The Exponential Spread of Ebola

In summary: April 12, 2019.In summary, the conversation revolved around the concern over the Ebola virus outbreak in West Africa and its potential to spread to other parts of the world. Participants discussed the exponential growth of new infections and the difficulty in obtaining reliable data from the affected areas. They also touched on the possibility of the virus spreading to more populated areas with better travel infrastructure. The conversation also mentioned the challenges in containing the virus and the potential for it to continue for years if a vaccine or effective treatment is not developed. Finally, the conversation mentioned the possibility of some individuals in West Africa having natural immunity to the virus.
  • #1
dimensionless
462
1
Have any of you been tracking the rate of new Ebola infections? It seems that there is pretty clear exponential growth, and the virus is anything but contained. Is anyone else bothered by this? By looking at this just mathematically, some huge swath of people will become infected. At a certain point the shear number of infections could threaten to collapse the efforts to contain it. Maybe the outbreak is just too big to contain. Maybe the outbreak is too slow moving to cause a health care collapse. I'm no epidemiologist, but I'm guessing that this outbreak will continue for years into the future.
 
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  • #2
Is there any reliable data that can be followed? I was under impression we have no clear idea about what is going on in Africa - just isolated data from several points where the outbreak was observed (but neither fully controlled nor contained).
 
  • #3
Most of the data on the outbreak is coming from the World Health Organization. Currently there are an estimated 125 new cases per day. I have seen reports that stating that this is the "tip of the iceberg" and that many cases are probably going unreported. The full extent is not clear to me.
 
  • #4
I'm quite sure the number of ebola cases in africa are under reported. Western civilization does not feel it poses a threat, so it gets scant attention.
 
  • #5
dimensionless said:
Have any of you been tracking the rate of new Ebola infections? It seems that there is pretty clear exponential growth, and the virus is anything but contained. Is anyone else bothered by this?

It's hard to tell what is going on for certain, since news doesn't travel very fast or reliably from west Africa to the rest of the world.

It would be of greater concern if it is found that the virus has spread out of west Africa and into the large cities of Europe or the Americas, since the travel infrastructure is well developed and large numbers of people are constantly on the move between cities and countries. Fortunately, this has not occurred yet.

By looking at this just mathematically, some huge swath of people will become infected. At a certain point the shear number of infections could threaten to collapse the efforts to contain it. Maybe the outbreak is just too big to contain. Maybe the outbreak is too slow moving to cause a health care collapse.

Right now, the virus outbreak is confined to west Africa, where travel and communication between villages is relatively slow. If the virus were to spread to Nigeria, for example, the large cities there could provide for thousands, if not millions, of potential victims.

I'm no epidemiologist, but I'm guessing that this outbreak will continue for years into the future.

Unless the ebola virus mutates into some other milder strain than is currently existing, I don't think the outbreak will be long lasting: the current strain is very virulent and is fatal to a rather large percentage of those infected. When the number of hosts is depleted, if not eradicated entirely, the virus dies along with its victims.

In the worst case scenario, if a village becomes infected with ebola, and all the villagers succumb, the spread of the virus is stopped at that point. If villagers who have potentially been infected travel to a village where no infection is present, then the virus spreads. The key to stop the spread is to make sure no large population center like a city becomes host to refugees from the countryside who may potentially be carrying the virus. In the absence of effective anti-viral treatment or a vaccine, quarantine is the best defense we have to contain the spread of the virus.

The American volunteer doctors who were infected and survived ebola reportedly have developed anti-bodies to the virus. It might be possible to harvest these anti-bodies and develop a vaccine, but such a solution, if it is possible at all, would seem to be years away.

[Late Edit]

It's also not clear, but for various reasons, certain groups in west Africa may have naturally acquired immunity to the ebola virus currently spreading there. Since the virus apparently infects some of the animal population without the same virulent effects which human patients exhibit, it is thought that the individuals with immunity acquired it by either eating infected animals or by eating fruit which may have been contaminated by these animals:

http://www.nytimes.com/2014/09/06/health/ebola-immunity.html
 
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  • #6
SteamKing said:
Right now, the virus outbreak is confined to west Africa, where travel and communication between villages is relatively slow. If the virus were to spread to Nigeria, for example, the large cities there could provide for thousands, if not millions, of potential victims.
Ebola has jumped into Nigeria because a diplomat violated a quarantine and took himself to Port Harcourt, Nigeria.

