Ebola, news and discussion

[MsTinkerbelly]

There was an incident yesterday in Los Angeles, where a man with a mask got onto a Metro bus and told the bus driver he had Ebola. When leaving the bus, he told the entire bus he had Ebola and threw his mask on the floor of the bus.

The driver drove back to the yard, told his supervisors, and thus began the isoation of the bus and the driver. They are saying they have the tape from the bus, and if they find this man they will bring charges of making a terrorist threat. What a waste of resources.

Let the crazy begin....

[SleepyButch]

I just read that the Zuckerbergs are donating $25 million to the CDC foundation.


Also the WHO says that west Africa could see up to 10,000 new cases a week within two months. The confirmed that the death rate currently is 70% over there.

If that continues, in an 8 week time, approximately 56,000 people will die. That's a lot of lost lives.



NEW YORK (AP) -- Facebook CEO Mark Zuckerberg and his wife, Priscilla Chan, are donating $25 million to the CDC Foundation to help address the Ebola epidemic.

The money will be used by the U.S. Centers for Disease Control and Prevention's Ebola response effort in Guinea, Liberia and Sierra Leone and elsewhere in the world where Ebola is a threat, the foundation said Tuesday.

The grant follows a $9 million donation made by Microsoft co-founder Paul Allen last month. Zuckerberg and Chan are making the grant from their fund at the nonprofit Silicon Valley Community Foundation.

Also on Tuesday, the World Health Organization said West Africa could see up to 10,000 new Ebola cases a week within two months and confirmed that the death rate in the current outbreak is now 70 percent. The disease has killed more than 4,000 people, nearly all of them in West Africa. The WHO has called the outbreak "the most severe, acute health emergency seen in modern times."

"The most important step we can take is to stop Ebola at its source. The sooner the world comes together to help West Africa, the safer we all will be," said CDC Director Tom Frieden in a statement.

[cricket26]

[MsTinkerbelly]

Originally Posted by cricket26

They also have someone else that was close to Nina in isolation as they are showing symptoms. This was per CNN, just a few minutes ago.

[TruTexan]

Originally Posted by MsTinkerbelly

They also have someone else that was close to Nina in isolation as they are showing symptoms. This was per CNN, just a few minutes ago.

The person that was close to Nina Pham, the Dallas Nurse, is her boyfriend, it was on the news today in Dallas. They didn't mention anything about him having symptoms today that I recall. I'll check the Dallas news tonight and go from there.

I"m glad the CDC is there giving extensive training for all the caregivers for PPE protection usage and giving the hospital protocols to follow. That should have happened when Duncan showed up at the hospital and it was reported to the CDC. They dropped the ball from the get go in my .02 opinion.

[firegal]

Folks are all ready slowly starting to over react.... In the emergency medicine world... God help anyone if they cough and have a fever!

Went thru I it with 9-11 twin towers and terrorist stuff and abandoned bags and white powder etc.

It's ok to be carefully and cautious but paranoid makes life harder!

[cricket26]

https://www.facebook.com/photo.php?fbid=717755041627102

[TruTexan]

Originally Posted by MsTinkerbelly

They also have someone else that was close to Nina in isolation as they are showing symptoms. This was per CNN, just a few minutes ago.

MsTinkerbelly, the Dallas news stations have NOT reported that Nina Pham's boyfriend, who is the contact person in isolation for 21 days, as showing any symptoms, they have said he is being monitored only.

And the Dallas news stations have NOT reported anything about the claims that CNN has made about the Nursing Union statements made on behalf of anonymous nurses either.

Not sure why it's different reporting, makes me wonder though if someone somewhere isn't making HYPE to scare people.

[EnchantedNightDweller]

CNN is reporting that a second health worker has it. CDC admitting more should have been done.

[*Anya*]

2nd health care worker tests positive for Ebola at Dallas hospital
By Holly Yan, CNN
updated 6:52 AM EDT, Wed October 15, 2014


STORY HIGHLIGHTS
>>Official: Duncan should have been transferred out of Texas immediately
>>Health department has interviewed the patient to find contacts
>>The second health care worker with Ebola reported a fever Tuesday
**Like nurse Tina Pham, the second worker cared for Thomas Eric Duncan**

(CNN) -- A second health care worker at Texas Health Presbyterian Hospital who cared for Thomas Eric Duncan has tested positive for Ebola, health officials said Wednesday -- casting further doubt on the hospital's ability to handle Ebola and protect employees. The worker reported a fever Tuesday and was immediately isolated, health department spokeswoman Carrie Williams said.

