Though incidence is down, treatment success for resistant strains is low.
Have you been privileged to interact with that fine, tiny but very loud cabal we call #antivaxxers? Do you know the ones? Those who have minds totally made up. They aren’t hesitating to use vaccines, they are all-in against them in every fantastical way you can imagine.
The hardcore antivaxxer is better described as #proillness, #prodisease or even #proplague. If you’ve engaged with them, you may have been on the receiving end of a particular Gish Gallop that includes a single bolus of dozens (currently over 150) articles. Let’s look at how rubbish that listrealy is.
But first: what is a Gish Gallop?[1-3] This is a debate technique named after Duane Gish a creationist and first coined by Eugenie Scott. The Gish Gallop confuses an argument by drowning the user’s opponent in a flood of weak half-truths and baseless feelz so as to prevent the target from immediately replying to each point.
The Gish Gallop is intended to give the impression that the user has lots of evidence and that the opponent doesn’t know about the topic or doesn’t have the answers.
On Twitter, this is used a lot by the #prodisease cabal. Sometimes its use is followed by them walking away saying the opponent – often an expert – doesn’t know what they’re talking about. And if the opponent does address each issue, the audience will probably have walked off through boredom!
The naughty list
Somewhere during these debates on social media, the more well-prepared #prodisease cultist will throw at you a long list of articles which they strongly believe support their position on vaccines being bad mmkayyy?
In reality, the list is made up of articles that don’t really support the prodiseaser’s position; the pieces are just that bad; you’d expect that given the lack of relevant expertise among those creating and curating this list. the list looks impressive but, in short, it isn’t. Its contents can be dismissed or debunked. And they have been. On multiple occasions.
Bring on the debunking
Below are some of the best sources of analysis that take this list apart.
The authors have spent time from their own lives – and probably part of their souls – to do this work and it is greatly appreciated by those of us looking to get a quick understanding of this list and its articles without reinventing the wheel.
124 (now 144) (now 157) papers that DO NOT prove vaccines cause autism
Those Lists of Papers Claiming That Vaccines Cause Autism: They Don’t Show What They Claim (Part 1)
Vaccines and autism: A thorough review of the evidence (2019 update)
These will prove very handy when I head off hunting the wild #prodisease beasts. Debunking doesn’t make for a fun read, but these are important resources in a time when we need to be organised and have our facts on hand.
- Gish Gallop
- Gish Gallop
- GISH GALLOP – LOGICAL FALLACIES
The post Galloping Gish! So many papers, so little relevance appeared first on Virology Down Under.
A mild illness, or perhaps even no obvious illness at all, after infection by Ebola virus, could be seen by some as heretical. But new evidence adds to that which already exists, suggesting it really does happen.
An aerial view of Guéckédou, Guinea,
Source: United Nations, Flickr
Hints that Ebola virus can cause mild or even unnoticeable illness, or that it may circulate unreported, can be found in the scientific literature.[6,7,8]
What do we know about mild infection and Ebola virus?
A big new study has emerged, looking for asymptomatic or “paucisymptomatic” Ebola virus-infected people. To be clearer, the authors are talking those who may have been infected but showed no symptoms or just mild illness. They used the detection of antibodies specific to a Zaire ebolavirus as a marker that they had been infected.
Big new study
Scientists from France and Guinea enrolled people who had had physical contact with a confirmed case of Ebola virus disease (EVD) in Guinea. None of 1,390 contacts followed, were vaccinated against EVD and none had officially developed EVD during the period between 12th May 2016 and 8th September 2017. Based on their recollection, none had developed symptoms that suggested to them that they had a viral haemorrhagic fever virus infection.
Ebola Prevention and Treatment in Conakry, Guinea.
Source: United Nations, Flickr
Antibodies in the contacts
The laboratory tests detected antibodies made against three different pieces (antigens) of the Zaire ebolavirus (glycoprotein or nucleoprotein or 40-kDa viral protein), in response to virus infection. The tools had been well evaluated beforehand so the results produced are reliable, an issue with earlier studies of this sort. The scientists considered samples that reacted with at least two of the three antigens as positive for past infection.
The genetic regions encoding the proteins used as antigens in the Zaire ebolavirus lab testing are marked in red. More detail on the method which also seems capable of discriminating between the EBOV, SUDV, BDBV, RESTV species of ebolaviruses.
Click on image to enlarge.
In a very handy approach, the scientists dried blood onto special filter paper. This avoided the need to send away whole blood which doesn’t store for long without separation and freezing. These dried blood spots (DBS) store well and can be shipped easily. Apparently, they can also be used to detect antibodies once the DBS is reconstituted and heat inactivated.
More of those with some symptom of illness (18 of 216 or 8%) developed antibodies to Ebola virus. Only 39 of 1,174 (3%) among those who reported no symptoms, developed antibodies.
