gon Bass (work supervisor) did not let me sleep even three hours at a stretch and woke me up three times on three different occasions in spite of the fact it was a Saturday.


My dog was the only considerate soul who did not disturb my sleep but left a big poo in the living room to state emphatically, industrial action all right I need to go out and I am not a prisoner on hold, like an American prisoner in the Guatemala Bay.


 I had to do the cleaning.

Tuesday, November 11, 2014

A Model of Ebola Transmission and Its Suppression


 From NEJM

A Model of Ebola Transmission and Its Suppression

Stephen G. Baum, MD reviewing Yamin D et al. Ann Intern Med 2014 Oct 28.

Isolation of critically ill patients within 4 days after symptoms develop is key to truncating the epidemic.
The current Ebola outbreak in three West African countries is unprecedented in both the number of people infected and the case fatality rate. Without a vaccine or a curative drug, hopes for arresting the epidemic rest on hygiene and isolation measures. To quantify what might be necessary for effective control, researchers developed a stochastic model based on incidence, case fatality rates, and contact tracing from the early days of this outbreak in Liberia, as well as viral load data for survivors and nonsurvivors of an outbreak in Uganda in 2000–2001.
The resulting assumptions for the model were that Ebola transmission increases with viral load. For survivors, the load is greatest 4 days after symptom onset. For nonsurvivors, it is greatest late in the disease and immediately after death; throughout the course of infection, it may be 100-fold that of survivors. Based on these data-driven assumptions and the likely number of contacts for infected individuals at the various stages of illness, the probability of infecting at least one other person was 32% for survivors and 67% for nonsurvivors. The authors estimated that isolation of 75% of critically ill individuals within 4 days of symptom onset has a high probability of eliminating the disease.

Sunday, November 9, 2014

Slippery “Banana Bat Story” or the “Fruit Bat Story” of Ebola


Slippery “Banana Bat Story” or the “Fruit Bat Story” of Ebola

It is easy to get Ebola from a banana kept in the veranda / porch for ripening.

These are the steps.

1.The bats (who are staving in the wild due to deforestation, now venture into houses for food) come at night, and land on a tray containing banana.

2. It accidentally drops an ornamental ceramic on the floor shattering it and scattering the pieces on the floor.

3. House wife eats banana from the bunch and discovers a piece of banana on the floor and her prized ornamental ceramic on the floor.

She picks one piece and in the process cuts her tender fingers in the left hand.

She immediately touches the wound with the right hand fingers smeared with (contaminated by the bat) banana fruit contaminated with bat's saliva.

4. Then she washes her hand and wipes her face with a towel hung over night for drying.

Unfortunately, she does not know that bat's thick fruity dropping had been on it.

(She loves fruity aroma of her make-up.)

5. She had high dose of virus (minute dose of virus is enough to cause disease) in her BLOOD, BOWEL and her FACE.

She is downed with fever and later hemorrhage and was diagnosed as Dengue and was not isolated and she contaminates the entire intensive care unit.


The first case of Ebola in this country of ours was misdiagnosed.



The disease spread by our bats into the villages.

The government orders the extermination of bats and in this pretext clears, the remaining rain forest.

Poor Sri-Lankans in the cities catch the bats trapped on the giant electric wires and eat them as a delicacy.

The entire island is now on full alert and the politicians leave the country on the pretext of international Ebola conference and never return.


The Ebola has saved this country from corrupt politicians.



The caveat is one should not eat slippery banana and should not slip away from this country.
The citizens are considered a high risk population (on this planet) except politicians and are trapped in this island enclave for ever.


Friday, November 7, 2014

Pepe, The People's President (Mewa Lankawe Venne Nane)


From BBC (Mewa Lankawe Venne Nane)
Pepe, The People's President
Uruguay's President Jose Mujica says he has been offered $1m (£630,000) for his vintage Volkswagen Beetle.
Mr Mujica, once dubbed "the poorest president in the world" because of his modest lifestyle, said the offer had come from an Arab sheikh.
He told the weekly Busqueda magazine that if he did accept the offer, the money would be used to help the poor.
President Mujica - popularly known as Pepe - lives on a ramshackle farm and gives away most of his pay.
In 2010, his annual personal wealth declaration - mandatory for officials in Uruguay - was $1,800, the value of his blue 1987 Beetle.
Busqueda reported that the offer for the car was made at an international summit earlier this year in Santa Cruz, Bolivia.
"They made me an offer," Mr Mujica, 79, told the magazine.
"I was a bit surprised, and at first I really didn't pay too much attention to it. But later, another offer came in, and I began to take it a little more seriously."
Jose Mujica has lived in his wife's farmhouse rather than in the presidential palace
The president said he had "no commitment to cars" and would happily auction it.
He joked that he had not sold it so far because he needed it for his dog Manuela, famous for only having three legs.
Mr Mujica said that if he got $1m for the car, he would donate it to a programme he supports that provides housing for the homeless.
President Mujica is barred by the constitution from running for a second consecutive term and a presidential election held last month is to go to a second round.
A recent survey gave Mr Mujica an approval rating of nearly 60%.