Mobility in Africa has increased over the years, and now apparently some infected people flee the area to new areas and infect others outside the various quarantined areas.

http://www.npr.org/blogs/goatsandso...infected-a-doctor-as-ebola-spreads-in-nigeria
How did Ebola hop from Lagos to Port Harcourt?

It all started at the beginning of August, when a diplomat in Lagos violated a quarantine order and fled to Port Harcourt. That man infected a doctor at the port city, who then had contact with more than 200 people, the World Health Organization said Wednesday. About 60 people had what WHO calls "high-risk exposure" — they were in direct contact with the doctor or his bodily fluids.

The doctor secretly treated the diplomat in a Port Harcourt hotel room. The diplomat reportedly has survived.

The doctor developed symptoms — and thus became contagious to others — on Aug. 11. But for the next two days, he continued to treat patients in his private clinic, performing surgery on two.

As his Ebola symptoms worsened, but before he went into the hospital, the doctor had "numerous contacts" with relatives and friends who came to his home to celebrate the birth of a baby, the WHO said.
. . . .
The WHO currently reports 21 cases of Ebola and seven deaths in Nigeria. According to Nigerian Health Minister Onyebuchi Chukwu, five of these cases — two of whom have died — are in the Port Harcourt cluster. . . .

And there is concern that some folks may travel to Europe or North America.
http://www.npr.org/blogs/goatsandso...ases-likely-in-u-s-air-traffic-analysis-shows
 
  • #7
SteamKing said:
.
The American volunteer doctors who were infected and survived ebola reportedly have developed anti-bodies to the virus. It might be possible to harvest these anti-bodies and develop a vaccine, but such a solution, if it is possible at all, would seem to be years away.

[Late Edit]

It's also not clear, but for various reasons, certain groups in west Africa may have naturally acquired immunity to the ebola virus currently spreading there. Since the virus apparently infects some of the animal population without the same virulent effects which human patients exhibit, it is thought that the individuals with immunity acquired it by either eating infected animals or by eating fruit which may have been contaminated by these animals:

http://www.nytimes.com/2014/09/06/health/ebola-immunity.html


[/QUOTE]
Those who are immune can donate blood containing antibodies to be given to acutely ill patients, as was done for Dr. Kent Brantly, one of the first two Americans to get Ebola. He survived, although his Emory University doctors later said it was unclear whether the transfusion or an experimental drug, ZMapp, containing cloned antibodies, helped him at all.

The antibody thing from survivors has been tried before in other outbreaks and zero success rate in curing the disease was noted.

As for the people "immune" to Ebola, as said in the text
“It’s fair to say that some people are immune,” said Robert F. Garry Jr., a Tulane University expert in hemorrhagic fevers who works in Sierra Leone. “But we don’t know if it’s 1 percent or 2 percent or 20 percent.”
sounds like jabbeywocky. Any volunteers lining up to find out if they are immune. I don't think so.
 
  • #8
I listen to a BBC podcast that sheds some real light on some of the statistics we here reported in the news:

http://www.bbc.co.uk/podcasts/series/moreorless

Scroll down a bit to "How Deadly is Ebola?" to get a good numerical take on this.

Probability-wise, consider the following:

The probability that someone in Africa is infected with Ebola
The probability that person is not showing symptoms (If they are showing symptons, it is not likely they will travel)
The probability that person will then get on a plane

Then:

The probability that that person will infect another passenger (given that it is not an airborne disease).
or
THe probability they will arrive safely and infect another person here.

All of the above has to happen for the disease to come here.

-Dave K
 
  • #9
256bits said:
The antibody thing from survivors has been tried before in other outbreaks and zero success rate in curing the disease was noted.

'Curing' a viral infection is one thing; using anti-bodies to develop a vaccine is different.

Vaccines are administered to people who do not already have the infection, in order to stimulate their immune systems to produce anti-bodies to fight off a virus should an individual become exposed after vaccination.

