“The primary tenet of nuclear, chemical, and biological warfare defense is contamination avoidance.”

UPDATE:  10/26/2014:

This post was originally titled, “Ahhh!!!  The stupid, it burns!  (Ebola edition)”.   I decided to retitle it to better reflect what motivates my thinking.  As I noted in an earlier post, I worked for about 15 years on chemical and biological warfare defense-related projects.  I wrote a number proposals for R&D funding which started off “The primary tenet of nuclear, chemical, and biological defense is contamination avoidance.”  (The other two are force protection and decontamination.)  Anyhow, “The primary tenet of nuclear, chemical, and biological defense is contamination avoidance.” is where I’m coming from.  Spread of highly contagious and lethal diseases like Ebola don’t follow from malicious intent like a bio-warfare attack but, from a public health standpoint, there’s no difference in what constitutes an appropriate response.


From the NY Times, Doctor in New York City Tests Positive for Ebola:

A doctor in New York City who recently returned from treating Ebola patients in Guinea tested positive for the Ebola virus Thursday, becoming the city’s first diagnosed case…  Dr. Spencer had been working with Doctors Without Borders in Guinea, treating Ebola patients, before returning to New York City on Oct. 14, according to a city official.

Please explain to me why the @#$% Dr. Spencer was not put immediately into quarantine when he showed up at U.S. Customs?  He was treating individuals with a highly contagious and lethal disease for chrissakes.  Checking his temperature is all well and good but people infected can be asymptomatic for up to three weeks.  Stupid.  Stupid.  Stupid.   And, yes, I support denying entry to persons who have been to CDC Level 3 countries within the past 21 days.   Have Customs check passports.  If you’ve been in a CDC Level 3 country with the past 21 days then straight to quarantine.  No discussion.  No debate.  Sorry for the inconvenience.

Another thought:  Multidrug-resistant tuberculosisContinue reading

On the importance of having a good decontamination protocol and executing it properly

This post is inspired by the two nurses, Nina Pham and Amber Vinson, who contracted Ebola virus after treating Thomas Eric Duncan at Texas Health Presbyterian Hospital.  See the timeline of events surrounding Duncan’s diagnosis and treatment here.

I was somewhat surprised – and moderately alarmed – when Nina Pham was diagnosed last weekend.  That Amber Vinson also contracted Ebola is also alarming but as we learn more about how the hospital treated Duncan it’s not a huge surprise.  When Pham’s diagnosis was announce, while the possibility of Ebola having mutated and “gone mobile” was scary it also seemed remote.   More likely it seemed to me was that the nurses either didn’t have good personal protective equipment (PPE) or that the hospital didn’t have a good decontamination protocol for workers coming out of the hot zone.   It now appears that not only was the PPE used insufficient but that there was no decontamination protocol in place.   Given that, it doesn’t surprise me that several health care workers became ill.  When working with highly toxic materials or contagions good PPE is essential but if you don’t have a good decontamination protocol in place then you can easily expose yourself to the hazard when removing your PPE.  Good practice is to decontaminate your PPE before removing it.  My understanding is that bleach kills Ebola virus so, with the caveat that a little knowledge can be a dangerous thing, my take is that proper decon of potentially-exposed health workers would involve spraying them down with bleach before they removed their PPE.  Continue reading