Thursday, November 6, 2014

Facts File on EBOLA-2014


Facts File on EBOLA-2014
Typically, Ebola symptoms appear 8-10 days after exposure to the virus, but the incubation period can span from two to 21 days.
It can be difficult to determine if a patient is infected with the Ebola virus disease in the early stages.
This is because the Ebola symptoms such as fever, headache and muscle pain are quite common symptoms to other diseases.
It is no different from dengue
The diagnosis is based on the patient’s history.
If any person is presented with Ebola symptoms, then he/she will be tested for the Ebola disease. Samples of blood or body fluid can be sent to a laboratory to be tested for the presence of Ebola virus.
Then a diagnosis can be made rapidly.
This is how Sri-Lankan Attitude and no preparation at all.
“When issuing visas to persons from countries where the Ebola virus is prevalent, we have made medical certificates a prerequisite. A lot of countries have on arrival visa privileges at the airport. But in these cases we will be requiring medical certificates. Before arriving in our country they must secure a medical certificate proving that they are not carriers. Measures have been taken to examine persons arriving at the Bandaranaike International Airport.”
Health staff are inspecting passengers as they disembark.
This measure is in place especially for visitors from West African nations and Congo.
The data is referred to the Divisional Medical Officers of Health who then carry out follow up inspections.
Also in the event that any person displays symptoms of the disease within 21 days of arriving in the country then steps have been taken to have them immediately taken to the IDH hospital.
Ambulance services have been provided at the airport and doctors too have been assigned for this purpose.


Risk factors

For most people, the risk of getting Ebola or Marburg viruses (hemorrhagic fevers) is low.
The risk increases if you:
    1.Travel to Africa.
    You're at increased risk if you visit or work in areas where Ebola virus or Marburg virus outbreaks have occurred.
    2. Conduct animal research.
    People are more likely to contract the Ebola or Marburg virus if they conduct animal research with monkeys imported from Africa or the Philippines.
    Provide medical or personal care.
    Family members are often infected as they care for sick relatives.
    Medical personnel also can be infected if they don't use protective gear, such as surgical masks and gloves.
    Prepare people for burial.
  • The bodies of people who have died of Ebola or Marburg hemorrhagic fever are still contagious. Helping prepare these bodies for burial can increase your risk of developing the disease.

Ecology

Ebola virus is a zoonotic pathogen.
Intermediary hosts have been reported to be "various species of fruit bats throughout central and sub-Saharan Africa".
Evidence of infection in bats has been detected through molecular and serological means.
However, ebolaviruses have not been isolated in bats.
Secondary hosts are humans and great apes, infected through bat contact or through other end hosts.
Pigs on the Philippine islands have been reported to be infected with Reston virus, so other interim or amplifying hosts may exist.
Ebola virus disease
Ebola virus is one of the four ebolaviruses known to cause disease in humans. It has the highest case-fatality rate of these ebolaviruses, averaging 83 percent since the first outbreaks in 1976, although fatality rates up to 90 percent have been recorded in one epidemic (2002–03). There have also been more outbreaks of Ebola virus than of any other ebolavirus. The first outbreak occurred on 26 August 1976 in Yambuku.
The first recorded case was Mabalo Lokela, a 44 year-old schoolteacher. The symptoms resembled malaria, and subsequent patients received quinine. Transmission has been attributed to reuse of unsterilized needles and close personal contact, body fluids and places where the person has touched.
During the 1976 Ebola outbreak in Zaire, Ngoy Mushola traveled from Bumba to Yambuku, where he recorded the first clinical description of the disease in his daily notes.
"The illness is characterized with a high temperature of about 39°C, haematemesis, diarrhea with blood, retrosternal abdominal pain, prostration with "heavy" articulations, and rapid evolution death after a mean of three days."
The prototype Ebola virus, variant Mayinga (EBOV/May), was named for Mayinga N'Seka, a nurse who died during the 1976 Zaire outbreak.
Ebola is a rare but deadly virus that causes bleeding inside and outside the body. As the virus spreads through the body, it damages the immune system and organs.
Ultimately, it causes reduction in clotting factors leading to severe, uncontrollable bleeding. The disease, also known as Ebola hemorrhagic fever or Ebola virus, kills up to 90% of people who are infected.
Ebola virus disease is a serious, usually fatal, disease for which there are no licensed treatments or vaccines.
It is endemic in Africa.
Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. It is thought the Ebola virus has been living harmlessly in fruit bats for many years, building up in this population and spreading to other forest animals including chimpanzees and gorillas.
Ebola is extremely infectious but not extremely contagious.
It is infectious, because an infinitesimally small amount can cause illness.
Humans can be infected by other humans if they come in contact with body fluids from an infected person or contaminated objects from infected persons.
While the exact reservoir of Ebola viruses is still unknown, researchers believe the most likely natural hosts are fruit bats.

