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While admittedly, the ZMapp story is still very much an "unfinished story", it seems to me to be a bit overly dogmatic to censor it out of the main article altogether, simply because its most recent apparently successful use did not follow the normal regimen of drug testing procedures. I have reinserted some of the ZMapp information into the main article, with the brief caveat that it s use in Africa did not follow such normal drug testing procedures. News of the most recent apparently successful uses of the drug on the two American missionaries is widely available throughout the world. For Wikipedia to bury it's head in the sand and to refuse in the main article, to even admit that such a ZMapp story ever took place, seems to me to be unnecessarily extreme. Thanks, Scott P. (talk) 09:42, 5 August 2014 (UTC)
It is a "news story" Wikipedia is an encyclopedia not a new source. Have left it but summarized it further. Additional issue is the ref you used does not support the text in question. Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:38, 5 August 2014 (UTC)
Two studies involving this approach are from 2011 and 2012, and if you look up the studies authors on PNAS you might have more science.prokaryotes (talk) 09:58, 5 August 2014 (UTC)
Developing Vaccines
The Ebola virus contains 7 genes in its genome. The current vaccine that is being developed by Okairos in Bethesda, Md., includes two of those seven genes. While many other vaccines are being developed across the country and world, this vaccine seems to be in the lead, expecting results by early 2015. This vaccine was created using a chimp adenovirus non-replicating viral vector which expresses a protein that induces the body to make an immune response. In animal studies, the vaccine has been shown to protect rhesus monkeys for up to ten months, much longer protection than previous Ebola vaccines. — Preceding unsigned comment added by Isabelprado (talk • contribs) 16:42, 9 September 2014 (UTC)
According to this article of the BBC, the virus can be transmitted through the air. Due to the fact that I have not yet the ability (not enough edits) to alter the semi-protected article, can someone amend it please? Thanks — Preceding unsigned comment added by KwstasM (talk • contribs) 10:23, 5 August 2014 (UTC)
This does not make sense, and should be clarified. What does "they" refer to ? Neither "outbreaks" nor "visuses" seems appropriate (viruses are a lot smaller than 1um). Seems that whoever wrote it did not work out beforehand what it was he or she wanted to say ....
"Airborne transmission has not been documented during previous EVD outbreaks.[2] They are, however, infectious as breathable 0.8–1.2 micrometre laboratory generated droplets;"
I would guess that the second sentence should read "Ebola infections have been transmitted by airborn, and therefore breathable... etc ". But there is no way of editing the text. g4oep — Preceding unsigned comment added by 77.96.60.31 (talk) 07:43, 7 August 2014 (UTC)
Citations
The Antibodies section of the article contains that they transfused antibodies to patients in 1999, however the original publication that is given as citation tells a completely different date in the very first sentence of its abstract. "Between 6 and 22 June 1995, 8 patients in Kikwit, Democratic Republic of the Congo, who met the case definition used in Kikwit for Ebola (EBO) hemorrhagic fever, were transfused with blood donated by 5 convalescent patients." Sure, the article was published in 1999, but you shouldn't give scientific articles as citations if you don't even read the first sentence of their abstract. In this case it's not that much of a deal, but things like this just make the content seem unreliable. Regards: --Kohlins (talk) 16:00, 5 August 2014 (UTC)
That's a good point. The citations need attention and the article needs updating. SW3 5DL (talk) 03:47, 6 August 2014 (UTC)
Communicability of EVD
In the second paragraph of "Ebola virus disease", the article sites a "household study" on the communicability of EVD:
"In a household study, secondary transmission took place only if direct physical contact occurred. No transmission was reported without this direct contact. Airborne transmission has not been documented during previous EVD outbreaks.[2]"
The citation links to a World Health Organization page with one bullet point stating that transmission without direct contact hasn't been documented an that airborne transmission "..has not been documented during previous EVD outbreaks".[2]
However in November of 2012, Scientific Reports, a research outlet from the publishers of Nature, published a paper about Ebola transmission from pigs to non-human primates. It included reason to believe that Ebola can travel by air and not only by close contact or body fluid exchange.[3]
^Chappell, B. New Ebola Vaccine Is Tested In Humans, After Success In Monkeys. NPR. 2014 Sep 7.
You'll also note that the study failed to achieve transmission between primates in those circumstances, which is likely of more relevance to human transmission.
From that report:
"pigs can generate infectious short range large aerosol droplets more efficiently then other species"
"We have also never observed transmission of EBOV from infected to naive macaques, including in an experiment employing the same cage setting as in the current study, where three NHPs intramuscularly inoculated with EBOV did not transmit the virus to one naive NHP for 28 days, the duration of the protocol. During another study, three EBOV infected NHPs cohabiting with 10 naive NHPs in adjacent cage systems did not transmit the virus to naive animals for 28 days (unpublished data)." Donners (talk) 08:21, 6 August 2014 (UTC)
Couple of things. 1) the previous text was copied and pasted so I reworded it 2) we need to use secondary sources per WP:MEDRSDoc James (talk · contribs · email) (if I write on your page reply on mine) 09:22, 6 August 2014 (UTC)
We should mention the newest (as of today) CDC guidelines for staff treating Ebola patients which assume that "Aerosol Generating Procedures" are also risky:
"Avoid AGPs for Ebola HF patients. If performing AGPs, use a combination of measures to reduce exposures from aerosol-generating procedures when performed on Ebola HF patients..."
http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.htmlZezen (talk) 13:53, 8 August 2014 (UTC)
Yes would be good in the prevention section. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:34, 9 August 2014 (UTC)
Semi-protected edit request on 6 August 2014
This edit request to Ebola virus disease has been answered. Set the |answered= or |ans= parameter to no to reactivate your request.
Spread through the air has not been documented in the natural environment.[2] However limited laboratory testing shows likely spread through droplets between pigs and monkeys. The same testing shows that pigs could be a carrier of Ebola.
What is the request? Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:41, 6 August 2014 (UTC)
Not sure what he's asking. But I know there are sources that show there is a higher incidence of Ebola in humans working on pig farms. It's believed the original source is fruit bats, the bats bite the pigs/monkeys, the humans handle the pigs, etc. SW3 5DL (talk) 02:53, 7 August 2014 (UTC)
Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. Acalycine(talk/contribs) 06:53, 10 August 2014 (UTC)
Description
The article describes the disease in an unsatisfactory way. It seems to take some days until a patient shows symptoms, this is well explained. But then the disease seems to lead to two possible outcomes: either 1) the patient will die, or 2) he will survive. The article does not describe this appropriately. How do cases 1) and 2) typically look like? In case 1), how long does it usually take for the patient to die after having shown first symptoms? How do the symptoms worsen until death? In case 2), how long does recovery usually take? How do symptoms improve and when? This pretty basic information, describing the basic development of the disease, is lacking from the article. --rtc (talk) 13:39, 7 August 2014 (UTC)
I agree. I would also be interested in how much immunity survivors attain, or if they still suffer certain lasting effects after fighting off the virus. (I was wondering whether some of the international financial aid could flow into employing survivors as nurses etc.) — Providus (talk) 15:52, 7 August 2014 (UTC)
Added some info that I could find. --rtc (talk) 00:31, 11 August 2014 (UTC)
Nzara location where the virus first discover is not part of Sudan any more after South Sudan ceded
I want to clarify that after South Sudan ceded, Nzara (where the virus as first identified) is not part of Sudan any more. [1], please make the correction, regards. — Preceding unsigned comment added by 2.49.129.226 (talk) 11:45, 8 August 2014 (UTC)
yes that is the correct name of the region so correction should be made.Docsim (talk) 03:06, 11 August 2014 (UTC)
This edit made it complicated [1]. IMO was better before. This detail is in the body and lower in the lead already. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:02, 10 August 2014 (UTC)
I agree, we need to use simple language in the lede. -- CFCF🍌 (email) 15:03, 10 August 2014 (UTC)
User:FT2 we need to keep the lead simple. Happy to discuss changes but your changes are too complicated and should be dealt with in the body of the text.Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:44, 11 August 2014 (UTC)
I agree with Doc. Gandydancer (talk) 19:16, 11 August 2014 (UTC)
SImple is fine. Wrong information isn't. This is saying EVD is a disease resulting from one specific virus, EBOV. That's incorrect information. It's a disease resulting from several virii within a genus. I don't think saying it's caused by 4 out of 5 virii in a genus is very difficult at all in any sense, moreso when it's correcting incorrect information. If you're targeting users who need "hemorrhaging (bleed)" simplified, then you're in the wrong wiki. Even simple English wiki uses the term "hemorrhagic" in the lede. Dumbing down beyond a reasonable point, and making it incorrect in the process, would be an issue. The intent is good, but this wouldn't be okay. FT2(Talk | email) 09:00, 12 August 2014 (UTC)
I'm in full agreement for the need to change the article to read "At this point, some people begin to hemorrhage (bleed) internally and externally". The present wording has bothered me all along. Gandydancer (talk) 11:52, 12 August 2014 (UTC)
OK, I've had time to do some reading and I now believe that simple is important but not at the expense of accuracy. Why could we not just (simply) say EVD is caused by four of five viruses classified in the genus Ebolavirus? Gandydancer (talk) 16:31, 12 August 2014 (UTC)
We have changed it to caused by ebolavirus rather than Ebola virus as I agree the previous version was not correct and thus would like to thank User:FT2 for this improvement.
Hemorrhage and bleeding are the same thing. Our goal in medical articles is not to try to teach people medical terminology but to get information across. Guidelines state the lead should be in simple English here on main English Wikipedia. Would be happy with adding a further sentence like "this bleeding can occur inside or outside the body" Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:55, 12 August 2014 (UTC)
Actually bleeding and hemorrhage are not at all the same thing. Hemorrhage suggests uncontrolled or uncontrollable bleeding and that's what we want to convey. Besides, it is my belief that most people understand the term "hemorrhage (bleed)" with ease. "Bleeding problems", to me, makes the article sound like it was written by a person with little to no medical knowledge. Gandydancer (talk) 20:33, 12 August 2014 (UTC)
Gandydancer, if you were right, then you would have to start modifying the article on bleeding/hemorrhage first, which seems to equate bleeding to hemorrhage.--Gciriani (talk) 20:53, 12 August 2014 (UTC)
Interesting. Seems to me we are wrong at that article. A bloody finger, and very little blood at that, is not a hemorrhage. This site [2] is better. Gandydancer (talk) 21:17, 12 August 2014 (UTC)
useful article on how drugs are "approved" for use in ebola and similar diseases
this taught me a lot. perhaps it will be useful in discussions of treatments being used (short story it is utterly unethical to do clinical trials of drugs for things like Ebola and so the FDA lets you use them with only animal data and a phase I trial to get some idea about dose and safety in humans. there will not be data on how safe and effective they are for a long, long time. animal studies on drugs are therefore VERY relevant)
http://www.raps.org/Regulatory-Focus/News/2014/08/07/19977/Regulatory-Explainer-What-You-Need-to-Know-About-the-Regulation-of-Ebola-Treatments/Jytdog (talk) 05:26, 11 August 2014 (UTC)
Opening Paragraph - Lede
I see that more than one editor reverted changes I made to the opening paragraph of the Ebola_virus_disease, causing two inconsistencies. The reference name=CDC2014Out needs to be left at the end of the first paragraph, because the other reference doesn't mention the typical incubation period (8-10 days), only the range (2-21 days). Also, the references I have read do not say that the bleeding starts after other symptoms have stared; but several reversion to my correction start with At this point..., which implies that the other symptoms happen first, then the bleeding may or may not start. If this is indeed the case, it needs to be supported by a relevant citation or other source.--Gciriani (talk) 19:30, 12 August 2014 (UTC)
Okay restored the two days to 3 weeks bit to address the first part. The wider range is the more important one as this gives information on isolation
With respect to writing in simple English we should try to keep sentences from getting too long. Have changed At this point.. to Around this time
Ref says "This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding." [3]Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:53, 12 August 2014 (UTC)
Jmh649 or Doc James, I respectfully disagree with your changes. (1) This is a lede, therefore typical incubation period is better than reporting the whole range. (2) the expression around this time or anything that refers to time is still unsupported. Rather than paraphrase, quote the CDC sentence from the reference.--Gciriani (talk) 20:17, 12 August 2014 (UTC)
Okay we can have a RfC for wider input regarding if we should have the usual range or the full range. IMO we should use the full range as this is what isolation is based upon. It is not based on the usual range. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:46, 13 August 2014 (UTC)
Introduction generally
The intro was a very strange style, especially for a medical article on a disease, with omitted key information and unreasonable "dumbing down". When English wiki is omits more and is more - unreasonably - simplified than Simple English wiki, something's wrong. An intent to make it accessible shouldn't require this cost. Without much difference in language level or length, it's easy to address these in a more usual way. Two edits:
The disease is not just caused by EBOV, and no amount of "keep it simple" allows for this clear misinformation when even the limits of an introduction allow us to be accurate.
An article that describes Ebola's haemorrhagic symptoms as "victims begin to have bleeding problems" is almost insultingly weak to the reader. Again this isn't Simple wiki, we can name it for what it is, "haemorrhagic".
The mortality rate/seriousness is worth stating in the first para, fits in well there (It's also important enough to get "top spot")
The third paragraph can usefully have 2 points moved to the first paragraph: mortality rate percentages and non-specificity of treatment. Both are short. This leaves the first paragraph cogently covering the course of the disease (virus, symptoms, prognosis, treatment, all short) and the last paragraph covering purely epidemiology, which then reads cleaner.
FT2, wouldn't it be more correct to state the typical incubation time of 8-10 days as stated in the more recent reference from CDC, August 1]? (this is already referenced elsewhere in the article)--Gciriani (talk) 21:26, 12 August 2014 (UTC)
I hadn't checked that, if it's incorrect then yes, of course let's fix it. I would also like to see some other information made clearer, such as recommended precautions, difficulties faced with health education in Ebola (eg from WHO), if we can. Last I am a bit concerned that Marburg virus emphasizes exact causes of death that aren't haemorrhagic per se. Ebola is said to be very similar but we imply the main cause of death is organ failure, presumably due to bleeding/blood loss. can we tune the article to be a little more correct/exact on cause of death, if haemorrhaging itself isn't the direct cause? FT2(Talk | email) 21:43, 12 August 2014 (UTC)
I agree that it's better for the lead to stick to the flow of the whole article as a precise and concise summary of each section. However, I saw that the mortality rates were mentioned in the History part (but not sure why they appear in the Prognosis part as well), so why not put that info. to the last paragraph which can be about epidemiology & history? My logic is like this (not just confined to the lead): general intro. (of course this is for the lead only) --> cause & transmission --> symptoms & signs --> pathophysiology --> diagnosis --> treatment/management --> prognosis --> prevention --> epidemiology --> history. This is supposed to be also the "flow" of getting and dealing with a disease, isn't it? Biomedicinal (talk) 04:28, 13 August 2014 (UTC)
For the main article where there is space, I think that works, but for the intro... many readers are lay readers who skim to get an overview, or find long writings hard to plough through. So for various reasons, they often only read its intro and frequently even then, only the first paragraph. So for the intro it's often worth slightly reordering to allow for brevity and tight coverage of core material, and that when the intro covers primary and secondary material in some way, the primary material is all mentioned at least in the first para. In that context, the material that's useful for a lay reader is not a medical textbook layout. It's closer to "talk about the topic itself first" (the disease itself, its progression and impact, and brief touches of any other really crucial points), then in paragraphs 2-4 cover the broader material such as natural reservoir, transmission, precautions, history, epidemiology, social impact, etc.
