North Korea claims the US released Ebola in Africa

     While this headline is hardly newsworthy (or credible), given North Korea's historical record of making claims against the United States, it is a reminder of the same pattern of conduct that we should recognize. http://www.telegraph.co.uk/news/worldnews/asia/northkorea/11269553/North-Korea-accuses-US-of-developing-Ebola-virus.html  Quoted in the article, is a law professor from the University of Illinois (who teaches international law) who gave an interview in October 2014 that supports their claim. I had to listen to his interview before accepting the quote as accurate -- perhaps he was misquoted?  But I found he was not misquoted. He makes several claims that the U.S. is involved in making bioweapons and presents as proof our work in national laboratories on vaccines for exotic diseases like Ebola.  This is similar to the logic supporting the claim made by North Korea in the early 1950s during the Korean War (1950-53) that the U.S. had used bioweapons against them partially based on the logic that because the U.S. was vaccinating troops against yellow fever that it was likely the disease they would use against them with insect-vectors, Japanese style.  (See, M. Furmanski, "Misperceptions in preparing for biological attack:  an historical survey," (Rev. sci. tech. Off. int. Epiz., 2006, 25 (1), 53-70).
      There was more and the U.S.S.R. archives revealed when opened in 1998 that North Korea was being coached by the Soviet Union. In May 1951, North Korea charged that the U.S. had used smallpox and also multiple species of arachnids, clams, insects, mammals, paper leaflets etc. to spread plague, cholera, and other diseases on multiple occasions. A formal complaint was made to the UN Security Council. Long investigatory meetings followed and no allegations were ever proved. It was not until January 1998 when the Soviet archives revealed that the claims were not only wrong they were fraudulent.  For a full account and excellent footnoting of the case study of North Korea and their allegations of biowarfare against the United States see, Milton Leitenberg's chapter "False Allegations of U.S. Biological Weapons Use During the Korean War," in the book, "Terrorism, War or Disease?" (Stanford Univ Press, 2008).
      The trouble with misattribution in biological weapons and epidemics will continue to be difficult, even with advanced genomic identification of strains and the evolution of quickly evolving bacteria and viruses that can help to identify a timeline and origin of the disease. For example, the outbreak of cholera in Haiti during the earthquake disaster was traceable to the UN Peacekeepers and a group from Nepal who brought it into a country that had not seen cholera in 150 years.  However, even this clear evidence was not taken as a liability or calling for compensation from the United Nations.  We have a long way to go in attribution but even further in compensation for mass injury.
    These kinds of claims by North Korea and unsubstantiated claims by people who should know better just seem to keep us in the dark ages of bio-literacy.

Are new regulations called for? Study on bacteria and viruses found on planes is troubling

I made it a personal goal to bring attention to the problem of SARS and the benefits of a HEPA filter system on flights.  Trouble is, that we already have HEPA filter systems on flights, but the inability to change the filters can make them ineffective. I suggested an easier solution -- use ultraviolet light at the portal boarding the flight. I was told that the wind effect at the doorway into the plane would make all of that UV-disinfection pointless.  When I returned from my political appointment to my faculty position, I proposed a study to see if there really were hosts of bacteria and viruses on flights, and in TSA bins, etc.  I was pleased to see that these type of studies were funded recently at Auburn and University of Arizona and we have some hard data, at least about infection patterns and the presence of bacteria and viruses on surfaces with which passengers come in contact.

A microbiology study published in May 2014, found dangerous bacteria and viruses on surfaces on commercial flight seats, armrests, tray tables, bathrooms and just about everywhere else.   American Society for Microbiology. "Harmful bacteria can linger on airplane seat-back pockets, armrests for days." ScienceDaily. ScienceDaily, 20 May 2014.   I had always counted on the wisdom that viruses and bacteria are generally very fragile and cannot live long on surfaces not conducive to thriving.  However, this report shows the dangerous bacteria and viruses can last to infect passengers long after they were left by a previous host occupying the seat as much as 168 hours earlier.  Without disinfection of seats and armrests and tray tables between flights, it provides a regular garden of infection opportunities.  Here's a quote from the article announcing the findings:

In order for disease-causing bacteria to be transmitted from a cabin surface to a person, it must survive the environmental conditions in the airplane. In the study Vaglenov and his colleagues tested the ability of two pathogens, methicillin-resistant Staphylococcus aureus (MRSA) and E. coli O157:H7 to survive on surfaces commonly found in airplanes. They obtained six different types of material from a major airline carrier (armrest, plastic tray table, metal toilet button, window shade, seat pocket cloth, and leather), inoculated them with the bacteria and exposed them to typical airplane conditions.

