Talk:Ebola virus cases in the United States

Normal lab values?

Regarding Duncan's first trip to the ED, why did we write "Lab results including white blood cell, platelets, glucose, creatinine, and aspartate transaminase (AST) all returned within normal ranges."? According to the congressional testimony, he had a number of abnormal labs: From my reading of the document, he was neutropenic (3.08), thrombocytopenic (92), had elevated LFTs (AST 94), and had evidence of mild kidney injury (Cr 1.41).
Am I missing something? I'll go ahead and correct this unless someone points out that I'm reading the source wrong.Onefireuser (talk) 02:50, 27 October 2014 (UTC)

The correction has been made. --Onefireuser (talk) 16:47, 27 October 2014 (UTC)

Whoa. Wait a minute. We should be careful not to SYNTH and OR conditions here. You may be a doctor, but we need some verifiable secondary source that cites these conditions from the lab results. Here's what the document says:

• WBC – 3.08 L (low end of ‘normal range’ 3.98)
• Platelets – 92 L (low end of ‘normal range’ 130)
• Glucose – 180 H (high end of ‘normal range’ 100)
• Creatinine – 1.41 H (High end of ‘normal range’ 1.25)
• AST – 94 H (‘normal’ <34); can reflect abnormalities in liver function or muscle tissue

Radiology results reviewed at 0128 and included:

• CT scans Abdomen & Pelvis- “no acute disease” and Head - “unremarkable”

Now I made the mistake of reading AST as "normal". That's a good catch. But the document notes everything else as being within the "normal range". I'm going to keep the 'low' and 'high' judgments (as they're noted in the document, but I have to remove the note about 'abnormalities ... some minor' as being OR not directly found in the citation. -- Veggies (talk) 19:30, 28 October 2014 (UTC)

I agree. Thank you for making the wording more neutral. Onefireuser (talk) 23:26, 28 October 2014 (UTC)

The New York Times: Wikipedia Emerges as Trusted Internet Source for Ebola Information

• Cohen, Noam (October 26, 2014). "Wikipedia Emerges as Trusted Internet Source for Ebola Information". The New York Times. Retrieved October 28, 2014.

Might be a useful source for use in this article. — Cirt (talk) 03:08, 28 October 2014 (UTC)

Numbers in infobox

The current set of numbers is a good start.

• Cases contracted in the U.S.
• Deaths
• Cases first diagnosed in U.S.
• Cases evacuated to U.S. from other countries
• Quarantined people
• People under observation
• Cleared after 21 days

I'd like to see some additions and clarifications.

• Total cases

which would be equal to cases first diagnosed in the US + Cases contracted in the US

Then,

• Cases cured
• Deaths (already present)
• Active cases

Which also adds up to the total.

See any problems with this? Suggestions for improvement? Thundermaker (talk) 07:37, 28 October 2014 (UTC)

Dr. Spencer's apparent lack of full disclosure

http://nypost.com/2014/10/29/ebola-doctor-lied-about-his-nyc-travels-police/. SW3 5DL (talk) 12:56, 29 October 2014 (UTC)

photo request

Can someone find a freeby photo of Amber Vinson? Thanks. SW3 5DL (talk) 13:42, 29 October 2014 (UTC)

A freebie picture of Amber will be harder to find. She didn't visit Obama like Nina Pham did (hence the freebie White House photo). Anyone know Amber? (lol) BlueAg09 (Talk) 14:02, 29 October 2014 (UTC)

Ah, that's the reason. I looked earlier this morning and couldn't find anything. I wondered why. Thanks. SW3 5DL (talk) 15:46, 29 October 2014 (UTC)

Page move

Ebola virus disease in the United States → Ebola virus cases in the United States – Discussion here shows continuing issues SW3 5DL (talk) 16:06, 29 October 2014 (UTC)

• Support - Use of the word 'disease' is not neutral or accurate. There is no Ebola disease in the United States. There are only isolated cases. The title Ebola virus cases in the United States was previously the most stable version and it had consensus. SW3 5DL (talk) 16:06, 29 October 2014 (UTC)

• Support: Agree with rationale. --Light show (talk) 16:43, 29 October 2014 (UTC)

