20 August 2014

How would Canberra deal with an ebola outbreak?

| JessicaGlitter
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Our friends have been frightening each other on Facebook by following the news about the recent ebola outbreak in Africa and speculating about how we would fare if it came to Australia. We heard from some local experts, Professor Peter Collignon AM, Infectious Diseases Physician and Microbiologist at Canberra Hospital, about the resources Canberra has available to deal with infectious disease outbreaks, and Associate Professor Sanjaya Senanayake, a practising infectious diseases physician at the Australian National University Medical School, more generally about how ebola works.

What is ebola

Ebola is a recently discovered virus, having been with us since the mid 70s. Despite the deadly nature of four of the five strains, a fifth, the Reston Ebolavirus, found in the Phillipines and China, does not cause disease or death in humans.

The disease is spread through bodily fluids and the rumours going around facebook of it becoming airborne are completely rubbish. Theoretically the disease can be spread by any body fluid but the practical risk is only present in the blood of a very sick person. The initial spread of disease was caused by family members caring for the sick or preparing the dead for a funeral. It was exacerbated by hospitals not having enough resources to set up simple procedures like wearing one-use gloves to treat patients and keeping people isolated.

Ebola begins by resembling a flu, with pain and tiredness. Later a rash may appear and eyes turn red. Finally, toward the end of the disease blood clotting is impaired so people may begin to bleed internally while their liver and kidneys also come under attack.

Medical interventions and research

No treatment exists but MSF has increased survival to as high as 75% in some of their better resourced treatment centres.

Interventions include oxygen and fluids, controlling blood clotting and treating any secondary diseases that may appear.

Research into antibody treatment has been promising but in scientific articles and news about the two Americans who were recently treated with a mouse-derived antibody we see the words “may be” appear frequently, indicating that enough information has not yet been gained to draw a conclusion, or even get very hopeful.

Preventing ebola from entering Australia

Our geographical isolation is always Australia’s advantage in terms of quarantine. Under biosecurity guidelines, standard procedures are in place to identify any possible illness of passengers on board incoming flights. The system operates informally but pilots will report any deaths, illnesses or specific symptoms of concern that have developed during the flight.

Permission to disembark passengers and crew upon landing is assumed to be granted if there is nothing to report and where patients show symptoms of disease the ground crew may issue different instructions to the pilot.

Ground crews are on alert for symptoms and the time taken to travel here meanspatients would be likely to show symptoms before arriving.

Canberra’s health protection resources

Professor Collignon reports that from time to time people do present in Australia with flu-like symptoms following a trip overseas. The discovery of an easily treated disease like malaria is possible with a blood test and prompt treatment in this case will often save lives.

Now that the world is on alert for a possible ebola outbreak the lab would also check for ebola. A 24 hour turnaround would be possible and patients could be treated very early in the disease progression. American hospitals have already provided a model for isolating sick travellers until they know what disease they have.

ACT Health already has a variety of resources available to them to help identify people who may have come into contact with a virus. In the case of a measles outbreak, for example, they will often issue a media release to warn people who may have been exposed. For a foodborne disease they have people who can visit restaurants and markets, chat with people who might have dined with the patient and track down disease vectors. Any of these resources could be re-directed to help track down a bloodborne illness.

Can it truly be contained?

This is where your heart breaks. Professor Collignon has all confidence that an ebola outbreak could be easily contained in Canberra and reminds us that when African hospitals talk about being under-resourced they mean something very different from what you imagine.

MSF reported this week that they have reached the capacity of their teams to treat the sick and require more trained doctors. The countries in which they are working have statistics like one doctor per 10,000 people and not enough rubber gloves to examine and treat patients.

Liberia’s capital city of Monrovia has a million people and all the hospitals are closed. A 120 bed treatment centre was opened this week and is already overwhelmed.

Compared to this, Canberra would have it easy. We could easily test anyone who had appeared with the symptoms or reported coming into contact with body fluids of another person who had recently been in West Africa. We could easily deploy public health warnings to anyone who may have come into contact with the body fluids of the sick. We could even use our many media outlets to raise awareness. And our hospitals have enough resources to treat the sick even if an outbreak like the one seen in Liberia meant some other patients would have to wait a little longer for treatment. There is always room for improvement but we are incredibly lucky.

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VYBerlinaV8_is_back12:16 pm 26 Aug 14

watto23 said :

dungfungus said :

watto23 said :

dungfungus said :

farnarkler said :

Considering ebola is from the tropics, I doubt it would do too well in our lovely winters and our summers might be too dry for it.