A reader after a quick summary (little English, unfamiliar with encyclopedias, or casual curiosity from a news mention) who wants to read just a paragraph or a brief overview, is likely to want to know about the disease itself - the core material - if they aren't going to read it all. One with more interest will read the entire intro, covering these other areas in summary. A reader with deeper interest will read into the actual article. So it can help readers if we order the intro very slightly differently from the full content, so we present the core material on the actual disease and its course without fragmenting, for the benefit of quick skimmers or readers for whom it's unfamiliar or hard work. It's a bit like putting oneself in a reader's shoes - and not just an educated literate engrossed reader who will read it all.
Put another way, while a clinician might feel this is a logical order, an average reader (unlike any editor) will probably feel it's odd to discuss all about the disease - its cause, its symptoms - then stop, discuss prevention and fruit bats and other stuff, before mentioning in the very last paragraph, what happens to those who get the symptoms discussed in the first paragraph. FT2(Talk | email) 05:48, 13 August 2014 (UTC)
Okay we have a bunch of discussion. Lets try to separate them. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:57, 13 August 2014 (UTC)
My impression is that FT2 had made very good points, and improved the lead paragraph by a great deal. A couple of his arguments especially impressed me: "dumbing down" and "insultingly weak to the reader". I have the impression that the changes by Doc James are almost a reversion and disregard those points.--Gciriani (talk) 17:03, 13 August 2014 (UTC)
This is really being discussed in the Should we use terms more complicated than our sources? Does simplification matter? subsection below, but generally I'm thinking quite the opposite here. Doc's changes respect the audience better because they respect the wide variety of education and language fluency our audience reading this article has. Also this article is on the translation list for export to other language Wikipedias and the translations are done faster and better when the language isn't more complicated than necessary. Zad68 18:02, 13 August 2014 (UTC)
I have discussed each point one by one below. A number of the suggestions I have agreed with and they are in the current text.Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:16, 14 August 2014 (UTC)
Should we say it is caused by Ebola virus or ebolavirus?
I think we all agree the latter is better. Do we need to say it is just 4 out of the 5 in the first sentence? No I think that is too much detail. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:57, 13 August 2014 (UTC)
But it isn't. That's factually incorrect. The outbreak is caused by one specific virus, not by a genus. Point blank misinformation, and probably hairraisingly wrong to anyone checking Wikipedia for (in)accuracy on this outbreak. Equally to write it is caused by "Ebola virus" will imply there is only one such virus, also wrong. (Give or take some taxonomic leeway, using the genus is somewhat like writing "Mammal caused the Bay of Pigs.") FT2(Talk | email) 18:23, 13 August 2014 (UTC)
Ah so you are saying "Ebola virus disease" is not caused by "ebolavirus"? This article is not about one specific outbreak. All five do cause ebola virus infections. It is just that only 4 of the 5 cause disease in humans. Thus it is not at all like writing "Mammal caused the Bay of Pigs." Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:05, 14 August 2014 (UTC)
Information to ensure we don't misrepresent: (a) An outbreak (ie any one specific instance) is caused by one specific member of ebolavirus. (b) Only some members of ebolavirus can cause outbreaks.
We can clarify in the body, but that's in no way a license to mislead or simplify to the point of actually confusing/misinforming, in the introduction. Many articles have had considerable and very careful wording in the intro for exactly this kind of concern, and this one should too. How about "outbreaks are caused by certainebolaviruses" or "outbreaks can be caused by four kinds of ebolavirus"? Avoiding confounds is important here. FT2(Talk | email) 08:52, 14 August 2014 (UTC)
And which ebolavirus does not cause outbreaks of EVD is some animals? Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:34, 14 August 2014 (UTC)
The lead now (again) states that Ebola is caused by the Ebola virus. I thought that we all agreed that ebolavirus was better. For instance, there have been around 6 outbreaks of the disease caused by the Sudan species. I'm going to change it back. Gandydancer (talk) 11:54, 15 August 2014 (UTC)
Thanks. It was likely lost in the shuffling around of text. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:16, 15 August 2014 (UTC)
Should we have the whole or the most common range in the lead?
I think the whole range should go in the first paragraph as this is important for isolation. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:57, 13 August 2014 (UTC)
I think the typical range only, and not the whole incubation range, should go in the first paragraph; the argument by Doc James is not valid, because the lead paragraph is not read for isolation guidelines, but it is read to have a general idea of the disease. Those who are interested in the details read the rest of the article.--Gciriani (talk) 16:30, 13 August 2014 (UTC)
"About" is a good word here. But consider our readers. "About X days" will be taken to mean "after X+1 days there's no risk" by a lot of them. Be very careful... FT2(Talk | email) 18:23, 13 August 2014 (UTC)
"Up to X days" is also viable. While it implies no lower limit, that's less of a problem for exactly that reason: no lower limit is implied. FT2(Talk | email) 09:38, 14 August 2014 (UTC)
Should the lead match the same order as the body of the text?
Support following the same order as the article. The ordering of the article is listed here WP:MEDMOS and this is the order we use in nearly all disease related articles. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:57, 13 August 2014 (UTC)
Also support keeping the order in the lead the same as in the article, for logical flow and to keep it in line with MEDMOS certainly but beyond that I do not get the complaint in the argument for putting the treatment before the discussion on how you get it. The flow of: What it is, how you get it/avoid getting it, and then what the treatment is if you do it, makes perfect sense to me. Jumping from what it is to how to treat it and then going back to how you get it/avoid getting it breaks that logical flow. Zad68 14:17, 13 August 2014 (UTC)
I imagine it from the viewpoint of someone with a non-academic interest in the disease. I suspect for most readers, the human impact and course of the disease is of primary or even sole interest (agent, transmission, symptoms, treatment, prognosis). After that come the secondary/academic interest points (Where does the virus live when not in humans? What is the history/epidemiology of the disease?). FT2(Talk | email) 08:59, 14 August 2014 (UTC)
I am not completely opposed to changing the ordering of sections. This however should be based on consensus at WP:MEDMOS and applied to all 9000 or so disease related articles. Some consistency is important IMO. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:36, 14 August 2014 (UTC)
Should we mention mortality in the first paragraph?
We had a long discussion about mortality statistics and what the general populous wants to know. This has been studied and the conclusion was that people do not want to know mortality first thing. User:Johnbod has the data. Maybe we can present it in general terms in the first paragraph and than in more detail in the 4th paragraph? Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:25, 13 August 2014 (UTC)
Should we use terms more complicated than our sources? Does simplification matter?
There appears to be some who wish to use the term hemorrhage rather than bleeding? Our source which is the World Health Organization uses the term bleeding [6]. Bleeding is more general than hemorrhage but they more or less mean the same thing. IMO we are not here to teach people medical terminology. Thus I support using simple language as much as possible. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:25, 13 August 2014 (UTC)
This is a very serious concern for me, leads in general, and for this article in particular because of current events and the global effect, the lead needs to use accessible words and writing style. Technical terms should be avoided if there are more common terms, and especially if the sources we're using like from the WHO don't use them, that seems obvious. We should use the communication models of the WHO and Cochrane's plain-language summaries. Here, more technical stuff can go into the body if necessary, after the more simple presentation. Zad68 14:40, 13 August 2014 (UTC)
The previous wording: It is a hemorrhagic fever, meaning that victims may bleedinside the body or externally was an excellent compromise, and I'm quite surprised that it has not been accepted as such. Gandydancer (talk) 15:17, 13 August 2014 (UTC)
Victom is a term we should not use per WP:MEDMOSDoc James (talk · contribs · email) (if I write on your page reply on mine) 02:01, 14 August 2014 (UTC)
I'd rather see this explanation in the body than the lead. Zad68 15:19, 13 August 2014 (UTC)
Agree with Zad Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:01, 14 August 2014 (UTC)
I think that in this context the expression bleeding problems is a weasel expression. What about the more medically used bleeding complication? And instead of repeating the word bleeding almost next to each other in two consecutive sentences, what about merging the two as in: "Around this time, people infected begin to bleed either within the body or externally."--Gciriani (talk) 23:49, 13 August 2014 (UTC)
Weasel word for what? Happy with "Around this time, people infected begin to bleed either within the body or externally." Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:01, 14 August 2014 (UTC)
If you don't understand what I meant with weasel expression, you can consult Wikipedia.--Gciriani (talk) 02:46, 14 August 2014 (UTC)
(unindent) Then pick a different word from "victim" per MEDMOS and change that one word, if needed. This is a bit of a red herring in that it's an issue that doesn't (and can't) impact on or validate the alarmingly weak original wording of the sentence. "A hemorrhagic fever (meaning people may bleed inside and outside)" is a fine balance. If anything skip the parentheses comment; anyone can find what the word means by clicking the link or reading the article. Calling a hemorrhagic fever "may have bleeding problems" suggests one may be writing for the wrong wiki... or might be intending to edit gingivitis. Simple English is elsewhere... and even that Wiki would blanche at this (Simple English wiki has used almost identical wording along with the complicated word "hemorrhagic" in its introduction for 9 years, since August 2005 without complaint or change). Sorry, but the original wording was plainly, at a wrong level. We should call it what it is, even in the intro.
As for the other red herring of "terms more complicated than sources".... that's not the case obviously. There is no validity to a claim that normal sources of a level and quality typically used for an article on a disease, don't commonly call "hemorrhaging" "hemorrhaging", or that any wording discussed is "more complicated" than the majority of viral disease article sources we use. (Hint: article sources are predominantly WHO, Virology journal, CDC, etc. Probably not.) FT2(Talk | email) 09:24, 14 August 2014 (UTC)
The term hemorrhage redirect to our article on bleeding and has done so since 2006. The terms are more or less the same. One may imply slightly greater severity with bleeding being the broader term and thus in this context the more correct term. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:29, 14 August 2014 (UTC)
We no longer say "bleeding problem" and instead simply say "bleed". Not sure if this addresses the concerns. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:32, 14 August 2014 (UTC)
The term victim and patient
These has been introduced a number of times. Per the WP:MEDMOS these terms are not recommended. We should use the term "person with" instead as it keeps our articles more person centric rather than clinical. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:34, 13 August 2014 (UTC)
That's fine by me. Probably my doing, wasn't aware of this before. Thanks! FT2(Talk | email) 09:25, 14 August 2014 (UTC)
Doc James, I'm not sure where you found out that we need to keep the article person centric. At least I couldn't find it in the manual of style you mentioned. Specifically, Wikipedia:MEDMOS#Careful_language reads: Avoid saying that people "suffer" from or are "victims" of a chronic illness or symptom, which may imply helplessness. Since this is a disease with very high mortality, helplessness is already implied, and I don't see the basis for a person-centric approach.--Gciriani (talk) 14:31, 14 August 2014 (UTC)
It is a more encyclopedic style to avoid emotional or value-laden terms like suffer and victim. The affected individuals and their caregivers are the ones who will be making the determination about those concepts, not Wikipedia. Zad68 14:36, 14 August 2014 (UTC)
Who the disease occurs in
The disease per the WHO ref can occur in humans, other primates and pigs per "As RESTV outbreaks in pigs and monkeys have preceded human infections, the establishment of an active animal health surveillance system to detect new cases is essential in providing early warning for veterinary and human public health authorities." But this is only the RESTV infection. Thus probably enough to just mention humans and other primates in the first sentence. Should we remove pigs / discussion of RESTV from the lead all together? Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:51, 13 August 2014 (UTC)
"Prevention includes decreasing the spread of disease from infected monkeys and pigs to humans" This line is in the third paragraph of the article. Several human outbreaks have been linked to consumption of monkey meat, but I am struggling to think of any linked to pigs. This line implies that there have been a few. If that is not the case, perhaps it should be reconsidered. Donners (talk) 10:06, 13 August 2014 (UTC)
Agree User:Donners we need to look at this. It is from this source [7]Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:56, 13 August 2014 (UTC)
I have not researched this but I do know that Africans eat very little pork. In general, they keep chickens and goats and to a lesser extent cattle, but for religious reasons little pork is eaten. Gandydancer (talk) 15:27, 13 August 2014 (UTC)
Applies to Muslims but not necessarily Africans as a whole. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:58, 14 August 2014 (UTC)
Since RESTV doesn't cause the disease, I agree too, it's irrelevant here and shouldn't need mentioning (so long as we don't imply all ebolaviruses cause EVD). Pigs become relevant for some areas of discussion in the body, the intro is fairly optional. If they need mentioning then at most one word or so when covering animals known to harbor the disease: "the disease can be caught from some kinds of animals" and at most a parenthesis comment "including bats, pigs and monkeys".
More to the point, are we discussing the disease in other species here, except in the context of transmission to humans? If so we'll have to complicate it a lot (transmission to/from other primates? Symptoms in other primates/pigs?). I think we should follow other articles on zoonotic diseases, and simply say "EVD is a human disease that can be caught from animals and other people by contact with their body fluids". Then discuss other species pretty much as we are now, as vectors to humans. This article isn't really covering EVD in other species for any other reason than their status as reservoirs and vectors, so be direct and say so. Then we don't have any issue. FT2(Talk | email) 09:29, 14 August 2014 (UTC)
RESTV does cause disease it just does not appear to cause disease in human. WHO is careful to make clear that this conclusion is tentative per "More studies of RESTV are needed before definitive conclusions can be drawn about the pathogenicity and virulence of this virus in humans." [8]Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:11, 14 August 2014 (UTC)
Have changed the wording to Prevention includes decreasing the spread of disease from other infected animals to humansUser:FT2 and User:Donners does that address the concern? Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:13, 14 August 2014 (UTC)
Yes, thank you. That's an entirely appropriate way to express it. Donners (talk) 02:07, 15 August 2014 (UTC)
Yes not a great source. We should find something better. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:33, 14 August 2014 (UTC)
It's true that a better source would be desirable, but I don't think that warrants removing the information about Amiodarone entirely, seeing that we are talking about the Research section of the article and most other refs in that section are also to recent primary sources. AxelBoldt (talk) 11:43, 15 August 2014 (UTC)
OK, I have added the sentence about Amiodarone back in. I made clear that it's supported by just one recent study. AxelBoldt (talk) 20:22, 16 August 2014 (UTC)
Should we keep the compromise or should we delete the 2014 study? The text is now clear it is only a study. QuackGuru (talk) 20:36, 16 August 2014 (UTC)
The new Ebola virus
The new Ebola virus seems to have pandemic potential, but a slow moving one. I'm a little nervous because I went to the site and discussion forum at http://www.ebolainfo.org and that's what they're talking about. — Preceding unsigned comment added by 76.90.24.244 (talk) 00:40, 15 August 2014 (UTC)
Context
Disclaimer: I am currently living in Ghana and keeping abreast with the news on the spread of Ebola in the West African subregion.