There were signs of previous infection, but no severe disease
Most (1,174 or 84%) contacts did not report any symptoms of illness and about a sixth (216 or 16%) noticed mild illness of some sort; most often a headache (81% of those with a symptom), fatigue (74%) and fever (73%).
30 of the 216 (14%) had a fever plus three other symptoms; more than enough for them to have been classified as suspected EVD cases according to the World Health Organization case definition. But it seems they were not classified as such. Because of that, they were not tested at the time. Interestingly, this study already defines these people as contacts, so a sudden fever alone should have resulted in most of them being reported to a surveillance team.
World Health Organization case definition of a suspected case during an ongoing outbreak of Ebola or Marburg virus diseases.
Source: WHO 
It mattered what sort of exposure people had
Safe and Dignified Burials in Guinea.
Source: United Nations on Flickr
More of those with symptoms of illness had contact with a fatal EVD case (45 of 99 or 45%) than did those with no symptoms 67/280 or 24%). Those with contact with blood or vomit from a case or who took part in a burial ritual were also more likely to have become symptomatic.
Among those who were asymptomatic but had been infected, there was a greater likelihood that they had taken part in a burial ritual or had contact with infectious fluids than asymptomatic contacts with no developmentt of antibiodies.
Why do some get exposed and feel nothing while others die from the experience?
Another interesting question to come out of this study is whether there is a role for exposure outside of contact with a known case of EVD.
Did some number of these contacts already have antibodies to a Zaire ebolavirus strain or to another ebolavirus that we already know about, or a strain or virus we’ve yet to find? Could those infections have provided some protection (cross-protection) against illness during this new ebolavirus contact? Of course, that also generates the question of why don’t they notice those infections if this is all possible?
We do know that Zaire ebolavirus was in Guinea before the multi-country outbreak that started there, took over lives in 2013-2016.
Where does that leave us?
This study showed us that contacts of a EVD case sometimes became infected even if they didn’t notice anything, or only had a short-term illness after that contact. Those in contact with infectious materials (fluids or a body) were more likely to have symptoms. Even in the absence of symptoms though, evidence that infection occurs is solid. This will surprise some. But not others.
We should keep this in mind about previous studies, but also, it may be that these latest findings mean earlier findings might have been correct after all.
identifying true Ebola virus infections by ELISA is not yet an exact science
The genesis of the Ebola virus outbreak in west Africa
Eugene T Richardson, Mosoka P Fallah 
Having said that, this latest finding using this excellent and target-specific lab tool reinforces the need for even more study and better understanding of what is happening in less deadly Ebola virus infections. Some questions that need answering include:
- how often is mild illness occurring? This will impact on the fatality rate normally ascribed to Ebola virus.
- given these findings, how sure are we that Reston virus is as tame as we have labelled it to be? What if we simply haven’t experienced enough human outbreaks to see its dark side yet?
- can mildly ill, Ebola virus-infected people transmit and infect others? In this study, it was apparent that suspected cases were not being flagged for testing. This could have been an issue at the time and even in current and future outbreaks if follow-up is stretched thin.
- does an Ebola virus infection present at presumably low levels in a mildly ill or asymptomatic person, still spread and persist in tissues (reproductive tract, eye) as it does in more serious illnesses?
This study is a very nice reminder that we need to keep our minds open to new – and sometimes ‘out there’ concepts. We can talk about ideas on the edge of what existing data support as much as we like. Actual science being funded and done is what resolves these thoughts into hypotheses that lead to data and new hypotheses and more data. And so on.
- Yes, there were signs that Ebola was in west Africa, perhaps as far back as 1973
- Prevalence of infection among asymptomatic and paucisymptomatic contact persons exposed to Ebola virus in Guinea: a retrospective, cross-sectional observational study
- Development of a Sensitive and Specific Serological Assay Based on Luminex Technology for Detection of Antibodies to Zaire Ebola Virus
- The genesis of the Ebola virus outbreak in west Africa.
- Case definition recommendations for Ebola or Marburg Virus Diseases As of 09 August 2014 https://www.who.int/csr/resources/publications/ebola/ebola-case-definition-contact-en.pdf
- Serological Evidence of Ebola Virus Infection in Rural Guinea before the 2014 West African Epidemic Outbreak
- Hemorrhagic fever virus infections in an isolated rainforest area of central Liberia. Limitations of the indirect immunofluorescence slide test for antibody screening in Africa.
- Serological Evidence of Ebola Virus Infection in Rural Guinea before the 2014 West African Epidemic Outbreak
The 2018/19 outbreak of Ebola virus disease (EVD) in the Democratic Republic of the Congo (DRC) was showing some promising signs of control earlier this week. Then the latest attacks hit. Now, who knows?