The preliminary Ebola test was done late Tuesday at the state public health laboratory in Austin, and the results came back around midnight. A second test will be conducted by the Centers for Disease Control and Prevention in Atlanta.

"Health officials have interviewed the latest patient to quickly identify any contacts or potential exposures, and those people will be monitored," the health department said. But the pool of contacts could be small, since Ebola can only be transmitted when an infected person shows symptoms. Less than a day passed between the onset of the worker's symptoms and isolation at the hospital.

An official close to the situation says that in hindsight, Duncan should have been transferred immediately to either Emory University Hospital in Atlanta or Nebraska Medical Center in Omaha. Those hospitals are among only four in the country that have biocontainment units and have been preparing for years to treat a highly infectious disease like Ebola.

"If we knew then what we know now about this hospital's ability to safely care for these patients, then we would have transferred him to Emory or Nebraska," the official told CNN Senior Medical Correspondent Elizabeth Cohen.

"I think there are hospitals that are more than ready, but I think there are some that are not."

The latest infection marks the second-ever transmission of Ebola in the United States. Both stemmed from Texas Health Presbyterian Hospital. Late last week, nurse Tina Pham tested positive for Ebola. She also took care of Duncan, the first person to be diagnosed with Ebola in the United States. Duncan died last week. On Tuesday, Pham said she was doing well. "I am blessed by the support of family and friends, and am blessed to be cared for by the best team of doctors and nurses in the world," she said.

Troubling allegations

Also Tuesday, National Nurses United made troubling allegations about the hospital, claiming "guidelines were constantly changing" and "there were no protocols" about how to deal with the deadly virus." "The protocols that should have been in place in Dallas were not in place, and that those protocols are not in place anywhere in the United States as far as we can tell," NNU Executive Director RoseAnn DeMoro said. "We're deeply alarmed."

Nurses were told to wrap their necks with medical tape when equipment left their necks exposed; they felt unsupported and unprepared, and they received no hands-on training, union co-president Deborah Burger said. A Texas Health Presbyterian spokesman did not respond to the specific allegations, but said patient and employee safety is the hospital's top priority.

Global epidemic
While the Texas hospital deals with its third Ebola patient, the situation in West Africa is getting increasingly dire.

More than 4,000 people have died from Ebola this year in Sierra Leone, Liberia and Guinea.
And it could be up to 10,000 new Ebola cases per week in Guinea, Liberia and Sierra Leone by the end of this year as the outbreak spreads, the World Health Organization warned Tuesday.

U.S. President Barack Obama says he'll reach out directly to heads of state to encourage other countries to do more to fight back.

"There are a number of countries that have capacity that have not yet stepped up," he said. "Those that have stepped up, all of us, are going to have to do more."

CNN's Catherine E. Shoichet and Tina Burnside contributed to this report.

http://www.cnn.com/2014/10/15/health...bola-outbreak/

[SleepyButch]

Originally Posted by MsTinkerbelly

They also have someone else that was close to Nina in isolation as they are showing symptoms. This was per CNN, just a few minutes ago.

I wonder if this was referring to the second nurse who now is positive for the virus. I'm sure these two won't be the only ones who test positive before all is said and done.

Anyone know how soon you will test positive after exposure? Or do you have to start exhibiting symptoms first??

[*Anya*]

Originally Posted by SleepyButch

I wonder if this was referring to the second nurse who now is positive for the virus. I'm sure these two won't be the only ones who test positive before all is said and done.

Anyone know how soon you will test positive after exposure? Or do you have to start exhibiting symptoms first??

I think this is good information and hope it answers some questions:

Tests for Ebola

A number of tests can be used to diagnose Ebola within a few days of the onset of symptoms, which can detect the virus's genetic material or the presence of antibodies against the pathogen.

The most accurate of these is likely the polymerase chain reaction (PCR) test, a technique that looks for genetic material from the virus and creates enough copies of it that it can be detected, Hirsch said. "PCR is a really definitive test," Hirsch said. It can pick up very small amounts of the virus.

>>>>>However, this test can be negative during the first three days an infected person has symptoms, said Dr. Sandro Cinti, an infectious-disease specialist at the University of Michigan Hospital System/Ann Arbor VA Health System.

