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Blog post:
Ebola
Date:
this blog came out some time before year 2017. A facebook blog app
ceased to function, and MEDIC's back-up captured the content but not the date of
writing.
HOW THE VIRUS WORKS
Viruses turn our own body cells into virus replication factories. They
produce new viruses within our body cells. The "incubation period" of the
illness is the time before these now-virus-factory-cells burst – while the virus
is inside our cells, our immune system doesn't notice or find the virus and so
doesn't launch an immune response. After a while, our now-virus-factory
cells get too full with the produced viruses and burst, spreading virus and
wastes, ultimately making us "sick." Our body notices the foreign wastes
(not knowing if it's viral or bacterial) and increases our core temperature
(fever) just in case it is bacterial, because bacteria don't multiply above
102.5 or 103 degrees … and so if they're not multiplying, our immune system has
a better chance of catching up and winning the battle. However, Ebola is a
virus not a bacteria, so turning up our thermostat doesn't help this way.
What does help is that 2 to 3 days after cells start bursting, our immune system
creates antibodies to go out and try to kill the virus. Unfortunately, this
virus affects our immune system, making us be immuno-compromised and hence
susceptible to other maladies at the same time.
The Ebola incubation period is 2 to 21 days, commonly ~7 to 10 days. Then
comes the onset of flu-like symptoms: fever, headache, diarrhea, vomiting,
weakness, muscle pain, joint pain, abdominal pain; and less commonly: bloodshot
eyes, sore throat, rashes** such as maculopapular rash, bleeding, and easy
bruising.
In perhaps 4 to 5 days from time of onset of early symptoms, the illness can
progress to hemorrhagic fever symptoms: bloodshot possibly bleeding eyes,
bleeding gums, ulcers on lips/mouth, blood in vomit, blood in stool (may look
tarry), blood in urine, bloody nose, vaginal bleeding. Pregnant women may
suffer abortion and experience copious bleeding.
The reason for the aforementioned multiple places of bleeding is unclear; it may
be caused by a protein that the virus creates which increases the permeability
of blood vessels, leading to bleeding blood vessels; and/or "disseminated
intravascular coagulation" (also known as "disseminated intravascular
coagulopathy" or "consumptive coagulopathy"), in which there is widespread
activation of the body's clotting cascade mechanism, which results in the
formation of blood clots in small blood vessels throughout the body. This
leads to the compromise of body tissue blood flow, and can ultimately lead to
multiple organ damage and failure. In addition, while the blood clotting
process consumes the body's clotting factors and platelets, normal clotting is
disrupted and severe bleeding can occur from various locations … hence the risks
of death by multiple organ failure and/or hypovolemic (low-blood-volume) shock.
**The bleeding can happen through (ruptured) blood vessel walls themselves, and
so a red skin rash which won't "blanche" – if the patient pushes on his/her
rash, the skin does not turn white but rather stays red because the vessels have
hemorrhaged and fluids have leaked into the skin (unlike with the redness that
appears when healthy blood vessels dilate, in which case when the skin is
pressed it turns white momentarily, since the blood is still contained in the
vessels which collapse under the pressure).
Terminally ill Ebola patients may present with, in addition to the
aforementioned signs & symptoms: altered level of consciousness, little/no
urination, hypovolemic shock signs & symptoms including increased respiratory
rate, body temperature normal to hypothermic, and eye diseases. Death
timing can range from a few days to few weeks from onset of symptoms.
CONTAGEOUSNESS
The longer a patient has been ill, the more contagious s/he is, because there is
a greater quantity of virus in the person. Thus fluids from dead bodies
are especially contagious.
From what I understand and have read, the virus can spread via any bodily fluid.
If you touch a surface that has live virus on it, shake hands with an infected
person who went #2 messily wiped and did not wash hands, or touch a person who
is sweating (including shaking a sweaty hand) … and then you touch a mucous
membrane such as your eyes, nose or mouth, or a cut such as just an over-picked
skin beside a fingernail, you can get it. There is controversy out there
as to whether or not you can get it through the air from a cough (it seems that
it won't stay airborne but if you are in the direct path of a cough, you could
get it) so when you are around someone who might possibly be infected, to
prevent getting Ebola it is smartest to wear eye and respiratory protection (at
least an N100 mask and non-vented goggles, more preferably a full-face N100
respirator, better yet a PAPR and full body suit). Furthermore, if someone
with it is profusely vomiting and diarrhea-ing, if for example the patient is
expelling these fluids into a bucket at bedside, the fluids could get into the
air momentarily, or on surfaces … the virus can live on surfaces for at least
hours, and as long as a few months in dark, cold conditions. In blood that is
outside the human body, the virus can live a few days.
Ebola virus on surfaces can be killed by 3% acetic acid (e.g. vinegar), 1%
glutaraldehyde (medical/dental equipment disinfectant), alcohol-based products,
and bleach dilutions (see below). If you choose to use a household cleaner,
research it – does it kill the Ebola virus? Read the directions, how long
does the cleaning liquid have to be on the surface to disinfect? Just
spraying on and wiping off doesn't do the job – the fluid needs to sit there for
a while. Vinegar and the others may require 10 minutes to do their job.
How to disinfect surfaces which have spills of bodily fluids, using bleach:
> For surfaces which can tolerate strong bleach solutions, such as perhaps
cement or metal, flood the area with 0.5% bleach solution for 10 minutes.
> For more sensitive surfaces which may corrode or discolor under bleach, first
carefully wipe up visible stains, and then flood the area with 0.05% bleach
solution for more than 10 minutes.
Another way to deactivate the virus on physical items is to boil them for 5
minutes.
A good solution for disinfecting hands could be first wash them thoroughly with
soap and water, and once dry then use your own bottle of hand sanitizer … all
this after taking off your medical gloves.
Challenge: what if you're wearing eye and respiratory protection, and the
virus gets on your hair and neck for example; how do you wash it off with no
risk of it getting into a mucous membrane, small cut or small abrasion during
the washing process? For this I have no answer, other than using a full
body suit and obsessively-compulsively practicing its decontamination procedures
-- which might not be perfect, because some physicians and other health care
workers who likely know better than the rest of us how to avoid contracting the
virus, have contracted it. Scary.
TREATMENT
Think you might have Ebola? Hydrate, hydrate, hydrate (remember the
electrolytes), and see a physician who specializes in infectious diseases.
Wear at least an N100 face mask, and take other precautions as well to not
spread it to anyone else,
FEAR
There is one fear too powerful to write here, a fear that a physician revealed
to me, a fear that if read by people with bad intentions could worsen matters.
Ask me in person (only), or in any case, since no one really knows whether or
not this will become an epidemic in our country, simply consider taking steps to
"be prepared."
HOPE
Survivors might now be immune to this particular strain of Ebola if re-infected.
If so, perhaps scientists can study the bodily fluids of these survivors,
determine what factors make them immune, and reproduce those factors into the
form of a vaccine for mass distribution.
~ ~ ~ ~ ~
I am not a physician, please do not take this as medical advice / procedure /
protocol. These simply are my thoughts based on my education and reading.
I gathered them because yes, I am concerned that Ebola might significantly make
its way into the USA. I don't see how airline / border screening can catch
a person who lies on the Ebola exposure questionnaire, and whose virus is in
incubation stage hence no fever yet.
Sources:
Geo Medic course notes
Wilderness Medicine Newsletter
http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php
http://en.wikipedia.org/wiki/Viral_hemorrhagic_fever
http://en.wikipedia.org/wiki/Disseminated_intravascular_coagulation
http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola
.
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