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Divernan

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Clintons DO have to rely on the kindness of 1 percenters for private jet travel.

I mean it's not like Bill & Hill have his and hers private jets at their beck and call. When you look at the 5 star luxury of their travels - presidential suites, 4 or 5 personal assistants EACH, and luxury private jets - it appears that neither is physically fit enough to withstand the rigors of first class commercial travel.

http://www.reviewjournal.com/news/las-vegas/high-fashion-expense-hillary-travel
Hillary Rodham Clinton likes to travel in style.

She insists on staying in the “presidential suite” of luxury hotels that she chooses anywhere in the world, including Las Vegas.

She usually requires those who pay her six-figure fees for speeches to also provide a private jet for transportation — only a $39 million, 16-passenger Gulfstream G450 or larger will do.

And she doesn’t travel alone, relying on an entourage of a couple of “travel aides,” and a couple of advance staffers who check out her speech site in the days leading up to her appearance, much like a White House trip, according to her contract and supporting documents concerning her Oct. 13 speech at a University of Nevada, Las Vegas Foundation fundraiser. The documents were obtained by the Las Vegas Review-Journal through the state public records law.

CENTER OF ATTENTION: Clinton, a former first lady, U.S. senator from New York and U.S. secretary of state, is expected to run for president in 2016. Her lifestyles of the rich and famous ways and comments that she made about her wealth during a recent book tour have fueled criticism that she’s out of touch with average Americans.

HRC: "We are not truly well off, like other wealthy people we know."

This report is from last June:

http://abcnews.go.com/blogs/politics/2014/06/hillary-clinton-stumbles-from-dead-broke-to-not-truly-well-off/

Hillary Clinton’s latest attempt to explain away her comment that she and Bill Clinton were “dead broke” when they left the White House has prompted her to possibly stumble into another verbal thicket, saying that they are not “truly well off.”

In an interview with the Guardian published Sunday, Hillary Clinton made a third attempt to tamp down the “dead broke” comment, made earlier this month to ABC’s Diane Sawyer. While defending the millions of dollars she and the ex-president have earned giving paid speeches and writing books, she insisted they are not “truly well off” like other wealthy people they know, fueling criticism that the potential presidential candidate does not relate to ordinary people.


Says it all doesn't it? Their joint wealth is now estimated at over $100 million, but in her mind they are not truly well off.

As to the comment that "Bill Clinton has worked tirelessly in the capacity of president and past president for the betterment of peoples lives. And he does so at the cost of his own health." I agree that his continued high level of activity is not beneficial to his health or to slowing his progressive heart disease. Plain and simple, the man cannot stop himself from pursuing wealth, status, public attention and political power, at every opportunity, even though he has jokingly referred to the risks his level of activity poses to his longevity.

But it also included making sure Hillary gets the benefit of the national spotlight that’s sure to burn hot on her if the inevitable happens to Bill Clinton before the 2016 primary season.

“Obviously, you have to have a big state funeral for me, with as much pomp and circumstance as possible,” Bill Clinton says in the excerpt. “I’m thinking maybe I should be buried at Arlington rather than at my library in Little Rock. After all, I was commander in chief for eight years and have every right to be buried at Arlington …”

“When I’m gone, people will think only of my good points and forgive, if not forget, the bad. I’ll be remembered in a positive light more in death than I was in life. That always happens. Everybody knows that. So you’ll have to take maximum advantage of my death …”

“It should be worth a couple of million votes.”


Some have referred to his mindset as "Bill Clinton's Madness".

https://www.drmcdougall.com/health/education/health-science/featured-articles/articles/bill-clintons-madness/
One of the savviest politicians of our generation, known for his wit, charm, and calm under extreme pressure, Bill Clinton appears out of character in the speeches and interviews televised since his bypass surgery September 6, 2004 and his mental deterioration may be accelerating. Remember, this is the president who withstood public impeachment before the entire world for his relationship with Monica Lewinski without once losing control. Now, he is easily angered by hecklers, and makes factual mistakes and racial slurs while aggressively defending his wife’s campaign for presidency. Everyone sees his mental and emotional decline, yet to date, no medical professionals have spoken out about the cause or offered help.

