Alan Zelicoff, MD – Ebola Issues and Answers

Air Date: 11-7-2014 | Episode: 346


This week we are happy to announce the return of Alan Zelicoff, MD to discuss the current Ebola Scare in the US. We will discuss the hype and the reality surrounding this issue…

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This week we are happy to announce the return of Alan Zelicoff, MD to discuss the current Ebola Scare in the US. We will discuss the hype and the reality surrounding this issue. Has the 24-7 cable news environment over-hyped this issue or are the CDC and others downplaying what could be a huge problem for this country and the world? Dr. Zelicoff last joined us over five years ago on episode #143 when when Avian Flu was in the news. People were concerned about the potential for a pandemic but that crisis never materialized. The current Ebola coverage has been similar to what we saw during the 2009 scare or has it? Alan Zelicoff is a physician (board certified in internal medicine 1992, clinical fellowship in rheumatology, 1983) and physicist (A.B., Princeton, 1975), who has had a varied career including clinical practice, teaching, and operations research. In the latter roles, he was Senior Scientist in the Center for National Security and Arms Control at Sandia National Laboratories from 1989 to 2003. Dr. Zelicoff’s interests include risk and hazard analysis in hospital systems and office-based practice, and in technologies for improving the responsiveness of public health offices and countering biological weapons terrorism. Dr. Zelicoff has traveled extensively in countries of the former Soviet Union and has led joint research projects in epidemiology of infectious disease, while establishing Internet access at Russian and Kazak biological laboratories. He is the author of numerous text book chapters and articles in these subjects, and is a frequent contributor to Op-Ed pages in the Washington Post and other newspapers. Dr. Zelicoff’s latest book is: Microbe: Are we Ready for the Next Plague? published by AMAZON Books.

 

 

 

Z-Man’s Blog:

Born to Mutate

With media coverage inciting fear and panic over Ebola, IAQradio felt it important to get the facts from a knowledgeable and reliable source. Once again we called upon Alan Zelicoff, MD the Professor of Environmental and Occupational Health at Saint Louis University for his take on the Ebola situation.

 

Bio weapons are naturally occurring organisms that have been converted into weapons. Dr. Zelicoff traces his interest in infectious disease to the Biological Weapons Convention, an arms control treaty banning these weapons but having no verification regime.  He pondered verifying the treaty though monitoring, disease surveillance and early detection. For fast and accurate early detection medicine and public health need to work together, especially physicians and veterinarians.  Zelicoff developed a real-time clinician based disease surveillance system called Syndrome Reporting Information System (SYRIS) used for over seven years in several public health jurisdiction in the US to monitor the health of people, agricultural animals and wildlife.

 

Nuggets mined from today’s episode:

  • Over 1,000 viruses have been identified that cause human disease, it’s likely that there are many more.
  • The root of the word epidemic is “within people”. The root of the word pandemic is “everywhere there are people”. Pandemic is understood to affect people on 2 or more continents. Pandemic flu outbreaks occur annually, but they are usually mild.  Thus, the word “pandemic” is reserved for wide-spread and severe disease outbreaks.
  • Viral particles (when sitting on a table) are not living in the traditional sense.  They don’t make their own energy and they can’t replicate.
  • Because virus particles may not be viable, it’s unlikely that infection will occur on exposure to a single viral particle. Infection with Ebola likely requires exposure to numbers of tens of particles. “Better to be approximately correct than precisely wrong.”
  • Ebola particles on skin are harmless until introduces into mucus membrane such as eyes or nose.
  • Enveloped viruses are fragile because their membrane is partially comprised of host cells. When in blood on a surface they may remain viable for approximately 7 days (and probably less). Corona virus is an example of an enveloped virus.
  • Non-enveloped viruses are more resilient and may remain infectious for many weeks. The Noro virus on cruise ships is an example of a non-enveloped virus.
  • There are approximately 20,000 flu related fatalities in the US (the range is somewhere between 4500 and 40000 per year over the past twenty years).
  • Ebola virus is an enveloped virus. Ebola  and Marburg virus share a common ancestor that is at least a thousand years old.
  • A species of African fruit bat is one natural source of Ebola. Ebola does not require human host.
  • A mutation is a change in genetic code. Mutation is an error in replication. Not all mutations make viruses more contagious. It’s unlikely that Ebola will mutate and become airborne transmissible. Flu has many more opportunities to mutate than Ebola.
  • Aerosols are called aerosols because they behave like air. Aerosols are much smaller than droplets. Droplets are about 50-100 microns in size and tend to settle after traveling 1 meter. In Africa, two meters provides a known safety factor between Ebola patients and family visitors.
  • Really tiny particles have large surface area when compared to volume and fall apart or desiccate easily.
  • Speculates that the two Dallas nurses were either infected by a breach while doffing PPE or during patient Duncan’s second visit to the hospital before he was quarantined.
  • Fluid replacement is a key to treating people with Ebola.  Usually this has be done intravenously because of vomiting in patients with Ebola who are often unable to ingest fluid.
  • People who volunteer or are sent into harm’s way, deserve the best treatment available. There is no demonstrable benefit to quarantining Ebola workers. Quarantine may reduce the number of volunteers willing to perform aid work.
  • The “buddy system and checklist” are known to improve worker safety. PPE and low pressure spraying recommended for decontamination.
  • SARS breakout in Hong Kong likely caused by aerosolizing SARS laden fecal particles.
  • ZMapp is a promising  experimental biopharmaceutical drug comprising 3 antibodies under development as a treatment for Ebola virus disease.

 

Today’s music: Fergie “L.A. Love Parody Ebola (La La) Rucka Rucka Ali YouTube

 

Z-Man signing off

 

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