It's misleading to show bushmeat from a country which has no recorded cases of Ebola.
The bushmeat in the picture is the 'grasscutter' - the greater cane rat, which, to date has not been the cause of any known cases (as there are none) in Ghana. Please remove and show a more relevant picture! — Preceding unsigned comment added by Aoa4eva (talk • contribs) 12:09, 15 August 2014 (UTC)
Good point. Do we have a better image? Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:03, 15 August 2014 (UTC)
Typo in article.
The "Signs and symptoms" section currently says: "Ebola usually begin suddenly with AM influenza-like stage". This should probably be "Ebola usually begin suddenly with AN influenza-like stage".
This has been corrected. Pbmaise (talk) 03:44, 9 September 2014 (UTC)
How to sanitize surfaces that have been exposed to this pathogen
I'd like to discuss this recent addition:
Ebola virus can be killed by detergents / soap and alkaline substances dissolving fat, heating to 60 degrees Celsius for 60 minutes, boiling for 5 minutes and UV -light and not only various other types of disinfectants or gamma radiation etc. [9]
The site has several other suggestions that may be helpful - though on the other hand I have no idea if any of this should be included. It could go under a small new section... Gandydancer (talk) 16:47, 19 August 2014 (UTC)
The Ebola Virus Disease is already in my country(Nigeria,West Africa) but i haven't gotten any news of someone dying from Ebola. The vaccines arrived just 3 days ego here.And the government has ordered that everyone should wear gloves and wash their hands properly and no receiving the Eucharist directly from the priest. Instead it from your palm and i just pray that all this would be over.--Allbyme (talk) 18:24, 19 August 2014 (UTC)Ebola virus disease
Would go in the section on prevention Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:56, 20 August 2014 (UTC)
Allbyme writes, "The vaccines arrived just 3 days ego here." I would say "There is no Ebola vaccine, but charlatans peddling what they purport is one arrived just 3 days ago". Take care. --{{U|Elvey}}(t•c) 18:05, 7 October 2014 (UTC) Updated; apparently there are legit experimental vaccines.
We mention "Spreading through the air has not been documented in the natural environment" Would want better sources than the guardian and huffington post. If I remember correctly WHO and CDC state that this risk of spread in the developing world is very low. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:46, 20 August 2014 (UTC)
The fact that spreading though the air doesn't occur is only one of the major points, others being that people are becoming infectious not before first symptoms and the short time until death and thus short infectious period. The guardian and huffington post articles put the numbers of ebola deaths into context of some epidemics that are a lot more serious, like HIV, influenza etc, where the number of deaths easily goes into the six figures, every year. The article needs to be less supportive of the prevailing hysteria, which truly bears little relation to reality. --rtc (talk) 05:00, 20 August 2014 (UTC)
We already mention that people are not infectious before symptoms appear. We state "The potential for widespread EVD infections is considered low as the disease is only spread by direct contact with the secretions from someone who is showing signs of infection." based on a CDC source.
A couple of thousand is low numbers. We have never supported the hysteria of the popular press. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:02, 20 August 2014 (UTC)
Yes, the fact itself is mentioned somewhere in there, but it's not put at all into the context of epidemology, what it means for how the disease spreads. The same thing is true about the number of deaths. Nowhere does the article really say that, empidemologically, it's a pretty harmless disease. Plus the same issue about the mortality rate. Up to 90% seems high, but compared to the much more problematic and more common (in terms of cases in developed countries, where we essentially had zero Ebola cases so far) rabies, where you have a very hard time finding anyone at all who ever survived it, people have a pretty good chance to survive it, and that in countries with really bad, even nonexistent health systems. --rtc (talk) 23:40, 20 August 2014 (UTC)
I haven't seen where our disease articles compare the mortality rate to that of other diseases and then discuss the comparisons. Nor should they. Gandydancer (talk) 01:31, 21 August 2014 (UTC)
Agree with Gandy. We do not usually do this in other articles. If lots of reliable sources did so we may consider it. The popular press is not reliable though. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:32, 21 August 2014 (UTC)
Wood ash
User:TorstenMandal continues to try to add information about wood ash without any refs supporting its use for the prevention of ebola.[10]
To state that wood ash should be used we need a statement from the CDC, WHO or other high quality source IMO. We are not here to publish primary research or peoples extrapolations. Thoughts? Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:54, 20 August 2014 (UTC)
Yes high quality refs needed for such content. Zad68 22:00, 20 August 2014 (UTC)
That edit is about as WP:SYN-ful as it gets. Jytdog (talk) 22:05, 20 August 2014 (UTC)
I would not say that it is about as SYN as it gets at all. For those without access to detergents it works quite well. That said, I agree that we need the WHO to recommend it before it can go into the article. Gandydancer (talk) 02:00, 21 August 2014 (UTC)
TorstenMandal: I have documented everything with reliable scientific and official sources except that wood ash has not been particularly recommended for Ebola prevention (which I never have indicated). WHO recommendations for use of handwashing with ash in emergencies without soap (http://www.who.int/water_sanitation_health/emergencies/qa/emergencies_qa17/en/ ). Lipid solvents is also effective against the Ebola virus according to an official source(http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php), and in a separate sentence I added ash is highly alkaline and alkalis dissolves lipids. Journal references to 2% wood ash destroyed a very similar type of virus sometimes used as a model for Ebola research was also deleted. The effect of ash for using ash for handwashing is not specific to one bacteria because it both kill and removes germs as effective as soap in all published experimental studies I found. Again and again it is DocJames blocking this vital information to reach people, while the number of victims continues to grow exponentially, clinics are overwhelmed, and the virus spread before suspected cases are treated professionally.
It is better. Now you need to paraphrase rather than copy and paste from the sources. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:21, 23 August 2014 (UTC)
I disagree. The reference on the WHO website is only relevant to personal hygiene, as a soap substitute. It certainly does not refer to a context of highly infectious disease, and I can find no web page containing the words "ash" & "ebola" - except for this WP page. It's not appropriate for this topic to speculate on a possible substitute for soap. Robertpedley (talk) 21:26, 2 September 2014 (UTC)
Thanks Robert agree completely. We are not to publish primary research here and making an association that others do not is not supposed to occur. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:16, 3 September 2014 (UTC)
User:TorstenMandal - I can see that you have added "ash" back into the article, with two references. I understand that you think it's important, but please bear in mind your responsibility. Neither of the institutes you cite has performed original research on the ebola virus; they don't cite their sources. It's quite conceivable that the authors looked as this WP page as a source.
No institute which has performed primary research, has even suggested using ash. Therefore - although it is possible that you are right - it is more likely that you are wrong. I hope that no-one will be fooled by your edits to think that they can safely care for an ebola victim and subsequently wash their hands with ash.
I agree with Doc James & GandyDancer about this. WHO and CDC are the guys who do the research, and have the PhD's and professors and resources to decide what is safe and what isn't.
Robertpedley (talk) 22:25, 5 September 2014 (UTC)
Torsten Mandal: It is not correct that I did not add references. I added two references specifically about ebola and ash - one from a university and one from a government ministry. My references to e.g. WHO are deleted because they are for emergencies in general and not ONLY about ebola. — Preceding unsigned comment added by TorstenMandal (talk • contribs) 11:50, 6 September 2014 (UTC)
I have looked a little into this and found this reference that I agree with.
http://sanitationupdates.wordpress.com/2009/11/02/ifh-use-of-ash-and-mud-for-handwashing/
This is a peer reviewed article.
The review was prepared by Professor Sally Bloomfield and Professor KJ Nath. The report was peer reviewed by Dr Stephen Luby (International Centre for Diarrhoeal Diseases Research, Bangladesh)
Epidemiological and microbiological data show that, in low income communities, as elsewhere, handwashing is particularly important in reducing the burden of infectious and parasitic diseases. These data also suggest that the efficacy of the handwashing process itself has a significant impact on the risk of disease transmission. A key factor is the extent to which pathogens are detached from the skin surface, by rubbing with appropriate materials prior to rinsing. In low income communities in developing countries, soil, mud or ash are still frequently used as an alternative to soap. Therefore, it is an established fact that low income communities are washing their hands in this manner. However, I do not think an Ebola article should go into tall the possible ways to wash your hands. There is a Wiki page that describes handwashing at https://en.wikipedia.org/wiki/Hand_washing I suggest adding a paragraph to that page on the use of mud ash etc. to wash your hands. BTW I happen to wash my hands frequently with sawdust. It is excellent to get sticky stuff off the hands. Pbmaise (talk) 04:03, 9 September 2014 (UTC)
I have gone ahead and modified the hand washing page and now cite the above reference. Further I have added a cross link from this page onto that page. That hand washing page now reads
Mud, soil, saw dust, and wood ashes
The effectiveness of hand washing increases if the hands are first rubbed in clean mud, soil, saw dust, or wood ashes. These materials help to physically dislodge dirt and liquids already on the hands. This technique is particular useful in areas with limited water supplies, and when liquids on the hands do not easily dissolve into water. [1]
While I am more than ready to be proven wrong, I think that "Behavioral changes" is a poor heading for infection control issues. I think that simply "Infection control" would be much better. I moved the sterilization information to the Transmission section and will not feel at all insulted if it's moved back though it is, to my way of thinking, a very standard transmission issue. Gandydancer (talk) 14:27, 21 August 2014 (UTC)
BTW, a separate issue, the WHO does not mention detergents while the Canadian source does - I was not sure about what to do about that and left it out since I assume that while detergents do a good job of removing many pathogens, they do not remove them all. Thoughts? Gandydancer (talk) 14:35, 21 August 2014 (UTC)
This does fit best under prevention thus moved back. Happy with infection control. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:01, 21 August 2014 (UTC)
It is now properly placed now that the heading change I suggested is in place. Gandydancer (talk) 01:10, 22 August 2014 (UTC)
Human-to-human transmission
The CDC briefing states that "Individuals who are not symptomatic are not contagious." However, this is simply wrong. Symptoms facilitate easier transmission, but according to the WHO "People are infectious as long as their blood and secretions contain the virus" ( http://www.who.int/mediacentre/factsheets/fs103/en/ ). --Gralgrathor (talk) 19:52, 22 August 2014 (UTC)
So I guess does this mean that the blood / secretions only contain the virus when symptoms start.
Have you written to the CDC to ask them to clarify? Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:51, 22 August 2014 (UTC)
Fix grammar in first sentence of Medications section - should read:
As of Aug 14, 2014, the FDA has approved no medications or vaccines to treat or prevent Ebola, and advises people to watch out for fraudulent products.
Which would the regular editors around here find more preferable? Keilana|Parlez ici 15:27, 24 August 2014 (UTC)
Pending changes. Ideally, the page would have no protection. But if there is vandalism, pending changes allows IPs to still edit. The only difference being that their edits won't be seen until a named account editor reviews it. Not all IPs are vandals and many have made positive contributions here.SW3 5DL (talk) 20:48, 24 August 2014 (UTC)
Semi protection Pending changes is slow and clunky. IPs can comment here on the talk page. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:50, 24 August 2014 (UTC)
Comment. Actually, I don't think this should even be a question. There's no evidence of excessive vandalism requiring page protection, and certainly nothing requiring the page to be semi-protected until November. I just looked back at all the IP edits and there is definitely no reason for this page to be semi-protected until November. The page was just protected from August 4 to August 19. I didn't see any vandalism requiring a two week pp back then. And now, just two days after that pp expired, the page is protected again until November, yet there was only one instance of minor vandalism! And also, I may have missed it, but I didn't see a request for page protection at the pp noticeboard either for the page protection on August 4th or the one that's on now. The IP's have been contributing in a positive way. There's no excessive vandalism here. SW3 5DL (talk) 01:10, 25 August 2014 (UTC)
I disagree, there has been a tremendous amount of vandalism, but also a ridiculous amount of un-constructive edits that need to be reverted. With what was one day 500,000 page views (in a single day!) it is not viable to waste time monitoring the article non-stop in order to keep it at an acceptable level - without spammy or advertising content, or just free from plain misinformation. -- CFCF🍌 (email) 05:36, 25 August 2014 (UTC)
Semi protection The article is followed enough that requests are filled very quickly. -- CFCF🍌 (email) 05:38, 25 August 2014 (UTC)
Question. Why can't I edit the intro section? The lethality needs to be updated to the current WHO statement. It's not far off but a balanced statement is 50% average 25-90% variance. I was pleased to see that Wikipedia hits first on this search in Google and gets it more right than most of the mainstream news that followed - so much for Wikipedia not being reliable :) I find the WHO format of the statement the most balanced, listen to the excellent BBC podcast on this topic. I updated and provided all the citations in the Prognosis section already. — Preceding unsigned comment added by Greenbe (talk • contribs) 22:44, 8 October 2014 (UTC)
Typo
Can someone change "capitol Monrovia" for "capital Monrovia."
That was my error and I so appreciate when an anon goes to the trouble and takes the time to offer suggestions for needed small (or even large) adjustments to articles. Considering the millions of people that read our articles, how few people take part in helping to improve them - it is something that I never will understand. Gandydancer (talk) 14:57, 25 August 2014 (UTC)
I agree that it's too early to include in the article, however this is interesting:
Numbi said that one of the two cases that tested positive was for the Sudanese strain of the disease, while the other was a mixture between the Sudanese and the Zaire strain -- the most lethal variety.Gandydancer (talk) 14:39, 25 August 2014 (UTC)
I was really glad to see an editor change the "bleed within the body" to "bleed internally", so that it read, "Around this time, affected people may begin to bleed both internally and externally.[" It really bothers me when I see wording that, to me, has dumbed the article down to the level of young children. In fact, it wouldn't surprise me that since people are so familiar with the phrase "internal bleeding" that they might wonder if to "bleed within the body" wasn't something different than the more familiar phrase, "internal bleeding". I bring this up not because I'm sure that I am right, but because I want to know if this is just my impression and most others see it differently. Gandydancer (talk) 03:52, 26 August 2014 (UTC)
"Internally" versus "within the body" are both the same. We should be writing the leads of our articles for people who speak English as a second language. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:26, 26 August 2014 (UTC)
You don't need to talk down to me - I am aware that they mean the same thing. I was not aware that medical article leads are supposed to be written for a reader with English as his/her second language. Where do I find information with this suggestion. Gandydancer (talk) 04:41, 26 August 2014 (UTC)
I think the following wording has the potential to be clearer:
"The virus has been shown to travel without contact from pigs to nonhuman primates, although the same study failed to achieve transmission in that manner between primates."