A health worker prepares to disinfect MSF’s partly burnt-out Ebola treatment centre in Katwa, North Kivu, DRC, 25 February 2019. Photo and text from MSF.
This week has seen two violent attacks resulting in damage to Ebola treatment centres (ETCs) and in one instance, the death of a nurse.
The first attack came at night
The first attack occurred on an Médecins Sans Frontières (MSF) ETC on 24th of February in Katwa, North Kivu. Structures were burned and equipment damaged.
The Katwa health zone is the hotzone for most current EVD activity, having surpassed the case count in the previous most active zone of Beni (now almost controlled).
There were 10 EVD patients, including 4 confirmed cases, in this ETC. All safely transported to other ETCs.
We have decided to suspend the activities of an #Ebola Treatment Centre in #NorthKivu after a violent attack on 24 February where our facility was partially burnt down. pic.twitter.com/iT9clrSDIR— MSF International (@MSF) February 26, 2019
A second attack, a second hotspot
#RDC En ce moment, attaque du Centre de Traitement d’Ebola de l’ITAV/Butembo par des “assaillants” non autrement identifiés. Échange de tirs avec les FARDC. C’est la 2ème fois en l’espace de qlqs jours qu’un CTE est attaqué à Butembo. Quelle irresponsabilité! pic.twitter.com/21O3UtL9l8— Grégoire Kiro (@kiro_gregoire) February 27, 2019
The second and most recent attack was on 27th February and targeted the MSF ETC in Butembo; the biggest ETC built for this outbreak so far. 32 of 38 suspected cases and 4 of 12 confirmed cases fled as a result.
This follows last week’s attack on our Ebola treatment centre in Katwa.
Both Katwa and Butembo health zones are active Ebola virus transmission areas.
That means these health zones have active cases in their ETCs and most likely, in the surrounding community.
OCHA Map of the hotzones, via Reliefweb.
There has been frequent mention of resistance to the response to this EVD outbreak, from the community in the Katwa HZ. There is resistance to vaccination, resistance to presenting early for treatment when ill and resistance to safe and dignified burials. And there’s evidence for that; the outbreak is in its 8th month. That MSF article painfully spelt out the problem.
Organisations, including MSF, have failed to gain trust from communities; approaches to people must change
Médecins Sans Frontières (MSF) 
Working together, anything is possible
There was overwhelming evidence from the multi-country EVD epidemic in West Africa that engaging the community could shut down EVD. This engagement hasn’t succeeded – for whatever reasons – in the DRC this time around. Without everyone on the same page, transmission will continue its cruel and relentless path through family after family.
Disrupted responses in the region of most active transmission are bound to cause problems, just as we were warned from the outset. Infected people may move away from conflict and carry the virus to new (or back to old) places. Interruption of treatment, contact tracing, data recording, reporting and vaccination could drive new flare-ups in Katwa and Butembo.
The on-going #Ebola transmission in Butembo and Katwa means the outbreak could reach into even more volatile & dangerous areas – where almost no partners would be able to operate. This is why support is needed now. https://t.co/quhDfJ03GR pic.twitter.com/PgZ2Zilp1U
— World Health Organization (WHO) (@WHO) February 26, 2019
We don’t know what’s next
As with all things outbreak, it’s impossible to accurately predict what will happen next. Impossible except for knowing that the heroic and dangerous efforts of a host of foreign and local health workers of all types will keep striving to grind the virus to a standstill.
And now there are new calls by the World Health Organization for vigilance and urgent financial aid. A new plan to better empower the local response and communities has also been rolled out.
The violence and community resistance seems unwilling to let go and after recent events, this outbreak has regained the upper hand. There is still much work ahead before this particular Ebola virus is kicked out of the DRC.
- North Kivu: Ebola centre inoperative after violent attack
- Unknown forces attack Butembo Ebola treatment center, CIDRAP
- EPIDEMIOLOGICAL SITUATION IN THE PROVINCES OF NORTH KIVU AND ITURI Wednesday, February 27, 2019 http://translate.google.com/translate?hl=auto&langpair=auto|en&u=https://us13.campaign-archive.com/%3Fu%3D89e5755d2cca4840b1af93176%26id%3D693337893b
- RD Congo – Ituri et Nord-Kivu : 3W Qui faitquoi Où – Riposte de la Maladie à Virus Ebola (Semaine 06 : du 04 au 10 février 2019)
- Ebola response in Democratic Republic of the Congo risks slowdown.
The post Will violence Let Go of the DRC long enough to kick out Ebola virus? appeared first on Virology Down Under.
For the better part of a week there have been reports in the dissident Chinese press of a large African Swine Fever outbreak in Hebei Province – the only region of Eastern China not to have reported ASF – and of a massive cover-up.
Today, China’s MOA has confirmed Hebei Province’s first outbreak, and has announced the return of ASF to Inner Mongolia for the first time in nearly 3 months.