"Somebody could be in the hospital for three to five days before a diagnosis [of Ebola] is confirmed," Cinti told Live Science. "The important thing is keeping the patient isolated until you can get to a diagnosis." Meanwhile, doctors will be running tests to rule out other diseases, such as malaria, which can be detected more quickly than Ebola, he said.

>>>>Another test for Ebola looks for antibodies produced by the body's immune system in response to the virus. Known as the antigen-capture enzyme-linked immunosorbent assay (ELISA), this test can take even longer than three days to give a positive result for an infected person, Cinti said. And antibodies can also be detected after a patient recovers, he added.

Once a patient is diagnosed with Ebola, scientists may attempt to isolate the virus -- which is a type of filovirus, known for their filamentlike shape -- by culturing it with living cells and examine it using electron microscopy. But culturing Ebola is very dangerous, and should only be done in a high-biosafety-level lab, Hirsch said. Culturing the virus is not a practical means of diagnosing infection, but may help researchers understand how the virus infects cells and test possible treatments.

So, given the severity of an Ebola infection, why wouldn't you test everybody with the remotest chance of having the disease?

A huge number of people come to the United States from Africa with fevers, Cinti said, and testing all of them for Ebola would drain hospital resources and raise unnecessary panic. "We really have to be clear and get good histories about exposure," he said. "It makes absolutely zero sense to test people who aren't from high-risk areas."

http://www.cbsnews.com/news/how-doctors-test-for-ebola/

[MsTinkerbelly]

Originally Posted by TruTexan

MsTinkerbelly, the Dallas news stations have NOT reported that Nina Pham's boyfriend, who is the contact person in isolation for 21 days, as showing any symptoms, they have said he is being monitored only.

And the Dallas news stations have NOT reported anything about the claims that CNN has made about the Nursing Union statements made on behalf of anonymous nurses either.

Not sure why it's different reporting, makes me wonder though if someone somewhere isn't making HYPE to scare people.

I never said boyfriend. Close to her, worked closely with her, whatever.

Like i said there is someone at the hospital also being monitored.

As far as the nurses union goes, i have no clue.

[MsTinkerbelly]

Originally Posted by firegal

Folks are all ready slowly starting to over react.... In the emergency medicine world... God help anyone if they cough and have a fever!

Went thru I it with 9-11 twin towers and terrorist stuff and abandoned bags and white powder etc.

It's ok to be carefully and cautious but paranoid makes life harder!

After basically NO REACTION from the United States and the rest of the world during this crisis, I'll take a bit of over-reaction and paranoia. This disease has been around for decades and we did nothing.

No this was not a "United States" problem, but we could have helped stop this before it became our problem. Was this left alone because it was primarily killing poor black people? We involve ourselves in other people's wars and issues all of the time, was it because there was nothing in it for us to gain by helping?

This is going to get a lot worse before it gets better...paranoia? We will see!

[firegal]

Originally Posted by MsTinkerbelly

After basically NO REACTION from the United States and the rest of the world during this crisis, I'll take a bit of over-reaction and paranoia. This disease has been around for decades and we did nothing.

No this was not a "United States" problem, but we could have helped stop this before it became our problem. Was this left alone because it was primarily killing poor black people? We involve ourselves in other people's wars and issues all of the time, was it because there was nothing in it for us to gain by helping?

This is going to get a lot worse before it gets better...paranoia? We will see!

I'm talking about the public....not government or administration and paranoia doesn't address the problem. A appropriate reaction from all does.When the public is informed it helps any system not get slowed down as they address the problem.

When I say paranoia I mean like the over reaction that some folks did after sept 11 .....calling reporting suspicious folks just because they were were from the Middle East and/or wore a turbin.In the early 80,s there was over reaction from some folks about aids too,not helping injured folks, as folks were educated and informed about what to do and not to do that paranoia was stopped.

I do whole heatedly agree that ALL agency's need to get on this and soon as they should on all matters affecting the health and safety of ALL communities......and country's.

[femmsational]

Originally Posted by Sweet Bliss

Would you mind explaining to us how to safely remove protective gear? Do you dispose of it? How? Can you wash it?

Handling things others have touched makes my skin crawl. (During these super cootie days) think about it.... fast food ... groceries ... magazines in offices...ewwww.

This is enough to make you get your zombie apocalypse gear ready.

Sorry I missed this.

It's a detailed process that I don't feel comfortable trying to explain on a website. I'll try to tell you the best I can but don't quote me on it or rely on it. The bottom line is you have to remember that the pathogen is alive. So you have to kill it.