It is not immediately clear which "manner" the sentence is referring to, and "nonhuman primates" could be changed to just "primates", while adding a short clarification that this is not about humans.
Semi-protected edit request on 27 August 2014
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Not done: as you have not requested a change. If you want to suggest a change, please request this in the form "Please replace XXX with YYY" or "Please add ZZZ between PPP and QQQ". Please also cite reliable sources to back up your request, without which no information should be added to any article. - Arjayay (talk) 16:19, 27 August 2014 (UTC)
Potential application of melatonin in the Ebola disease
We need peer reviewed pubmed indexed secondary sources per WP:MEDRSDoc James (talk · contribs · email) (if I write on your page reply on mine) 04:14, 3 September 2014 (UTC)
Incorrect information regarding treatment (anticoagulant)
"administration of anticoagulants early in infection to prevent or control disseminated intravascular coagulation,"
Trust me, if you give anticoagulants to a person with DIC you will kill them. The idea is to give platelets, FFP e.t.c to encourage clotting. DIC is a problem where the blood DOESNT clot because youve used all your clotting factors. I cant change the page but perhaps someone else here can?
DIC is complicated. This ref supports our current content [17]Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:03, 4 September 2014 (UTC)
I'm on holiday at the moment, struggling to do edits using an android tablet. Would anyone else like to have a go?
Robertpedley (talk) 21:43, 3 September 2014 (UTC)
The WHO source is good. This one is a little lacking though [18]
We already link to the 2014 outbreak and do not need to link again IMO Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:05, 4 September 2014 (UTC)
Semi-protected edit request on 4 September 2014
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Please insert FILOVIR website among external links, as it is an internationally recognized resource for all researchers in filovirology and Ebola-related topics.
URL link is the following http://www.filovir.comLucazinzula (talk) 09:10, 4 September 2014 (UTC)
We have very few external links here with our efforts mostly revolving around writing content on Wikipedia. Best Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:17, 4 September 2014 (UTC)
"Society and culture": Ken Alibek and weaponized ebolavirus
First, since this section is currently solely about biological warfare, "Society and Culture" seems like a very odd section title.
Dr. Ken Alibek (b. Kanatjan Alibekov), former deputy director of the Soviet/Russian biological warfare research, development and manufacturing organization Biopreparat has stated his strong belief that not only has the Russian biological warfare research community succeeded in weaponizing Ebolavirus, but that they have also succeeded in creating a viral chimera of smallpox and Ebolavirus which has the relative stability and transmissibility of smallpox with the pathogenicity in humans of Ebola - a recombinant virus called "Ebolapox." [2][3]
^Zubray, Geoffrey (2013). Agents of Bioterrorism: Pathogens and Their Weaponization. New York, NY, USA: Columbia University Press. pp. 73–74. ISBN9780231518130.
I'm worried about presenting Alibek as a reliable source, especially given the significance of these claims. This LA times article raises some general questions about him. For example, and on "ebolapox" in particular:
Dr. Philip K. Russell, a retired Army major general and physician who joined the Bush administration from 2001 to 2004 to confront the perceived threat of smallpox, said he was convinced that Alibek had solid firsthand information about the former Soviet Union's production of anthrax. But regarding other threats, such as genetically engineered smallpox, Russell said he "began to think that Ken was more fanciful than precise in some of his recollections."
"He would claim that certain things had been done, and then when you came right down to it, he didn't have direct knowledge of it -- he'd heard it from somebody. For example, the issue of putting Ebola genes into smallpox virus. That was viewed, at least in many of our minds, as somewhat fanciful. And probably not true."
I think this is a really good point. There are two sources here, the Zubray 2013 book and the primary source that is the 1999 interview with Alibek. Of the two, Zubray 2013 is very strong as a recently-published academic book written by a university professor (emeritus) from an Ivy league university he is still associated with, and with a Ph.D. in the relevant field. The Alibek interview is weak as an older primary source. So I have edited the paragraph, taken out Alibek, and toned down the breathless language considerably. Thanks for this comment! Zad68 13:30, 8 September 2014 (UTC)
Semi-protected edit request on 8 September 2014
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The symptoms limits a person's ability to spread the disease as they are often to sick to by traveling.
Change to:
The symptoms limits a person's ability to spread the disease as they are often too sick to travel.67.40.211.239 (talk) 22:14, 8 September 2014 (UTC)
Done and thanks Cannolis (talk) 02:07, 9 September 2014 (UTC)
Overhaul on animals and Dog issue
A complete overhaul of the animal aspects of ebola is needed. Early on there is this strange reference to 30,000 animals tested and this has no relevance compared to all the animals tested positive recently in gorilla and dog population.
This paragraph needs to go:
Recovered carcasses from gorillas contain multiple Ebola virus strains, which suggest multiple introductions of the virus. Bodies decompose quickly and carcasses are not infectious after three to four days. Contact between gorilla groups is rare, suggesting transmission among gorilla groups is unlikely, and that outbreaks result from transmission between viral reservoir and animal populations.[135]
It comes from an abstract found at: http://www.ncbi.nlm.nih.gov/pubmed/14726594 I don't have access to read the actual article. Do you?
The more important points here are that zootonic transfer has occurred and that the CDC says eating bushmeat..and YES we must address fact that Liberia is a big consumer of dogs. Dogs are not considered bushmeat and studies show high level of ebola in dogs.
Pbmaise (talk) 05:54, 9 September 2014 (UTC)
I worked on that section and AFAIK the information is correct. I don't see a 30,000 figure and even if they are eating dogs in Liberia I am not aware of a study that connects it to this outbreak or any other. Gandydancer (talk) 15:32, 9 September 2014 (UTC)
Thank you Gandy dancer ... There are no absolute proofs in many things done in Africa. However, patient 0 was a 2 y o boy. He didn't get Ebola from washing bodies and preparing bushmeat or kissing fruit bats. Reason and logic dictates it was far more like a dog. Dogs become infected and that must mean a period of time the virus is active. I was told the direct references, and sourced material was deleted about dogs licking humans as a vector were deleted since a paper from the CDC is primary.
Many Ebola researches are dead. Is it dangerous to be a dog in Africa if we allow the CDC papers to be digested so the public inderstands? Certainly. But dogs where dog meat is consumed and termed "bush meat" are already in danger.
People are in danger too. Would I allow a dog in my house if I was living in Liberia. No. Not unless aleady seropositive. Pbmaise (talk) 22:44, 10 September 2014 (UTC)
I needed to read quite a few studies when I wrote that section and I think I know which one you are talking about. It is a lone study from a few years ago that suggested that dogs have been overlooked as a source of infection - it especially suggested that source when the infected person was not known to have any contact with a bat or bush meat. But since it is a lone study and no one picked up on it, it must be assumed that other researchers found fault with it...or whatever. My own problem with it was that considering that a sizable number of dogs carry the virus, one would expect Ebola to be more common. But we don't put that sort of single study in this article as it is just one of many studies - some of which may have come to an opposite conclusion.Gandydancer (talk) 00:17, 11 September 2014 (UTC)
International response and impacts on Africa
These are two sections currently missing. Please take some time to comb press to update the 2014 outbreak section.Pbmaise (talk) 05:54, 9 September 2014 (UTC)
I plan to broaden the 2014 section today. Gandydancer (talk) 15:34, 9 September 2014 (UTC)
Poor communication on my part - by "broaden" I meant make it more broad rather than a blow-by-blow account. Gandydancer (talk) 00:14, 11 September 2014 (UTC)
History section
The History section seems incomplete and out of place to me. It starts with a short paragraph on the 1976 outbreak, which is covered in more detail in the Epidemiology section. The rest of the section is about the 1989 outbreak. As it stands now, I think it would make more sense to combine these two sections. If we're going to have a History section, it should be more of a narrative timeline than what we currently have. Kendall-K1 (talk) 14:47, 9 September 2014 (UTC)
Yes, that section is a leftover from the "old" article - the article as it was before this 2014 outbreak that has resulted in so many improvements. I agree that it does need work. Gandydancer (talk) 15:27, 9 September 2014 (UTC)
Possible typo
The history section of the article about the "ebola virus disease" starts with the phrase "The first recorded outbreak of EBD occurred...". Given that "EBD" appears not to have been defined anywhere in the article, could it be a just a typo for EVD? — Preceding unsigned comment added by 138.87.140.243 (talk) 03:38, 2 October 2014 (UTC)
2014 West Africa outbreak
This section has become bloated and contains a lot of information that needs to be more general and broad rather than information about, for instance, the riot in Monrovia. Hopefully by this evening I'll get it done, but my garden needs pretty drastic attention as well and with fall in the air, it won't wait. Please feel free to offer feedback. Gandydancer (talk) 15:20, 9 September 2014 (UTC)
I highly recommend a whole new page for the 2014 Outbreak. This section will grow too huge for the overall Ebola page.
I don't know how to do this. Please name page Ebola virus 2014 outbreak Pbmaise (talk) 03:41, 10 September 2014 (UTC)
I shortened and rearranged this section. Ruslik_Zero 12:51, 10 September 2014 (UTC)
Thanks, I could see a whole lot of duplication between the 2 pages. There's a link in the header of this article - would it help to move it closer to the top? Robertpedley (talk) 14:45, 10 September 2014 (UTC)
Typically we put the header at the top of the appropriate section. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:49, 11 September 2014 (UTC)
Good job Ruslik. I am glad to have it off my to-do list. Thanks for leaving the growing financial crisis info. Gandydancer (talk) 18:56, 10 September 2014 (UTC)
The Ministry of Health (MOH) wishes to clarify that there are no suspect cases of Ebola in Singapore at present. MOH will continue to closely monitor the situation, and continually assess and calibrate its measures.
You may have heard of the recent news report of a suspected Ebola case entering Singapore. You might have even panicked if you know exactly how deadly Ebola is.
However, you will be relieved to know that it was just a false alarm. Here’s what happened, based on news reports.
According to a report in The Straits Times, a Nigerian woman in her 50s was identified as a suspected Ebola case by doctors in Gleneagles hospital on Thursday (August 14th) morning. She had flown into Singapore recently and arrived at the hospital’s emergency department with fever.
The woman was immediately isolated and transferred to Tan Tock Seng Hospital (TTSH) by ambulance. Since then, however, reports reveal that this was a false Ebola alarm and the woman has been discharged.
According to the Straits Times report, Professor Philip Choo, TTSH’s chief executive officer, said, “We saw a patient with a history from Nigeria,” but her detailed history revealed “no contact with any suspect or confirmed patients.”
While we can all breathe a collective sigh of relief knowing that this was just a false alarm, it still is good to know some facts about this disease and understand what precautionary measures the Singapore government has in place, should an Ebola outbreak occur. — Preceding unsigned comment added by Elite Whitesands Force (talk • contribs) 06:57, 11 September 2014 (UTC)
Article Does Not Acurately State the Risk of Ebola Virus Transmission from Bodily Fluids and Fomites
The Ebola virus clears from different bodily fluids at different rates and is present in infected persons after they no longer show symptoms. It is inaccurate to state that people are only contagious when they show symptoms. Further, it is important to note the different rates at which the Ebola virus clears from different bodily fluids. It is only through accurate information that people can properly prevent transmission, and therefore, these wikipedia articles must meet a higher standard. In infected persons, the Ebola virus is shed in a wide variety of bodily fluids and has been detected in specimens including saliva, stool, semen, breast milk, tears, and a skin swab. In one very small study, the last Ebola positive specimen of saliva occurred 8 days after disease onset while breast milk remained positive 15 days after onset and semen remained positive 40 days after disease onset even though the virus was already cleared from the blood. In another outbreak, the Ebola virus was detected in the semen of patients who had recovered three months after disease onset. Patients who recover from the virus should be warned to avoid breastfeeding and abstain from sex (or at the bare minimum use condoms and properly dispose of condoms) for at least 3 months after recovery. It was also suggested to avoid contact with the mucous membranes of the eye of a recovered patient for 3 months as well.
See the following article in The Journal of Infectious Diseases: [1]
This is the wording the CDC uses. People are not infectious until symptoms have developed. Have you asked them to correct their website yet? The ref you provide is a primary source. We typically use secondary sources per WP:MEDRSDoc James (talk · contribs · email) (if I write on your page reply on mine) 08:06, 16 September 2014 (UTC)
The Journal paper cited states in its final conclusion paragraph "Taken together, our results support the conventional assumptions and field observations that most EBOV transmission comes from direct contact with blood or bodily fluids of an infected patient during the acute phase of illness.". The citation does not seem to support the implication suggested above, so it seems like WP:OR to me - can you point to something else? Nevertheless I concur we need a high standard on the topic of infection mode and spread. I have been reading the epidemiology papers and my impression is that they have investigated this topic extensively in the field back to 1976Greenbe (talk) 01:04, 16 October 2014 (UTC) and not found any counter examples to the onset of symptoms model.
WHO has said that blood transfusions from survivors are likely the most effective method of tackling the outbreak
There is no approved cure for Ebola and in the short term the WHO has said that blood transfusions from survivors are likely to be the most effective method of tackling the outbreak. Work is currently under way to establish a registry of survivors complete with their blood types in order to begin the process of extracting their plasma for use to treat future victims.
Yes added something about this to the section under research. We are currently using a WHO source which is much better than the independent. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:31, 19 September 2014 (UTC)
Hello, I would like to change something in this page because it's very offensive to some (animal rights activists and such..) "Prevention includes decreasing the spread of disease from infected animals to humans. This may be done by checking such animals for infection and killing and properly disposing of the bodies if the disease is discovered.". Wikipedia is supposed to be neutral and about facts, I don't think there should be a suggestion to kill defenseless and peaceful beings, instead I'd like that part of the page to be changed to "Prevention includes decreasing the spread of disease from infected animals to humans and other animals. This may be done by checking such animals for infection and quarantine them if the disease is discovered.".
Thank you for taking the time to read this and I hope you change that part of the page (or allow me to).