It is worth noting that the Chinese media reports (based, in part, on social media posts) suggest a substantially higher number of pigs affected than does the official report below.
African swine fever epidemic in Xushui District, Baoding City, Hebei Province
Date: 2019-02-24 12:54 Author: Source: Ministry of Agriculture and Rural Press Office
The Information Office of the Ministry of Agriculture and Rural Affairs was released on February 24, and an African swine fever epidemic occurred in Xushui District, Baoding City, Hebei Province.
On February 24, the Ministry of Agriculture and Rural Areas received a report from the China Animal Disease Prevention and Control Center, which was diagnosed by the China Center for Animal Health and Epidemiology, and an African swine fever occurred in a farm in Xushui District, Baoding City. There are 5,600 live pigs in the farm, and there have been morbid deaths.
Immediately after the outbreak, the Ministry of Agriculture and Rural Affairs sent a steering group to the local area. The local government has started the emergency response mechanism according to the requirements, and adopted measures such as blockade, culling, harmless treatment, disinfection, etc., to treat all the sick and culled pigs harmlessly. At the same time, all pigs and their products are prohibited from being transferred out of the blockade, and pigs are prohibited from being transported into the blockade. At present, the above measures have been implemented.
The African swine fever epidemic occurred in the Sandor Forest Farm of the State-owned Forest Management Bureau of Daxing’anling, Inner Mongolia Autonomous Region
Date: 2019-02-24 16:54 Author: Source: Ministry of Agriculture and Rural Press Office
The Information Office of the Ministry of Agriculture and Rural Affairs was released on February 24, and the African swine fever epidemic occurred in the Sandor Forest Farm of the State-owned Forest Management Bureau of Daxing’anling, Inner Mongolia Autonomous Region.
On February 24, the Ministry of Agriculture and Rural Affairs received a report from the China Animal Disease Prevention and Control Center, which was diagnosed by the Inner Mongolia Autonomous Region Animal Disease Prevention and Control Center. A wild pig swine outbreak occurred in a wild boar farmer in the Sandor Forest Farm of the Daxinganling Key State-owned Forest Management Bureau.
There are 222 domestic wild boars in the farm, with 222 diseases and 210 deaths. The farm is located in the hinterland of Daxing’anling, and there is no pig breeding in the radius of 60 km.
After the outbreak, the Ministry of Agriculture and Rural Affairs and the Forest and Grass Bureau immediately dispatched a steering group to the local area. The local government has initiated an emergency response mechanism in accordance with the requirements, and adopted measures such as blockade, culling, harmless treatment, and disinfection to strengthen the inspection of surrounding wild boar activities. At present, the above measures have been implemented.
A Google search on the term `死猪” (`Dead Pigs’) returns dozens of results each day, with many describing the dumping of large numbers of pig carcasses into rivers and streams (see Taiwan BAPHIQ: ASF Positive Pig Carcass Found On Matsu Island Beach).
But there are ample reasons to suspect the official reports we get from the MOA may not fully describe the ASF situation on the ground.
- Chinese farmers and local officials have a history of not reporting disease outbreaks to the central government – preferring instead to deal with problems internally – as not to invite unwanted attention from Beijing.
- It seems unlikely that Hebei Province – which has been surrounded by provinces reporting ASF outbreaks for months – only now detects ASF.
- And perhaps most telling, Taiwan’s BAPHIQ (Bureau of Animal Plant Health Inspection & Quarantine) continues to intercept ASF contaminated food products, with the latest reports showing 10% of Chinese pork products collected at their airport tested positive for the virus.
Obviously, significant quantities of ASF contaminated pork are making it into the food chain – and while that poses no health risk to humans – it does speak to the amount of undetected (or reported) infected livestock being processed.
Six months ago the FAO warned that AFrican swine fever (ASF) threatens to spread from China to other Asian countries, and over the past 7 weeks we’ve seen the virus attack farms in two of China’s neighbors; Mongolia and Vietnam.
While ASF does not pose a direct threat to human health, it can be devastating to pork producers, and its further spread in China and across Asia could compromise already fragile food security in many regions
According to the FAO‘s most recent report, food insecurity and world hunger continue to increase, making agricultural diseases such as ASF, avian flu, FMD, and others important detriments to human health as well.
RECENT TRENDS IN HUNGER AND FOOD INSECURITY
- New evidence continues to point to a rise in world hunger in recent years after a prolonged decline. An estimated 821 million people – approximately one out of every nine people in the world – are undernourished.
- Undernourishment and severe food insecurity appear to be increasing in almost all regions of Africa, as well as in South America, whereas the undernourishment situation is stable in most regions of Asia.
- The signs of increasing hunger and food insecurity are a warning that there is considerable work to be done to make sure we “leave no one behind” on the road towards a world with zero hunger.