Ebola Symptoms are the following:

1. Fever
2. Bad headaches
3. Muscular Pain
4. Increased Weakness
5. Fatigue
6. Diarrhea
7. Vomiting
8. Stomach pains
9. Unexplained bleeding and breathing difficulty
Over time, symptoms become increasingly severe and may include:
    Nausea and vomiting
    Diarrhea (may be bloody)
    Red eyes
    Raised rash
    Chest pain and cough
    Stomach pain
    Severe weight loss
    Bleeding, usually from the eyes, and bruising (people near death may bleed from other orifices, such as ears, nose and rectum)
    Internal bleeding
    It is almost like Dengue Fever
    Severe headache
    Joint and muscle aches
    Chills
    Weakness
    But, only mode of transmission is different.
    Complications
      Both Ebola and Marburg hemorrhagic fevers lead to death for a high percentage of people who are affected.
      As the illness progresses, it can cause:
      Multiple organ failure
      Severe bleeding
      Jaundice
      Delirium
      Seizures
      Coma
      Shock
      One reason the viruses are so deadly is that they interfere with the immune system's ability to mount a defense.
      But scientists don't understand why some people recover from Ebola and Marburg and others don't.
      For people who survive, recovery is slow. It may take months to regain weight and strength, and the viruses remain in the body for weeks. People may experience:
      Hair loss
      Sensory changes
      Liver inflammation (hepatitis)
      Weakness
      Fatigue
      Headaches
      Eye inflammation
      Testicular inflammation

Wednesday, November 5, 2014

Ebola Survivors and Sex


From Scientific American

Let’s Talk about Ebola Survivors and Sex

Wear a condom: That has been the standard—and strong—advice from public health officials trying to thwart the spread of HIV or syphilis.
 The U.S. Centers for Disease Control and Prevention has spent decades trying to get people to put them on.
 But now health workers are pushing the latex prophylactic for a different reason:
Ebola recovery.

People are surviving the disease. Doctors Without Borders, which oversees many Ebola clinics in west Africa, is sending home recovered Ebola patients with a stack of condoms, and health workers are urging them to only engage in protected sex for at least three months after recovery. The virus has been found in the semen and vaginal fluids of convalescents for weeks or even months after symptoms of Ebola have abated, setting off concern that the virus could be spread via sexual contact with otherwise healthy individuals. In men, one study found that Ebola continued to persist in semen for 90 days. U.S. health officials are echoing this caution as a small number of patients have been released from American hospitals.

To date, however, there has not been a single documented case of Ebola transmission from sexual activity.
Moreover, simply detecting the genetic presence of the virus in recovering patients does not automatically mean that disease transmission could or would take place—especially if the virus is only present in relatively low concentrations. Although a whole, functioning virus is needed to transmit an infection to another person, current testing methods are also so sensitive they also detect nucleic acids from the virus that continue to lurk in bodily fluids during recovery. “It’s essentially like finding a bone of an animal but that doesn’t tell you if there’s a live breathing animal,” says Daniel Bausch, a professor of tropical medicine at the Tulane School of Public Health and Tropical Medicine.

That may be why one 1999 study in the Democratic Republic of the Congo, which followed 29 people recovering from Ebola and their household contacts (including sex partners) for up to 21 months, found that although four of the five tested convalescents had at least one semen sample with detected Ebola virus inside it none of their sexual partners developed symptoms of Ebola, even if they had unprotected sex during that period.

So why the “safe sex” warning when thousands of patients have survived Ebola and may have gone on to have sex, apparently without infecting their partners? Extreme caution is not an overreaction with this disease. Studies by Bausch and others have also detected live Ebola virus in sexual fluids that can successfully grow in cell culture, suggesting it could also lead to infections in other individuals. It is possible that sexually transmitted Ebola may have flown under the radar because there has been a dearth of data from outbreaks in years past. Also, although extremely unlikely, it is possible that mild Ebola—with very minor symptoms that were not recognized as such—has developed in patients’ sexual partners. Thus, the CDC warns that convalescing patients must either abstain from intercourse and oral sex for three months or use condoms for that entire time.

Let’s Talk about Ebola Survivors and Sex
With any infectious disease, when patients have a high viral load in their bodily fluids, it increases the risk they will pass disease to someone else through direct contact with those fluids. With HIV, for example, the risk of passing the disease between partners increases with higher viral load: For every 10-fold increase in viral concentration, one 2012 study suggests there is about a threefold increase in the risk of transmission per sexual act. And with HIV, condoms are a highly effective mode of blocking disease transmission because the virus is primarily spread via contact with sexual fluids or blood.

