Monday, October 13, 2014

Ebola

for all the hysteria about Ebola, the dirty little secret is that more folks in Africa die of simple diarrhea and malaria. But never mind.

There are complaints that budget cutbacks in the NIH stopped or slowed Ebola research, but given the money spent on "social problems" that are not really medical but political agenda, this sounds like nonsense.

The dirty little secret is that infectious diseases have caused a headup in the military since Charles VIII's army was destroyed by syphilis, thanks to the friendly ladies of Naples who had caught it originally from some sailors who caught it from some friendly Americans during Columbus' visit there.

Disease kills more soldiers than bullets, which is why the sanitation is so important, and why the military was on top of most epidemics before the ordinary folks recognized it. I mean, I heard about a venereal disease that killed everyone from one of our unit medics who learned about it in a conference a year or two before it was recognized as HIV...and yes, I later attended HIV classes to give classes to our units. So when people talk about gay marriage, I just ignore the elephant in the room, i.e. a high rate of promiscuity that astounded our good old boys.

Well, anyway, military docs ususally checked the women and forbad men to man sex which spreads STD's a lot more efficiently, and if you want pictures why, well, this is an R rated blog, not an X rated one...

well, anyway, since the NIH is busy spinning their incompetence to bash Republican budget cuts, and keeps sending out confusing bulletins, maybe you need to go to the military sites.

LINK 


Ebola infographic

lots of the information are in PDF files, to download and read later.


bmj says that the very political MSF organization insists the military has to help, which is ironic since they hate the US. And just ignore that most of the medical work in these countries is done either by locals or by missionaries.


but the BMJ does note:


FeatureEbolaOnly the military can get the Ebola epidemic under control: MSF head
BMJ 2014349 doi: http://dx.doi.org/10.1136/bmj.g6151 (Published 10 October 2014)Cite this as: BMJ 2014;349:g6151
  1. Sophie Arie, freelance journalist, London, UK
  1. sarie@bmj.com
Sophie Arie talks to MSF’s president, Joanne Liu, about her frustrations at the slow international response to the Ebola epidemic
Médecins Sans Frontières (MSF), the humanitarian medical charity, has been on the front lines of the Ebola epidemic since it began. It has had a major role in the international effort to control the outbreak, caring for two thirds of the 8000 people in Guinea, Sierra Leone, and Liberia who have been infected. But in early September, after six months of battling Ebola in vain, and with the death toll mounting exponentially, MSF effectively admitted defeat and said that it would take major military mobilisation by wealthy countries with biohazard expertise, not just international aid, to stop the disease. The charity had doubled its staff, MSF’s president, Joanne Liu, told the UN members, but it still was overwhelmed.
Liu, a Canadian paediatrician who has worked for MSF in war zones and natural disasters for the past 18 years, called upon UN members to dispatch their disaster response teams, backed by the full weight of your logistical capabilities. “Without this deployment, we will never get the epidemic under control,” she said.1Peter Piot, director of the London School of Tropical Medicine and Hygiene and the microbiologist who first identified the Ebola virus in 1976, also called in September for a “quasi military intervention.” He suggested that a major UN peacekeeping force should be deployed to Sierra Leone and Liberia, with huge donations of beds, ambulances, and trucks as well as an army of clinicians, doctors, and nurses.
The message came as the numbers of deaths from Ebola began to spiral, particularly in Liberia. There have been over 3800 reported deaths in the region, according to the latest World Health Organization figures, 40% of which have been recorded since September.2 WHO has estimated that there could be 20 000 infections before the outbreak is brought under control, and the US Centers for Disease Control has predicted that, in a worst case scenario, as many as 1.4 million may be infected by the end of January.3 As the economies and health infrastructures of the three countries, home to over 22 million people, risk total collapse, the UN Security Council declared the outbreak was a threat to international peace and security.
Limited response
Yet a month after the first calls for military deployment, forces are only now starting to be mobilised in any numbers. The US, UK, Germany, and France have responded, although not exactly as Liu had hoped they would. The US has said it will send 4000 troops to build new isolation units and treatment facilities in Liberia, a country created by US citizens as a colony for former African American slaves. But President Obama has made it clear that US troops will not be staffing those units and coming into contact with Ebola patients. The UK has pledged to send 750 troops to establish new Ebola treatment centres in Sierra Leone, its former colony, and a training academy for those working in treatment centres. Around 5000 German troops have volunteered to work in west Africa but they have not yet been deployed, and the government has now admitted that it would not have the resources to fly any troops home for treatment should they become infected.
So far no other countries have offered their armed forces, and President Obama warned in early October, if most countries choose to remain on the sidelines and watch the US do the bulk of the military work, the outbreak will continue to be a global threat.4Liu says she is exasperated at the slow, hands-off response. “Countries are approaching this with the mindset of going to war,” she says. “Zero risk. Zero casualties.”
Liu describes the current military efforts as the equivalent, in public health terms, of airstrikes without boots on the ground. Pledges of equipment and logistical support are helpful—“The military are the only body that can be deployed in the numbers needed now and that can organise things fast.” But there is still a massive shortage of qualified and trained medical staff on the ground. “You need to send people not stuff and get hands on, not try to do this remotely,” Liu says, “Local doctors have been extremely brave, but we are running out of staff and that is why we are asking for a major workforce to deploy.”
Since the 9/11 attack on New York’s twin towers, Western countries have developed military and civilian biohazard teams to protect their populations against a possible bioterrorist attack. Liu had hoped that these could be deployed to west Africa. “I think with the massive investment and knowing how much they are afraid of bioterrorism, they have some knowhow about highly contagious diseases.”