This is stated by the sources and should not be changed. -- CFCF🍌 (email) 15:49, 24 September 2014 (UTC)
Dear requester: I am able to edit the main section directly and I noticed your request by chance. Although I will admit I probably don't share all your views on this matter, I do respect animals so I think your voice should be heard. I will edit the main page to note the new controversy that just broke out in Spain over an order to euthanize the infected nurse assistant's dog. — Preceding unsigned comment added by Greenbe (talk • contribs) 23:39, 8 October 2014 (UTC)
Useful Links
The following are some links that might be useful as references in this article. If you use the link, then please remove it from this section. • Sbmeirow • Talk • 08:58, 24 September 2014 (UTC)
This is about the disease not the specifically the ongoing outbreak. These are best their. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:59, 1 October 2014 (UTC)
Proposal for 2014 Outbreak Section
According to the CDC's conference, the first United States patient traveled from West Africa and started showing symptoms of Ebola after 4 days of staying in the U.S. — Preceding unsigned comment added by OliviaTorbett (talk • contribs) 22:13, 30 September 2014 (UTC)
We have a whole subpage specifically on the outbreak Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:58, 1 October 2014 (UTC)
And a short section on it here, that redirects to that page. As it should be. I've uploaded File:Thomas Eric Duncan 2.jpg (image at right) for use in one of those places, or perhaps a new article is needed, as the subject - the first case with illness onset and discovery in the USA - is arguably not within the topic of Ebola virus epidemic in West Africa.
Of course respect wp:BLP re. the subject is paramount. I took advantage of surprising (to me) wording in the source sites terms that made the photo free content.
Thoughts on whether a new article is needed or an article title change?--{{U|Elvey}}(t•c) 02:56, 7 October 2014 (UTC)
A pandemic, by definition is widely spread. Ebola is not highly spread anywhere, it's moderately spread within relatively small regions. Indeed, out of nearly 4000 infected out of a population of 4 million, that certainly does not qualify as widespread.Wzrd1 (talk) 17:22, 7 October 2014 (UTC)
Can it be contagious during the incubation period?
However, according to EmedTV, a major website, during the incubation a person may still contagious, and can therefore still spread the virus.("Ebola Incubation Period", EmedTV) I then checked some other sources, and for general infectious diseases, states one, “although there are no symptoms of disease during the incubation and convalescent periods, the host can be contagious and spread the infectious agent.”(Lim, Daniel V., Microbiology, Kendall Hunt (2003). Another medical reference went a bit deeper, noting that "some people with some infectious diseases may have no symptoms or have such mild symptoms to be considered 'subclinical.' The importance of this is that they may still be able to transmit the infectious agent" during this period. It adds that some diseases such as influenza, HIV, and hepatitis C are transmissible near the end of the asymptomatic incubation period, which could be days, months or more before symptoms. Other books said the same about measles and SARS, for which they quarantine all potential contacts until the incubation period has passed.
I don't plan on adding any of this to the article, but thought it would be useful for editors to include something about the subject. --Light show (talk) 21:50, 1 October 2014 (UTC)
emedtv is not a reliable source. The CDC and WHO are. It is not contagious until symptoms start. After recovery symptoms have started thus not contradictory if still infectious after. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:56, 1 October 2014 (UTC)
It might worry some, since a Google search on the above question has EMed as the #1 result, even above WHO and the CDC. --Light show (talk) 22:05, 1 October 2014 (UTC)
When I search for ebola I get WHO, Wikipedia, CDC, WebMD, CNN. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:12, 1 October 2014 (UTC)
I searched "ebola infectious during incubation period". --Light show (talk) 22:17, 1 October 2014 (UTC)
Yup. Would be good to email MedTV and see if they can improve their site. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:37, 1 October 2014 (UTC)
Already did a few hours ago. And FWIW, MedlinePlus, which is a RS, states that infection exists once the incubation has started. About the asymptomatic period, it includes, The disease can be passed to humans from infected animals and animal materials. Ebola can also be spread between humans by close contact with infected body fluids or through infected needles in the hospital.[19] --Light show (talk) 22:40, 1 October 2014 (UTC)
MedlinePlus (which is actually ADAM) is not a very reliable source. Please see WP:MEDRS with respect to sourcing. ADAM does not say it is contagious during the incubation period. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:46, 1 October 2014 (UTC)
The link didn't seem to include anything about it not being a good RS. But can you link to show that Medline and ADAM are the same, since I couldn't find anything connecting them. In fact, searching the ADAM site for Ebola showed no results at all. It looks like they sell healthcare products. --Light show (talk) 23:07, 1 October 2014 (UTC)
This might be a dumb question but I'm going to ask it anyway. Regarding "blood and bodily fluids", under the bodily fluids would saliva and/or mucus be counted as a carrier of a significant viral load? Or are we saying this is strictly bodily fluids e.g., breastmilk, semen, vaginal secretions, and blood? TylerDurden8823 (talk) 23:31, 1 October 2014 (UTC)
Since the answer differs between some of the sources, I went ahead and did some more research, in case anyone is interested. One recent medical textbook, Infectious Disease Epidemiology: Theory and Practice (2012) actually had a diagram showing the timeline of typical infections (p. 135), and showed the period when a person becomes infectious is about halfway during the incubation period. If an infection's incubation period was 10 days, for example, then a person would have been able to transmit the infection after around 5 days, with infectiousness increasing even more after the symptoms showed up. The same type of diagram with the same timeframe is in Companion to Biological Anthropology (Wiley, 2010).
Another text, much older, Modern Medicine and Bacteriological Review, Volume 2, gave the ranges of incubation for a number of diseases, including measles, scarlet fever, mumps, small pox, chicken pox, and typhoid fever, and claims that while the incubation periods differed, they were all contagious during part of the incubation period. The previous book said that persons infected with HIV can transmit the disease over years.
The article states, "The potential for widespread EVD infections is considered low as the disease is only spread by direct contact with the secretions from someone who is showing signs of infection," cited from the CDC. However, the CDC site is somewhat vague about that, stating, "When an infection does occur in humans, the virus can be spread in several ways to others. Ebola is spread through direct contact (through broken skin or mucous membranes) with blood or body fluids (including but not limited to urine, saliva, feces, vomit, and semen) of a person who is sick with Ebola." But it does not state when a person is considered "sick," which is left open to interpretation.
The medical definition of when an infection occurs, however, makes it clear that the incubation begins upon infection: "An infection may cause no symptoms and be subclinical, or it may cause symptoms and be clinically apparent." --Light show (talk) 03:38, 2 October 2014 (UTC)
Are these textbooks specific for ebola or are they about incubation periods generally? The medicinenet is not about ebola [20]Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:59, 2 October 2014 (UTC)
General infections, covering a wide spectrum of bacterial and viral diseases. From those sources, by the time a person shows symptoms, they were infectious to others for half the incubation period. The peak of the infectiousness curve comes after the symptoms start. It's a smooth curve, but it begins halfway into incubation. --Light show (talk) 16:38, 2 October 2014 (UTC)
If it is not specifically about Ebola it is not applicable here. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:51, 2 October 2014 (UTC)
So I was looking to see into this as well, as I wanted to see some actual papers to support the position that Ebola isn't infectious while pre-symptomatic. I found this Canadian Public Health Agency site, indicating four sources for Ebola being noninfectious while asymptomatic. However, the first two sources they provide under the relevant 'Mode of Transmission' (Sources 1 and 2, from Darling & Woods and Acha & Szyfres, respectively) do not in fact refer to Ebola whatsoever, but rather to Plague (Presumably Y. pestis). The third source, 22 (Bausch, Jeffs, & Boumandouki) indicates under the section 3. Filovirus outbreaks—controlled chaos that "Although seroprevalence data suggest that some degree of endemic transmission probably exists beneath the threshold of detection, especially for ebolaviruses (Monath, 1999 and Bausch et al., 2003), filovirus transmission is generally recognized only in outbreak form (Bausch, 2007a)." (The fourth source, Arthur 2002, is behind a paywall and I don't have access to it)
Further research into Bausch 2007a (Ebola, Marburg, Lassa, and other hemorrhagic fevers) indicates the only mention I can find of asymptomatic infectivity on p147, stating that while suspected HF patients should be treated as infectious (And providing a relevant CDC release from 1998), that asymptomatic patients are not infectious. Bausch does not provide any source for the secondary statement about asymptomatic infectivity however, and there the paper trail ends.
Does anyone happen to have links for studies and/or papers supporting the lack of asymptomatic infectivity? Right now everything I seem to be finding keeps sourcing back to either sourceless WHO/CDC statements/press releases, or unsourced information from dubious sources. — Preceding unsigned comment added by 134.121.132.61 (talk) 17:08, 6 October 2014 (UTC)
Being a fairly new African-sourced primate disease, maybe it's never been tested. Some of the well-known diseases that are contagious during the incubation period when asymptomatic, are the cold, flu, polio, hepatitis, AIDS, TB, chickenpox, measles and typhoid. But according to some experts, pre-symptom blood testing is not yet feasible. --Light show (talk) 20:20, 6 October 2014 (UTC)
I suspect the reason that they believe it to be the case is that during the incubation period, the viral load is so low that there isn't a high enough concentration of the virus within bodily fluids for it to be likely to infect someone else - the same reason why the virus cannot be detected by testing in pre-symptomatic patients. It would be interesting to see if we could trace back any cases to someone who came in contact with someone who wasn't symptomatic, but AFAIK that has never been done and it is probably very hard to determine unless you have a very isolated environment without any other possible contact. Titanium Dragon (talk) 05:56, 7 October 2014 (UTC)
Presumably one way they know it is not asymptomatic contagious is through empirical epidemiological research. If you contact trace a case and the only contact to another case was squarely during incubation then you could disprove it with enough samples. Any epidemiologists reading this please comment whether there is data on this. My impression reading around is that there is a lot of this type of data existing despite the difficulty collecting it. Greenbe (talk) 03:31, 10 October 2014 (UTC)
This article by virologist Vincent Racaniello who cited his sources, is interesting, ie. "When vaccines are not available, acute infections are difficult to control – most are complete by the time the patient feels ill, and the virus has already spread to another host." He used polio as an example: "because 99% of the infected individuals had no symptoms and were leading normal lives and spreading infection." Can we page Dr. Salk? --Light show (talk) 04:14, 10 October 2014 (UTC)
So without a pre-symptom test likely, I wonder if a 21-day advance booking requirement for outbreak countries would minimize the risk. In that case, a traveler would be required to purchase tickets in person, with a photo ID, and when they board after 21 days or more, they're checked for symptoms. Most flights are booked weeks ahead anyway, so the inconvenience factor would be reasonable during a dangerous epidemic. --Light show (talk) 04:18, 8 October 2014 (UTC)
Some people would catch the disease between booking and getting on the plane. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:29, 8 October 2014 (UTC)
True, but the goal is to minimize the risk. Besides telling a ticket purchaser that the average incubation period is 8 to 10 days, they could be given a handout letting them know how to avoid becoming infected. And if they do become infected, they should know that the odds are that they will be prevented from traveling since symptoms will probably appear. This has a few effects: it mostly stops those who think they are infected from traveling elsewhere, and it gives them, having now paid for their ticket, a strong incentive to stay uninfected for the next 21 days. It's more of an incentive than a worry about undergoing a temperature check and answering a few questions. --Light show (talk) 05:02, 8 October 2014 (UTC)
Reverted edits saying the "virus itself" is detected, because this is not scientifically meaningful. If someone familiar with specific detection modalities would like to expand this please do so (i.e. specific methods used to detect e.g. positive cultures, aside from more straightforward and more commonly used nucleic acid or antigen/antibody detection). Thanks.--Xris0 (talk) 15:11, 2 October 2014 (UTC)
One of the detection methods is by "virus isolation by cell culture" another is "electron microscopy" [21]. This is detection of the virus itself. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:53, 2 October 2014 (UTC)
Typo ("elabovirus") in the Section titled "Domesticated Animals"
Regarding the SECTION titled "Domesticated animals"... The second sentence of the first paragraph reads:
"This virus was discovered during an outbreak of what at the time was thought to be simian hemorrhagic fever virus (SHFV) in crab-eating macaques in Reston, Virginia (hence the name Reston elabovirus) in 1989."
Please NOTE and CORRECT the typo ("Reston elabovirus") to read "Reston ebolavirus".
Done Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:03, 2 October 2014 (UTC)
Diagnosis - PCR - RNA
The Diagnosis section says that viral RNA can be detected by PCR, but Wikipedia's PCR page is pretty definite about PCR being a DNA technique. This article might mean to say that viral RNA can be detected by reverse-transcription PCR. If anybody knows, please make the clarifying change. — Preceding unsigned comment added by 68.185.94.153 (talk) 19:25, 3 October 2014 (UTC)
A little off topic, but the entire Diagnosis section could use some major work, IMO. The very first sentence is not correct in its priorities. And a later sentence will certainly be a barrier to average readers: Isolating the virus by cell culture, detecting the viral RNA by polymerase chain reaction (PCR) and detecting proteins by enzyme-linked immunosorbent assay (ELISA) is effective early and in those who have died from the disease. Besides telling a reader that it's easier to diagnose the disease after a patient dies, the reading level is aimed at epidemiologists. Is that who we're writing for? The 2nd paragraph in the section is likewise jargon-loaded and likely off-putting to 99.999% of readers.
An example of the level of writing that should be used in this article can be seen here, from a medical textbook written to inform doctors. --Light show (talk) 21:11, 3 October 2014 (UTC)
There is no immunology section in this article
We have sections on other -"ologies", and we have immune response discussed in the vaccine section. We also have discussion of thousands of people who have survived ebola - what is their immunology relative to the virus? (This may have important implications with regard to the ability or inability of the survivors to be able to safely work with infectious patients). — Preceding unsigned comment added by 123.3.163.79 (talk) 23:25, 5 October 2014 (UTC)
You raised an excellent question! So, a bit of digging and I found the following on the CDC's massive site; "Ebola infection develop antibodies that last for at least 10 years, possibly longer. We don’t know if people who recover are immune for life or if they can become infected with a different species of Ebola.". http://www.cdc.gov/vhf/ebola/transmission/qas.html My schedule doesn't permit me much chance to research this further and add a section, any takers?Wzrd1 (talk) 06:28, 6 October 2014 (UTC)
We really want a reliable medical source, which would be some sort of recognized medical authority or, most preferably, a scientific paper on the matter. Honestly, we probably have no idea, because I don't know that anyone who has ever been exposed to ebola has been re-exposed to it many years later. Titanium Dragon (talk) 05:57, 7 October 2014 (UTC)
No need for there to have been many years passing before re-exposure. There must be hundreds, perhaps thousands, of survivors re-exposed within the last few weeks. Perhaps someone has studied the rate of re-infection among those re-exposed in the last few weeks? — Preceding unsigned comment added by 122.151.89.40 (talk) 07:30, 8 October 2014 (UTC)
I put in a request for assistance at wikipedia project medical. I suspect that the experience and information is still, sadly lacking. My concerns are: Lack of evidence of effective protection from this virus from previous strains, lack of evidence that immunity to re-exposure to this strain is harmless due to immunity for the first quarter second thoughts. The list continues for far longer lengths within the second enough to become absurd, due to the lack of knowledge on the first two considerations.Wzrd1 (talk) 08:24, 7 October 2014 (UTC)
No need for there to have been many years passing before re-exposure. There must be hundreds, perhaps thousands, of survivors re-exposed within the last few weeks. Perhaps someone has studied the rate of re-infection among those re-exposed in the last few weeks?