Not a single one — not one bypass surgeon, cardiologist or psychiatrist — has stepped forward in his defense; even though all of them are trained to recognize “post bypass surgery cognitive dysfunction.” One of the best-kept secrets in medicine is the brain damage caused during bypass surgery. During my 40 years of medical practice I have never heard a doctor warn a patient before bypass surgery that an expected complication is memory loss. After surgery when the family complains of dad’s fits of anger, I have never heard a doctor admit that personality change is a common consequence of surgery. Yet these well-recognized side effects have been reported in medical journals since 1969.1

Brain damage during bypass surgery is so common that hospital personnel refer to it as “pump head.” The primary cause is emboli produced during surgery from clamping the aorta and from the “heart-lung machine.” This machine pumps blood to keep the patient alive while the heart is stopped during the operation. Unfortunately, this pump also introduces toxic gases, fat globules, and bits of plastic debris into the bloodstream of the patient under anesthesia. Once they are in the bloodstream, these particles migrate to the brain where they can clog capillaries and prevent adequate amounts of blood and oxygen from flowing to the brain. Essentially, all patients experience brain emboli during surgery and for many the damage is permanent.

In 2001, an article in the New England Journal of Medicine reported that 5-years after bypass surgery 42% of patients showed decline in mental function of approximately 20 percent or more.2 A study published this year (2008) in the Annals of Thoracic Surgery using MRI testing just after bypass surgery found brain damage in 51% of patients.3 Three years after their time on the bypass pump, significant permanent reduction in mental capacity was identified in 31% of patients. I am not talking major stroke here; but these patients can’t remember names or numbers as they once did, experience sleep disturbances (including nightmares), suffer mood swings, and lose intellectual acuity. Approximately 30 percent of people suffer persistent depression and some even contemplate suicide
.

1) Hill JD, Aguilar MJ, Baranco A, de Lanerolle P, Gerbode F. Neuropathological manifestations of cardiac surgery. Ann Thorac Surg. 1969 May;7(5):409-19.

2) Newman MF, Kirchner JL, Phillips-Bute B, Gaver V, Grocott H, Jones RH, Mark DB, Reves JG, Blumenthal JA; Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. N Engl J Med. 2001 Feb 8;344(6):395-402.9 Link » (pdf)

3) Knipp SC, Matatko N, Wilhelm H, Schlamann M, Thielmann M, Lösch C, Diener HC, Jakob H. Cognitive outcomes three years after coronary artery bypass surgery: relation to diffusion-weighted magnetic resonance imaging. Ann Thorac Surg. 2008 Mar;85(3):872-9.

The damage control will be in overdrive at WVU re "a very eventful night."

I worked in a Dean of Students office at one of the top private universities for a couple of years, and the coverups focused on protecting the university's reputation - student victims/witnesses were coerced, manipulated, threatened - often encouraged to "take a semester off". Any parents who think an undergraduate institution sees itself as acting "in loco parentis" is delusional.

More from the article:
Burch, a native of Buffalo, N.Y., was pledging to become a brother of the Kappa Sigma Fraternity. MPD and University Police are working on identifying and interviewing pledge and fraternity members who were with Burch during the night.

Burch tweeted, “It’s about to be a very eventful night to say the least” hours before the incident.

Wolf to impose 'No, thank you' Rule on Appointees

Source: Pittsburgh Tribune-Review

Wolf plans to sign an executive order to prohibit gifts even though state law allows officials to accept gifts worth up to $250 without reporting them, or gifts worth more than that amount if disclosed. The law sets a $650 threshold for travel, hospitality and lodging.

Critics during Republican Gov. Tom Corbett's campaign pointed to his acceptance of legally allowed gifts, totaling more than $28,000 during his tenure, from tickets to sporting events and Broadway shows to a free yacht vacation.

In his Campaign for a Fresh Start, Pennsylvania governor-elect, Democrat Tom Wolf spelled out his rule on gifts — for himself, his Governor's Office staff, and his appointees to state agencies and boards: “The rule will be easy to apply and easy to report — no free lunches, no free tickets to ball games, and no free trips to conferences or vacation resorts. If you come and work for Tom Wolf in Harrisburg, there will be no ‘gifts' as part of your job.”

Barry Kauffman, lobbyist for Common Cause of Pennsylvania, said the rule is “strong incentive to do the right thing. It means you'll be beholden to no one.”

Read more: http://triblive.com/news/adminpage/7133693-74/wolf-gifts-rule#ixzz3IoA2UhcA
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Read more: http://triblive.com/news/adminpage/7133693-74/wolf-gifts-executive#axzz3IkgdSNWT



Good for Governor-elect Wolf - off to a fine start. Sadly, it will be a cold day in hell before the state legislators of either party agree to apply such a rule to themselves. I worked for the Democratic Caucus of the PA House for 10 years. On session days, legislators from both parties routinely attended hot breakfast buffets in the Capitol rotunda, sponsored by lobbyists/special interest groups. They were also taken out to restaurants by lobbyists most evenings they were in the state capitol. And OH! all the college/professional sports outings where they were wined and dined in private, luxury boxes. Then there were the golf outings. Most outrageously, the overwhelming majority of these state legislators collected their undocumented per diems for food, even though they rarely paid for even a can of soda.