 MRSA lasted longest (168 hours) on material from the seat-back pocket while E. coli O157:H7 survived longest (96 hours) on the material from the armrest.

Another study, by Dr. Gerba of University of Arizona, followed the passengers who were infected from another passenger with influenza. The findings appeared only in news articles and I was unable to substantiate this report by finding a peer-reviewed publication on this study by Dr. Gerba.  This graphic was provided in the news article and shows who was infected.

Further burdening the airlines with more regulations is a consideration, but the potential for sickness and spreading a global pandemic is reason enough for me to support mandatory wipedowns of the surface of planes between each flight. 

Ebola Updates --New app for iOS and Android devices

http://app.lk/sos-ebola This application is a central place to find the latest news about Ebola in any country, travel restriction information and general information. It is for both iOS and Android devices.  The U.S. media is uneven with its coverage of other countries and Ebola and this app is a good source for Ebola news around the world.  

CDC's ratings by Americans fell 10% since last year

Not surprisingly, the CDC has lost some confidence of the American people over its lack of responsiveness to the need for guidance in dealing with Ebola patients in the U.S., as well as perhaps CDC Director, Frieden's misstatements about the risk of Ebola, and remarks colored with criticism of anyone other than CDC. Lack of Presidential leadership on the Ebola crisis has hindered CDC's response, and that is unfortunate for everyone, including the American people. Gallop's headlines, just out read as follows:

Americans' Ratings of CDC Down After Ebola Crisis

Americans' ratings of the job the Centers for Disease Control, or CDC, is doing are down significantly from last year, whereas ratings of other key government agencies measured both years are the same or better.  . . . .In May 2013, 71% of Democrats and 65% of Republicans said the CDC was doing an excellent or good job. Since then, Democrats' ratings have fallen eight percentage points to 63% while Republicans have dropped 25 points to 40%.   Gallop Poll Report

Can the President mandate national hospital standards?

     The National Nurses United organization is circulating a petition to urge the President to demand standards for hospitals to follow for caring for Ebola patients. 
      The California Nurses United, the state affiliate of NNU, held a strike of 18000 nurses on Tuesday and Wednesday, against health care providers throughout the state to demand better protection standards. As a result the California Department of Industrial Relations and the California Department of Public Health issued regulations last Friday (11/14/2014) that are more stringent than the CDC guidelines as described by the media:

The new guidelines, which build on the department’s Interim Guidance for Ebola released Oct. 15, require workers at risk of contracting the virus to be covered head to toe in fluid-resistant protective garb. The measures go a step further than the current Centers for Disease Control and Prevention standards by requiring battery-powered air purifying respirators, which must include full hoods to cover the face, neck and torso. They also require the hospital to provide in-person training to staff on the donning and removal of the equipment.

Read more here: http://www.sacbee.com/news/local/health-and-medicine/healthy-choices/article3960436.html#storylink=cpy

       October 10, 2014, the Department of Health and Human Services through their two agencies, CDC and ASPR, sent this memorandum outling a "policy" and "strongly" "urging" hospitals to comply.  The National Nurses United are asking in their petition for a "must" from the President.  California issued new standards, which is a state issue and within their jurisdiction.  So, the question is whether the President can mandate hospital standards?
   Previously, I have written how the President could declare a National Public Health Emergency, which would allow the President to take greater authority to mandate action. Even the suspension of  narrowly selected regulations for a short period of time may be reasonable in a declared national public health emergency, but not otherwise. Because the President has not had his DHHS Secretary declare a national public health emergency, it is unlikely that he would impose standards on hospitals that are regulated by federal law, like EMTALA, for emergencies.  That said, without a declared national public health emergency, the President could mandate such standards as long as it is not contrary to law and is not a constitutional violation of federalism by trying to replace or contradict state law. Given these choices, it is not likely the President will mandate hospital standards.
   Here is the National Nurses United petition:

Nurses across America demand that President Obama and Congress act now.

