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Ebola and Other Disease

Threats

A community brief
on the progress of
Ebola in Africa and
other potential
disease threats.
What can be done to
prepare for a
pandemic?

MAJ Eric Vought


!ommanding
"a#rence !ounty
$heriff%s Au&iliary

'( October )(*+

Distribution, -o
restrictions.

About the Author

MAJ Vought #or.ed in A/$AA01entagon in the 2(%s


#ith -uclear 3iological!hemical 4-3!5 #arfare
models. 6as studied Ebola in connection and after.
-ot a medical practitioner.

!reated county intelligence0threat analysis capability


under "!$O0"!$A.

7ecently coordinated study for "!$O0"!$A on


ME7$8!oV and recommendations for protecting local
"E from infectious disease.

9ntroduction

:nderstanding Ebola

What is the threat?

What is the response to


pandemic threats?

6o# should community


respond?

Applies to other diseases



Disclaimer,

The $heriff%s Au&iliary and the "!$O


is not pro;iding medical ad;ice.
9nformation is pro;ided in hopes that it
may be useful and is the same
information pro;ided to our
;olunteers0family. <ou and your doctor
must ma.e your o#n health decisions.

What is Ebola?

/ilo;irus, Ebola Marburg !ue;a;irus

/ilaments shepherd%s croo.

Viral 6emorrhagic /e;er disco;ered


*2=>

?aire $udan 7eston



Disease 4?aire5

)8)* day incubation 4@8*+ typical5

A(82(B mortality

1rogression

/lu8li.e 9llness 4/"95

$uppress immune system destroy T8cells

1ermeability of blood ;essels lymph nodes 4bleeding petechiae5

$uppress clotting ;omiting diarrhea

Ma.e lots of ne# ;irus particles



Treatment

/luids and support can ha;e benefit if


started early.

$ome e&perimental treatments 4e.g.


?MA115 but )8> years from production.

$ome herbal methods C7A$ may pro;ide


some help in pre;ention or treatment.but
much misinformation and no solid ans#ers.

1rogress of outbrea.4s5

) current outbrea.s

West Africa 4"iberia $ierra "eone


Cuinea -igeria $enegal Mali + in :$5

!entral Africa 4!ongo5

W6O, Outbrea. Dout of controlE but


not an e&pected :$ danger.

Daily !ase !ounts

West Africa

Ongoing since December )(*'

Not normal range.

*'=(' suspected cases 4=>'= lab confirmed +2)) deaths5


a0o )= October ;ia !D!

$amaritan%s 1urse says under8count 4)8).A&5

-igeria 41atric. $a#yer5 no cases since A $ep.

$enegal )> August no ne# cases

:$ )+ $eptember 4Thomas Duncan5



West Africa Distribution

-igeria0"agos0$a#yer

)( August 1atric. $a#yer tra;eled from


$ierre "eone to "agos -igeria en route to
Minnesota and collapsed ;omiting in airport.

)( confirmed cases and @ deaths primarily


medical0*st responderF

-O 9-/E!T9O-$ from airport0plane.

-o ne# infections since A $eptember.



!ongo

$eparate outbrea. separate strain of


Ebola ?aire

May ha;e been ongoing for some time


first detected in August

>= cases as of )* October.

6a;e had outbrea.s there before.



Ebola in :$

On '( $eptember !D! confirmed first


:$ case 4Thomas Duncan5 #ho had
tra;eled from "iberia to Dallas TG.

T#o nurses also infected. -o# H)* days.

)' October !raig $pencer -< doctor


returning from Cuinea.

E;ery#here else

There ha;e been -O !O-/97MED


!A$E$ outside of these areas so far.

Many suspected ;ictims ha;e collapsed


of malaria.

Difficult diagnosis time8delay on


testing ma.es identifying difficult.

9s it airborne?

-O. E;en Ebola 7eston may not actually be


airborne.

*22) :$AM799D study considered


inconclusi;e.

WeaponiIed Ebola can be deli;ered airborne


initially but not human8to8human.

7eally airborne is #rong Juestion.



9s it dangerous?

Absolutely.

May infect AA(((( by end of January.

9s it dangerous 6E7E?

Maybe but not the same as in Africa.

3etter system here but our response


needs #or. 4Dallas5.

Will it come here?

!learly yes..

9nfectees from other countries through transport.

3ut #ill it escape containment here?

-ot li.ely but may cause problems esp.


economic.

"oo. at cost of one "agos0Dallas8type incident.



What #ill it loo. li.e in :$?

3etter medical response isolated poc.etsF


concentrate response.

"imits to facilities supplies training in


response to dispersed threat.

Multiple threats, may need to limit


transportation to slo# it do#n.

Domestic animals may be a problem.



7esponse to pandemic

/irst try to isolate and contain indi;idual


incidents. Mo;e e&perts and eJuipment.

*( 1rinciples of Modern Kuarantine 8 !D!

$lo# do#n spread by international and


interstate transportation.

-othing goes in0nothing comes out not


necessary and not effecti;e.

!ommunity preparation

Disruption of suppliesF disinfect #hat


comes inF

Telecommute reduce commerce0contact

!an emergency ser;ices be maintained?

Disruption of ser;ices

DON'T PANIC!

Personal Protective
Eqipment !"ad E#ample

3etter 1rotection

1rotect s.in0eyes first.

Cood shield ;s. cheap mas..

Cood sanitation.

7educe contact #ith public fi&tures.

Disinfect surfaces 4any hospital8grade


disinfectant light and O)5

7adio cell te&t email doesn%t infectL



Transportation $hutdo#n

Who do you #ant enforcing?

Do you ha;e enough nurses? /irst aid?


1OD8trained? 7adio operators?

"ocal community0local core capability

7ural areas lo#8priority for help any#ay.

3ut lo#er8ris. more self8reliant.



$pecial -eeds !ommunities

/EMA euphemism socially or physically


isolated incl. Minority

6o# respond to epidemic in /erguson?

"atino community #on%t trust responders.

Many #hite Americans #on%t trust go;%t.

Must address proacti;elyF o#nership0trust



6erbalists As 9nsurance

!ulti;ation0identification0preparation of
medicinals pro;ide reser;oir if needed.

C7A$ treatments faster to put into effect in


emergency less ethically challenging than
untested synthetics but may not #or..

%-atural% not #ithout do#nside but option.

3e#are fraud and sna.e oilM/DA releaseN.



Other Threats

$A7$ $#ine /lu recently

ME7$ 4#ill come to MO not Hthreat5

Other hemorrhagic fe;ers and tropical


diseases

9ncreasing mosJuito8born illnesses

O;er long8term bio8terrorism



!onclusions

Cood bad and ugly.

$ignificant un.no#ns.

9f not Ebola #e $ill ha;e increasing


disease threats must face response.

/ocus on changes ma.ing community


better0stronger either #ay.

Kuestions0!ontact

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