As with HIV, when Ebola progresses, a patient’s viral loads inch upward and that boosts the chance of disease transmission via contact with bodily fluids. Moreover, a certain degree of natural immunological protection for certain body parts—the central nervous system, eyes and gonads—makes it difficult for virus to exit those bodily parts, which may lead to the virus continuing to be present even after the virus was cleared from the blood, according to Bausch. And if an Ebola patient’s disease proves fatal, his viral load at death is particularly high, which boosts the risk of contracting the disease from interacting with the corpse.

Ebola virus manages to thrive in a variety of bodily fluids. It is found in its highest concentrations in blood, vomit and feces. But coming into direct contact with semen, vaginal fluids, saliva or even sweat could still be risky while a patient is symptomatic. (Although it’s not likely patients in the throes of illness would be engaging in sex. And live Ebola virus, according to WHO, has never been isolated in human sweat.) Just how infectious those fluids may be after recovery, however, remains a series of question marks. Studies in this area have been extremely small and continue to be largely inconclusive. Thus far, there are no recorded cases of sexual transmission of Ebola. With more than 13,500 cases currently in west Africa right now, however, public health officials do not want to take any chances.

Bruce Ribner, the clinician who led the Emory University Hospital team that treated patients Kent Brantly and Nancy Writebol, said in a recent interview with Scientific American that although studies have shown Ebola patients shed genetic material from the pathogen into their sexual fluids there is scant evidence they are often shedding viable virus that could infect others.
Yet even Ribner advised his patients about the recommended CDC guidelines of not having unprotected sex for three months.
For now, it’s better safe than sorry.

EBOLA, Stands for


EBOLA,


Stands for,


Educationally


BACKWARD


Occult Arm (Art) of


Lunatic (im)Practical (Practical Joker)


Astrological Adviser/s


To the Lord of the Planet


Administered,


By our very own MaKarios (almost MAx Election Commissioner) MakKos MakKa!


Monday, November 3, 2014

Ebola Education Strategy


Ebola Education Strategy

The plan of our strategy for the first 10 days.
Low key from 3-5th November.
Intensify from 6-10th November.
Outrageous from the 10th.
It should end in three months to take stocks.
Then each one who participated makes a little fictional character.
All this can be done through the W.W.W. and Internet.

1. 3-5th November-How to inform
Each one should make a little commentary on the patient activities.
A group of eight and the 9th member as a leader makes a smallest group.
Th group can be as big as 21.
Then the big group should be divided into two.
For each story, there should be a counter story.
I will explain it below.

Facts-EBOLA INFECTION
1. It is a viral infection.
2. It is a zoonotic infection.
3. It is highly contagious.
4. It kills 50-90% of the patients depending on the epidemic.
5. First outbreak happened in Germany and West Africa in 1975.
6. There is no treatment.
7. It can be transmitted by Air Travel Industry.
8. Animal hosts are not known but Primates including humans are secondary carriers.
9. All mammals including dogs could be infected (Rats, Bats, Monkeys, Humans)
10. Animals do not die including monkeys.

So your stories should initially fit in with the facts.
Some stories should be outrageous lies.
Say, the patient got it from an imported variety of fish (blue tetras) from Africa.
Stories should be related to
1. The dog, say it is ill, but NEVER dead.
2. Fish Tank-All fish dead.
3. Infection From Water (our water plants), Olu Nelum, Manel
4. From Cats
5. Birds who venture into the mulberry tree.
6. Snakes.
7. Rats
8. Bats

The observations
No visitors to the house

2. Intensify from 6-10th November.
Counter stories could only be four.
Birds do not carry the disease.
Plant do not but contaminated water and food can.

3. Outrageous from the 10th
By emails and cell phones, now that you are free to roam.

Makkos. Mackkas, and Mac OS


Mak-kos. Mack-kas, and Mac OS
1. Makkos (Mathiwarana Komasaris) is our Election Commissioner.
He trains his officers to rig the count at Counting Stations.
This was what happened in Kandy, last time round.
They (counting officers) are given drinks after midnight and the covert operation begins.
They should be sacked (according to our civil service practice that originates from British) from their normal work and appoint them as our foreign ambassadors after the victory parade.

2. Makkas are the fleas.
They rig the voter at home and at the polling booths.
They are blood suckers and live on blood (political violence).

3. Mac Os is Apple Mackintosh Computer with its latest Operating system to rig the results.
Last time they were imported from India with Indian hacker's to help the commissioner.
This time they come from America, now that Steve Job is dead it is easy to use Mac Os for rigging.
It is called “Computer Gilmart”