On behalf of registered nurses and other healthcare workers across the United States, we understand that the only way to adequately confront the Ebola crisis, which the World Health Organization has termed the most significant health crisis in modern history, is for the President to invoke his executive authority to mandate uniform, national standards for care and protocols that all hospitals must follow to safely protect patients, registered nurses, other front-line healthcare workers, and the public. Every healthcare employer must be directed to follow the Precautionary Principle and institute optimal protocols and personal protective equipment for Ebola that meets the highest standards used by Nebraska Medical Center, or a higher standard, including:

• Full-body hazmat suits that meet the American Society for Testing and Materials (ASTM) F1670 standard for blood penetration, the ASTM F1671 standard for viral penetration which leaves no skin exposed or unprotected.
• National Institute for Occupational Safety and Health-approved powered air purifying respirators with an assigned protection factor of at least 50 — or a higher standard as appropriate.
• Continuous interactive training with the RNs who are exposed to patients, continuous updated training and education for all RNs that is responsive to the changing nature of disease, and continuous interactive training and expertise from facilities where state-of-the-art disease containment is occurring.
• If the Employer has a program with standards that exceed those used by Nebraska Medical Center, the higher standard shall be used. The Ebola pandemic and the exposure of healthcare workers to the virus represent a clear and present danger to public health. We know that without these mandates to healthcare facilities, we are putting registered nurses, physicians and other healthcare workers at extreme risk. They are our first line of defense. We would not send soldiers to the battlefield without armor and weapons.

In conclusion, not one more patient, nurse, or healthcare worker should be put at risk due to a lack of healthcare facility preparedness. The United States should be setting the example on how to contain and eradicate the Ebola virus. Nothing short of President Obama's mandate, that optimal safety standards apply, will be acceptable to the nurses of this nation. We demand protection for all healthcare workers.  http://www.nationalnursesunited.org/train-site?gclid=CKres9Kng8ICFWFgMgodwDAACg 

Dallas Hospital Settles with Duncan Family for "mistakes"

News Release Texas Health Dallas Amicably Resolves Matters with Family of Thomas Eric Duncan 11/12/2014 DALLAS — Texas Health Presbyterian Hospital Dallas today announced that it has amicably resolved all matters with the family of Thomas Eric Duncan. We know that this has been a terribly sad, difficult and trying time for Mr. Duncan’s family and friends, and they will continue to be in the hearts and prayers of the entire Texas Health Presbyterian family. As part of the healing process, we have again extended our sincere apologies to the family and shared our regret that the diagnosis of Ebola Virus Disease was not made at the time of Mr. Duncan’s initial Emergency Department visit. The hospital is honoring Mr. Duncan’s memory by facilitating creation of the Texas Health Dallas Thomas Eric Duncan Memorial Fund for the express purpose of providing assistance to victims of Ebola in Africa. Texas Health Dallas greatly appreciates acknowledgment by the family’s attorney that Mr. Duncan’s inpatient care was excellent. We are grateful to reach this point of reconciliation and healing for all involved. Today’s resolution with the Duncan family serves as an example of the common-sense Texas laws that allow discussions to take place immediately and be resolved quickly. As a result, health care organizations, patients and family members are able to resolve matters fairly and equitably. Contact: Wendell Watson, Director Public Relations Media Hotline: 800-314-7722

US Army Public Health Command releases 21-day control guidelines for returning personnel from Ebola-stricken regions

The Joint Chiefs of Staff released an action memorandum for managing the 21-day controlled monitoring for personnel returning from Ebola stricken areas.  The video above, is the newest video information on EVD (Ebola Virus Disease) from the U.S. Army Public Health Command.