"Rational Preparedness" : The Blog: Basic Strategies for Safety:Should Ebola Escape Containment Outside Africa

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Sunday, August 3, 2014

Basic Strategies for Safety:Should Ebola Escape Containment Outside Africa


This is what the filovirus which causes Ebola Hemorrhagic Fever looks like under electron microscopy.	)

                                         Photo: Wikimedia Commons

        As a family who is serious about general preparedness, you should already have some strong ideas of your own as to what your family could do in order to maximize your own personal safety should Ebola virus escape western Africa and afflict small pockets of the United States, or wherever you presently are.   This is one of the benefits of preparedness education in that families who are taught general preparation skills, and how to evacuate their families and how to shelter-in-place can adapt well to whatever the emergency with a minimum of governmental input, until such an emergency is over.   This post will focus on the unlikely possibility that Ebola will enter the US, potentially through undocumented aliens, and that cases are geographically near your area before massive attempts by government occur in order to quarantine such areas.

   The fact is, that one to ten viral organisms have been shown to cause infection, and that these viruses can remain pathogenic for days on an inanimate object. The assertion that one can only become infected through contact with body fluid from an infected individual, is not a great deal of comfort. Tell me, how many people perspire onto doorknobs ?    Why has this particular outbreak of Ebola been so much more broad than the others ? Could it be that we don't yet appreciate all the potential modes of transmission ? This organism has demonstrated a strong ability to mutate as evidenced by the multiple strains which have evolved in different regions since 1976. Has the version that is found in Sierra Leone, Liberia, and Guinea mutated once again ?

             First, in such an event as Ebola virus afflicting American towns, laws are in place that would allow federal officials to close up such an area very quickly. Supplies would be sent in to them, and they would be restricted from leaving. In addition, armed perimeter guards, possibly military staff would be stationed around a perimeter.    Your family would either be one of the families inside a towns isolation perimeter, or you would be a family outside one, desperately trying to stay away from such things, and trying to get your own supplies which could be diverted to the towns with Ebola.

           Such emergencies are why we prepare.   Each family should have at least three months worth of supplies in your home so that if an emergency of a biological hazard such as this occurred, that you and your family could remain inside your homes for an extended period.   Three months might seem like an extended period of time, but it is realistic, and moving to the country and staying put is how the families who did, survived the Black Plague in England all those years ago.

1. One of the reasons we should save three to six months worth of emergency savings is so that we could shelter in place during such an emergency.    If Ebola, or a new Spanish flu escaped containment, or a terrorist act placed some form of contagion in the US, then the people who would survive and most likely the people who could shelter-in-place.

2. Although you can shelter-in-place within your home almost anywhere, it is likely easier to do so in a rural area. A New York apartment, for example, still places you closer to other people and makes interaction with other human beings much more likely.    A cabin on acreage with a septic tank and independent well would allow you to shelter your family quietly, and allow you to venture outside on your property, thus providing a "vacation" for your kids, despite the magnitude of worry you and your spouse might be enduring.
It's ironic that such a stressful time for you, if handled correctly, would become a golden memory of family togetherness for your children.

3. You would need three months of balanced food that would not require repeated trips from your home, as so many of us do now. This is why packaged #10 cans of freeze dried food with a shelf life of 25-30 years, depending upon product, as so valuable. They allow us to gradually put away emergency food for a variety of emergencies, and then reconstitute it as needed. A great deal of emergency food can be stored in a relatively small space if you choose the freeze dried option.

www.augasonfarms.com

www.beprepared.com

www.nitropak.com

Certainly, you may use any supplier you like and can afford.

4. You would need sick room supplies at your home or at your escape cabin, because even if you don't succumb to Ebola, children and adults develop other illnesses from time to time, and you would need to competently care for these.

1. Extra wash cloths and towels
2. Extra bedsheets and pillowcases      (laundry detergent for these.)
3.Diapers, if anyone in your household is using them, abundant feminine hygiene supplies, sanitary napkins, tampons etc., as they have some multiple uses. Baby wipes (which are not flushable, by the way)
4. Toilet paper and plenty of facial tissues.
5. packages of vinyl gloves (many people develop allergies to latex gloves eventually)   Sam's Club sells different size gloves in packages of 200, for about eleven dollars a box.
6. conventional medical masks, available at any pharmacy.     You should probably buy some N95 (or N100) masks in addition, for the individual who may leave the house in emergencies, but you are planning for isolation at home.
7. a large package of conventional bar soap. (You can stock some antibacterial and some alcohol based hand cleaner, but I don't use these, preferring instead to simply wash my hands well with conventional soap.)
8. Any prescription or OTC medications your family uses on a regular basis. This is why there is great value in having a trusted family physician who would accomodate you in such an emergency.
9. Thin incontinent underpads. (Big bag is found at Sam's Club for $20.00) Useful for any family illness or emergency, and not a bad idea to have on hand for pets too.
10. The items needed in the oral rehydration kit, I have discussed in my book and in numerous posts online:

     http://rationalpreparedness.blogspot.com/2011/11/dehydration-and-rehydration-solutions.html