Ross River fever is a tropical affliction also but people living in the ACT have contracted it.
When Ebola shows up in the ACT it will be via someone who has visited a more Ebola friendly climate.
Where it goes from there is anyone’s guess. In the meantime, are there any checks in place at Canberra Airport to detect it?

ummm seriously why?????
As someone who has actual experience rather than just stupid fear mongering, if you come from any country where something like ebola or yellow fever for example exists they will take the necessary precautions at the international airport you enter the country through. If Canberra ever gets direct flights to South America or Africa they will have the necessary checks in place there too..

You have experienced Ebola and lived? Wow. Please tell us all about it.

No I’ve actually traveled to endemic areas and survived (whoa amazing!) and actually have first hand experience of what questions you get asked at an international airport if you’ve been to any of these tropical locations with endemic diseases. Even better, ebola isn’t even an airborne virus. Its spread via transfer of body fluid and poor hygiene. So the chances of an ebola outbreak in a first world country are close to zero. Not worth spending wasteful amounts of money on protecting ourselves, when we’d be far better off, helping the third world countries who face it everyday.

But lets not use facts at all, because we all know its far more fun to spread rumours and fear in society so the uninformed masses panic about things they can educate themselves about rather easily.

And build a train set.

dungfungus said :

watto23 said :

dungfungus said :

farnarkler said :

Considering ebola is from the tropics, I doubt it would do too well in our lovely winters and our summers might be too dry for it.

Ross River fever is a tropical affliction also but people living in the ACT have contracted it.
When Ebola shows up in the ACT it will be via someone who has visited a more Ebola friendly climate.
Where it goes from there is anyone’s guess. In the meantime, are there any checks in place at Canberra Airport to detect it?

ummm seriously why?????
As someone who has actual experience rather than just stupid fear mongering, if you come from any country where something like ebola or yellow fever for example exists they will take the necessary precautions at the international airport you enter the country through. If Canberra ever gets direct flights to South America or Africa they will have the necessary checks in place there too..

You have experienced Ebola and lived? Wow. Please tell us all about it.

No I’ve actually traveled to endemic areas and survived (whoa amazing!) and actually have first hand experience of what questions you get asked at an international airport if you’ve been to any of these tropical locations with endemic diseases. Even better, ebola isn’t even an airborne virus. Its spread via transfer of body fluid and poor hygiene. So the chances of an ebola outbreak in a first world country are close to zero. Not worth spending wasteful amounts of money on protecting ourselves, when we’d be far better off, helping the third world countries who face it everyday.

But lets not use facts at all, because we all know its far more fun to spread rumours and fear in society so the uninformed masses panic about things they can educate themselves about rather easily.

watto23 said :

dungfungus said :

farnarkler said :

Considering ebola is from the tropics, I doubt it would do too well in our lovely winters and our summers might be too dry for it.

Ross River fever is a tropical affliction also but people living in the ACT have contracted it.
When Ebola shows up in the ACT it will be via someone who has visited a more Ebola friendly climate.
Where it goes from there is anyone’s guess. In the meantime, are there any checks in place at Canberra Airport to detect it?

ummm seriously why?????
As someone who has actual experience rather than just stupid fear mongering, if you come from any country where something like ebola or yellow fever for example exists they will take the necessary precautions at the international airport you enter the country through. If Canberra ever gets direct flights to South America or Africa they will have the necessary checks in place there too..

You have experienced Ebola and lived? Wow. Please tell us all about it.

” … reminds us that when African hospitals talk about being under-resourced they mean something very different from what you imagine.”

What on Earth do you mean? That (unlike you, apparently) Canberrans aren’t capable of understanding how dire the state of health facilities are in those countries where Ebola is at its worst? And aren’t capable of understanding that Canberra’s first-world health facilities, disaster risk management protocols, and communications, and an absence of cultural drivers that facilitate the spread of Ebola, are the reason we would be able to contain and address an outbreak?

dungfungus said :

farnarkler said :

Considering ebola is from the tropics, I doubt it would do too well in our lovely winters and our summers might be too dry for it.

Ross River fever is a tropical affliction also but people living in the ACT have contracted it.
When Ebola shows up in the ACT it will be via someone who has visited a more Ebola friendly climate.
Where it goes from there is anyone’s guess. In the meantime, are there any checks in place at Canberra Airport to detect it?

ummm seriously why?????
As someone who has actual experience rather than just stupid fear mongering, if you come from any country where something like ebola or yellow fever for example exists they will take the necessary precautions at the international airport you enter the country through. If Canberra ever gets direct flights to South America or Africa they will have the necessary checks in place there too..

dungfungus said :

farnarkler said :

Considering ebola is from the tropics, I doubt it would do too well in our lovely winters and our summers might be too dry for it.