• Support sure, with how the article content has been developing. It's not what I thought the article was supposed to be but I guess a more general article can be done elsewhere. Zad68 16:47, 29 October 2014 (UTC)
• Counter-proposal: Ebola in the United States. Clear. Unambiguous. Concise. Precise. --Born2cycle ☎ 16:58, 29 October 2014 (UTC)
  • The entire intro is wrong if you do not treat the hatnote as part of the intro, there have been cases of Ebola (Ebola Reston, or Reston Virus) previously in the United States, and zoological cases of Ebola Virus Disease in the United States in the 20th century. If we do not add "2014" to the article name, then the article should be expanded to cover the zoological cases as well. -- 67.70.35.44 (talk) 05:47, 30 October 2014 (UTC)
    • I don't know where this idea comes from that titles have to precisely convey the WP:SCOPE of an article. It's nonsense. Our titles don't do that. They can't do that. Article leads do that. The scope of an article entitled "Ebola in the United States" may or may not be limited to 2014, may or may not include zoological cases, may or may not include Ebola Reston, etc. It's all good. Title and scope are not so entwined. The title should be clear and recognizable - the decision about article scope is obviously related but is largely separate. --В²C ☎ 17:08, 30 October 2014 (UTC)
• Support "cases" is much more accurate and precise than "disease." The word "disease" also implies that we might be discussing previous research that 's taken place in the US. "Cases" makes it clear that we're just talking about this current Ebola scare. Onefireuser (talk) 17:55, 29 October 2014 (UTC)
• Support as above. Much more accurate and precise than 'disease.' Dr. Mike (talk) 19:48, 29 October 2014 (UTC)
• Support but also support the alternate Ebola in the United States Gaijin42 (talk) 15:50, 30 October 2014 (UTC)
• Oppose, contains information such as quarantines and philanthropic efforts which don't belong under the heading "cases". Support the alternative "Ebola in the United States" for this reason. Siuenti (talk) 08:41, 31 October 2014 (UTC)

discussion

@Born2cycle and В²C:, that's too vague and would only compound the problem, but thanks for the suggestion. I believe it was suggested way back when the article was created. Ebola virus cases in the United States is accurate and neutral. SW3 5DL (talk) 17:22, 29 October 2014 (UTC)

Vague? What else could "Ebola in the United States" reasonably mean other than "Ebola virus cases in the United States"? --В²C ☎ 17:35, 29 October 2014 (UTC)

Use of the term "cases" makes the title more precise, since Ebola alone is defined as a disease, but up until a month ago was only a disease in Africa. Adding the word "cases" implies that it is not endemic or a recognized disease in the U.S., since it is restricted to a few isolated cases, which makes it more precise and accurate. --Light show (talk) 17:47, 29 October 2014 (UTC)

Append: However, the word "virus" may not be needed, since Ebola is a virus. --Light show (talk) 18:16, 29 October 2014 (UTC)

Again, what else could "Ebola in the United States" reasonably refer to other than cases of the Ebola virus disease in the United States? To claim a need for precision, you must identify what else you believe the allegedly imprecise title may reasonably mean. --В²C ☎ 19:01, 29 October 2014 (UTC)

Wait, you think since "Ebola in the United States" could refer to an Ebola endemic in the US, or it being a "recognized disease" in the US, it's a problem? That's the epitome of unnecessary precision. Since we don't have articles about those more precise topics, there is no need to make this one precise enough to distinguish from them. --В²C ☎ 19:06, 29 October 2014 (UTC)

Hold on, didn't you mean to say "infer" instead of "refer," which have totally different meanings? What I wrote meant "infer." As for articles about those precise topics, this article is mostly about those very topics, primarily devoted to cases. To infer that some isolated cases warrants it being a "U.S. disease" might be the epitome of an unnecessary generality. The CDC rightly calls TB a "disease", while describing "cases" of Ebola in the U.S. --Light show (talk) 19:43, 29 October 2014 (UTC)

If we had to make our titles so precise that they could not infer anything else if taken out of context, well, we'd be doing nothing but renaming all of our titles. You're basing your argument on a requirement for WP article titles that does not exist. --В²C ☎ 20:21, 29 October 2014 (UTC)