So glad there is no USSC appointment in the immediate offing!

Because Obama would roll right over on that one and immediately agree to the youngest, most conservative, white, male nominee Mitch could come up with. All those harping at Ginsburg to retire during Obama's last 2 years? That is definitely off the table. Stay healthy, Justice Ginsberg!

There are currently 64 vacancies in the Federal judiciary, with 32 Obama nominees hanging in limbo. Mitch can hold up those 32 nominees and pressure Obama to fill the other 32 slots with little Scalias, Thomases, etc. Probably set up a 10 to 1 ratio, i.e., Obama gets one of his appointees for every 10 of Mitch's he supports.

http://www.uscourts.gov/JudgesAndJudgeships/JudicialVacancies/CurrentJudicialVacancies.aspx

Sadly Obama couldn't negotiate his way out of a wet paper bag.

So here's the deal. When the next Senate session opens, Obama puts four issues on the table for what he laughingly calls "negotiations."
1. Trade deals
2. Keystone
3. Chained CPI
4. Rebuilding infrastructure.

The GOP snaps up the first three. Obama claims victory - hey! he got 3 out of 4!

Mitch McConnell's horrific agenda as Senate leader:

Here's a link to last August's Courier-Journal report on McConnell's comments at a Koch Brother fianced soiree. As per yesterday's results, the majority of voting Kentuckians never need unemployment benefits, never struggle working for a minimum wage, and have no interest in refinancing student loan debt. What a bubble they live in!

U.S. Senate Minority Leader Mitch McConnell told a conference of rich, politically active conservatives in June that he wouldn't allow votes on the minimum wage and extending unemployment if he becomes majority leader, according to a leaked audio recording.

In the recording, which appeared on the website of The Nation, he also said that passage of the McCain-Feingold Act to limit political contributions was "the worst day of my political life."

The event was organized by billionaire brothers Charles and David Koch, who donate heavily to conservative and tea party causes. The Nation reported that political action committees and people with ties to Koch Industries have contributed at least $41,800 to McConnell during this campaign cycle.

The recording includes passages in which McConnell says he would block votes on issues like raising the minimum wage, extending unemployment benefits and refinancing student loan debt. "We're not going to be debating all of these gosh darn proposals," he said during the discussion. "These people believe in all the wrong things."

A wife who stays w/ a serial adulterer for political power and prestige?

What's not to love!?!? (sarcasm). Fooled her (HRC) once, shame on him; fooled her over and over and over again for decades? Shame on her! I fully empathize with giving someone a second chance - but not 3rd, 4th, 5th, etc. I can even understand and empathize with wives who stay with a serial adulterer because they lack the self-confidence, education, resources, and or ability to support themselves post divorce, or whose children would face a significant reduction in quality of life if adulterous daddy is kicked out. That was not the case with HRC. With a law degree from Yale? Gimme a break! When Bill was Governor of Arkansas and she was with a prestigious law firm, Bill joked that she was supporting the family.

No wife has ever been so publicly, brutally and internationally humiliated by a husband's philandering. Where is her self-respect? What has tolerating such humiliation done to her psychology? I think it explains her aggression. She's displaced what she'd like to do to her husband to being a war-monger, and documenting political enemies as targets for her eventual revenge.

An unguarded look into the Clintons

Blair's documents give an unguarded look into the lives of Hillary and Bill Clinton, from Bill Clinton's days as Arkansas governor and rising Democratic star to the couple's time in the White House, warts and all.

Blair wrote in her diary that Hillary Clinton called Monica Lewinsky, the White House intern who nearly brought down her husband's presidency, a "narcissistic loony toon." Hillary Clinton defended her husband's adultery by saying it was caused, partly, because "the ugly forces started making up hateful things about them, pounding on them."
Diary: Hillary kept records for 'revenge'

Blair also noted a 1994 conversation in which the first lady asked her for advice on "how best to preserve her general memories of the administration and of health care in particular." When asked why she wanted to keep the documents, Clinton replied, "Revenge."