Ross River fever is a tropical affliction also but people living in the ACT have contracted it.
When Ebola shows up in the ACT it will be via someone who has visited a more Ebola friendly climate.
Where it goes from there is anyone’s guess. In the meantime, are there any checks in place at Canberra Airport to detect it?

Considering I walked through their security recently with a substantial pocket knife in my carry on luggage, I’m guessing the answer is a firm NO.

farnarkler said :

Considering ebola is from the tropics, I doubt it would do too well in our lovely winters and our summers might be too dry for it.

Ross River fever is a tropical affliction also but people living in the ACT have contracted it.
When Ebola shows up in the ACT it will be via someone who has visited a more Ebola friendly climate.
Where it goes from there is anyone’s guess. In the meantime, are there any checks in place at Canberra Airport to detect it?

dungfungus said :

Rattenbury is in Africa now so what are the chances he gets infected?

Well his big boss hit the beaches and resorts in Sri Lanka, so no doubt Shane has taken a leaf out of her book and is sunning himself on Diani Beach.

Considering ebola is from the tropics, I doubt it would do too well in our lovely winters and our summers might be too dry for it.

Voice of Reason7:20 pm 21 Aug 14

There’s been a thousand Ebola deaths in Africa in 2014.

There will be a thousand viral hepatitis deaths in Australia in 2014.

Back on topic – very nasty business, Ebola.

Ben_Dover said :

First of all Mayor Rattenbury would commission a $500,000 committee to investigate how the outbreak will affect his plans for the light rail, followed up by a survey which would show that 95% of Canberrans think they would still use the light rail following an Ebola outbreak.

ACT health would employ 7 new managers, and 15 new middle managers to head up a “Ebola Taskforce”. The taskforce would decide that they would best be prepared by going to the States for a month long Ebola conference, the outcome of which would be the decision to buy all Ebola taskforce managers new laptops with “Ebola Friendly” software. The taskforce would, under pressure for results, also employ a part time Ebola nurse, who would not receive any training, be expected to work 40 hour weeks for 12 hours pay, and who would leave after one month.

The Labour party would en

Ben_Dover said :

First of all Mayor Rattenbury would commission a $500,000 committee to investigate how the outbreak will affect his plans for the light rail, followed up by a survey which would show that 95% of Canberrans think they would still use the light rail following an Ebola outbreak.

ACT health would employ 7 new managers, and 15 new middle managers to head up a “Ebola Taskforce”. The taskforce would decide that they would best be prepared by going to the States for a month long Ebola conference, the outcome of which would be the decision to buy all Ebola taskforce managers new laptops with “Ebola Friendly” software. The taskforce would, under pressure for results, also employ a part time Ebola nurse, who would not receive any training, be expected to work 40 hour weeks for 12 hours pay, and who would leave after one month.

The Labour party would enshrine into Canberra’s constitution the right of any person with Ebola, regardless of sex, gender, ethnicity, race, disability, ability, inability, inhumanity, specie, living or dead the fundamental right not to be discriminated against in any terms ever.

The rest of us would just die.

shrine into Canberra’s constitution the right of any person with Ebola, regardless of sex, gender, ethnicity, race, disability, ability, inability, inhumanity, specie, living or dead the fundamental right not to be discriminated against in any terms ever.

The rest of us would just die.

Rattenbury is in Africa now so what are the chances he gets infected?

Ben_Dover said :

First of all Mayor Rattenbury would commission a $500,000 committee to investigate how the outbreak will affect his plans for the light rail, followed up by a survey which would show that 95% of Canberrans think they would still use the light rail following an Ebola outbreak.

ACT health would employ 7 new managers, and 15 new middle managers to head up a “Ebola Taskforce”. The taskforce would decide that they would best be prepared by going to the States for a month long Ebola conference, the outcome of which would be the decision to buy all Ebola taskforce managers new laptops with “Ebola Friendly” software. The taskforce would, under pressure for results, also employ a part time Ebola nurse, who would not receive any training, be expected to work 40 hour weeks for 12 hours pay, and who would leave after one month.

The Labour party would enshrine into Canberra’s constitution the right of any person with Ebola, regardless of sex, gender, ethnicity, race, disability, ability, inability, inhumanity, specie, living or dead the fundamental right not to be discriminated against in any terms ever.

The rest of us would just die.

I do like your last para . ( your not in the assembly drafting area by chance ?) The wheels would be turning.

Ben_Dover said :

First of all Mayor Rattenbury would commission a $500,000 committee to investigate how the outbreak will affect his plans for the light rail, followed up by a survey which would show that 95% of Canberrans think they would still use the light rail following an Ebola outbreak.