Is Ebola in the U.S. different from Ebola anywhere else? No. An article with that title would seem too general, implying it's about the disease. But the article is about specific instances, namely some "cases" in the U.S. Per guidelines: Titles should be precise enough to unambiguously define the topical scope of the article,. --Light show (talk) 20:46, 29 October 2014 (UTC)

No, an article entitled Ebola would be a general article about the disease. An article with the title Ebola in the United States would be about the disease in the United States. If there are only handful of cases, then it's about that. If there are more than it's accordingly more general. But the title is appropriate either way. The title of the article should not depend on how many cases there are. Should we have a table set up that specifies the title based on how many Ebola cases there are? That's just silly. --В²C ☎ 21:42, 29 October 2014 (UTC)

Clunky lead

The current lead sentence is verging on unreadable:

There have been four cases of Ebola virus disease (EVD) diagnosed in the United States to date. Although first described in Africa in 1976[5], EVD was never seen in America until 2014.[6]

I suggest:

There have been four Ebola cases diagnosed in the United States to date. Although first described in Africa in 1976[5], Ebola was never seen in America until 2014.[6]

--В²C ☎ 17:39, 29 October 2014 (UTC)

Agree. Although most of the lead, which should be a summary of the article, now seems dated and off-balance, as it could include more of the recent details from the body text. For instance, the last sentence is too limited: Public health experts and the Obama administration have opposed instituting a travel ban on Ebola endemic areas, stating that it would be ineffective and would paradoxically worsen the situation. The lead doesn't mention airport screening, quarantines, CDC, or evacuated cases. To make room, the paragraph about Duncan, for one, could be summarized. --Light show (talk) 18:11, 29 October 2014 (UTC)

State by State?

Has any thought been given to splitting the article up based on State, maybe structured like the main 'Ebola outbreak in West Africa' article? 72.224.172.14 (talk) 13:46, 30 October 2014 (UTC)

I don't think its needed yet as the number of cases is small, but if there are more significant outbreaks, it may be useful in the future. Gaijin42 (talk) 15:48, 30 October 2014 (UTC)

Okay, thanks. 72.224.172.14 (talk) 20:50, 31 October 2014 (UTC)

Current tag

I'd just remove this, but I don't want to have the jackals on me for disruption or some BS, so I'll bring it here and see if anyone can justify the inclusion of this tag. It's meant for instances where articles are being rapidly expanded as information just becomes available. This is not the case here. Thoughts? - Floydian ^τ _¢ 18:34, 30 October 2014 (UTC)

Scope?

What is the scope of this article? It seems to be "anything about the 2014 outbreak of Ebola that has anything to do with the United States". The first paragraph is:

There have been four cases of Ebola virus disease (EVD) diagnosed in the United States to date. Although first described in Africa in 1976, EVD in humans was never seen in America until 2014.

I do not think this is a definition: for one thing, it's not reversible. We should have a definition, if at all possible. See WP:BEGIN.

Can you think of a scope that covers all of these sections?

1. The four cases diagnosed in the US.
2. Medical evacuations to the US. [These are not diagnosed in the US. Maybe the title should be changed to "EVD on American soil"?]
3. Containment in the US. [With this, maybe "Ebola virus (symptomatic or not) in the US".]
4. Treatment. This seems to be drugs and vaccines being developed in the US without any record of the work that WHO is doing in Switzerland and other places. These experiments are a lot closer to success that the US. Shouldn't this be moved to Ebola virus disease?
5. Philanthropic efforts. Only of American donors.
6. Operation United Assistance. Work done in Africa by Americans.

Can you think of anything other than "anything about the 2014 outbreak of Ebola that has anything to do with the United States" or "United States efforts in dealing with Ebola" that covers all of these?

Perhaps we could do it by steps. What about splitting the Containment section into its own article "Containment of Ebola in the US"?

