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“Ebola Was Already Here”: How The United States Contains Deadly Hemorrhagic Fevers

The Centers for Disease Control and Prevention announced Tuesday the first diagnosis of Ebola in a person in the United States. The man was admitted to a hospital in Dallas after traveling from West Africa. In August, infectious disease specialist Tara C. Smith wrote about how the United States stops the spread of diseases that are similar to Ebola. The original article is below.

This article originally appeared in the blog Aetiology.

It’s odd to see otherwise pretty rational folks getting nervous about the news that the American Ebola patients are being flown back to the United States for treatment. “What if Ebola gets out?” “What if it infects the doctors/pilots/nurses taking care of them?” “I don’t want Ebola in the United States!”

Friends, I have news for you: Ebola is already in the United States.

Ebola is a virus with no vaccine or cure. Any scientist who wants to work with the live virus needs to have biosafety level 4 facilities (the highest, most secure labs in existence, abbreviated BSL-4) available to them. We have a number of those here in the United States, and people are working with many of the Ebola types here. Have you heard of any Ebola outbreaks occurring here in the United States? Nope. These scientists are highly trained and very careful, just like people treating these Ebola patients and working out all the logistics of their arrival and transport.

Second, you might not know that we’ve already experienced patients coming into the United States with deadly hemorrhagic fever infections. We’ve had more than one case of imported Lassa fever, another African hemorrhagic fever virus with a fairly high fatality rate in humans (though not rising to the level of Ebola outbreaks). One occurred in Pennsylvania, another in New York just this past April, a previous one in New Jersey a decade ago. All told, there have been at least seven cases of Lassa fever imported into the United States—and those are just the ones we know about, people who were sick enough to be hospitalized, and whose symptoms and travel history alerted doctors to take samples and contact the Centers for Disease Control and Prevention. It’s not surprising this would show up occasionally in the United States, as Lassa causes up to 300,000 infections per year in Africa.

How many secondary cases occurred from those importations? None. Like Ebola, Lassa is spread from human to human via contact with blood and other body fluids. It’s not readily transmissible or easily airborne, so the risk to others in U.S. hospitals (or on public transportation or other similar places) is quite low.

OK, you may say, but Lassa is an arenavirus, and Ebola is a filovirus—so am I comparing apples to oranges? How about, then, an imported case of Ebola’s cousin virus, Marburg? One of those was diagnosed in Colorado in 2008, in a woman who had traveled to Uganda and apparently was sickened by the virus there. Even though she wasn’t diagnosed until a full year after the infection (and then only because she requested that she be tested for Marburg antibodies after seeing a report of another Marburg death in a tourist who’d visited the same places she had in Uganda), no secondary cases were seen in that importation either.

And of course, who could forget the identification of a new strain of Ebola virus within the United States. Though the Reston virus is not harmful to humans, it certainly was concerning when it was discovered in a group of imported monkeys. So this will be far from our first tango with Ebola in this country.

Ebola is a terrible disease. It kills many of the people that it infects. It can spread fairly rapidly when precautions are not carefully adhered to: when cultural practices such as ritual washing of bodies are continued despite warnings, or when needles are reused because of a lack of medical supplies, or when gloves and other protective gear are not available, or when patients are sharing beds because they are brought to hospitals lacking even such basics as enough beds or clean bedding for patients. But if all you know of Ebola is from The Hot Zone or Outbreak, well, that’s not really what Ebola looks like. I interviewed colleagues from Doctors without Borders a few years back on their experiences with an Ebola outbreak, and they noted:

As for the disease, it is not as bloody and dramatic as in the movies or books. The patients mostly look sick and weak. If there is blood, it is not a lot, usually in the vomit or diarrhea, occasionally from the gums or nose. The transmission is rather ordinary, just contact with infected body fluids. It does not occur because of mere proximity or via an airborne route (as in Outbreak if I recall correctly). The outbreak control organizations in the movies have no problem implementing their solutions once these have been found. In reality, we know what needs to be done, the problem is getting it to happen. This is why community relations are such an issue, where they are not such a problem in the movies.

So, sure, be concerned. But be rational as well. Yes, we know all too well that our public health agencies can fuck up. I’m not saying there is zero chance of something going wrong. But it is low. As an infectious disease specialist (and one with an extreme interest in Ebola), I’m way more concerned about influenza or measles or many other “ordinary” viruses than I am about Ebola. Ebola is exotic and its symptoms can be terrifying, but also much easier to contain by people who know their stuff.

