Ebola: "Out of Control in West Africa" - Page 13

PSM · 10-09-2014, 10:29

How did Yugoslavia handle the 1972 Smallpox outbreak? How long did it last? Was it draconian? Clearly, it was successful.

Pat

Sdiver · 10-09-2014, 13:15

This aired last night (Wed 8Oct) on PBS.

http://www.pbs.org/wgbh/nova/body/surviving-ebola.html

Fairly up to date information.

It's 53 minutes long, but well worth the time to watch.

T-Rock · 10-12-2014, 07:01

We had our scare just the other day:
http://www.wsoctv.com/news/news/loca...bola-pr/nhf57/

But it makes one curious, if all the protocols are being followed, how could a healthcare worker in this country contract the virus?

> http://www.theblaze.com/stories/2014...cts-the-virus/

An interesting story from one of the hospitalists we work with. Something is different from this particular strain, via Dr. Plyler:
http://www.glennbeck.com/2014/10/07/...survive-ebola/
^Edited to add, fast forward to 6:20 in the 1st GB TV Video with Dr. Plyler.

Paslode · 10-13-2014, 20:04

A possible Ebola suspect in flyover country doesn't make major headlines

Quote:

KANSAS CITY, Kan. — A man in his 40’s who complained of a high fever and other serious symptoms contacted and then entered The University of Kansas Hospital at about 6 a.m. on Monday. The hospital says that the patient recently worked as a medical officer on a commercial ship off the west coast of Africa and has a low-to-moderate risk of Ebola.

http://fox4kc.com/2014/10/13/univers...isk-for-ebola/

We were told it was all under control, we were told it couldn't happen, we only have had two known cases of Ebola and now the CDC bureaucracy wants cash in by creating Ebola hospitals in all 50 states.......this smells like all those body scanners we had to have for the airports in the name of Public Safety.

Quote:

Dedicated Ebola Hospitals Sought After Nurse’s Infection

U.S. and local health officials want to set up dedicated hospitals in each state for Ebola patients, part of a new emphasis on safety for health-care workers after a nurse caring for an infected patient in Dallas tested positive for the virus.

The U.S. Centers for Disease Control and Prevention is also reconsidering its existing infection control protocols and will boost health-worker training with a series of calls and online seminars

, officials said today.

“We’d like to have at least one hospital in every state that does feel they could manage a patient from start to finish,” said Abbigail Tumpey, the CDC official in charge of the education outreach. So far, the new system is only in the discussion stage, and one issue is that there are currently only four U.S. hospitals with top-level bio-containment units.

http://www.bloomberg.com/news/2014-1...infection.html

**The Reaper** · 10-13-2014, 20:38

Wouldn't it be much easier to just keep people from Ebola infested areas out of the US until it burns itself out?

Oops, sorry, what was I thinking....

TR

mugwump · 10-13-2014, 21:08

Quote:

Originally Posted by The Reaper

Wouldn't it be much easier to just keep people from Ebola infested areas out of the US until it burns itself out?

Oops, sorry, what was I thinking....

TR

Very un-Kumbayah of you to even propose that.

Question: How do you remove isolation garments contaminated with Ebola-laden sputum, feces, urine, and/or blood without exposing yourself? How do you decontaminate the room in which you remove the garb? Dispose of said garments? If anyone knows, please circulate the protocol to all US hospitals, because no one seems to know bugger-all about it.

**The Reaper** · 10-13-2014, 21:18

Quote:

Originally Posted by mugwump

Very un-Kumbayah of you to even propose that.

Question: How do you remove isolation garments contaminated with Ebola-laden sputum, feces, urine, and/or blood without exposing yourself? How do you decontaminate the room in which you remove the garb? Dispose of said garments? If anyone knows, please circulate the protocol to all US hospitals, because no one seems to know bugger-all about it.

You have to suit up like you are dealing with a lethal agent and strictly follow procedures. Layer by layer.

All contaminated material gets triple bagged and incinerated.

Chlorine is a great disinfectant if flame is not acceptable.

Remember the DS2 sprayers and boxes full of STB to stomp through?

TR

Richard · 10-13-2014, 22:01

Dealing with something like Ebola is like following the -10 on a SADM, there are NO deviations. Period. Or else.

Richard

mugwump · 10-13-2014, 22:30

My daughter works at a major university medical center (one with biological safety level 3 -- BSL3 -- accreditation, about $17M and 36 months away from attaining BSL4). Hospital staff have gotten only the most rudimentary direction on how to handle an Ebola patient.

Ebola is a Classified as a BSL4 pathogen. There are only 14 BSL4 facilities in the US (most gov't labs) and only a subset are allowed to study Ebola. This is how you're supposed to handle contact with an Ebola patient:

When dealing with biological hazards at this level the use of a positive pressure personnel suit, with a segregated air supply is mandatory. The entrance and exit of a level four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors from opening at the same time. All air and water service going to and coming from a biosafety level 4 (or P4) lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release.

Note that none of these safeguards were in effect with the Dallas patient. And they're saying the nurse who contracted Ebola in Dallas "breached established protocols", as if she's to blame. Taping your pants cuffs with duct tape might work for deer ticks, but not a BSL4-level virus.

That patient was intubated, routinely suctioned, was on dialysis, had diarrhea, and they even attempted resuscitation at the end (WTF? Multiple catastrophic organ failure? BSL4 virus?). There must have been virus slung all over that ward. Good thing this isn't something that's easy to catch. That said, I'll be shocked if more cases don't spawn from that admission.

PedOncoDoc · 10-14-2014, 01:35

Quote:

Originally Posted by mugwump

My daughter works at a major university medical center (one with biological safety level 3 -- BSL3 -- accreditation, about $17M and 36 months away from attaining BSL4). Hospital staff have gotten only the most rudimentary direction on how to handle an Ebola patient.