Confidante's diary: Hillary wanted to preserve records for 'revenge'
http://www.cnn.com/2014/02/17/politics/diane-blair-hillary-clinton-documents/

GOP Cong.Young blames family/friends/fed. govt. for teen suicide

Due to its relatively small population, Alaska has only 1 representative in Congress. Since 1973, that has been the increasingly irascible Don Young, who is now 81 years old. It's fair to say we're talking about dementia here. Think of Young as Ronald Reagan with a nasty, vicious personality. Young was listed as the third-worst congressman by the popular magazine Rolling Stone, and dubbed "Mr. Pork" due to his involvement in the Gravina Island "Bridge to Nowhere" incident. In the article, Young is quoted as saying that "Environmentalists are a self-centered bunch of waffle-stomping, Harvard-graduating, intellectual idiots" who "are not Americans, never have been Americans, never will be Americans." Dickinson, Tim (2006-10-17). "The 10 Worst Congressmen". Rolling Stone.

In the past week, while addressing first the students at Wasilla High School, and later residents at a senior citizen center, Young has been more unapologetically outrageous and insensitive than ever. At Wasilla HS, students are in counseling for the recent suicide of a classmate. There was a similar suicide of a Wasilla HS student the year before. Here's how Young's appearance played out:

Alaska’s lone congressman, Don Young, spoke to a group of students at Wasilla High School Tuesday. Earlier this month, Young barked at his Democratic opponent after a touch on the arm, “Don’t ever touch me! The last guy who touched me wound up on the ground, dead!” This time it’s insensitive remarks about suicide, berating friends of the victim, and comparing Alaska’s newly legal same-sex marriage to bull fornication. And getting drunk in Paris.

Teacher Carla Swick asked a question: “We had a suicide here last week. Alaska has the highest rate of suicide and domestic violence in the country. What can your office do to decrease this statistic?”

Young then used the full measure of sensitivity and diplomacy he’s absorbed during the last 40 years of public service, and blamed suicide on substance abuse, and a lack of support from friends and family. “When I heard ‘a lack of support from family’ and I heard ‘a lack of support from friends,’ I felt the oxygen go out of the room, but I gasped as well,” Wasilla High principal Amy Spargo said. “It just isn’t true in these situations. It’s just such a hurtful thing to say.”
“I wanted to say, ‘Don’t you realize we are a grieving school, and the kids you are talking to… many of them are his friends. This kid was very well-liked, and he had friends. He had support,” Swick said. “Neither of these boys had drug or alcohol problems,” said teacher Allison Little. “They were from intact strong families. And there was support. I don’t know why you would say that when these kids were his friends.”
.
At that point, a friend of the victim became emotional and called out, “He had friends. Depression is a mental illness.” According to Swick, Young then said suicide wasn’t a sickness, and that if it were a sickness “then get a vaccine.”

“Later on he used the word depression, but it was only after that,” Swick said. “And he said, I think in response to that kid, ‘Oh, so we’ve got a genius in the audience,’ in a very sarcastic tone. It was his tone… He is harsh. He is so harsh, and rough around the edges, and he demands respect but he doesn’t give respect.”


At one point Young asked the students what they thought the hardest part about being a congressman was. And no, it wasn’t learning how to sustain a stratospheric level of idiocy over a span of decades. According to Young, it’s the travel.

According to Swick, Young then said, “’I can travel to Paris, get drunk, and come back in the time it takes me to get to DC.’ He was trying to make a point, but why did he have to put ‘get drunk’ in there? It was just inappropriate. And he also said Hell several times. Witnesses also say that Young referred to a student as a smartass, or an asshole. Shock tends to fuzz out the memory. http://www.themudflats.net/archives/44801
There's lots more at the above Mudflats link re Young's views on gay marriage, marijuana.

Fast forward a couple of days and Young is addressing senior citizens when one of them dares to ask about his comments on suicide. http://www.themudflats.net/archives/44816

A press release sent out Wednesday evening from the campaign of Young’s opponent, Forrest Dunbar, details the continued gaffing of the most senior member of the United States House of Representatives. Now he’s talking nonsense to senior citizens instead of high school kids.

Today at the Mat-Su Senior Center Don Young remained unapologetic when asked about the ignorant comments he made to Wasilla students yesterday, claiming that suicide is a result of a lack of support from friends and family. He defended his comments and did not offer an apology or rescind any of his remarks. He did, however, add that the federal government is to blame for suicide.

“This suicide problem did not exist until we got largesse from the federal government,” said Young. Young continued, “It comes from the largesse that says you are not worth anything but says you’re gonna get something for nothing.”


