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Okay, so I'm catching up on this hurricane deal.
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theweaselking posted an awesome newsclip you can see here.
panthertriad on the other hand linked to a jounral post http://thememoryblog.org/archives/000588.html, and while some of this is a little exagerrated, as in Ebola and Marburg are not level 3 contagions, they are level 4 and thus would not be located at these facilities (in theory), the premise is still frightening. I was personally concerned about outbreaks of cholera, maybe typhoid since they are common in this sort of situation, but now it could be that release of a variety of pox and flus would also be a legitimate concern. The probability is low that an outbreak would happen, but I can certainly also see why the evacuation of people from the affected areas, willing or not, would be a little more pressing that just "death by dysentery". Also http://www.cdc.gov/od/sap/index.htm.
Quick Primer of Biosafety
Biosafety Level 1
Basically these are things that are difficult to catch as defined by how it is spread (airborne is more contagious than by touch), and are not life threatening. Many of these things can not even be contracted by humans. Think E.Coli infection or low level bacterial or yeast infections.
Biosafety Level 2
These are things that are easier to acquire (bloodborne or by touch, longer persistence in the environment), and while they are generally not life threatening, they can cause serious complications. There is immunization or antibiotic treatments available for each of the items in this category. This is where salmonella, chicken pox, Hepatitis B and measles reside. Not enjoyable, but won't kill you.
Biosafety Level 3
I'll be honest, this can still be scary despite not being the highest level. All of these pathogens can be lethal, but take a little effort to catch and are mainly bloodborne. This includes things like HIV, encephalitis and tuberculosis.
Biosafety Level 4
These are scary, and as such are only housed in 5 reported facilities in the world. These are all typically airborne, highly infectious and deadly. This includes Ebola and Marburg.
I think I need to not read anymore for now. *The part of my brain trained in epidemiology shivers*
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I did misunderstand the 40 million number, and misread it as another statistic.
As for mumps, I *personally* know 37 people who developed mumps through failure to vaccinate. I hear reported cases of the other conditions I mentioned since it is of concern for the WHO and the CDC. I can understand resistence to new varicella (chickenpox) vaccines since the vast majority of children suffer no lasting effects from chicken pox, but the DPT (diphtheria, polio, tetanus) and the MMR (Measles, Mumps, Rubella) were very widespread and damaging infections. Death, blindess and nervous system damage were not uncommon. I think it will be a long time before vaccines stop being controversial.
Fortunately, post-exposure inoculations are available for pox viruses, though they are not in high production. That would also require that France was not suffering any sort of outbreak for us to get those vaccines. I am eternally grately for that high school teacher who made it very clear to us that while it is unfortunate, science, medicine and politics are not independant of teach other.
("But one of the side effects is death, but I have a pill to cure that too." -from Foamy)
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I believe the US currently has enough vaccine to provide post-exposure innoculation to the entire population--if you get the vaccine within three days after exposure, you can develop an immunity from it before the damn stuff finishes incubating, and even four to seven days after exposure it still helps. Health Canada's page says they're working on adding ten million doses to their supply, but doesn't give a solid record of how close they are to it; they started working on that in 2003.
(Apologies on the earlier figures, I was off by a decimal point. Atopic dermatitis affects 15% of the population (off the AAP page), world population is 6446 million, minus the 40 for HIV gives you 6406, times 0.15 gives you 960.9, round down because I'm an optimist, add the 40 back in...
Based off HIV and atopic dermatitis alone, that's a billion people who shouldn't be living with someone who's been vaccinated against smallpox. My bad.)
From:
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I'm sure there probably still several billion people immunized (I was born within 5 years of the cessation of routine immunization and both my parents are immunized, as are my grandparents... in theory I probably should not have been living with them).
Canada is indeed working on getting enough doses and I was under the impression they were close to that goal. Unless something has changed in 3 years though, that supply is being stored in France where the vaccine is produced since Canada presently (as of 2002) does not have the facilities to produce the smallpox vaccine or store it for any length of time. I hope someone has changed this practice/remedied this situation because I don't doubt France would use the stock to vaccinate its own populace before turning it over to us. I mean, wouldn't you try to protect your own people first?
Scary, but with luck we'll never have to find out.
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365,000 doses of the vaccine are stored in Canada, and they're loking at the possibility of dilution (according to the AAP page, 2001 studies show that the vaccine seemed to remain effective at at least 1:5 dilution, and possibly 1:10; the CDC doesn't give proportions, but does say that diluted doses are just as effective).
Also, in January, the WHO started doubling its smallpox vaccine stock to 5 million.
And yes, I would try to protect my own people. But France was confident enough to give away 85 million doses of the stuff in 2002, so I'm guessing (I can't find stats on this, unfortunately) they feel they have enough for their own use.
On a more practical note, I would not innoculate my entire population because smallpox hit elsewhere, or even because smallpox hit one segment of my population. I realize it's a lot easier for diseases to travel, but it's not like an individual who's infectious is as unnoticeable as someone with a cold; you're either on your back with a 101-104'F fever and possibly vomiting (and not even guaranteed to be infectious by then), or you've started bursting with pus and lesions.
If all of France was exposed to the virus by aerosol or some other means, and no-one realized until people started getting sick, then yes, I'd innoculate everyone.
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We probably debating this into the ground at this point.
It's freaky, there's no clear answer.
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It does. On the plus side, if it's contagious you're obvious to very obvious, and it's not likely to be mistaken for anything else.
> Ebola doesn't scare me as much since a person will be dead before stepping
> off the flight. Five day incubation is plenty of time to get on a plane
> and hop continents.
Ebola's incubation period is 2 to 21 days--longer than smallpox--and the only references I can find to how long it takes to die say things like "the fifth day of illness (http://www3.baylor.edu/~Charles_Kemp/ebola.htm)", "begin to recover after 7 to 10 days (http://tarakharper.com/v_ebola.htm)", and "8 to 10 days, but may be up to two weeks (http://en.wikipedia.org/wiki/Ebola#Fiction)". The specific discussion of a 1976 outbreak (http://www.itg.be/ebola/ebola-12.htm) mentions patients dying on day 7 and 8 after admission.
> We probably debating this into the ground at this point.
Probably. Also, it's worth remembering all those recommendations about vaccination not being worth it are based on smallpox no longer existing outside of labs. If that changes, so do the recs.
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I would rather not catch either one in any case.
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> kills quickly with a 95% mortality. Kinder, friendlier Ebola incubates
> longer and has a 25% mortality rate.
Adding up the figures on cases and deaths from the WHO website gives Ebola-Zaire an 81% mortality rate (a couple of sites say 90% - Wikipedia and what looks like a student page at Stanford), Ebola-Sudan a 53% mortality rate, and Ebola-Côte d'Ivoire (all two cases) a 0% mortality rate. Ebola-Reston has never caused illness in humans, although four people developed antibodies.
Can't find anything on the incubation periods for either; if you have a reference I'd be grateful.
> I would rather not catch either one in any case.
Agreed.
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I did a research project on it in 1999, though it is possible these numbers have changed based upon scientific review and/or further outbreaks. Speaking of outbreaks, apparently Marburg virus is currently an epidemic in Angola
http://www.who.int/mediacentre/factsheets/fs_marburg/en/index.html
I wonder if I was thinking of Marburg and Ebola...
this one has an update of the Marburg outbreaks...
http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/marburg/marburgtable.htm
Other Ebola sites.
http://www.cdc.gov/mmwr/preview/mmwrhtml/00037078.htm
http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/ebola.htm
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