AFAIK, there are no cures for viral infections; the patient either recovers or he does not.
 
  • #10
dkotschessaa said:
the probability that someone in africa is infected with ebola

I know you meant it as "probability a specific individual is infected", but as it's stated the probability of that statement being true is 100%.

the probability that person is not showing symptoms (if they are showing symptons, it is not likely they will travel)
Given that the incubation period is about 3 weeks, and everyone who is sick goes through the incubation period, and they won't likely travel if sick*, this too is 100%.

*in fact, people who are sick and travel anyway is believed to be how the disease spread to Lagos. A diplomat fled the quarantine area, went to a densely populated city, and sought treatment. He infected his doctor who continued to work after becoming sick, perhaps not realizing he had Ebola:

http://abcnews.go.com/Health/diplomat-fled-quarantine-center-ebola-cluster-nigeria/story?id=25248411

the probability that person will then get on a plane

This one is less likely, but planes fly out of Africa full of passengers every day.

then:

The probability that that person will infect another passenger (given that it is not an airborne disease).
Or
the probability they will arrive safely and infect another person here.

I bet if you show up in any ER in North America with a fever and diarrhea, no one is going to suit up in full protective gear to treat you. They probably don't in most areas of Africa that aren't affected, either.

all of the above has to happen for the disease to come here.

-dave k

Hmm. I don't feel much better, honestly!

I mean, consider that diplomat in the link above. What if he/she had gone elsewhere -- Rio de Janeiro? Bangladesh? Miami? The fact is, it can (and already has) pop up elsewhere rather suddenly, because people travel easily.

Where the outbreak goes is dependent on the comings and goings of the not-yet-sick people who have already been infected.
 
  • #11
lisab said:
I know you meant it as "probability a specific individual is infected", but as it's stated the probability of that statement being true is 100%.

Ok, fair

Given that the incubation period is about 3 weeks, and everyone who is sick goes through the incubation period, and they won't likely travel if sick*, this too is 100%.

*in fact, people who are sick and travel anyway is believed to be how the disease spread to Lagos. A diplomat fled the quarantine area, went to a densely populated city, and sought treatment. He infected his doctor who continued to work after becoming sick, perhaps not realizing he had Ebola:

http://abcnews.go.com/Health/diplomat-fled-quarantine-center-ebola-cluster-nigeria/story?id=25248411

This one is less likely, but planes fly out of Africa full of passengers every day.

Implicit in fact #2 though is that during the incubation period, people are not infectious. So no-one on the plane is at risk, was part of my point there. But remember, we're talking about the chances of someone in (West) Africa, who is infected, boarding a plane en-route to the U.S. Pretty low when you stack them.

I bet if you show up in any ER in North America with a fever and diarrhea, no one is going to suit up in full protective gear to treat you. They probably don't in most areas of Africa that aren't affected, either.

Per the person on the attached link (I wish there was a transcript) most hospitals are alerted to this fact and "containment would occur right away" for anyone that turned themselves in when feeling that sick. (And they would feel VERY sick.)

Hmm. I don't feel much better, honestly!

I mean, consider that diplomat in the link above. What if he/she had gone elsewhere -- Rio de Janeiro? Bangladesh? Miami? The fact is, it can (and already has) pop up elsewhere rather suddenly, because people travel easily.

Where the outbreak goes is dependent on the comings and goings of the not-yet-sick people who have already been infected.

What happened was already very improbable. But improbable things do occur.

The chances of it spreading at a rate proportional to the current level of hysteria I think are still quite low. (Remember that SARS *was* airborne, and it was contained.)

-Dave K
 
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  • #12
There is another aspect to the issue: There is; ignorance, fear and distrust involved.

Liberian mob attacks Ebola clinic; dozens of patients missing

The day before the attack, several hundred protesters chanted “No Ebola in West Point” as they forced away a burial team seeking to isolate the bodies of suspected Ebola victims. Health experts say this hostility toward government and outside aid is strong in the West African nations most impacted by Ebola and has posed a central challenge to controlling the outbreak.


http://www.pbs.org/newshour/rundown/raid-ebola-clinic-sparks-new-fears-infection-patients-flee/
 
  • #13
I guess it's just coincidence i recently stumbled across Jack London's 1910 short science-fiction story "Scarlet Plague" which describes a worldwide plague starting in 2013.