When I was dealing with the horses, I had a quarantine area, a room to put on the equipment and a separate room to remove it. We worked in twos at the minimum. I had buckets of bleach that we stepped in when coming out of the quarantine area and buckets to dunk our gloves into. I also had a stack of those thick gauze bandages soaking in a vat of bleach.

So what we did was coming out of the quarantine area we put our bagged feet into the buckets on the floor. We took the bags off our feet as we stepped out. then dunked our gloved hands in the hand bleach buckets. Then we had our buddy hand us a bleach soaked gauze to remove one glove and it was removed by placing the bleached gauze around the top lip of the glove and pulling it inside out. Then it was placed it in a lined bucket. Repeat. Buddy hand another bleached gauze to remove the second glove. Removed it so it was inside out. After all that I had people sprayed down with a 50/50 mix of bleach and water.

To dispose I got an approved container and burned it FAR away from the horses.


There are going to be significant differences in how this needs to be handled such as masks, suits and the importance of not having exposure to skin especially if there are cuts or scrapes. I'm almost positive that what happened with the nurse is that she removed gloves and without thinking reached up to remove her mask and somehow infected herself. Sad.

For the most part the problem won't be with the putting on of the stuff. People who are scared are going to suit up. It's remembering to stay alert while taking it off.


There doesn't need to be panic but there sure as hell needs to be honesty and education.

And if we think we can control this by trusting other people to be honest with us we're crazy.


LOL, I must sound like a crazy person. Sorry.

[Kelt]

I am having a bit of a problem understanding some of the reactions in the US to problems controlling an infectious disease, particularly in hospitals. Obviously, in countries in the midst of the breakout, things are well past dire so I confine this thought to the United States.

When I watched the video interview attached to the story out of Kansas I was glad that the Dr pointed out that 22 thousand people in the US died of the flu last year and yet folks are blasé about even getting inoculated against it. He also put up the thought that if 22 thousand people died of Ebola there would be rioting in the streets. I agree.

When it comes to protocols in hospitals for dealing with this; what is the surprise? Nosocomial diseases are rampant. These are hospital acquired infections (HAI), illness either bacterial or viral you come out with that you didn't have when you went in. They infect 700,000+ per year and kill over 75,000. Eblola is an infectious disease but thankfully much more difficult to transmit than flu, C.diff and others.

Only a couple of hospitals in the US are designed for containment. Just as many hospitals do not have trauma centers, or specialize burn units, etc. Why do we all of a sudden start thinking all hospitals should be equipped for something that has never happened here before? It is clearly demonstrated most cannot handle regular prevention of common bacterial spread.

I am not trying to minimize the danger to healthcare workers and do believe that a ramp up of training and equipment beyond what was previously provided is prudent and urgent at this time, things will likely get worse before they get better. But all of these 'representatives' screaming about how far behind or unprepared we are must have only just now taken off their blinders and are looking for targets to blame.

[MsTinkerbelly]

Originally Posted by Kelt

I am having a bit of a problem understanding some of the reactions in the US to problems controlling an infectious disease, particularly in hospitals. Obviously, in countries in the midst of the breakout, things are well past dire so I confine this thought to the United States.

When I watched the video interview attached to the story out of Kansas I was glad that the Dr pointed out that 22 thousand people in the US died of the flu last year and yet folks are blasé about even getting inoculated against it. He also put up the thought that if 22 thousand people died of Ebola there would be rioting in the streets. I agree.

When it comes to protocols in hospitals for dealing with this; what is the surprise? Nosocomial diseases are rampant. These are hospital acquired infections (HAI), illness either bacterial or viral you come out with that you didn't have

when you went in. They infect 700,000+ per year and kill over 75,000. Eblola is an infectious disease and much more difficult to transmit than flu, C.diff and others.

Only a couple of hospitals in the US are designed for containment. Just as many hospitals do not have trauma centers, or specialize burn units, etc. Why do we all of a sudden start thinking all hospitals should be equipped for

something that has never happened here before? It is clearly demonstrated most cannot handle regular prevention of common bacterial spread.

I am not trying to minimize the danger to healthcare workers and do believe that a ramp up of training and equipment beyond what was previously provided is prudent and urgent at this time, things will likely get worse before they get better. But all of these 'representatives' screaming about how far

behind or unprepared we are must have only just now taken off their blinders and are looking for targets to blame.

Well said Kelt, well said.