ACT health would employ 7 new managers, and 15 new middle managers to head up a “Ebola Taskforce”. The taskforce would decide that they would best be prepared by going to the States for a month long Ebola conference, the outcome of which would be the decision to buy all Ebola taskforce managers new laptops with “Ebola Friendly” software. The taskforce would, under pressure for results, also employ a part time Ebola nurse, who would not receive any training, be expected to work 40 hour weeks for 12 hours pay, and who would leave after one month.

The Labour party would enshrine into Canberra’s constitution the right of any person with Ebola, regardless of sex, gender, ethnicity, race, disability, ability, inability, inhumanity, specie, living or dead the fundamental right not to be discriminated against in any terms ever.

The rest of us would just die.

You paint a black picture…Lol

wildturkeycanoe4:58 pm 21 Aug 14

Canberra’s hospital system can’t cope with simple outbreaks of gastro, let alone a deadly virus like Ebola. It isn’t how the hospital system works that will determine the spread, it is people’s own hygiene or lack thereof. If one case hits the A.C.T, I’d be locking up the house and quarantining my family until there are no cases left. Guaranteed rate of survival this way.

neanderthalsis4:14 pm 21 Aug 14

How would Canberra deal with an ebola outbreak?

Badly…

But when the official statistics come out it will all be rosy.

First of all Mayor Rattenbury would commission a $500,000 committee to investigate how the outbreak will affect his plans for the light rail, followed up by a survey which would show that 95% of Canberrans think they would still use the light rail following an Ebola outbreak.

ACT health would employ 7 new managers, and 15 new middle managers to head up a “Ebola Taskforce”. The taskforce would decide that they would best be prepared by going to the States for a month long Ebola conference, the outcome of which would be the decision to buy all Ebola taskforce managers new laptops with “Ebola Friendly” software. The taskforce would, under pressure for results, also employ a part time Ebola nurse, who would not receive any training, be expected to work 40 hour weeks for 12 hours pay, and who would leave after one month.

The Labour party would enshrine into Canberra’s constitution the right of any person with Ebola, regardless of sex, gender, ethnicity, race, disability, ability, inability, inhumanity, specie, living or dead the fundamental right not to be discriminated against in any terms ever.

The rest of us would just die.

Grail said :

Now if you really want to scare yourself, ask how Canberra deals with outbreaks of respiratory illnesses.

Here’s the short version: “with Codral you can soldier on!”

That is to say, our way of dealing with a disease far more virulent with more deaths per year than Ebola has in its whole known existence, is to cover up the symptoms and continue with the normal daily routine, having very little if any regard for our colleagues and friends.

In Africa, Ebola spreads because of distrust of Western Medicine. In Australia, Ebola will spread because of disregard for Western Medicine.

Someone in Canberra will die from Ebola sometime in the next few years. Maybe two people, by which time people in Canberra will start taking hand-washing and quarantine seriously. In the meantime, nobody is concerned about deaths from flu. The prevailing attitude is apathy. All those fancy precautions won’t help if nobody is motivated to trigger them.

Canberrans are already dying from preventable communicable diseases, and nobody cares.

“with Codral you can soldier on!”
That ad angers me, telling people to go out and spread their cold to everyone else. The cynic says that’s what Codral wants; more customers.
Where I worked if people with colds dared to show their faces they were sent home. Better to have one person away than infecting the rest of the staff. I say colds, because if it were really the flu, they would probably be too sick to be there. One person turned up after being in contact with his wife who had been placed in home quarantine. His selfish presence upset the other staff and he had a visit from senior management ORDERING him to go home immediately, and not to show his face while his wife was in quarantine. Some people are thoughtless, uncaring and selfish, spreading their infection without regard for others.

Now if you really want to scare yourself, ask how Canberra deals with outbreaks of respiratory illnesses.

Here’s the short version: “with Codral you can soldier on!”

That is to say, our way of dealing with a disease far more virulent with more deaths per year than Ebola has in its whole known existence, is to cover up the symptoms and continue with the normal daily routine, having very little if any regard for our colleagues and friends.

In Africa, Ebola spreads because of distrust of Western Medicine. In Australia, Ebola will spread because of disregard for Western Medicine.

Someone in Canberra will die from Ebola sometime in the next few years. Maybe two people, by which time people in Canberra will start taking hand-washing and quarantine seriously. In the meantime, nobody is concerned about deaths from flu. The prevailing attitude is apathy. All those fancy precautions won’t help if nobody is motivated to trigger them.

Canberrans are already dying from preventable communicable diseases, and nobody cares.

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