Ebola in 2019

Ebola is still with us, we only get to know about it when its in the interests of Corporate news networks to 'sell' the news. We'll see how long this headline from the BBC lasts, "Ebola outbreak 'not global emergency yet'".

New Ebola case in Sierra Leone (Jan 2016)

New Ebola case in Sierra Leone. WHO continues to stress risk of more flare-ups

Ebola survivor relapse

Ebola research enters completely new territory with UK nurse previously infected and cleared, relapsing and in critical condition. News of this is troubling with respect to the survivors of the 2014/15 outbreak. Interesting however is how this relapse fits in to the bigger picture of previous outbreaks where relapses have not been documented to have occurred - once cleared, individuals seems to stay clear of the virus. That begs the obvious question as to what's different about this UK case?

Where's Ebola gone?

It seems Ebola is out of fashion and might be said to no longer be an issue, this despite the CDC originally suggesting there would be some "1.4 million cases by January 2015" (the CDC has since backed away from the claim to a more conservative estimate in line with others). That's the three-day news cycles for you, or the easier sell of Ferguson and Police Brutality taking up the charge to the front page.

The question remains though; what happened to all those potential cases on the CDC's Ebola watch list (not available to the public it seems) - about 1000 at its height mid-November. One reasonable idea is that anyone showing symptoms has been whisked away and sequestered as part of the human trails of the soon-to-be-released Ebola Vaccines. There are a few on the market but given the actual rarity of Ebola in North America and Europe, it stands to reason infected individuals are a pretty valuable resource.

Additonal Reading
http://www.who.int/csr/disease/ebola/situation-reports/en/?m=20141126
https://www.internationalsos.com/ebola/index.cfm?content_id=438&language_id=ENG
http://www.nhs.uk/news/2014/11November/Pages/Ebola-vaccine-shows-promise-in-human-trials.aspx

Executive Order 13295 "Symptoms of... other respiratory illness" = catch-all?

Does the change mean anything beyond the practicalities of mitigating, monitoring or managing an outbreak. Does it provide a catch-all to withhold anyone for any reason? It's not supposed to apply to common flu, but the initial stages of many infections, Ebola included, are similar to those of the common cold, so some determination process has to be performed to filter one from the other which might include (require) quarantine.

"(b) Severe acute respiratory syndromes, which are diseases that are associated with fever and signs and symptoms of pneumonia or other respiratory illness, are capable of being transmitted from person to person, and that either are causing, or have the potential to cause, a pandemic, or, upon infection, are highly likely to cause mortality or serious morbidity if not properly controlled. This subsection does not apply to influenza." [emphasis added]

Additional links
• Executive Order 13295: Revised List Of Quarantinable Communicable Diseases (CDC)
• Executive Order -- Revised List of Quarantinable Communicable Diseases (White House)

Colloidal Silver, a cure for Ebola?

Question: Is Colloidal silver a cure/treatment/vaccine for Ebola?.
Short Answer: "no".

Long Answer: Colloidal, or nano-particulate, silver is being researched as part of a broader spectrum of investigation into the use of nano or microscopic particulate substances in many fields of interest, from the Military (e.g. weaponised nano-tech, etc.), Information Technology (e.g. nano-processors, etc.), to Medical (e.g. vaccines, treatments, etc.). With respect to colloidal, or nano-particulate, silver, some research into it's use as a possible/potential treatment for HIV/AIDS[cf. fn.] and other blood-born infections is ongoing, but as of writing there is simply not enough data available to say with any confidence that colloidal silver is a viable option in a curative sense (i.e. a viable vaccine protocol).

What this means is that current (at time of writing at least) ideas regarding Colloidal Silver being a 'cure', or a 'treatment' at least, for Ebola misrepresents current understanding of the available data - that is not to say nano-particulate silver may never be a treatment for Ebola, rather it's far too early to suggest this with any veracity. For example, a number of sources are actively misrepresenting data presented in a power-point presentation (allegedly) from the Defense Threat Reduction Agency/Air Force Research Laboratory; [sic] "Novel Nanotechnology-Based Antiviral Agents: Silver nanoparticulates neutralization of hemorrhagic fever viruses" ("Novel Nanotechnology-based Antiviral Agents: Silver nano-particulates neutralization of haemorrhagic fever viruses"). The research*, undertaken by Saber M. Hussain, Ph.d^[1] & Janice Speshock, Ph.d^[2], shows tentative explorative results on the interaction of colloidal (nano-particulate) silver on various pathogens, Ebola (EBV-Z, Ebola Zaire) being one. It was found that at certain ppms Ebola's ability to replicate or further 'infect' in-vitro samples was disabled/deactivated - note that Ebola was not killed.