[SleepyButch]

Originally Posted by Kelt

I am having a bit of a problem understanding some of the reactions in the US to problems controlling an infectious disease, particularly in hospitals. Obviously, in countries in the midst of the breakout, things are well past dire so I confine this thought to the United States.

When I watched the video interview attached to the story out of Kansas I was glad that the Dr pointed out that 22 thousand people in the US died of the flu last year and yet folks are blasé about even getting inoculated against it. He also put up the thought that if 22 thousand people died of Ebola there would be rioting in the streets. I agree.

When it comes to protocols in hospitals for dealing with this; what is the surprise? Nosocomial diseases are rampant. These are hospital acquired infections (HAI), illness either bacterial or viral you come out with that you didn't have when you went in. They infect 700,000+ per year and kill over 75,000. Eblola is an infectious disease and much more difficult to transmit than flu, C.diff and others.

Only a couple of hospitals in the US are designed forN containment. Just as many hospitals do not have trauma centers, or specialize burn units, etc. Why do we all of a sudden start thinking all hospitals should be equipped for something that has never happened here before? It is clearly demonstrated most cannot handle regular prevention of common bacterial spread.

I am not trying to minimize the danger to healthcare workers and do believe that a ramp up of training and equipment beyond what was previously provided is prudent and urgent at this time, things will likely get worse before they get better. But all of these 'representatives' screaming about how far behind or unprepared we are must have only just now taken off their blinders and are looking for targets to blame.

Nosocomial diseases are usually those infections/viruses contracted by patients in the hospital who are already immunocompromised. This does not related to hospital staff, which I think is what the big deal is over. The surprise is as nursing/healthcare staff, we should know how to prevent ourselves from being infected with anything, whether that be ebola, HIV, tuberculosis, etc. Unfortunately, as I mentioned in a previous post, we are all human and as humans we make errors. Now you have nurses who have been infected, taking care of patients in a hospital. To me that is a huge deal. I'm not so much worried about the person that they encounter in the grocery store.

While every hospital doesn't have to be prepared for this type of thing, what happens when a person comes into any ole hospital with symptoms that may not scream ebola or do for that matter. What's that hospital to do? They all need to be prepared for any type of infectious disease scare in my opinion, which to me means protective garb and a negative pressure room. Also they should have yearly training as part of continuing education, which we all need to have anyway. Unfortunately though, hospitals are busy and short staffed so this kind of training doesn't occur.


I agree that we shouldn't be pointing fingers. We just need to get everyone on the same page and try to contain it as much as possible and save as many people as they can.

[Kelt]

Originally Posted by SleepyButch

Nosocomial diseases are usually those infections/viruses contracted by patients in the hospital who are already immunocompromised. This does not related to hospital staff, which I think is what the big deal is over. The surprise is as nursing/healthcare staff, we should know how to prevent ourselves from being infected with anything, whether that be ebola, HIV, tuberculosis, etc. Unfortunately, as I mentioned in a previous post, we are all human and as humans we make errors. Now you have nurses who have been infected, taking care of patients in a hospital. To me that is a huge deal. I'm not so much worried about the person that they encounter in the grocery store.

While every hospital doesn't have to be prepared for this type of thing, what happens when a person comes into any ole hospital with symptoms that may not scream ebola or do for that matter. What's that hospital to do? They all need to be prepared for any type of infectious disease scare in my opinion, which to me means protective garb and a negative pressure room. Also they should have yearly training as part of continuing education, which we all need to have anyway. Unfortunately though, hospitals are busy and short staffed so this kind of training doesn't occur.


I agree that we shouldn't be pointing fingers. We just need to get everyone on the same page and try to contain it as much as possible and save as many people as they can.

I couldn't agree more and should clarify that I was not talking about healthcare staff individuals. My thoughts are more about admin policies that allow for training and basic equipment to be inadequate for regular encounters with the sick public. The reactions are as though it was somehow new.

Anytime you put a lot of sick people in a small space things are going to spread. This time of year especially lots of folks will present with fever and who knows where they came from? I don't have the answers but also wish everyone could stop looking for targets and and coordinate getting sensible precautions in place. A possible positive outcome would be that facilities will have the needed supplies and training going forward beyond whatever this outbreak brings.

A surprise to me or maybe I'm misunderstanding... I though all hospitals in the US would have at minimum PPE and a negative pressure room. Is that not true?

Note; my background is not medical at all. I come from the biohazard/HAZWOPER side of "keeping tiny bugs out".