 

By: Tara C. Smith, Associate Professor of Epidemiology at Kent State, studies zoonotic diseases and blogs at Aetiology; Slate, September 30, 2014

October 3, 2014 Posted by | Ebola, Infectious Diseases, Public Health | , , , , | Leave a comment

“Irrational Fears”: Ebola Shouldn’t Be The New Political Football

A couple of weeks ago, President Obama traveled to the Centers for Disease Control and Prevention in Atlanta to unveil an ambitious U.S. response to the Ebola outbreak in Africa, including money, materials, and military and health personnel. Almost immediately, the right started complaining bitterly.

“We are sending more soldiers to fight Ebola than we are sending to fight ISIS or other Muslim terrorists,” Rush Limbaugh told his listeners. “I didn’t know you could shoot a virus. Did you?”

Now that an Ebola case has been diagnosed in the United States, the right’s politicization instincts are kicking in once more. Fox News’ Steve Doocy went so far as to suggest the CDC may not be entirely trustworthy – it’s part of the Obama administration, Doocy said, which Fox News viewers believe “has misled a lot of people on a lot of things.”

And then there’s Sen. Rand Paul (R-Ky.), who’s worried about Ebola and “political correctness.”

[Paul] on Wednesday questioned President Obama’s decision to dispatch 3,000 U.S. troops to West Africa to help combat the Ebola virus.

“Where is disease most transmittable? When you’re in very close confines on a ship,” Paul said on Laura Ingraham’s radio show. “We all know about cruises and how they get these diarrhea viruses that are transmitted very easily and the whole ship gets sick. Can you imagine if a whole ship full of our soldiers catch Ebola?”

The senator specifically added, “I really think it is being dominated by political correctness.”

Also yesterday, Paul talked about Ebola with Glenn Beck – because, you know, that’s what U.S. senators and prospective presidential candidates do – and argued that the public may not be frightened enough. “I do think you have to be concerned,” the Kentucky Republican told Beck. “It’s an incredibly transmissible disease that everyone is downplaying, saying it’s hard to catch…. I’m very concerned about this. I think at the very least there needs to be a discussion about airline travel between the countries that have the raging disease.”

I’ll assume the senator isn’t recommending a flight ban for Dallas.

Because Rand Paul has a medical background, some may be more inclined to take his concerns seriously on matters of science and public health. With this in mind, it’s probably worth noting that the senator, prior to starting a career in public office four years ago, was a self-accredited ophthalmologist before making the leap to Capitol Hill.

So when Paul compares Ebola to an ailment that is “transmitted very easily,” and describes the virus as “incredibly transmissible,” it’s a mistake to assume the senator knows what he’s talking about. There are actual medical experts and specialists in the field of transmittable diseases – and the junior senator from Kentucky isn’t one of them.

If Paul were just a little more responsible, he wouldn’t make public comments like these at a time when many Americans already have irrational fears.

As for concern for the safety of U.S. troops, CNN reports that the Pentagon does not expect servicemen and women to come in direct contact with Ebola patients as part of the American response to the African outbreak.

 

By: Steve Benen, The Maddow Blog, October 2, 2014

October 3, 2014 Posted by | Politics, Public Health, Republicans | , , , , , , , | Leave a comment

“Wedding Dresses And Boyfriends”: Listen Up, Ladies; Republicans Understand You

Political ads, as a rule, are terrible in every way. Lacking in anything approaching subtlety, creativity or production values, they usually achieve their impact through numbing repetition—you may be skeptical upon hearing that “Candidate Smith doesn’t share our values,” but once you’ve heard it 50 or 60 times, the theory goes, it should sink in. But every once in a while, one stands out, as is the case with this little gem trying to tell ladies to vote for Governor Rick Scott of Florida. It’s actually one in a cookie-cutter series, with the names of other Republican governors and Democratic candidates substituted in.) The thinking behind it seems to be that if you want to relate to ladies, what you’ve got to do is talk about wedding dresses. Take a look: http://youtu.be/ZOppsQJtL2M

It’s a takeoff on the reality show Say Yes to the Dress, which I haven’t actually seen, but I gather involves wedding dresses, and saying yes to them. While pop culture references are always a good way to grab attention, the message here is pretty condescending. It’s as though they’re saying, “Look, ladies, we know this politics thing is complicated, but think about this way. Candidates are like dresses…” You may recall that just a couple of weeks ago, a Republican group put up an ad showing a young woman comparing Barack Obama to a terribly disappointing and possibly abusive boyfriend. It’s as though when Republicans try to figure out how to appeal to women, they say to each other:

“OK, so how do we get our message to broads? Any ideas?”