I took the liberty of placing your question in the correct order. As for the question, I'm doubtful that any significant study has been made, all medical personnel are still involved in treating, triaging, supporting and generally scrambling to try to get control of the situation. Statistical analysis is for after the epidemic is brought under control.Wzrd1 (talk) 07:34, 8 October 2014 (UTC)
What can stop this virus? Wealth fails as expected(nurses in US and Spain show this), surely our immune system is the number one contender, yet where are the immunological results to monitor our immune systems response?
Does our immune system conquer it and leave lucky humans "immune"? If so then how can we best utilise the skills of those immune systems to conquer the virus? — Preceding unsigned comment added by 123.3.179.5 (talk) 00:27, 17 October 2014 (UTC)
Local to where?
I would suggest dropping the word "local" from the line "Because dead bodies are still infectious, local traditional burial rituals may spread the disease." found in the Transmission section, or at least rewriting it. This is a region non-specific article. 180.200.148.114 (talk) 09:53, 6 October 2014 (UTC)
Done Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:55, 6 October 2014 (UTC)
vote,,,west Africa ebola
hi there is a vote for the article title at "west Africa ebola" its under the Spain section.thank you--Ozzie10aaaa (talk) 22:55, 6 October 2014 (UTC)
here. --Ozzie10aaaa (talk) 00:02, 7 October 2014 (UTC)
False separation
Separating treatments into "Officially endorsed experimental treatments" and "Speculative and unproven treatments" is a false separation made by no source. We should not be making it either. [22]
Also we should not be writing in bullet points. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:21, 7 October 2014 (UTC)
Uh, officially endorsed experimental treatments is different from non-endorsed ones, but "speculative and unproven treatments" is probably not the best way to word that section. Titanium Dragon (talk) 05:47, 7 October 2014 (UTC)
Agree that a big demarcation like that is unwarranted and misrepresents the sourcing. Some treatments may be endorsed by certain individual medical societies for use in certain situations but no treatment is "The Official Treatment" universally. If individual treatments are recommended those recommendations (along with any caveats) can be described in-line. Experimental treatments that medical societies look at cautiously can also be described as such in-line. Per WP:USEPROSE, the bullet lists need to be prose. Zad68 15:59, 7 October 2014 (UTC)
Mention the owner of the virus
It could be prudent to mention within the article the owner of the Ebola Patent.
That was an annoying trend in US patents, where people tried the patent the genome of anything and everything that they could. Fortunately, Association for Molecular Pathology v. Myriad Genetics cleared that up before I lost the rights to my own genes.Wzrd1 (talk) 16:36, 7 October 2014 (UTC)
Not on this article. Maybe on Ebola virus in the society and culture section if their are secondary sources about the issue. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:39, 7 October 2014 (UTC)
I think that would be beating a dead horse. The SCOTUS found against patents on genes and genomes found in nature. Hence, the "point" is irrelevant.Wzrd1 (talk) 16:48, 7 October 2014 (UTC)
Just mentioning it based on google I agree would be inappropriate. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:13, 7 October 2014 (UTC)
The owner of the virus? You can only patent a life form if altered by man I think. The EboBun variant patented by the CDC and The Government Of The United States Of America is not the same variant currently believed to be circulating in West Africa. Luckily for them, otherwise the owners should be held responsible for damage and death caused by their virus imo. Ochiwar (talk) 19:13, 7 October 2014 (UTC)
This meme needs to be quashed. It is completely false. The patent is for isolating a wild virus, it was not synthesized by CDC. I explained it at length in another section below.Greenbe (talk) 04:16, 15 October 2014 (UTC)
While I find the description and claims in the US Patent to be writtten in a nearly incomprehisible combination of legalese/trade jargon, my understanding is that it appears to be for some very specific methods and aspects of a particular strain of hEbola named EboBun. It certainly is not a claim of ownership or creation of Ebola. What nonsense to claim that someone owns ebola. Also, while I do find Google patent search to be much easier to use than the USPTO search, it does have its isssues and should not be a substitute for a correct direct link. Nyth83 (talk) 14:13, 18 October 2014 (UTC)
Unsupported and vague statement - "semen in survivors"
Statement that "Semen may be infectious in survivors for up to 3 months" should be supported by a valid reference or removed/labeled "ref needed". The reference given leads to a general info web page (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/qa.html) that as of 10/7 that does not contain neither the word "semen" nor "month".
Also, would be nice to change the wording to make clear whether "semen in survivors" refers to the "seminal fluid of the male survivors" (as opposed to a layman's word choice for "infectious agents remaining in the body of survivors") -- btw this is why I started reading the ref in the first place. 12.104.156.31 (talk) 18:30, 7 October 2014 (UTC)
The ref is this one [23]Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:29, 7 October 2014 (UTC)
I wonder if other immune privileged body parts also remain "hot" for as long?Wzrd1 (talk) 06:03, 8 October 2014 (UTC)
Edit request: Sudan 1976 cases
This edit request has been answered. Set the |answered= or |ans= parameter to no to reactivate your request.
"The first identified case of Ebola was on 26 August 1976, in Yambuku, a small rural village in Mongala District in northern Democratic Republic of the Congo (then known as Zaire).[79]"
to:
"An outbreak of Ebola virus disease (EVD) occurred between June and November 1976 in southern Sudan and was caused by Sudan virus, a member of the genusEbolavirus. The Sudan outbreak infected 284 people and killed 151, with the first identifiable case on 27 June. [24]
Also in 1976, an outbreak of EVD caused by Ebola virus (formerly called Zaire ebolavirus) began in Yambuku, a small rural village in Mongala District in northern Democratic Republic of the Congo (then known as Zaire), with the first case identified on 26 August.[79]"
And remove "Another ebolavirus, the Sudan virus species, was also identified that same year when an outbreak occurred in Sudan, affecting 284 people and killing 151.[82]" from the end of the paragraph.
I looked at the source and this seems like a reasonable request; Sudan virus does seem to have caused the first outbreak of EVD. Looks like Xqxf recently added the first sentence to Sudan virus. Gotta log off, so not making the change though.--{{U|Elvey}}(t•c) 05:22, 8 October 2014 (UTC)
It would be interesting if we had a reference to specifically call it the first outbreak. It does seem like that from the timing, but I left the wording ambiguous due to lack of a good reference. (There are a few that say the outbreaks were almost simultaneous, and some references like [25] calling Sudan first, but that reference is an "honors thesis" as noted at Talk:Ebola virus disease#History of 1976 Zaire/Sudan outbreak. It does point to an interesting retrospective case in 1972 that we don't currently include.) The lead of this article actually points more to Sudan right now. Xqxf (talk) 12:05, 8 October 2014 (UTC)
Done Note that I'm no expert here, just patrolling the list of semi-protected edit requests. Feel free to revert if you disagree. Stickee(talk) 11:37, 8 October 2014 (UTC)
Thanks for taking care of this Xqxf. I worked on this section a few weeks ago and the Sudan outbreak was not even mentioned, so I added it. I assumed that it was second by a few weeks since the WHO info page lists the Congo outbreak as the first: [26] That is good info that you have found and I enjoyed reading it. Gandydancer (talk) 16:18, 9 October 2014 (UTC)
Semi-protected edit request on 8 October 2014
This edit request to Ebola virus disease has been answered. Set the |answered= or |ans= parameter to no to reactivate your request.
Append to "On 30 September 2014, the first confirmed case of Ebola was diagnosed in the United States at Texas Health Presbyterian Hospital in Dallas, Texas.[101]" the following: "The victim, Thomas Eric Duncan, died at 7:51 a.m. Wednesday, October 8, 2014." The resource for this information was the Wall Street Journal article "Dallas Ebola Patient Dies" accessed at URL http://online.wsj.com/articles/dallas-ebola-patient-dies-1412781778?mod=U.S._newsreel_1 on 10/7/14 at 1718 EST.
HPwikiwhat (talk) 21:20, 8 October 2014 (UTC)
Please change "The disease has a high risk of death, killing between 50% and 90% of those infected with the virus.[1][3]" in the 3rd paragraph intro section to "The disease has a high mortality rate. The average case fatality rate is around 50%. Case fatality rates have varied from 25% to 90% in past outbreaks. [78]" Use citation 78 instead, WHO current statement. Some of the research quoted is out of date (2005) even though not inaccurate. This line is a straight copy from WHO media packet but I don't think there is any copyright issue with that. I've looked into the misreporting a bit and I think the wording of the WHO statement is the most balanced way of summarizing the current data. The current statement could imply average rate of 70% (average 50 and 90) (without knowing frequency distribution) and I don't think anyone is claiming that in 2014 the highest I heard was 60% average, but WHO "around 50%" seems to be consensus. See Prognosis section for more in depth and more cites.
WHO stuff is copyright and thus we must paraphrase. Will correct. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:58, 9 October 2014 (UTC)
Thanks for updating the intro. Nice to see some accuracy amid all the noise. Interesting that WHO press kit can be copyright - isn't the point that it can be copied? Just curious. Greenbe (talk) 03:08, 10 October 2014 (UTC)
So in journalism there is fair use. On Wikipedia we do not allow fair use for text, and just allow it for a very few select images in a few narrow situations. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:12, 10 October 2014 (UTC)
United States has a patent for Ebola? WTF?
The US government patent office granted a patent for Ebola to the United States government... Invention means it was invented, right? Thoughts?
patent doesn't mean invention though. Cannolis (talk) 00:03, 9 October 2014 (UTC)
Good article! Why would they patent it though? Even if natural, why go through the effort? Nobody took the time to patent Polio.... Couldve made a killing in selling medicine then... Curious...? — Preceding unsigned comment added by 70.196.201.225 (talk) 00:29, 9 October 2014 (UTC)
Er, uh. When we invented this internet thing knew it would change the world and we assumed for the better but it cuts both ways. First let's try this for an accessible level-headed overview of patentable life sciences. http://purdylucey.com/patenting_life_sci.php. The term "Invention" and "Inventor" have a 400 year history in common-law countries and in the context of patents are legal terms with mountains of case law. In the US you can patent a virus currently if you are the first to isolate it from its natural environment. So in legal terms you may be the Inventor, but in lay terms "isolator" would be the closest. By the way, you can also patent plant hybrids (like roses). All life-science patents and plant patents are a special class of patents and the rights you get (or don't get) with them are different than regular Utility Patents such as the light bulb or transistor. People regularly mix all these together because of the term "patent" but they are not the same.
So that is all this '51502 patent is. Up to that time there were four known species of Human Ebola virus. in an outbreak in 2007, CDC isolated a fifth species they named Bundibugyo after the place it was found, shortened to EboBun. In order to get the patent you need to sequence the gene, publish it (in the patent application), and deposit a viable specimen and make it available to any bona fide researchers for a long long time. The reason CDC and Universities bother to apply for these types of patents is simply to prevent someone else from trying to patent them later. I actually don't know what rights this type of patent conveys you would need to ask a life science patent lawyer. By patenting and publishing they make a previously unknown sequence available to the whole world to develop tests and vaccines. At the time of the 2007 outbreak existing tests were not coming up positive for this new species. So this is an advance that benefits everybody. It's also only 1 of 5 species, so it is not "the" Ebola virus. Also it seems this outbreak is a new strain so it makes further doubt on this conspiracy theory that it has much to do with EboBun. — Preceding unsigned comment added by Greenbe (talk • contribs) 02:40, 9 October 2014 (UTC)
Yes certainly but this is not the place to raise the fact. "The 90% fatality rate was only reported in one outbreak in the Congo in 2003 and this value is widely misreported in mainstream media over many years implying or stating 90% is the average while not mentioning 25% or 50%. [27][28][29][30](talk · contribs · email) (if I write on your page reply on mine) 16:54, 9 October 2014 (UTC)
Here is my experience. Until I heard this BBC podcast maybe a month ago, if you asked me I would have said Ebola is 90% fatal, or thereabout. Even if you asked me a few years ago. I was surprised to hear it is around 50% (BBC actually said 60% but the difference may be in the definition). So then I was more surprised it is still misreported and that the correct data is so easily obtained (right of the WHO site, first hit). Then you start to wonder what else is misreported if the basic facts can't be stated.
Separately, I am curious to know more about the CFR and Ro. There is some discussion under Prognosis (recently renamed to Outlook) section of Ebola virus epidemic in West Africa but maybe it should be on this page, and on that page if it differs significantly per outbreak. Is there some kind of "worst" combination of CFR and Ro that make spread more likely or faster? Greenbe (talk) 03:52, 10 October 2014 (UTC)
I am with the post at the top we should have some CFR and Ro data and related statistics either in Prognosis section or Epidemiology or both. The Greenbe (talk) 04:41, 10 October 2014 (UTC)potential spread rates I think is interesting. I would prefer this page to be more medical and focused on the disease and less quotes from WHO officials and the like, I think that's what readers would want more of under the 2014 article.
Transmission via blood-sucking insects?
I would like to know what makes Ebola so different from Malaria and Dengue fever vis á vis mosquitos as a transmission vector.