11. Petfood. Having a dog to notify you of unexpected visitors would be beneficial. Some cats do this well also.


Other items you would need, and why

http://rationalpreparedness.blogspot.com/2011/12/assembling-your-own-excellent-first-aid.html

http://rationalpreparedness.blogspot.com/2013/09/proper-stocking-of-your-home-emergency.html

http://rationalpreparedness.blogspot.com/2011/09/creating-your-own-emergency-medical-kit.html

http://rationalpreparedness.blogspot.com/2011/10/continuation-of-emergency-medical-kit.html

http://rationalpreparedness.blogspot.com/2014/03/what-you-might-do-next.html

http://rationalpreparedness.blogspot.com/2012/03/how-are-your-medical-kits-evacuation.html

Clean water is absolutely essential    The ideal is a rural cabin with your own well, which has been tested at some point prior to your occupation of it with your family.   Certainly, if you have any questions about your water quality whatsoever, then bringing your own Berkey for filtration of water you drink, or with which you brush teeth or prepare food would be wise.

This is one source of a Berkefeld water filtration device:

    http://www.getberkey.com/?gclid=CK2T14yf978CFc1i7Aod6mYAbQ

If you do not already homeschool, you need to find out how to legally homeschool where you are going, and to have a curriculum ready.   Unusual trips and learning experiences are the times in which your children will learn the most. Be sure to make use of these times for educational purposes.

Preparations tailored to Ebola virus specifically:

1.   Your strategy to dealing with Ebola is simple avoidance of others for a period of time.   If you have minimal contact with others, and are only sending a careful adult out for a rare supply run, no additional preparations should be necessary.

2. If you do send an adult on a supply run, these should be to small supply outposts and not to the Super Wal-Mart which sees twenty thousand people daily.   Precautions you might take could include wearing cotton gloves over vinyl ones, and then removing those before entering the house. Ebola is not felt to be airborne, but if pandemic flu were the issue, you might wish to outfit your sole supply traveller with a mask, as is often done in Asian countries.

3. Make sure that the exterior clothes and shoes you wore for a visit out of your home, are kept separate from your home and your children. One solution would be to change your coat and shoes in the garage and leave them in a large plastic bag, before entering your home.

4. Bleach is an effective cleanser on objects when sanitizing for Ebola virus.

5. Get plenty of sleep. Take a multivitamin including vitamin C. Eat properly and avoid junk food which may furthur stymie your immune system.

Certainly, during an outbreak of dangerous contagion of any type, you and your family would need to avoid eating in restaurants.   As fun and as helpful as this would be while traveling, you cannot control the health, the habits or the conditions in which such food is prepared.

You should be prepared to shelter in place with your family for a period of about three months until you receive additional information from radio or media as to conditions beyond your home. This provides you and your family the maximum safe environment during this time.

This plan could be modified to allow one family member to travel to work daily and isolate him/her in another region of the home with its own external exit. This person would need to bunk and eat separately from the family, and communicate via phone, skype or internet.

The Canadian government believes that aerosolized transmission of Ebola person to person is possible, but that one must be sick and not simply within the incubation period in order to contract it. We also know that even diluted bleach will kill this virus on clothing, bottoms of shoes, and anything else.

On a positive note, there are some indications that a new broad spectrum antiviral drug is showing some promise against filoviruses, the viral group to which Ebola is a member.    This does not help us yet, but is a move in the right direction.

http://www.iflscience.com/health-and-medicine/new-antiviral-shows-potential-against-ebola

Yesterday, I read an article which discussed selenium supplementation being an important strategy in helping to avoid overt Ebola, or to help to survive it, if you do succumb. There are not complete studies available yet, but supplemental selenium within package guidelines should be an innocuous enough practice that it may be of benefit.