Interesting read for his observations on society.

http://www.gutenberg.org/ebooks/21970
 
  • #14
  • #16
Fourth Sierra Leonean doctor dies from Ebola
http://news.yahoo.com/fourth-sierra-leonean-doctor-dies-ebola-185820314.html

Freetown (AFP) - A fourth Sierra Leonean doctor, a woman, died Sunday after contracting the dreaded Ebola virus, a top health official said, while a Dutch charity repatriated two doctors suspected of having been contaminated with the disease.

Doctor Olive Buck, who was in charge of Lumley Government Hospital in the Sierra Leonean capital, tested positive for Ebola on Tuesday and was admitted to the Connaught Hospital in central Freetown.
Two doctors from the Netherlands have returned to NL for treatment.
 
  • #18
The situation is pretty dire in Africa in my honest opinion. Even with the military support provided by Obama, it'll take several months for military support to go online.

I am skeptical about one claim being tossed around in the media: the virus wouldn't be successful in America. I think people are underestimating ignorance. In addition, some of our cities have a high population density.
 
  • #19
I share your concern.

http://www.npr.org/blogs/goatsandso...ce-of-west-africa-has-fueled-the-ebola-crisis
The Africa of today is far different from the Africa of 1976 when Ebola was first discovered. Over the past four decades, the population of the continent has tripled. Forests have been cut down. Roads have sliced into areas that used to be almost inaccessible to outsiders.

These changes have made it more likely that Ebola outbreaks will occur and that when they do, they'll affect more people than in the past.

"If we just take a look at this current Ebola outbreak, the virus hasn't changed, Africa has changed," says Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "We now have this virus in an urbanized population among people who travel far and wide."......

In West Africa, the virus is being carried by passengers on buses that link remote rural villages to capital cities. It's spreading through social rituals such as funerals. The virus is moving from person to person in hospitals.

"This outbreak is totally driven by social dynamics," says Epstein. "This, right now, is the largest outbreak because of factors that really have to do with people."

It's being fueled not just by population growth and new transportation networks but also by human emotion. When people with Ebola are afraid and flee treatment centers, they end up spreading the virus further.
It's comforting though that the virus didn't go rampant in Lagos...
https://www.internationalsos.com/ebola/index.cfm?content_id=418&language_id=ENG

Nigeria must have done something right.
https://www.premiumtimesng.com/news...-case-left-minister.html#sthash.Lm6YjL4b.dpbs
Nigeria has successfully reduced the number of Ebola cases in the country to one, the Minister of Health, Onyebuchi Chukwu, has said.

As of Tuesday, only one Ebola patient remained in isolation in Nigeria, down from the 13 cases the country confirmed since the outbreak of the virus in July, Mr. Chukwu said at a press conference.

“Ebola has been curtailed,” Mr. Chukwu said. “All 129 people under surveillance have completed the 21day observation period and only a person is symptomatic and is being observed.”

- See more at: https://www.premiumtimesng.com/news...-case-left-minister.html#sthash.Lm6YjL4b.dpuf
 
  • #21
http://www.cnn.com/2014/09/30/health/ebola-us/index.html?hpt=hp_inthenews

CNN) -- A patient being treated at a Dallas hospital is the first person diagnosed with Ebola in the United States, the Centers for Disease Control and Prevention announced Tuesday.
The man, whose identity was not released, left Liberia on September 19 and arrived in the United States on September 20, said Dr. Thomas Frieden, director of the CDC.

At that time, the individual did not have symptoms. "But four or five days later," he began to exhibit them, Frieden said. The individual was hospitalized and isolated Sunday at Texas Health Presbyterian Hospital.

Citing privacy concerns, health officials declined to release any details about how the patient contracted the virus, what he was doing in Liberia or how he was being treated.
 
  • #22
Anyone traveling to nations affected by Ebola is a risk of contracting Ebola.
LOS ANGELES (Reuters) - An American freelance television cameraman working for NBC News in Liberia has tested positive for the Ebola virus and will be flown back to the United States for treatment, the network said on Thursday in an online report.

