Tuesday, September 30, 2014

In what should be glaringly obvious, the first US case of ebola..diagnosed here gets news leads across nation

Over 3,100 dead in West Africa, but one isolated case in the US gets US news lead. If I could say so with anything approaching bias against brown peoples, I would. At best this will raise awareness of the West African situation. At worst, it will do nothing but feed on the mis-informed and uninformed fears. Given how fearful that the US id collectively, I know I would place my bet.

In one other ebola bit, the ebola CFR is now at 70% according to the WHO The old WHO case fatality rates were 50%(initially), then 63%. The rise in case fatality rates is not surprising as much more attention is being paid to l'épidémie. The 70% CFR is typical for African outbreaks of the most deadly form of ebolavirus infection(formerly Z-EBOV). It is really difficult to parse how much is due the lethality of the pathogen, and how much is due to shattered health care systems.

As an example, I will use the closely related Marburg virus.

In the West with the best palliative care, the CFR is roughly 25%. The Angola Marburg outbreak of 2005 had a CFR of 93%. Now, do not draw what on the surface seem to be clear differences given differing standards of care. Remember that there are many Marburg variants in a given patient*. RNA viruses do not replicate with error correcting mechanisms. That said, there are two recognized species of Marburg virus yet discovered, and I find no clinically significant difference in the CFR of either species. So, supportive care does appear to make an enormous difference in the survivability of infected individuals. Appear is the key word. I need more supporting data before I form conclusions.

Time to strap on the feedbag.

*To qualify as a new Marburg species, greater than 10% of the nucleotides(RNA in the case of Marburg) must differ. A rather arbitrary figure.

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