“How about we talk about the things they’re into? Like, you know, boyfriends and wedding dresses and stuff?”

“That’s genius!”

As Amanda Marcotte wrote, “At this point, it’s hard not to wonder if the people being hired to do outreach to women on behalf of Republican candidates aren’t all a bunch of Democratic moles.”

(An aside: The dress ad was produced by the College Republican National Committee, which, in case you don’t know, is a much bigger deal in many ways than the College Democrats are. The College Republicans isn’t just a bunch of kids registering people to vote on their campuses; instead, it’s a kind of combination finishing school and Thunderdome death match funded with millions of dollars in big-donor money, where the most vicious, unscrupulous, ruthless operatives-in-training rise to the top by sticking shivs in their peers until, with the blood of vanquished fellow Republicans dripping from their teeth, they are rewarded with careers in the politics business. It’s the place where people like Lee Atwater, Karl Rove, Ralph Reed, and Jack Abramoff learned their craft and came to the attention of their elders. If you want to know more, a few years back Franklin Foer wrote a terrific article about this little pack of Damiens.)

This isn’t even the first time the College Republicans have tried this. I came across this takeoff on The Bachelorette which they put up in April, though apparently no one noticed:

To be fair, it isn’t as though there’s necessarily anything wrong, in the abstract anyway, with comparing candidates to romantic partners. (Remember “I’ve Got a Crush On Obama“?) But when you’re trying to reach out to a particular group, it’s important to communicate to them that you respect them and you understand their concerns. And these ads do precisely the opposite. Instead of talking about the things that are important to women, they take the same message they’d offer to anyone else, and just put in what they consider a womanly context (wedding dresses! boyfriends!). Imagine that a candidate went before an audience of Hispanics and said, “Let me explain this in a way you can relate to: My economic plan is like a really good tamale. My opponent’s economic plan is like the worst tamale you ever ate. Understand?” And he’d expect everyone in the audience to turn to each other and say, “I may not care for his position on immigration, but that tamale analogy showed me that he really gets us.”

Perhaps Republicans think that if nothing else, women will give them points for trying. After all, if nothing else these kinds of ads show that the GOP wants women’s votes, right? Which is better than just calling them sluts all the time, I suppose. But not by much.

 

By: Paule Waldman, Contributing Editor, The American Prospect, October 2, 2014

October 3, 2014 Posted by | GOP, Republicans, Rick Scott | , , , , , , | Leave a comment

“The Dangers To Everyone”: A Gun-Carrying GOP Congressman Is Outraged A Man With A Concealed Gun Got Near Obama

Stipulating that none of the Secret Service lapses, revealed in the press over the past week, should’ve happened in the first place, the only one that strikes me as truly inexplicable is the revelation that USSS allowed an armed felon into an elevator with President Obama at the Centers for Disease Control, and that they didn’t know he was armed.

The two other big stories aren’t as terrifying, at least to me. Inexcusable, maybe, but explicable. In the case of the fence jumper, I get why people on a security detail might let their guard down when the people they’re charged with protecting are off site. And the inconvenient truth is that the Secret Service can’t stop every determined person with a sniper rifle from taking shots at the White House from a number of different locations in the city. Maybe they bungled the response, but the rifle shots themselves were probably not preventable.

The armed felon in the elevator represents a different level of failure. There appears to be widespread recognition of this fact in both the media and in Congress. That’s good, and important, but it’d be nicer still if elected gun enthusiasts thought through the logical implications of their completely warranted outrage.

Consider the following exchange from a Tuesday oversight hearing on Capitol Hill.

Rep. Jason Chaffetz (R-Utah), who heads a House subcommittee that oversees the Secret Service, first heard of the breakdown from a whistleblower. The Washington Post confirmed details of the event with other people familiar with the agency’s review.

“You have a convicted felon within arm’s reach of the president, and they never did a background check,” Chaffetz said. “Words aren’t strong enough for the outrage I feel for the safety of the president and his family. “

Chaffetz added: “His life was in danger. This country would be a different world today if he had pulled out his gun.”

This is all true, but it could use a little further unpacking. Chaffetz isn’t a gun grabber. He’s spoken openly about the fact that he carries a concealed weapon when he’s in his Utah district. He cosponsors legislation that would erode state concealed carry restrictions by requiring those states to honor concealed carry permits from other states, including states with weaker permitting processes. (This would presumably apply to Washington, D.C., now, too.) And yet Chaffetz also joins the overwhelming consensus that Obama shouldn’t have been on an elevator with a person carrying a concealed weapon because he fully grasps that people carrying concealed weapons can be incredibly dangerous.