Diagnosis of the cameraman, who the network said came down with symptoms on Wednesday that included aches and fatigue, is believed to mark the first time an American journalist has been infected with the deadly virus since the current outbreak in West Africa.

The freelancer, . . . , is the fifth U.S. citizen overall to have contracted the disease in West Africa. All but one were infected in Liberia.
. . . .
http://news.yahoo.com/american-cameraman-nbc-news-diagnosed-ebola-liberia-004538346.html
 
  • #24
https://gma.yahoo.com/ebola-patients-family-ordered-stay-inside-trying-leave-162000280--abc-news-topstories.html

The family of the Texas http://abcnews.go.com/topics/lifestyle/health/ebola-virus.htm patient Thomas Eric Duncan have been ordered to stay in their home after violating official's initial request not to leave.

"There were violations of the request to not leave their premises," Dallas judge Clay Jenkins said of the breach that prompted the Texas Department of State Health Services to order the quarantine.

http://abcnews.go.com/Health/texas-...s-flaw-reason-ebola-patient/story?id=25912405
public health control order
http://www.dshs.state.tx.us/news/releases/20141001.aspx

http://www.cdc.gov/mmwr/preview/mmwrhtml/su6303a1.htm?s_cid=su6303a1_w

figures%5Csu6303a1appendixf10.gif
 
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  • #25
Thomas Eric Duncan flew from Liberia to Brussels, Brussels to Washington Dullet (IAD), then to Dallas Ft Worth. He may not have been contagious for Ebola during the flights, but he became sick some time (soon?) after arriving in Dallas. He should have alerted authorities (in Liberia) that he had come from a high risk area. He may not have been aware that he was exposed to Ebola, but nevertheless, he should have known based on the area, the he would be at risk for Ebola, and thus he could be at risk for exposing others.

We now live in a time when people are highly mobile, and this greatly increases the risk of the spread of highly contagious diseases, well beyond the point/region of origin.

Many sick in US Ebola patient's Liberia hometown
http://news.yahoo.com/texas-ebola-patients-neighborhood-scores-sick-140016735.html
When no ambulance came, Duncan, Marthalene Williams' parents and several others lifted her into a taxi, and Duncan rode in the front seat as the cab took Williams to the hospital. She later died.
Within weeks, everyone who helped Williams that day was either sick or dead, too — victims of Ebola, the virus that is ravaging Liberia's capital and other parts of West Africa, with more than 3,300 deaths reported.
The disease is spread through direct contact with saliva, sweat, blood and other bodily fluids, and all those who fell ill after helping Williams had touched her. She turned out to have Ebola.
Family that hosted Ebola patient confined to home
http://news.yahoo.com/dallas-er-sent-ebola-infected-patient-home-050718374.html
DALLAS – A flawed computer system and untruthfulness by the patient led medical workers to mistakenly send a sick man home instead of isolating him for Ebola, a Texas hospital announced Thursday night.
http://news.yahoo.com/texas-hospital-reveals-how-ebola-patient-was-missed-032028517.html

and
http://news.yahoo.com/prescription-avoiding-ebola-airport-screening-ibuprofen-051746791.html
 
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  • #26
Patient with Ebola symptoms enters Washington hospital
http://news.yahoo.com/patient-ebola-symptoms-enters-washington-hospital-170221779.html

Of course, it's not confirmed that the patient has Ebola, but folks are taking precautions.Meanwhile - U.S. nurses say they are unprepared to handle Ebola patients
http://news.yahoo.com/u-nurses-unprepared-handle-ebola-patients-140327416.html

and - United contacting those who flew with Ebola victim
http://news.yahoo.com/united-contacting-those-flew-ebola-victim-132652368.html
 
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  • #27
DALLAS (AP) — The condition of the lone Ebola patient to be diagnosed in the U.S. has worsened and is now deemed critical, the Dallas hospital that has been treating him reported Saturday.
. . . .
Health officials said Saturday that they are monitoring about 50 people who may have had contact with Duncan for signs of the deadly disease. Among those are nine people who are believed to be at a higher risk. Thus far none have shown symptoms.
http://news.yahoo.com/home-where-ebola-patient-stayed-disinfected-061137265.html
Hopefully, that's as far as that case goes.