Whilst there is potential in Colloidal or nano-particulate silver as a possible treatment** for Ebola and other infectious diseases then, proof-positive of this from the point of view of a vaccine or other one-shot kill treatment, is a long way off and requires extensive funding and research. It's simply too early to tell in other words.

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Footnotes:
* awareness of silver as an antiviral agent against Ebola appears to emanate from the release of the above mentioned unclassified power-point presentation in 2009. Made available through a third-party (with potential conflicts of interest), the actual originating source of the document, i.e. the Defense Threat Reduction Agency, is unconfirmed at time of writing.
** it's vitally important to stress that ingestion of colloidal silver, whilst potentially beneficial for a number of other ailments, is unlikely to, if ever, be a direct treatment for Ebola; the mechanisms of immune system deployment differ a great deal, in essence Ebola, being blood-borne, is already in the body system and requires more direct action than might otherwise be had using indirect approaches.

Further Reading
^[1] Saber M. Hussain Ph.d
• Department of Pharmacology & Toxicology profile
• Google Scholar profile
• Biomolecular Interactions of Nanoparticles
^[2] Janice Speshock Ph.d
• Tarleton State University profile

Primary research by either/or/both Messers Hussain and Speshock in relation to the use of nano-particulates
• A Preliminary Assessment of Silver Nanoparticle Inhibition of Monkeypox Virus Plaque Formation
• Silver and Gold Nanoparticles Alter Cathepsin Activity In vitro
• Interaction of silver nanoparticles with Tacaribe virus
• Biological Interactions of Nanomaterials

Additional example of research on the use of nano-particulates
• Use of Silver Nanoparticles in HIV • Treatment Protocols: A Research Proposal
• Interaction of silver nanoparticles with HIV-1
• Potential Vaccines and Post-Exposure Treatments for Filovirus Infections
• Viral Therapy and Prophylaxis Using Nanotechnology Delivery Techniques
• Nanotechnology: A possible healer in drug delivery system
• Novel applications of nanotechnology in medicine
• Can biowarfare agents be defeated with light?
• Chimeric human parainfluenza virus bearing the Ebola virus glycoprotein as the sole surface protein is immunogenic and highly protective against Ebola virus challenge

What eye protection to use against Ebola

Secondary to disposable respiratory protection, consideration should also be giving to EYE WEAR - goggles, safety glasses or other fitted eye protection. Ideally they should form a perfect seal around the eyes and preferably non-vented (or optionally indirectly ventilated if non-vented unavailable) to prevent ingress of fluids or particulates (note the following protect against PARTICULATES and/or FLUIDS and are not typically suitable for GASES or VAPORS). Although every effort has been made to ensure accuracy, the reader is encouraged to perform their own due-diligence.

IMPORTANT: PPE effectiveness is solely dependent on HOW WELL THEY FIT. 

It's highly recommended all Personal Protection Equipment be fit-tested with family members, friends or colleagues before full deployment or use to ensure they fit the user safely and securely across a wide range of shapes and sizes for both head and body as needed (facial hair, jewelry or other impediments to secure fit severely reduce the effectiveness of personal protection equipment). For further information visit the OSHA (US) or HSE (UK)

Goggles
The following is a list of suggestions (all items listed below are rated for airborne PARTICULATES but may not fully protect against VAPORS, MISTS and/or GASES - double-check option chosen for open/direct venting [avoid], indirect venting [alternative when 'no vent' unavailable], and/or no vent [preference] so double-check version before purchase);