Chaffetz is appalled that USSS allowed a person to carry a concealed handgun around the president without conducting a background check, but supports legislation to make it significantly easier for people—many of whom come into lawful possession of firearms without undergoing background checks—to carry concealed weapons around you and me.

This isn’t to give USSS a pass. They should’ve been aware of every armed person on the premises in advance of the visit, and followed protocol to keep them or their guns away from the president. But the man on the elevator was a security contractor at CDC. His employer issued him that gun. His felony convictions only underscore the dangers—to everyone, not just the president—of combining easy access to firearms with lax carry laws. But that’s more or less the beau ideal for the gun lobby, gun enthusiasts, many Democrats, and the entire Republican party.

 

By: Brian Beutler, The New Republic, October 1, 2014

October 3, 2014 Posted by | Background Checks, Concealed Weapons, Secret Service | , , , , , , | Leave a comment

“An Intra-Republican Bloodbath”: The 2016 Presidential Race And The Coming Death Struggle Within The GOP

There’s an interesting article in The Hill today about some early 2016 jockeying, and it shines a light on just how important this presidential campaign will be to the ongoing struggle within the GOP. Once next month’s elections are over, things are going to get very intense. Here’s an excerpt:

For the past year, Speaker John Boehner (R-Ohio) has been wooing his longtime friend Jeb Bush to jump into the 2016 presidential race, even as he has shunned potential Tea Party rivals like Sens. Ted Cruz of Texas and Rand Paul of Kentucky.

Boehner stepped up his lobbying efforts this week, singing the former Florida governor’s praises in a pair of media interviews.

The Speaker’s preference for yet another Bush White House run is partly political, partly personal. He sees Bush as undeniably the strongest, most viable candidate who could pull the party together after a bruising primary and take on a formidable Hillary Clinton, sources said. And the two men are aligned politically, hailing from the same centrist strand of the GOP.

The next presidential campaign will shape how we all understand the eight-year intra-Republican bloodbath that will have lasted through the Obama presidency, in a way that the 2012 election didn’t. While most of the candidates in 2012 spent plenty of time pandering to the Tea Party, none of them were birthed by the movement. All of the real contenders had been around for a long time, some for decades.

In contrast, 2016 will be the first presidential election in which some of the GOP candidates rose to prominence after Barack Obama’s election. Three potential candidates (Rand Paul, Marco Rubio, and Scott Walker) first got elected to their current positions during the revolution of 2010, and one other (Ted Cruz) two years later. Even if only Cruz among them is still considered a 100 percent pure Tea Partier, this is going to be a primary race defined by a generational split between those who rode the Tea Party to prominence and those who came to public attention before.

If you’re John Boehner, somebody like Ted Cruz getting the Republican nomination would be a terrible rebuke, not just because Cruz has personally been such a pain in Boehner’s behind (constantly encouraging conservative House members to turn against the Speaker), but also because of what it would say about this period in Republican history. If a real Tea Partier were elected, Boehner’s entire Speakership would look like nothing more than roadkill along the way — the “GOP establishment” had done nothing but resist the inevitable, by trying to keep the Tea Party in check, for too long. On the other hand, someone like Jeb Bush becoming president would mean that all the aggravation Boehner endured wasn’t futile; he held the barbarians back, prevented them from ruining the GOP, and the party came through on the other side by taking back the White House.

On the other hand, nothing would be worse for Boehner and other establishment figures than somebody like Bush getting the GOP nomination but then losing to Hillary Clinton — and short of a Tea Partier winning the presidency, nothing would be better for the base conservatives. Those conservatives could say: Look, we’ve tried nominating old, familiar, establishment Republicans three times in a row now, and all it got us was President Obama and now President Clinton. We can’t repeat the same mistake in 2020. It’ll be an awfully compelling argument to those in the party, even if the counter-argument — that nominating someone like Cruz would be a complete disaster — might be true.

It’s possible that a candidate who successfully bridges the two sides could emerge (for instance, Indiana governor Mike Pence could be that candidate). And the establishment folks are going to try to play down the idea that there’s any “battle for the soul of the Republican party” going on at all, since that’s a battle they aren’t sure they can win. But the battle is real, and its outcome, at least for the next decade or two, could be determined by what kind of Republican gets the 2016 nomination, whether he wins or loses, and more broadly, what kind of GOP we have in coming years.

 

By: Paul Waldman, Contributing Editor, The American Prospect; The Plum Line, The Washington Post, October 2, 2014

October 3, 2014 Posted by | Election 2016, GOP Presidential Candidates, John Boehner | , , , , , , , , | Leave a comment

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