Young then went on to say he was disappointed with Wasilla High School for being interrupted, “and I am very upset with the school system that would take the side of individuals that are being disrespectful to their fellow students.”

Young commented that the Wasilla students should not be indulged, “Now you know me. You’re going to hear me. And I’m not going to coddle anybody. We have a society today that coddles people. It’s an ‘oh we’re sorry.’ We don’t want to hurt your feelings. You screwed up. Alright thank you. That’s what I’m saying.”


Young’s comments continue to astound his opponent. “This has gone past the point of bizarre. In the last two days I have gone from shocked, to saddened, to angered. If Don Young honestly believes that the suicide crisis in Alaska is because of public assistance programs, and he also believes that Wasilla High administrators were ‘coddling’ students dealing with the death of a classmate, then he is completely out of touch,” stated Dunbar, Young’s opponent for U.S. Congress. “Yesterday I said I hoped Don regretted his statements to WHS, and would learn from them. After his remarks today it is clear Don Young will not change. The Don Young that lashed out at those students, and who is so painfully ignorant on the issue of suicide, is the Don Young we have representing us in Congress. Unless Alaskans make a change.”

PA State Supreme Court Justice McCaffery suspended in email porn scandal

Source: Pittsburgh Tribune Review

HARRISBURG – The Pennsylvania Supreme Court on Monday suspended Justice Seamus McCaffery with pay for sending and receiving 234 emails containing pornographic photographs or videos.

After apologizing last week for a “lapse in judgment,” McCaffery, 64, blamed Chief Justice Ronald Castille for the disclosure of emails from 2008 and 2009, saying it was “a vindictive pattern of attacks.” Castille, 70, had demanded the emails from the attorney general's office after the attorney general this month released sexually explicit emails circulated among former prosecutors.

Neither McCaffery nor Castille could be reached. The justices have had a long running feud. Castille, the former Philadelphia District Attorney and a Republican, faces mandatory retirement by Dec. 31.

McCaffery is “hereby relieved (of duty) on an interim” basis, the court's order said. The matter is under investigation by the Judicial Conduct Board, Chief Counsel Robert Graci told citizen activist Gene Stilp, who filed a complaint.

Read more: http://triblive.com/news/adminpage/6999531-74/mccaffery-emails-castille#ixzz3Gk0DzuJx
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Read more: http://triblive.com/news/adminpage/6999531-74/mccaffery-emails-castille



This Justice has already admitted to sending/receiving, on a state computer, during his work day, over 200 emails & videos, described by the court as "extremely disturbing". I disagree with Justice Todd's statement that suspension with full pay violates due process. The Fifth Amendment says to the federal government that no one shall be "deprived of life, liberty or property without due process of law." As long as McCaffery is not imprisoned and gets his salary & employment benefits, no due process question arises. In Mathews v. Eldridge, the U.S. Supreme Court said three factors had to be analyzed:

"First, the private interest that will be affected by the official action; second, the risk of an erroneous deprivation of such interest through the procedures used, and the probable value, if any, of additional or substitute procedural safeguards; and finally, the Government's interest, including the function involved and the fiscal and administrative burdens that the additional or substitute procedural requirement would entail."

As to the 3rd factor, the function involved, we're looking at a governmental interest in the court's ability to dispense full and fair justice, free of prejudices. McCaffery's self-admitted penchant for hard core porn, which demeans and degrades women, can be strongly argued to consciously or subconsciously affect his interpretation of the facts of a case, and his evaluation of parties, witnesses & testimony in a case. His sharing said porn, repeatedly, including in ex parte communications with attorneys who come before the state supreme court, casts an ugly shadow over the court's proceedings and provides grounds for appeal therefrom.

Hard core porn is to women as racism is to blacks. If the Justice had sent and received hundreds of racist emails and videos, that would provide grounds for appeal to any black parties who had come into his court. Employers have a legal right to suspend an employee pending investigation, and this is often seen in the field of law enforcement, i.e., suspension on full pay can be used when an employee needs to be removed from the workplace to avoid prejudicing an investigation This is used not as a punishment, but in the employer's best interest. For example, a police officer who shoots a person while on duty will be given a suspension with pay during the investigation, not to punish, but to enable the department to carry out its investigation, as well as to avoid inflaming the public if said officer is allowed to continue working in a community.

234 actions over a 2 year period? A review by the attorney general's office found McCaffery's emails contained more than 700 unique sexually explicit images and 60 unique video files, according to a statement last week by Castille.

Hardly a "lapse in judgement" as McCaffery weakly claims.