• 3M™ Safety Goggles 2890S - (UK/EU) / (US) [info]
• Bolle Blast BLAPSI - (UK/EU) / (US) [info]
• Bolle Atom ATOEPSI - (UK/EU) / (US) [info]
• Bolle Attack ATPSI - (UK/EU) / (n/a) [info]
• UCI Kara - (UK/EU) / (n/a) [info]
• Uvex Stealth OTG - (n/a) / (US) [info]
• Uvex V-Max - (n/a) / (US) [info]
• Uvex Carbonvision - (UK/EU) / (US) [info]

Additional Reading
OSHA (US) - PPE Selection - Chemicals: Goggles
CDC (US) - 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings
CDC (US) - Healthcare Infection Control Practices Advisory Committee (HICPAC)
CDC (US) - Eye Protection for Infection Control (obsolete)
HSE (UK) - Infections at work
HSE (UK) - Are you exposed to micro-organisms at work?
NHS (UK) - Eye Safety
EASHW OSHA (EU) - Health and safety of healthcare staff

What face masks to wear to protect against Ebola

PPE (Personal Protection Equipment) MASKS

The following list of items may be useful in mitigating the risks associated with infections and transmission generally not just for the current Ebola concern (equally functional for smog, pollution and other airborne particulates - note these are PARTICULATE filters and not suitable for VAPORS or GASES). Although every effort has been made to ensure accuracy, the reader is encouraged to perform their own due-diligence.

IMPORTANT: PPE effectiveness is solely dependent on HOW WELL THEY FIT. 

It's highly recommended all Personal Protection Equipment be fit-tested with family members, friends or colleagues before full deployment or use to ensure they fit the user safely and securely across a wide range of shapes and sizes for both head and body as needed (facial hair or other impediments to proper fit severely reduce the effectiveness of filtering face piece PPE's). For more information on UK Health & Safety Executive fit-testing techniques click here to read "Fit testing of Respiratory Protective Equipment Face pieces" (PDF).

Face Masks

If you are in the United Kingdom, the following are suggested (items marked [#] are designed for health care environments/usages);

• 3M 8233 N100 Valved Respirator [info]
    • 3M 8511 N-95 Valved Respirator [info]
    • 3M 1870 N-95 Non-valved Respirator [#] [info]
    • 3M 1860 N-95 Non-valved Respirator [#] [info]
• Moldex 2505 FFP3 (P3) Valved Respirator [info]
  • Moldex 3100 FFP2 (P2) Non-valved Respirator [#] [info]
• Silverline 633895 FFP3 (P3) Valved Respirator [info]
  • Silverline 282590 FFP2 (P2) Valved Respirator [info]
• 3M Aura 1863 FFP3 (P3) Non-valved Respirator [#] [info]
• 3M Aura 9332 FFP3 (P3) Valved Respirator [info]
  • 3M Aura 9322+ FFP2 (P2) Valved Respirator [info]

If you are in the United States, the following are suggested (items marked [#] are designed for health care environments/usages);

• 3M 8233 N100 Valved Respirator [info]
    • 3M 1870 N95 Non-valved Respirator [#] [info]
    • 3M 1860 N95 Non-valve Respirator [#] [info]
    • 3M 1805 N95 Non-valved Respirator [#] [info]
• 3M 8293 P100 Valved Respirator [info]
• Moldex 2730 N100 Valved Respirator [info]
  • Moldex 2310 N99 Valved Respirator [info]
  • Moldex 2315 N99 Valved Respirator [info]
• Moldex 2360 P100 Valved Respirator [info]

If you are in the USA*, NIOSH-Certified PPE^[1], "N-95" filtering face pieces should be a minimum requirement.
If you are in the EU*, CE-Certified PPE^[2], "FFP2" filtering face pieces should be a minimum requirement.
If you are in the UK*, BS EN-Certified PPE^[3], "FFP2" ("P2") filtering face piece should be a minimum requirement.

In all cases Surgical Face Masks (look like paper-towels with string behind the ears) are NOT classed as RPE (Respiratory Protective Equipment) and DO NOT PROTECT against air-borne particulates. They should be avoided unless absolutely no other options are available.

[1] NOISH : NIOSH-Approved Particulate Filtering Face piece Respirators
[2] European Commission : Directive 89/686/EEC on personal protective equipment
[3] BSI : Personal Protective Equipment (PPE) product certification