--RoyGoldsmith (talk) 11:02, 31 October 2014 (UTC)

What we're currently experiencing is not really an epidemic or even an outbreak, but a "scare." In that context I feel that this article is really about the "2014 Ebola Scare in the United States." Given that as our topic, it makes sense that medical evacs to the US should be included (because they could theoretically transmit the illness to others here). Containment in the US should obviously be included as well. A short section on treatment makes sense because that is an important part of containing the scare. Philanthropic efforts and OUA may also deserve very brief mention here because they are part of the way that we are attempting to contain the scare by keeping Ebola "over there." Onefireuser (talk) 13:56, 31 October 2014 (UTC)

@Onefireuser: If we want to have an article named "2014 Ebola Scare in the United States" we must gather enough reliable sources (about fear to Ebola in the US) to be notable. If not, this is original research and must be deleted. We cannot use one name to stand for (wink, wink) another. I guess what I'm really asking is what was the scope of this article when it was approved for notability and has it changed significantly since then? --RoyGoldsmith (talk) 14:46, 31 October 2014 (UTC)

@RoyGoldsmith: I wasn't involved in the early stages of working on this article and so I'm not sure what was initially notable about it. At this time, it does seem that the occurrence of the disease in the US and all the various aspects of the response can merit its own article (ie this article). I'm not sure what the best term for what we're experiencing is. (See the above discussion about changing the title.) It does meet the WHO definition of an "outbreak." However, using the term outbreak--even if technically correct--seems misleading. I guess what I'm saying is that I also don't know what other editors consider the scope of the article to be. I think the current scope is reasonable (if we are talking about the 2014 Ebola "excitement"), but I'm sure a narrower scope would be reasonable too. Onefireuser (talk) 15:57, 31 October 2014 (UTC)

Counter-proposal: How about the United States in the 2014 Ebola virus epidemic? This is a far reach from the suggested titles above, but it's mostly true since the epidemic did not reach the U.S., it is the U.S. that is combating the epidemic. Although this is a lame proposal, it covers the U.S. involvement and the cases of the disease at once. Epicgenius (talk) 16:28, 31 October 2014 (UTC)

Ebola virus is not endemic to the United States. Ebola virus has come to the United States as a result of travelers but it has not spread as it did in Sierra Leone, Liberia, et al. So far the only cases of transmitted virus while in the United States were the nurses who cared for the first diagnosed patient, Thomas Duncan. The article covers the cases, the reaction of state and federal government to treat and contain the virus, as well as important information on treatment and vaccine development. It includes a section on public concerns. Creating an article to focus only on the 'fears' in the U.S. might be problematic. What's wrong with people being afraid of something that causes death in 70% of it's victims, is poorly understood by the CDC as evidenced by their ever changing stance on transmission, and for which there is no vaccine, but there are expensive treatments if you're lucky enough to have the same blood type as Dr. Brantly and nurse Writebol? SW3 5DL (talk) 16:58, 31 October 2014 (UTC)

One way to clarify the scope of the article is to start with a clean slate and just answer 6 key questions: who, what, where, when, how and why. Briefly, here are some ideas. Who: The people who contracted Ebola and were eventually treated in the U.S. What: Cases, a few quickly isolated and contained, as opposed to an "outbreak" of uncontained cases. Where: In the U.S., cities or states or hospitals included. When: Beginning in 2014. How: Evacuated cases, unrecognized Duncan case, which infected his nurses. And Why: Because this was a new and unexpected situation for which we were unprepared.

Since Ebola is a disease and nothing but a disease, having "Ebola disease" in the title is redundant. What's unique and why a separate article wisely started by SW3 is fine is that Ebola in the U.S., so far, has been limited to a few contained "cases," which could be made clearer per the suggested title. --Light show (talk) 18:16, 31 October 2014 (UTC)

Per Light show re: the use of 'disease.' And note also, it's an imported virus, it's not an endemic virus, like chicken pox and measles. No cases in America would ever occur without the virus first breaking out in Africa where it is endemic. To date, only two cases have resulted from direct transmission on U.S. soil and those were nurses caring for Thomas Duncan, the first case brought to the U.S. As President Obama has said, an epidemic of Ebola virus is not expected in the United States. SW3 5DL (talk) 19:28, 31 October 2014 (UTC)