Thanks in advance.--66.249.81.61 (talk) 03:57, 10 October 2014 (UTC)
Well Malaria is a type of parasite, but Dengue is a virus. It seems Ebola needs a mammal as host, I've read they've looked at many things but suspect bat. Primates are easily infected but it's very lethal so is not a likely reservoir. It's amazing how they can study these things given how remote these areas are and how sporadic the outbreaks seem. Greenbe (talk) 04:22, 10 October 2014 (UTC)
Though it does not explain why, this older study shows that Ebola virus appears not to be able to replicate in Mosquitoes. Ochiwar (talk) 18:40, 10 October 2014 (UTC)
Sorry I can't help you. I've seen and read more in recent days, they always seem to say it only infects mammals. I don't know why - could be the type of epithelial cells in mammals, could be details of blood and fluids, I have no idea. Assuming they are sure it is only mammals (for any reason) I'm not sure how they know. My vague understanding is that after epidemiologists find patient zero for an outbreak, they try to find the source that infected. If there is no exposure to a plausible host that is repeated in several outbreaks, they rule it out. Zoologists and microbiologists please help -- this is an excellent question that I think would enrich the article. I think people would want to know: What do we know about the source of infection and rate of spread of the disease, and how do we know it, and how do we rule out other possibilities. Greenbe (talk) 01:09, 14 October 2014 (UTC)
I edited for English language usage and readability to delet "other" in the phrase "human or other animal" just because it is rather silliness and POV newspeak to tendentioously remind people in this context that humans are animals. I get that and don't buy the creationist anthropic exceptionalism. But the lede of this article is not the place to push that point [of view). But in view of this thread I also changed "animal" to "mammal" please advise or edit if there is evicdence of transmission via non-mammals thanks. Wikidgood (talk) 22:03, 19 October 2014 (UTC)
All my reading seems to indicate only mammals if anyone can find contrary please mention it. But until they find the reservoir species with sufficient quantities of whole virus and can prove the animal-human infection cycle, I think any statement needs to contain a "most likely" hedging statement or similar.Greenbe (talk) 22:41, 20 October 2014 (UTC)
Moving
Have moved this text "Recent major cuts in WHO budgets, paired with recently inadequate oversight in the WHO's Africa division, a severe shortage of locally available medical personnel and inadequately educated local population, regarding proper Ebola containment procedures, which in itself was a direct result of the the first two items above have contributed to the spread of Ebola outbreaks.[31]: How Ebola Sped Out of Control, Washington Post, by Michelle du Cille, 4 Oct. 2014, as recent cuts do not and cannot pertain to Ebola generally just the most recent outbreak. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:44, 12 October 2014 (UTC)
Telegraph
Is a really poor quality source and IMO we should not be using it "Successfully facing one of the "biggest danger(s) of infection" faced by medical staff requires their learning how to properly suit-up with personal protective equipment and to remove it afterwards. In Sierra Leone, the typical training period for the use of such safety equipment lasts approximately 12 days. [32] "Ebola medics 'better trained in Sierra Leone than Spain'" The Telegraph, by Fiona Govan, 11 Oct. 2014.
Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:53, 13 October 2014 (UTC)
We are also supposed to paraphrase sources. This wording was more encyclopedic. " One challenge faced by medical staff is to learn how to properly suit-up with personal protective equipment and remove it afterwards. In Sierra Leone, the typical training period for the use of such safety equipment lasts approximately 12 days" We should not be blowing things out of proportion like the popular press so often dose. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:55, 13 October 2014 (UTC)
Agree that the article shouldn't carry such specific time-sensitive instructions as how long individual techniques of certain management practices take in specific countries, as of right now. If we had an in-depth article on ebola virus disease management, maybe. Zad68 02:45, 13 October 2014 (UTC)
Re: symptoms
Results in the New England Journal of Medicine recently published WHO study based on Ebola cases since disease was first identified. The study indicates 12.9% of patients present without fever and may remain without fever well into second stage of the disease. This hampers efforts of early detection for purposes of isolation. [33]
Do we know why Ebola kills?
There are many places in Wikipedia that say "No specific treatment for the disease is yet available". But that is different than saying that we don't know the mechanism of Ebola fatalities. For example, the article on the 1918 "Spanish" flu pandemic says the H1N1 virus kills through a cytokine storm (overreaction of the body's immune system). I may have missed it but is there anything that says Ebola kills because of, for instance, extreme dehydration or meningitis due to high fever? Do we know the killing method or is that still to be discovered? If it's the latter, I think we should state so explicitly, with proper sources. --RoyGoldsmith (talk) 15:33, 13 October 2014 (UTC)
"death due to multiple organ dysfunction syndrome occurs within 7 to 16 days (usually between days 8 and 9) after first symptoms" in Signs and Symptoms. I think the article needs to be reorganized into a more logical progression, I had trouble finding things. My vote - History, Cause, the virus details, Prognosis, Progression (signs and symptoms), Treatment, and then "Spread" Epidemiology and all related statistics and potential for spread, CFR, Ro etc. At the end we will get into the unknowns since this outbreak seems to be showing some slightly specifics characteristics of spread that may be different than previous (at least that's my impressionGreenbe (talk) 01:08, 14 October 2014 (UTC)
We have 10,000 or so disease related articles mostly organized per WP:MEDMOS. This article is currently organized per MEDMOS. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:32, 16 October 2014 (UTC)
WP:MEDMOS is the normal guideline for the layout of this type of article and don't see a particular reason not to follow that guideline here. Zad68 01:41, 16 October 2014 (UTC)
That is fine leave the structure then. It an be addressed through better content. Greenbe (talk) 00:13, 17 October 2014 (UTC)
genome size given in kilo-basepairs instead of kilo-nucleotides
In the Virology->Genome section:
"Ebolavirus genomes are approximately 19 kilobase pairs long and contain seven genes ..."
You are right at a high level about RNA being single stranded but I don't know why they use bp (or kbp) I found the direct gene listing reference and it shows 18613 bp. Maybe that's just how the results of PCR are quoted. (That may not be the whole thing and there are many pieces of it so don't take that as the absolute length). I think we should leave it at bp unless someone can find a journal article showing otherwise. http://www.ncbi.nlm.nih.gov/nuccore/KM233118.1Greenbe (talk) 01:07, 14 October 2014 (UTC)
Adrenal impairment and destruction issues - add to pathophysiology and treatment subtopic areas
Ebola is known to commonly cause adrenal gland destruction.
Since untreated adrenal failure is fatal in and of itself, treatment of
adrenal deficits with adrenal glucocorticoid and mineralcorticoid replacement
may be one important component to supportive care. — Preceding unsigned comment added by 74.93.120.21 (talk) 21:43, 13 October 2014 (UTC)
UptoDate is okay but usually the direct literature (e.g., PubMed reviews) are preferred. If you find any accessible sources there, definitely link them. TylerDurden8823 (talk) 22:18, 13 October 2014 (UTC)
D-dimer and D.I.C. in Ebola disease
D-dimer is a commonly available test that may be a marker to aid in differential dignosis.
D.I.C. is a common consequence of Ebola infection - potentially related to the
effects of the soluble GP. — Preceding unsigned comment added by 74.93.120.21 (talk) 21:47, 13 October 2014 (UTC)
It's true that disseminated intravascular coagulation occurs in Ebola virus disease, but you can't make the diagnosis with just a D-dimer. It's certainly a good start though and can get you thinking about DIC if it's abnormal. TylerDurden8823 (talk) 21:50, 13 October 2014 (UTC)
Agreed. Clearly. RT-PCR and Elisa would be much better (and definitive).
D-Dimer is relatively cheap and available although clearly only one part
of a diagnostic approach.
BTW do you have any specific data on HOW EARLY RT-PCR can detect Ebola ?
I've read 3 days (suggesting often BEFORE presentation of signs and symptoms,
but then presumably the CDC wouldn't be messing around with assessing fever
at US airports for passengers from the Ebola-infected regions.
(And self-report may obviously be grossly inaccurate).
Any more specific data on RT-PCR detection ? — Preceding unsigned comment added by 74.93.120.21 (talk) 22:14, 13 October 2014 (UTC)
It seems PCR can be used "a few days after onset of symptoms" according to CDC. I don't know why it is not possible earlier, not enough viral load? http://www.cdc.gov/vhf/ebola/diagnosis/index.html. The incubation is 1-21 days. I thought I saw this in some Harvard articles - I encourage those interested in answering this to search Harvard publications for hard data they seem to be all over detection and sequencing. Greenbe (talk) 01:21, 14 October 2014 (UTC)
We are not a news outlet
We link to the 2014 outbreak in both the 4th paragraph of the lead and in the epidemiology section. We do not need a banner at the top linking to it as well. See WP:NOTNEWS. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:23, 15 October 2014 (UTC)
Thus removed this [34]Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:24, 15 October 2014 (UTC)
Disambiguation
I've routed five-letter "Ebola" user searches to the disambiguation page (previously they came here, which as you might imagine has blown in a gale of people over the past few months); hopefully this will see a reduction in non-academic meddling.--Froglich (talk) 06:41, 16 October 2014 (UTC)
When people type in Ebola they are usually looking for information about the Ebola disease. Thus restored. They are not looking for the band or the slightly differently spelled town in Italy. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:53, 16 October 2014 (UTC)
I'd wager that the goodly mass of people chucking that term into the search box are more interested in the ongoing outbreak than the virus itself. Also, I noted complaints above regarding the influx of unwarranted editing as of late, which I would deduce is due to heightened traffic funneled in by the redirect. IMO it's advisable to "contain the outbreak" in the outbreak-in-west-africa article (which is rapidly evolving anyway). Thus diverting the major search term to the disambig page takes the heat off this article.--Froglich (talk) 09:12, 16 October 2014 (UTC)
We link to the 2014 outbreak both in the epidemiology section and in the 4th paragraph of the lead. The editors coming here are already Wikipedians as this article is semi protected. Thus it is not the general population editing. We could leave a hidden note in the edit box? Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:40, 16 October 2014 (UTC)
FroglichWP:RELATED covers why we don't use a hatnote for this. WP:PRIMARYTOPIC is why "Ebola" redirects here. I've responded on your talk page, and I've asked for protection for the redirect (I'm guessing it's our most used redirect, to get to our most used article). Saying that, I do have sympathy for letting readers find the outbreak article more easily - please comment at Talk:Ebola (disambiguation)Widefox; talk 23:36, 16 October 2014 (UTC)
Typo and incorrect link
Under "Signs and Symptoms", it says Ebola is "characterized by feeling tiered..."
"tiered" should read "tired".
Also, "feeling tiered" links to the disambiguation page for fatigue rather than the page for medical fatigue here: http://en.wikipedia.org/wiki/Fatigue_(medical)— Preceding unsigned comment added by 76.168.63.18 (talk) 10:52, 16 October 2014 (UTC)
I didn't see "tiered" but I did fix the "fatigue" target as you suggested, thank you!! Zad68 12:44, 16 October 2014 (UTC)
Adding: I see someone else got to "tiered" already, here. Zad68 12:46, 16 October 2014 (UTC)
________________________________________
Ebola is a BSL 4 pathogen
I wonder if a section on BSL 4 status could be inserted into this Ebola topic page? Factual BSL information has its own Wikipedia topic page, and is quite descriptive about safely handling BSL 4 pathogens such as Ebola. I suggest this because the CDC itself requires its lab employees to use very restrictive lab gear and techniques whenever they work with Ebola samples. Take a look at that page and note the training required for employees to expose themselves to Level 4 pathogens. I think it's clear that this Ebola lab work has gone on for years, yet without any "civilian" cross-contamination; so it is possible to contain the pathogen to the patient. Inserting this BSL info into the Ebola article would give readers a clue as to the standard safety protocols used for the last 40 years at CDC with this pathogen. The fact remains that working with positive Level 4 samples requires than just a simple training demonstration to healthcare personnel. — Preceding unsigned comment added by Tell someone (talk • contribs) 12:51, 16 October 2014 (UTC)
Society and culture
"Ebola-chan" - 421,000 results on Google and growing. We love you Ebola-chan! Tiptoethrutheminefield (talk) 21:18, 16 October 2014 (UTC)
Ebola virus disease and Reston virus
User:Nodove made this change [35] to move the Reston virus information to that article. It is possible we need a better reference that the Reston virus monkeys were afflicted with something that can be called Ebola virus disease. From the references I have seen (I cannot recall a specific one, and the references from that time period are a bit harder to search due to naming changes with ebolaviruses), it is reasonable to consider the Reston virus cases in monkeys as "Ebola virus disease", even though the humans did not develop EVD. The CDC list of "Known Cases and Outbreaks of Ebola Virus Disease" [36] includes the Reston virus cases, for one. Xqxf (talk) 00:20, 17 October 2014 (UTC)
Incubation period
Please note major change listed as follows
Signs and symptoms of Ebola virus disease usually begin suddenly with an influenza-like stage characterized by feeling tired, fever, headaches, and pain in the joints, muscles, and abdomen.[2][3] Vomiting, diarrhea, and loss of appetite are also common.[3] Less common symptoms include sore throat, chest pain, hiccups, shortness of breath, and trouble swallowing.[3] The time between exposure to the virus and the development of the disease is the incubation period. Most people, that are exposed to the virus, and eventually develop the disease, will start to show symptoms in 8 to 10 days. Approximately 95% of cases have an incubation period within 21 days, [3][4][5]and 98% within 42 days. [6][7][8] Pbmaise (talk) 04:01, 17 October 2014 (UTC)
Seriously we need to STOP using the popular press.
This PLoS paper is one person's estimate [39]. It deserves little weight. And it is a primary source thus fails WP:MEDRSDoc James (talk · contribs · email) (if I write on your page reply on mine) 06:16, 17 October 2014 (UTC)
Semi-protected edit request on 17 October 2014
This edit request to Ebola virus disease has been answered. Set the |answered= or |ans= parameter to no to reactivate your request.
