Galt's Gulch

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  • Posted by RonC 9 years, 6 months ago
    What if, on a transcontinental flight, you boarded the plane asymptomatic, and in flight you developed a fever, sniffles, muscle aches, and an occasional cough or sneeze?

    Could be the flu...or something else.

    I don't know that happened, but how inconsiderate or ignorant of the facts must he be to physically handle dying patients, and then get on an airplane?

    On another tangent. With open flights, how long before a terrorist goes to Liberia, infects himself, then travels to a target nation. If he had made the decision to wear a suicide suite, what's the difference? I think the terror level is even higher with ebola.
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  • Posted by $ jlc 9 years, 6 months ago
    This is a good question. The answer is that we have the ability to detect the presence of the virus (whether or not there are observable symptoms in the person) in body fluids using PCR. If you take a swab from a person before he comes down with symptoms, you do not find any virus genomes in it. If you take a swab from a person with symptoms, you do. If you take a swab from a person after they recover, then all of the body fluids are negative for the virus - except for semen, which is positive for the virus for another 3 months.

    It is possible, especially with a virus that is mutating as happily as this one is, that we could have (or develop) asymptomatic carriers. I found an article from 2001 (in Clin Exp Immunol. Jun 2001; 124(3): 453–460) that indicated that some people mount a vigorous IgG response to ebola and never develop symptoms. If I read the abstract correctly, it looks like the virus was never expressed in body fluids - but these people had a immune system that was smashing the virus effectively and they were not carriers.

    The neat thing about this is that IgG response is generally an immune response by educated lymphocytes (they have seen this virus before) and indicates that a vaccine is possible.

    Jan
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    • Posted by khalling 9 years, 6 months ago
      whew!. hope there are Dagny's and Rearden's on it!
      here's a policy question for you: Is it moral to begin "swabbing" people before they board a plane? 2. If the US would limit flights to emergency ebola countries, how might the parameters be set? Can states make that call?
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      • Posted by $ jlc 9 years, 6 months ago
        I would think so. I do not see that 'detection of an organism by PCR' is different philosophically from 'detection by taking a temperature'. (It is just more accurate!) Right now the PCR detection of ebola is still in research/expert status. Some of the new HIV kits that use 'canned' PCR techniques are as simple as the pregnancy kits you buy at drug stores, though, so it is possible to make such kits...by the time they transition ebola detection from research level to drugstore level, the epidemic will probably be spent.

        I would think that - right now - the best policy would be to:
        1. Allow anyone INTO an infected zone who wanted to go.
        2. Limit departures from infected zones to 'essential travel' and require temperatures to be taken.
        3. If the person is running a fever, then sort the individual into a clinical lab set up at the airport where a PCR test can be done. (If no ebola is detected by PCR, then the person gets a chit and may board an outgoing flight.)
        4. Permit departures of dedicated "Angel Flights" taking known ebola patients to volunteer quarantine facilities in other countries. This would be primarily for health workers who caught ebola in the course of their attempting to treat sufferers in the infected areas.

        I would let the destination of the flights set the rules for whether or not there are Angel Flights or whether a person cured of ebola within the last 3 months can fly.

        Jan
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  • Posted by ObjectiveAnalyst 9 years, 6 months ago
    Travel restrictions seem like a reasonable precaution. If doctors knew how to eradicate this virus, how to contain it and exactly when one is contagious it would not be an issue.
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