Your model & terminology are overly simplistic & out of date.

Here's the "better background" you requested.

http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola
How are infectious diseases transmitted via aerosols?

Medical and infection control professionals have relied for years on a paradigm for aerosol transmission of infectious diseases based on very outmoded research and an overly simplistic interpretation of the data. In the 1940s and 50s, William F. Wells and other "aerobiologists" employed now significantly out-of-date sampling methods (eg, settling plates) and very blunt analytic approaches (eg, cell culturing) to understand the movement of bacterial aerosols in healthcare and other settings. Their work, though groundbreaking at the time, provides a very incomplete picture.

Early aerobiologists were not able to measure small particles near an infectious person and thus assumed such particles existed only far from the source. They concluded that organisms capable of aerosol transmission (termed "airborne") can only do so at around 3 feet or more from the source. Because they thought that only larger particles would be present near the source, they believed people would be exposed only via large "droplets" on their face, eyes, or nose.

Modern research, using more sensitive instruments and analytic methods, has shown that aerosols emitted from the respiratory tract contain a wide distribution of particle sizes—including many that are small enough to be inhaled.5,6 Thus, both small and large particles will be present near an infectious person.

The chance of large droplets reaching the facial mucous membranes is quite small, as the nasal openings are small and shielded by their external and internal structure. Although close contact may permit large-droplet exposure, it also maximizes the possibility of aerosol inhalation.

As noted by early aerobiologists, liquid in a spray aerosol, such as that generated during coughing or sneezing, will quickly evaporate, which increases the concentration of small particles in the aerosol. Because evaporation occurs in milliseconds, many of these particles are likely to be found near the infectious person.

The current paradigm also assumes that only "small" particles (less than 5 micrometers ) can be inhaled and deposited in the respiratory tract. This is not true. Particles as large as 100 mcm (and perhaps even larger) can be inhaled into the mouth and nose. Larger particles are deposited in the nasal passages, pharynx, and upper regions of the lungs, while smaller particles are more likely to deposit in the lower, alveolar regions. And for many pathogens, infection is possible regardless of the particle size or deposition site.

It's time to abandon the old paradigm of three mutually exclusive transmission routes for a new one that considers the full range of particle sizes both near and far from a source. In addition, we need to factor in other important features of infectivity, such as the ability of a pathogen to remain viable in air at room temperature and humidity and the likelihood that systemic disease can result from deposition of infectious particles in the respiratory system or their transfer to the gastrointestinal tract.

]We recommend using "aerosol transmissible" rather than the outmoded terms "droplet" or "airborne" to describe pathogens that can transmit disease via infectious particles suspended in air.

Altogether, these epidemiologic and experimental data offer enough evidence to suggest that Ebola and other filoviruses may be opportunistic with respect to aerosol transmission.28 That is, other routes of entry may be more important and probable, but, given the right conditions, it is possible that transmission could also occur via aerosols.

Guidance from the CDC and WHO recommends the use of facemasks for healthcare workers providing routine care to patients with Ebola virus disease and respirators when aerosol-generating procedures are performed. (Interestingly, the 1998 WHO and CDC infection-control guidance for viral hemorrhagic fevers in Africa, still available on the CDC Web site, recommends the use of respirators.)

Facemasks, however, do not offer protection against inhalation of small infectious aerosols, because they lack adequate filters and do not fit tightly against the face.1 Therefore, a higher level of protection is necessary.

To summarize, for the following reasons we believe that Ebola could be an opportunistic aerosol-transmissible disease requiring adequate respiratory protection:

Patients and procedures generate aerosols, and Ebola virus remains viable in aerosols for up to 90 minutes.
All sizes of aerosol particles are easily inhaled both near to and far from the patient.
Crowding, limited air exchange, and close interactions with patients all contribute to the probability that healthcare workers will be exposed to high concentrations of very toxic infectious aerosols.
Ebola targets immune response cells found in all epithelial tissues, including in the respiratory and gastrointestinal system.
Experimental data support aerosols as a mode of disease transmission in non-human primates.

Risk level and working conditions suggest that a PAPR will be more protective, cost-effective, and comfortable than an N95 filtering facepiece respirator.

Acknowledgements

We thank Kathleen Harriman, PhD, MPH, RN, Chief, Vaccine Preventable Diseases Epidemiology Section, Immunization Branch, California Department of Public Health, and Nicole Vars McCullough, PhD, CIH, Manager, Global Technical Services, Personal Safety Division, 3M Company, for their input and review.

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