The best, most honest, least "sanitized", and most complete information on Ebola Hemorrhagic Fever and the organism which causes it, comes from the Public Health Service of Canada

http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php

These are the best references on the subject of Ebola:

REFERENCES:

Plague. (2004). In R. G. Darling, & J. B. Woods (Eds.), USAMRIID's Medical Management of Biological Casualties Handbook (5th ed., pp. 40-44). Fort Detrick M.D.: USAMRIID.
Acha, P. N., & Szyfres, B. (2003). In Pan american Health Organization (Ed.), Zoonoses and Communicable Diseases Common to Man and Animals (3rd ed., pp. 142-145). Washington D.C.: Pan American Health Organization.
Sanchez, A. (2001). Filoviridae: Marburg and Ebola Viruses. In D. M. Knipe, & P. M. Howley (Eds.), Fields virology (4th ed., pp. 1279-1304). Philadelphia, PA.: Lippencott-Ravenpp.
Feldmann, H. (2010). Are we any closer to combating Ebola infections? Lancet, 375(9729), 1850-1852. doi:10.1016/S0140-6736(10)60597-1.
Beran, G. W. (Ed.). (1994). Handbook of Zoonosis, Section B: Viral (2nd ed.). Boca Raton, Florida: CRC Press, LLC.
Mwanatambwe, M., Yamada, N., Arai, S., Shimizu-Suganuma, M., Shichinohe, K., & Asano, G. (2001). Ebola hemorrhagic fever (EHF): mechanism of transmission and pathogenicity. Journal of Nippon Medical School = Nihon Ika Daigaku Zasshi, 68(5), 370-375.
Sanchez, A., Kiley, M. P., Klenk, H. D., & Feldmann, H. (1992). Sequence analysis of the Marburg virus nucleoprotein gene: comparison to Ebola virus and other non-segmented negative-strand RNA viruses. The Journal of General Virology, 73 ( Pt 2)(Pt 2), 347-357.
Takada, A., & Kawaoka, Y. (2001). The pathogenesis of Ebola hemorrhagic fever. Trends in Microbiology, 9(10), 506-511.
Towner, J. S., Sealy, T. K., Khristova, M. L., Albarino, C. G., Conlan, S., Reeder, S. A., Quan, P. L., Lipkin, W. I., Downing, R., Tappero, J. W., Okware, S., Lutwama, J., Bakamutumaho, B., Kayiwa, J., Comer, J. A., Rollin, P. E., Ksiazek, T. G., & Nichol, S. T. (2008). Newly discovered ebola virus associated with hemorrhagic fever outbreak in Uganda. PLoS Pathogens, 4(11), e1000212. doi:10.1371/journal.ppat.1000212 .
Harcourt, B. H., Sanchez, A., & Offermann, M. K. (1999). Ebola virus selectively inhibits responses to interferons, but not to interleukin-1beta, in endothelial cells. Journal of Virology, 73(4), 3491-3496.
Bwaka, M. A., Bonnet, M. J., Calain, P., Colebunders, R., De Roo, A., Guimard, Y., Katwiki, K. R., Kibadi, K., Kipasa, M. A., Kuvula, K. J., Mapanda, B. B., Massamba, M., Mupapa, K. D., Muyembe-Tamfum, J. J., Ndaberey, E., Peters, C. J., Rollin, P. E., Van den Enden, E., & Van den Enden, E. (1999). Ebola hemorrhagic fever in Kikwit, Democratic Republic of the Congo: clinical observations in 103 patients. The Journal of Infectious Diseases, 179 Suppl 1, S1-7. doi:10.1086/514308.
Zilinskas, R. A. (Ed.). (2000). Biololgical Warfare - Modern Offense and Defense. Boulder, Colorado, USA: Lynne Rienner Publishers, Inc.
Feigin, R. D. (Ed.). (2004). Textbook of Pediatric Infectious Diseases (5th ed.). Philadelphia, USA: Elsevier, Inc.
Casillas, A. M., Nyamathi, A. M., Sosa, A., Wilder, C. L., & Sands, H. (2003). A current review of Ebola virus: pathogenesis, clinical presentation, and diagnostic assessment. Biological Research for Nursing, 4(4), 268-275.
Bausch, D. G., Jeffs B.S.A.G, & Boumandouki, P. (2008). Treatment of Marburg and Ebola haemorrhagic fevers: a strategy for testing new drugs and vaccines under outbreak conditions. Antiviral Res., 78(1), 150-161.
WHO Disease Outbreak News - Ebola Haemorrhagic Fever in the Democratic Republic of Congo. (2007). , 2008.
Formenty, P., Boesch, C., Wyers, M., Steiner, C., Donati, F., Dind, F., Walker, F., & Le Guenno, B. (1999). Ebola virus outbreak among wild chimpanzees living in a rain forest of Cote d'Ivoire. The Journal of Infectious Diseases, 179 Suppl 1, S120-6. doi:10.1086/514296.
WHO Disease Outbreak News - Ebola Haemorrhagic Fever in Uganda - Update. (2007). , 2008 .
Morris, K. (2009). First pig-to-human transmission of Ebola Reston virus.9(3), 148.