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if I am sarcastic about the headline grabbing medics without borders, it is because they grab the headlines from those who are working there before and after them....including many locals and church or mosque funded charities who pay for physicians. But as a recent article complained, missionaries have no right to go there and preach (never mind that Liberia and SierraLeone are both highly Christian nations, or that Muslim charities often go to Musim areas.)

For example, in Monrovia there is not only the government hospital that has ties with the US, but also a Catholic hospital that treats people LINK In small local clinics, sometimes entire staffs of eight or 10 people were killed within days. The Catholic church’s biggest hospital in the capital of Monrovia, which employs over 185 staff, was forced to close after nine of their top doctors and administrators died of the virus.
According to World Health Organization statistics from Oct. 3, there have been 7,492 Ebola cases and 3,439 deaths in the current outbreaks. Liberia has been the hardest hit, accounting for 3,834 cases of Ebola and 2,069 death

Sunday, October 12, 2014

exciting new medical treatment

http://touch.latimes.com/#section/-1/article/p2p-81645496/

frozen poop pills.

c.difficile is a nasty disease, so this might make the treatment more palatable. The idea is to replace the normal bowel flora after treatment.

Sunday, October 5, 2014

let the kid die?

Jahi declared dead, mom takes her home against doctor's orders.

Jahi is now alive and showing signs of life. What's worse, he brainstem is damaged but her cortex is alive on tests.

Expect a major lawsuit against the hospitals, and as a doc I wonder if the rush to diagnose her was because if she lived, it would be an expensive and dirty lawsuit against the hospital.

And one wonders if racism was behind the rush to declare her dead. No, I don't think so (doctors are now being trained to see the mentally handicapped of all races as useless eaters). But one wonders if the family thinks racism might be behind it, or if the black community is taking note of the case. It's an open secret that Blacks and other minorities won't sign "living wills" because of distrust of the medical establishment, and given how our Native American patients were treated in "liberal" Minnesota, I suspect they have a point. Where is Al Sharpton when we need him?

Yes, I am joking, but I suspect Jahi's mom didn't go along with the doctors because of this mistrust (the black community still remembers Tuskeegee experiment).

One wonders if she was a thin blond child, not a fat black girl, if the docs would be so fast to diganose brain dead when there were still drugs and brain swelling going on.

But of course, a white kid's family would have agreed with the docs (especially if the parents were educated) and let them remove the tubes keeping her alive.

the doctor involved in the case, Dr Shewman, once wrote a detailed analysis in 1990 why anencephalic babies should not be declared brain dead. It's a really scary read, but didn't stop the AMA experts a few years later declaring these babies should be sacrificed for organs (public outcry stopped them and they changed their mind...one wonders if it would get the same reception now).

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2722973/



but the most disturbing part of all of this is the comments riduculing those who see her as a human being...essentially is saying hey she's dead because they think so (not because of any scientific reason) or worse, she's better off dead...

Friday, October 3, 2014

patient zero ebola

http://news.nationalpost.com/2014/10/01/graphic-how-the-ebola-epidemic-spread-from-patient-zero-to-claim-the-lives-of-more-than-3000-people/