Meanwhile - Dallas hospital retracts explanation for missed Ebola diagnosis
http://news.yahoo.com/hospital-retr...shandling-dallas-ebola-patient-185642366.html
 
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  • #29
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  • #30
The Public health Agency of Canada indicates that the Ebola virus is one tough critter to kill.

The WHO recommendations for cleaning up spills of blood or body fluids suggest flooding the area with a 1:10 dilutions of 5.25% household bleach for 10 minutes for surfaces that can tolerate stronger bleach solutions (e.g., cement, metal)

PHYSICAL INACTIVATION: Ebola are moderately thermolabile and can be inactivated by heating for 30 minutes to 60 minutes at 60°C, boiling for 5 minutes, or gamma irradiation (1.2 x106 rads to 1.27 x106 rads) combined with 1% glutaraldehyde Footnote 10 Footnote 48 Footnote 50. Ebolavirus has also been determined to be moderately sensitive to UVC radiation

UVC exposure sounds practical if it is effective enough.
http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php
 
  • #31
Ebola patient in Dallas struggling to survive, says CDC head
http://news.yahoo.com/ebola-patient-dallas-turns-critical-no-u-cases-000058624.html

DALLAS/NEW YORK (Reuters) - The first person diagnosed with Ebola in the United States was fighting for his life at a Dallas hospital on Sunday and appeared to be receiving none of the experimental medicines for the virus, a top U.S. health official said.
. . . .
Frieden said doses of the experimental medicine ZMapp were "all gone" and that the drug, produced by San Diego-based Mapp Biopharmaceutical, is "not going to be available anytime soon."

Asked about a second experimental drug, made by Canada's Tekmira Pharmaceuticals Corp, he said it "can be quite difficult for patients to take."
. . . .
 
  • #32
Madrid (AFP) - A Spanish nurse has contracted Ebola after treating two patients who died from the disease at a Madrid hospital, the government said Monday, in the first known case of transmission outside of Africa.
. . .
The woman was part of a medical team at Madrid's La Paz-Carlos III hospital that treated two elderly Spanish missionaries who died of Ebola shortly after they were repatriated from Africa.

She had gone on holiday the day after the second patient died on September 25, Madrid's primary healthcare director, Antonio Alemany, said at a news conference, without specifying where she had traveled to.
http://news.yahoo.com/first-outside-africa-nurse-spain-hospital-contracts-ebola-174043185.html

I wish her a speedy recovery, and I hope none of her contacts were infected. I would expect authorities will trace her route on holiday and since.

I would imagine her husband is at risk.
 
  • #33
Dallas Ebola patient receives experimental drug from North Carolina drugmaker
http://news.yahoo.com/drugmaker-provides-experimental-drug-ebola-173354015.html
WASHINGTON (AP) -- A North Carolina drugmaker is providing its experimental antiviral drug to a Dallas patient being treated for Ebola, an emergency step authorized by the Food and Drug Administration.

Officials at Texas Health Presbyterian Hospital said Monday that their patient, Thomas Eric Duncan, is in critical condition and being treated with brincidofovir, an oral medicine developed by Chimerix Inc.

Nigeria contains Ebola – and US officials want to know more
https://news.yahoo.com/nigeria-contains-ebola-us-officials-want-know-more-174923144.html

US teams are headed to Nigeria to learn about its success in using 'contact tracing' – a significant practical step that limited the spread of the virus.
. . .
Since July 20, the day Nigeria’s so-called “Patient Zero” arrived in Lagos, officials have recorded a total of only 19 cases, with no new cases since Aug. 31. Last week, on the same day the US confirmed its first case of Ebola, the Center for Disease Control (CDC) proclaimed that Nigeria had stopped its outbreak.
. . .
Ebola outbreak "pretty much contained" in Senegal and Nigeria
https://news.yahoo.com/ebola-outbreak-pretty-much-contained-senegal-nigeria-063733354.html
 
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  • #35
It seems I missed this on my Facebook news feed (posted about an hour ago by Fox News):
Breaking News: A second person in contact with the Dallas Ebola patient who died this morning is now exhibiting symptoms and signs of the disease.
 

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