Evans, A. S., & Kaslow, R. A. (Eds.). (1997). Viral Infections of Humans - Epidemiology and Control (4th ed.). New York, NY: Plenum Publishing Corporation.
Franz, D. R., Jahrling, P. B., McClain, D. J., Hoover, D. L., Byrne, W. R., Pavlin, J. A., Christopher, G. W., Cieslak, T. J., Friedlander, A. M., & Eitzen E.M., J. (2001). Clinical recognition and management of patients exposed to biological warfare agents. Clinics in Laboratory Medicine, 21(3), 435-473.
Bray, M. (2003). Defense against filoviruses used as biological weapons. Antiviral Research, 57(1-2), 53-60.
Leroy, E. M., Rouquet, P., Formenty, P., Souquière, S., Kilbourne, A., Froment, J. -., Bermejo, M., Smit, S., Karesh, W., Swanepoel, R., Zaki, S. R., & Rollin, P. E. (2004). Multiple Ebola Virus Transmission Events and Rapid Decline of Central African Wildlife. Science, 303(5656), 387-390.
Morvan, J. M., Nakouné, E., Deubel, V., & Colyn, M. (2000). Ebola virus and forest ecosystem. [Écosystèmes forestiers et virus Ebola] Bulletin De La Societe De Pathologie Exotique, 93(3), 172-175.
Connolly, B. M., Steele, K. E., Davis, K. J., Geisbert, T. W., Kell, W. M., Jaax, N. K., & Jahrling, P. B. (1999). Pathogenesis of experimental Ebola virus infection in guinea pigs. The Journal of Infectious Diseases, 179 Suppl 1, S203-17. doi:10.1086/514305.
Leroy, E. M., Kumulungui, B., Pourrut, X., Rouquet, P., Hassanin, A., Yaba, P., Délicat, A., Paweska, J. T., Gonzalez, J. -., & Swanepoel, R. (2005). Fruit bats as reservoirs of Ebola virus. Nature, 438(7068), 575-576.
Arthur, R. R. (2002). Ebola in Africa--discoveries in the past decade. Euro Surveillance : Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin, 7(3), 33-36.
Hewlett, B. S., & Amolat, R. P. (2003). Cultural contexts of Ebola in Northern Uganda. Emerging Infectious Diseases, 9(10), 1242-1248.
Stansfield, S. K., Scribner, C. L., Kaminski, R. M., Cairns, T., McCormick, J. B., & Johnson, K. M. (1982). Antibody to Ebola virus in guinea pigs: Tandala, Zaire. The Journal of Infectious Diseases, 146(4), 483-486.
Huggins, J., Zhang, Z. X., & Bray, M. (1999). Antiviral drug therapy of filovirus infections: S-adenosylhomocysteine hydrolase inhibitors inhibit Ebola virus in vitro and in a lethal mouse model. The Journal of Infectious Diseases, 179 Suppl 1, S240-7. doi:10.1086/514316.
Loutfy, M. R., Assmar, M., Burgess, D. C. H., & Kain, K. C. (1998). Effects of viral hemorrhagic fever inactivation methods on the performance of rapid diagnostic tests for Plasmodium falciparum. Journal of Infectious Diseases, 178(6), 1852-1855.
Elliott, L. H., McCormick, J. B., & Johnson, K. M. (1982). Inactivation of Lassa, Marburg, and Ebola viruses by gamma irradiation. Journal of Clinical Microbiology, 16(4), 704-708.
Mitchell, S. W., & McCormick, J. B. (1984). Physicochemical inactivation of Lassa, Ebola, and Marburg viruses and effect on clinical laboratory analyses. Journal of Clinical Microbiology, 20(3), 486-489.
Mahanty, S., Kalwar, R., & Rollin, P. E. (1999). Cytokine measurement in biological samples after physicochemical treatment for inactivation of biosafety level 4 viral agents. Journal of Medical Virology, 59(3), 341-345.
Biosafety in Microbiological and Biomedical Laboratories (BMBL) (2007). In Richmond J. Y., McKinney R. W. (Eds.), . Washington, D.C.: Centers for Disease Control and Prevention.
Emond, R. T. D., Evans, B., Bowen, E. T. W., & Lloyd, G. (1977). A case of Ebola virus infection. British Medical Journal, 2(6086), 541-544.
Formenty, P., Hatz, C., Le Guenno, B., Stoll, A., Rogenmoser, P., & Widmer, A. (1999). Human infection due to Ebola virus, subtype Cote d'Ivoire: Clinical and biologic presentation. Journal of Infectious Diseases, 179(SUPPL. 1), S48-S53.
Human pathogens and toxins act. S.C. 2009, c. 24, Second Session, Fortieth Parliament, 57-58 Elizabeth II, 2009. (2009).
Public Health Agency of Canada. (2004). In Best M., Graham M. L., Leitner R., Ouellette M. and Ugwu K. (Eds.), Laboratory Biosafety Guidelines (3rd ed.). Canada: Public Health Agency of Canada.