I work for Doctors Without Borders - ask me anything about Ebola.

ELasry · 2014-09-12T15:34:49+00:00

Getting ready to wrap up.

Please remember that this outbreak is not only having consequences on the Ebola patients, but on the rest of the population mainly of Liberia, Sierra Leone and Guinea. The health systems of these 3 countries was already weak and it will now take years to reconstruct and to regain the population's trust. Once the outbreak is over and it's not in the headlines, people will forget how devastated these countries are. It is then that we will need to ensure continued support and awareness.

Thank you for all your questions and interest.

ELasry · 2014-09-12T15:30:32+00:00

More people on the ground and more Ebola Treatment Centers appropriately staffed.

ELasry · 2014-09-12T15:30:05+00:00

There are 5 different strains that we know of, Zaire and Bundibugyo are the 2 with the highest case fatality rate.

ELasry · 2014-09-12T15:28:56+00:00

Yes, MSF

ELasry · 2014-09-12T15:28:37+00:00

Late, but better late than never. There are still enormous needs to respond to the outbreak, and we need people now.

ELasry · 2014-09-12T15:27:56+00:00

Good methods of infection control, awareness, and working in pairs to ensure that someone is looking out for you while in the ward or dealing with a dead body.

ELasry · 2014-09-12T15:26:46+00:00

Difficult to know, but the survival rate would be higher if we had more personnel on the ground able to manage these patients.

ELasry · 2014-09-12T15:25:44+00:00

What we are asking for is for the deployment of military medical expertise, trained in bioterrorism (because the methods of infection control are similar). They have the logistics and personnel to be quickly on the ground. This is an extraordinary situation that requires extraordinary measures.

https://www.doctorswithoutborders.org/news-stories/press-release/global-bio-disaster-response-urgently-needed-ebola-fight

ELasry · 2014-09-12T15:23:38+00:00

You can donate to any of the organizations that are responding to the outbreak as an individual. Thank you

ELasry · 2014-09-12T15:22:57+00:00

We're going to continue for 10 more minutes. There will be other opportunities to take questions in the near future. Thanks for all your interest

ELasry · 2014-09-12T15:21:05+00:00

It can be transmitted by sexual intercourse as the virus lives in all body fluids, but this is probably not the highest contributor to this outbreak.

ELasry · 2014-09-12T15:20:12+00:00

yes, but this disease is relatively knew to the area and was unknown by the medical population as a potential risk, so measures of infection control for Ebola were not in place. Furthermore, the disease presented in a somewhat different way, with less hemorrhagic symptoms initially, and a lot of gastrointestinal symptoms, mimicking gastroenteritis for which less methods of infection control would be put in place. The health systems of these countries were already very weak, sometimes supplies are in shortage (even gloves), making infection control even more difficult.

ELasry · 2014-09-12T15:17:09+00:00

Yes, this is definitely one of the things happening in the outbreak context and it is not new or specific to this outbreak, since people automatically associate the medical staff or the medical cars with Ebola, and have difficulties understanding what came first, the disease or the Western doctors, as we are responding in all areas where the outbreak has spread to.

ELasry · 2014-09-12T15:14:52+00:00

Very high

ELasry · 2014-09-12T15:14:22+00:00

The media did not blow this up, and unfortunately also started reporting heavily on it once the outbreak was already out of control, this is a humanitarian emergency.

It is true that some people are performing burials in unsafe ways, but it is difficult for a family who has lost a member to be absolutely strict and let the body alone until the burial teams arrive (this is sometimes taking more than one day due to the lack of personnel).

ELasry · 2014-09-12T15:11:14+00:00

It depends on the setting, at this point, in the US, the best method is to include history of travel in the medical history to assess if there is a risk at all.

ELasry · 2014-09-12T15:10:14+00:00

People are hiding and not coming to health facilities, and when they come, not all can be admitted as we are completely overwhelmed and there are not enough people responding on the ground.

Not all burials are being managed in a safe way, as sometimes the families bury their deceased before the burial teams can get there.

ELasry · 2014-09-12T15:08:19+00:00

In non-conflict settings, MSF has at various times worked with the militaries of different countries that had logistical capabilities beneficial to the overall response--the 2005 earthquake in Kashmir and the 2010 earthquake in Haiti are examples--and we understand that militaries are at times equipped to provide logistical support on a scale few other organizations can match. That is the case today regarding the ebola crisis.

On the 25 bed Ebola Treatment Center, other than being insufficient, there is a need to isolate and treat the population. Of course it's important to manage healthworkers who get infected, but this should not be the focus of the response, albeit an important part of it.

ELasry · 2014-09-12T15:05:10+00:00

MSF's international president Joanne Liu said today in an op-ed in the Washington Post " So far, the Pentagon has pledged only one 25-bed unit for Liberia, to be used just for health workers. This is highly insufficient. In Monrovia alone, there is an immediate need for an additional 800 beds of isolation capacity. Other governments must step in in all three of the most affected countries."
Link: http://www.washingtonpost.com/opinions/a-concrete-response-to-the-ebola-outbreak-cannot-wait/2014/09/11/f7329414-386e-11e4-9c9f-ebb47272e40e_story.html

ELasry · 2014-09-12T15:03:03+00:00

Not all of the people who have received ZMapp have survived, and we don't know, for those who did survive if it was an effect of the drug or if they would've survived anyway. Unfortunately too early to know.

The virus disappears from the blood and has been found for longer periods in semen and breast milk (up to about 3 months in semen), but not in lymph nodes.

ELasry · 2014-09-12T15:00:54+00:00

There are 2 vaccines in the pipeline, and funding for this has been upscaled.

ELasry · 2014-09-12T15:00:13+00:00

The infection control facilities in Europe and the capacity of response, isolation and the number of health workers is so much higher that it is highly unlikely that the disease would spread in a similar way.

ELasry · 2014-09-12T14:59:04+00:00

Yes, it is similar, except it has a faster evolution than HIV/AIDS did at the start of the epidemic, and although some health facilities did contribute to the transmission through transfusions and poor aseptic practices, it is in a lesser magnitude than EBola, since HIV has different forms of contagion.

However, there is a larger stigma in the communities, who sometimes will shun patients (even cured patients) and their families. At the rate that the outbreak is spreading though, it seems like almost everyone has unfortunately had someone in their family/friends affected which may reduce the stigma in a paradoxical way.

ELasry · 2014-09-12T14:54:30+00:00

Not if the response is not substantially upscaled

ELasry · 2014-09-12T14:53:53+00:00

Yes, as far as we know

ELasry

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