Not done: as you have not requested a change. If you want to suggest a change, please request this in the form "Please replace XXX with YYY" or "Please add ZZZ between PPP and QQQ". Please also cite reliable sources to back up your request, without which no information should be added to, or changed in, any article. - Arjayay (talk) 10:49, 17 October 2014 (UTC)
Ebola and American/European wild animal populations
One of the more surprising bits of news about Ebola I saw was that in the Spanish case, a dog that had been exposed to Ebola was initially left in an apartment with 30 pounds of dog food, a bathtub of water, and the terrace door open so that (very optimistically) the dog might do its business outside. [40] This makes me wonder -- is there any systematic effort being made to ensure that wild animal populations in Europe and the U.S., especially bats, are protected from Ebola exposure? And if they are exposed, has any effort been made to identify in advance which species of bats in the Americas and Europe are best suited as long-term hosts for Ebola to become endemic to these continents? If it does become established in local bats, is it feasible to stop it early by regularly dropping poison gas in the caves within some radius, or would it inevitably get out ahead of any containment efforts? I didn't see anything very relevant in the news or on PubMed. (Encouraging caveat: the identified bat species from the article are all from a familyPteropodidae that does seem limited to the Old World south of the Mediterranean/Bosporus/Himalayas, so Spain and Texas at least don't have close relatives of those. But if it can infect shrews.....) Wnt (talk) 23:08, 17 October 2014 (UTC)
Operon Labs
http://www.operonlabs.com/ has a whole lot of interesting data about Ebola. But so far as I can figure out, it looks like an anonymous blog that I can't cite for anything (though it gives useful sources). Even so it seems worth recommending to fellow editors as being enriched for "interesting" leads, with everything to be cited through to the sources it cites, not to the blog. For example, it points out that a filovirus fragment was found "fossilized" in the genome of North American microbats, quoting figures from [41], a paper which observes " In concordance with the recent identification of Ebola Reston in swine [45], this unexpected result indicates that the distribution of filoviruses is likely much broader than has previously been recognized." Interesting, no? Wnt (talk) 23:28, 17 October 2014 (UTC)
Nodove has introduced "stages of Ebola". I have not see these mentioned and cannot find them in the refs? [42] Which ref refers to the first and second stage? Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:16, 18 October 2014 (UTC)
Which ref says stages? Have removed again unless we have a high quality ref that makes the claim. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:16, 19 October 2014 (UTC)
I'm inferring "first symptoms" from the WHO2014 refence to be "stage one" and inferring "followed by" (from the same reference) to mean "stage two" (maybe I'm totally wrong for inferring these phrases to mean such other phrases). However, doing some more research, it seems the CDC groups all symptoms together--Nodove (talk) 14:59, 20 October 2014 (UTC)
Mabalo Lokela
in this dif i redirected content from the article Mabalo Lokela. in this difGandydancer reverted. Gandy please see the discussion here - there is a proliferation of articles on people who are notable only for having been infected. most of them are being deleted. this one is arguably of historical note since she is the index patient. if the content doesn't go here, it doesn't go anywhere. am taking the rare step of re-reverting while we discuss, since is the product of a redirect. Jytdog (talk) 15:35, 18 October 2014 (UTC)
(edit conflict) I have removed the History section for further discussion. This gets a bit tricky and I was confused at one point as well. While many sources suggest that the Zaire case was the first Ebola case in Africa, actually the Sudan case was the first, with the Zaire outbreak following the Sudan case by a few weeks. See the "1976" section for details. We could just leave the article as is, or we could introduce a new "History" section and include the info from the "1976" section in a new history section. I rather like adding a new History section. Thoughts? Gandydancer (talk) 15:38, 18 October 2014 (UTC)
interesting! so the content in the former article was wrong. let me do some digging; let me look at hthe 1976 outbreak article. i betcha i agree that it goes there, not here, with better sourcing :) please give me a few minutes to fix, and then to fix the redirect on the former article. thanks! Jytdog (talk) 15:41, 18 October 2014 (UTC)
i just self-reverted. there is already content on her here, so the redirect is actually fine. content in former article was inaccurate. she is still covered in WP. sorry for the mini-drama - i didn't want (what i thought was good) content to be lost. thanks for correcting me. Jytdog (talk) 15:44, 18 October 2014 (UTC)
(edit conflict)Please see the fixed version [43] I merged as well (I will put that text back into 1976, with some details trimmed, if there are no objections, since it matches the rest of the section. I reverted myself since I didn't see User:Gandydancer's original revert before I saved.) See the original WHO refs that document the dates of the June 1976 Sudan outbreak [44] and August 1976 Zaire outbreak [45]. But in any case, that information belongs with the information currently in Ebola virus disease#1976. (Also see my edit request from Oct 7 where we fixed it in that section: Talk:Ebola_virus_disease#Edit_request:_Sudan_1976_cases.) Xqxf (talk) 15:49, 18 October 2014 (UTC)
"All's well that ends well"...but wait!, there's more! ;) How about the idea of adding a new History section where we explain this? Gandydancer (talk) 16:00, 18 October 2014 (UTC)
I'm not that opposed to adding a new "History" section. However, where would we end it? Does 1976 count as history, and 1995 not? I'm not sure if there's a sensible place to break apart from the Epidemiology section. But if you have a sensible idea of how to structure it without the things becoming confusing, then go for it. Xqxf (talk) 16:05, 18 October 2014 (UTC)
I don't think it would be so hard to figure out what to include. The discovery of the Reston virus could go in the section as well. I don't have time to tackle anymore than what I'm doing right now. Gandydancer (talk) 00:29, 19 October 2014 (UTC)
Grammatical Mistake
In the line: "The Health Ministry of Russia also claim to..." it is supposed to be "The Health Ministry of Russia also claimS". — Preceding unsigned comment added by 41.34.62.182 (talk) 20:37, 18 October 2014 (UTC)
It's fixed. Thanks for the heads up! TylerDurden8823 (talk) 20:48, 18 October 2014 (UTC)
Colorized electron micrograph
Instead of the colorized image File:Ebola virus virion.jpg at Ebola virus disease#Virology, the article should use the black and white image File:Ebola Virus TEM PHIL 1832 lores.jpg. The diameter is only 80 nm, so there is no true color. The caption also states only that it is an "Electron micrograph of an Ebola virus virion"; there is no mention of the artificial colorization. This article is about science rather than PhotoShop, so it should use the actual electron micrograph. Glrx (talk) 20:50, 18 October 2014 (UTC)
Spelling of diarrhea
Why was the spelling change of diarrhea, from "diarrhoea," reverted? Our article spells it "diarrhea," and the two articles should be consistent with each other. The link presently goes to a redirect page, when it should go directly to the article. If no explanation is given, this change will be redone. Thank you. -Jordgette[talk] 18:44, 9 March 2020 (UTC)
Wiktionary:diarrhoea is the British spelling. Are you familiar with Wikipedia's guideline on British English? What counts is that the rest of this article uses British English, not some American English in the Diarrhea article. The guideline is the result of long, heated debates in the past and won't be changed without the consensus of hundreds of editors. Art LaPella (talk) 19:32, 9 March 2020 (UTC)
Double standard categories of Ebola compared to Corona virus
Besides issues related to the fact I'm less politically correct than you:
For one thing, the name "West African Ebola virus epidemic", whose name has been endlessly debated and changed for many reasons but not that reason, needs to be distinguished from other Ebola epidemics in Central Africa. The most easily identified difference is that it's further west, so the title is geographical. There were a few cases in other places, mostly medical personnel who got infected and brought the disease home. But almost all of the epidemic was in West Africa.
The names "China virus", "Wuhan virus", "Wu Flu" etc. are controversial, but to draw a comparison you would have to use a name like "African Ebola", rather than just using place names for places that had Ebola outbreaks. Come to think of it, "Ebola" is like "Wuhan virus", because it's named after the Ebola River in Africa. But Ebola is the only name for it. Art LaPella (talk) 18:15, 29 March 2020 (UTC)
Virus Disease vs. Hemorrhagic Fever?
Does anyone know the reason why the World Health Organization renamed the disease from "Ebola Hemorrhagic Fever" to "Ebola Virus Disease"? Is it a new trend of disease nomenclature? — Preceding unsigned comment added by PanVoyager (talk • contribs) 09:14, 20 February 2020 (UTC)
Because it very often doesn't cause haemorrhaging. Bueller 007 (talk) 19:30, 29 March 2020 (UTC)
1976 Ebola outbreak: Dr Jean-Jacques Muyembe and Dr Peter Piot contributions during the epidemic
8.1 Zaïre 2nd paragraph, line 4 to 8 and 3rd paragraph, 1st sentence read like this:
"The initial response was led by Congolese doctors, including Jean-Jacques Muyembe-Tamfum, one of the discoverers of Ebola. Muyembe took a blood sample from a Belgian nun; this sample would eventually be used by Peter Piot to identify the previously unknown Ebola virus.[156] Muyembe was also the first scientist to come into direct contact with the disease and survive.[157] Researchers from the Centers for Disease Control and Prevention (CDC), including Piot, co-discoverer of Ebola, later arrived to assess the effects of the outbreak, observing that "the whole region was in panic."[158][159][160]
Piot concluded that Belgian nuns had inadvertently started the epidemic by giving unnecessary vitamin injections to pregnant women without sterilizing the syringes and needles. "
All of this above is complete fiction and should be removed. The version most of the actors in that first Ebola epidemic agreed on(Drs Jean-Jacques Muyembe and Peter Piot included) was published in 2016, in the Journal of Infectious Diseases <ref Discovery and Description of Ebola Zaire Virus in 1976 and Relevance to the West African Epidemic During 2013–2016 https://doi.org/10.1093/infdis/jiw207>
According to that article:
-Dr Muyembe is not one of the discoverers of Ebola, although he was one of the first on the ground, he actually suspected it was typhoid fever and didn't take any preventive measures to secure the area and stop the spread of the disease.
-The blood sample he collected was not sent to Dr Peter Piot in Antwerp,nor was it the one used to identify the new virus.
-Dr Peter Piot was just a junior member of the Antwerp Institute of Tropical Medicine (ITM) team that received the sample sent by Dr Courteille from Ngaliema Hospital in Kinshasa. Wim Jacob, an electron microscopist at ITM was the first to observe a Marburg-like virus.The team couldn't tell the difference.
-Dr Ngoyi Mushola is the first scientist to come in direct contact with the disease and survive.He was also the first to describe it.
- Researchers from CDC were the first to "identify and recognized it was a new virus" in a convalescent blood sample collected by Dr Krubwa and his team (Drs Raffier and Ruppol)
- Dr Peter Piot was not a part of that CDC team and thus couldn't be called co-discoverer of Ebola.
- Dr Piot went to Zaïre as a junior member of the ITM team sent to take part to the International Commission set up by the Government of Zaïre with WHO guidance and help. As such, he "recorded clinical and epidemiological information that was incorporated into the final International Commission report" and not much more. His role in the control of this epidemic is way overblown.Claude dunia (talk) 13:16, 6 April 2020 (UTC)
Error in describing vaccine
The current version, in the section about vaccines, states this:
"An Ebola vaccine, rVSV-ZEBOV, was approved in the United States in December 2019.[8] It appears to be fully effective after ten days of being given.[8] "
To be accurate, the grammar of the second sentence should be changed to this:
"It appears to be 100% effective ten days after being given. [8]"
By saying "100%" the sentence is more precise, and consistent with the referenced article [8]. "Fully effective" means it reaches its maximum effectiveness, but with some vaccines that is not 100% effectiveness. By changing the word order at the end, it makes the meaning correct. As currently written, it means that the vaccine is given ten times over ten days.
It may help to include an additional phrase, such as this:
"It is administered in one dose, and a study showed it to be 100% effective ten days after being given. [8]"
I agree that changing the word order would make it more natural English. I'll let someone like User:Ozzie10aaaa make a medical judgment. Art LaPella (talk) 19:14, 23 April 2020 (UTC)
Art, though it may "sound" better...IMO its saying the same thing--Ozzie10aaaa (talk) 19:38, 23 April 2020 (UTC)
I meant that "ten days after being given" sounds better than "after ten days of being given", in the sense that the former is how we Americans talk.
If you meant "fully effective" means the same as "100% effective", Tamarinera's objection is medical, so I didn't express an opinion on it (I'm a finance guy). Art LaPella (talk) 19:52, 23 April 2020 (UTC)
I have now fixed the syntax issue, while leaving the medical definition of effectiveness to Tamarinera and Ozzie. Art LaPella (talk) 04:15, 25 April 2020 (UTC)
Requested move 25 April 2020
The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review after discussing it on the closer's talk page. No further edits should be made to this discussion.
The result of the move request was: Moved buidhe 22:41, 9 May 2020 (UTC)
The title Ebola virus disease provides more information than just Ebola for people unfamiliar with it. — Preceding unsigned comment added by Joejose1 (talk • contribs) 09:08, 25 April 2020 (UTC)
Support. A Google Scholar search (per WP:NCMED) shows "Ebola", "Ebola virus disease", and "Ebola hemorrhagic fever" as the three most prevalent terms for the disease in scientific literature, with none of them having a majority but perhaps a plurality for "Ebola". As a tiebreaker, "Ebola" is the overwhelmingly dominant WP:COMMONNAME, so all things considered I think it is the best choice. -- King of♥♦♣ ♠ 16:59, 25 April 2020 (UTC)
A doubt may people searching for Ebola are looking for the river. The outbreaks are subpages of the disease article and the virus links clearly from here. IMO this is the primary topic. Doc James (talk · contribs · email) 01:41, 26 April 2020 (UTC)
Support, I think if people type in only the word "Ebola" they are concerned with the disease, and not the outbreak, class of viruses or the river. Neutral to the DAB at base name.--Ortizesp (talk) 19:49, 25 April 2020 (UTC)
Support per WP:COMMONNAME, WP:CONCISE, and WP:PRIMARYTOPIC. This certainly seems to be the most common name for the disease. And when someone searches for "ebola", this is very likely to be the article they're looking for. Which is why "Ebola" already redirects here, making it the primary topic. Rreagan007 (talk) 20:01, 25 April 2020 (UTC)
Oppose as per the reasoning above by Netoholic. Matilda Maniac (talk) 00:10, 26 April 2020 (UTC)
Oppose per Netoholic. The name Ebola is the most common name, but it refers to a broad range of topics. It may be left instead as a disambiguation page. LSGH (talk) (contributions) 10:07, 30 April 2020 (UTC)
Support per discussion. Randy Kryn (talk) 13:17, 4 May 2020 (UTC)
Support, clear primary topic and common name. Ebola River is not in the same realm of notability. —Xezbeth (talk) 18:13, 6 May 2020 (UTC)
The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
Adding to "Recovery and death" section of article
Hello. I thought that it might be a good idea to add some more information to the recovery topic of EVD. Particularly, I was looking to add this sentence to that section: "It is recommended that survivors of EVD wear condoms for at least twelve months after initial infection or until their semen tests negative for Ebola virus on two separate occasions [2]." Do you all think this could be a beneficial add to the article? Aced 24 (talk) 19:31, 9 September 2020 (UTC)
initial capital
It's no more a proper noun than smallpox, so it's ebola. — Preceding unsigned comment added by 81.147.147.153 (talk) 08:57, 10 September 2020 (UTC)
The Crimean-Congo hemorrhagic fever is spelled as "Crimean Congo haemorrhagic fever". Due to this, it is not hyperlinked. MarkyMark1223 (talk) 15:26, 9 November 2020 (UTC)
{{Ebola affects}}
{{Ebola Africa}}
{{Ebola Uganda and DR Congo}}
This article is very useful to all communities where Ebola-affected. And helps medical workers too as well as researchers in this field. Galinnya (talk) 09:48, 19 February 2021 (UTC)
Not done: This doesn't seem to be an edit request. Please use edit request templates only when you wish to request changes to a protected article. Regards, DesertPipeline (talk) 09:58, 19 February 2021 (UTC)
How Ebola virus disables the body's immune defenses
Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. Acalycine(talk/contribs) 06:53, 10 August 2014 (UTC)
Not done: as you have not requested a change.
Done Note that I'm no expert here, just patrolling the list of semi-protected edit requests. Feel free to revert if you disagree. Stickee (talk) 11:37, 8 October 2014 (UTC)
Not done Nano Silver? Nigeria's Potential Ebola Treatment Unlikely to Work - Arjayay (talk) 15:06, 8 October 2014 (UTC)