Ebola is a Classified as a BSL4 pathogen. There are only 14 BSL4 facilities in the US (most gov't labs) and only a subset are allowed to study Ebola. This is how you're supposed to handle contact with an Ebola patient:

When dealing with biological hazards at this level the use of a positive pressure personnel suit, with a segregated air supply is mandatory. The entrance and exit of a level four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors from opening at the same time. All air and water service going to and coming from a biosafety level 4 (or P4) lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release.

Note that none of these safeguards were in effect with the Dallas patient. And they're saying the nurse who contracted Ebola in Dallas "breached established protocols", as if she's to blame. Taping your pants cuffs with duct tape might work for deer ticks, but not a BSL4-level virus.

That patient was intubated, routinely suctioned, was on dialysis, had diarrhea, and they even attempted resuscitation at the end (WTF? Multiple catastrophic organ failure? BSL4 virus?). There must have been virus slung all over that ward. Good thing this isn't something that's easy to catch. That said, I'll be shocked if more cases don't spawn from that admission.

Those are protocols for research on the ebola virus(es) - not for clinical management of patients with ebola.

LarryW · 10-14-2014, 01:45

IMO, this is an example of how not to react. The panic is becoming the backstory of this macabre dance. Anyone who declares they have a sniffle and that they’ve come from a tour of Liberia becomes the central point of corporate and public attention. What the hell: Who would want to risk having a cavalier attitude about this crap? It won’t be long before the attention deprived/depraved (both corporate and social) will start coming out of the woodwork to nurse at the nipple of the media.

In the meantime the response to the spread of this thing has all the earmarks of being orchestrated by the Marx Brothers. There needs to be a disciplined response to this smoky crisis, and no one in the theater knows the way out. The question will be: What do we do if Ebola comes to a theater near you?

Quote:

Richmond patient being evaluated for Ebola
By TAMMIE SMITH, MICHAEL MARTZ AND BILL MCKELWAY Richmond Times-Dispatch

http://www.timesdispatch.com/news/lo...7a43b2370.html

A woman who dropped by a South Richmond clinic with a low-grade fever Monday found herself being evaluated as the city’s first potential Ebola patient and was transferred to VCU Medical Center last night after being isolated most of the day at the clinic where she had sought treatment.

The unidentified patient was transferred from the CrossOver Healthcare Ministry clinic on Cowardin Avenue in a private car accompanied by the CrossOver physician who had assessed her.

“We’re trying to follow what is a logical process,” said Richmond Health Director Donald Stern, who worked with state and local caregivers to monitor the patient and assess her condition throughout the day.

The woman had a low-grade fever and had recently traveled to Liberia, one of the West African nations hard hit by the deadly virus.

Stern stressed that the patient did not fully meet entry-level criteria for establishing the presence of Ebola, but nevertheless would undergo further testing at the hospital as a precaution.

“Since the additional testing recommended cannot be performed at CrossOver, the patient was transferred to a local hospital for further clinical and laboratory evaluation,” Stern said in a statement Monday night.

“Depending the on the results of the emergency department evaluation (Monday night), the CDC will advise regarding any further testing,” Stern said.

He praised the CrossOver clinic’s “high degree of professional expertise,” noting that the patient had not come to CrossOver out of fear of Ebola but that clinicians there placed the patient in isolation after determining that she had traveled to Liberia and showed a low-grade fever.

Patients with Ebola tend to show far more serious symptoms, such as vomiting and high fevers.

“We immediately put the person in isolation and immediately called the health department,” said Julie Bilodeau of CrossOver, a faith-based free clinic whose patient population includes many immigrants.

A sign posted on the clinic’s front door Monday afternoon read: “Clinic closed for emergency.”

Stern said the case is the first instance in Richmond where local, state and national health experts have taken steps to confirm whether a patient in fact has contracted the Ebola virus.

It was not immediately clear what precautions that clinic workers took in handling the patient.

Stern declined to reveal more specific information for patient confidentiality reasons.

Bilodeau said that the names and contact information for others who may have been in close contact with the patient were obtained. The patient left the clinic about 8:30 p.m. after being kept in isolation since the early afternoon.

Virginia Health Commissioner Marissa J. Levine confirmed that the state had activated its process for assessing a patient for potential symptoms of Ebola, but she cautioned against drawing any conclusions about the outcome.

The process involves the health provider and health officials at the state and local levels, as well as the federal Centers for Disease Control and the state Department of Consolidated Laboratories. The Virginia Department of Health and the CDC must approve of testing for Ebola if a person meets the criteria.

“The process of assessing the situation has been activated,” the commissioner said.

Levine said the criteria are “whether a person is considered a high-risk exposure and also has symptoms that are consistent with the disease,” but she would not comment on the details of the case at CrossOver. Two people have been tested previously for the disease in Virginia; in both cases, the results were negative.

“There are a lot of concerns out there, but not all of them are Ebola,” the commissioner said.

Levine has discussed the situation with Secretary of Health and Human Resources Bill Hazel. “The health department will keep the community informed and will ensure if there is any risk the appropriate public health actions are taken,” she said.

The commissioner would not confirm whether the state had communicated with any hospital about potentially treating the patient. “We’ve had many conversations with local hospital systems, and that is ongoing, especially as the situation evolves around the country,” she said.

Hazel, a retired orthopedic surgeon, said the public should not rush to judgment each time health officials assess someone who potentially has been exposed to the disease.

“The big thing here is we’ve got to try to stick to facts as best we can,” he said, “because rumors can be dangerous, too.”

LarryW · 10-14-2014, 01:52

Quote:

Southcom Commander Warns of Potential Ebola-Driven 'Mass Migration' from South of Border

http://cnsnews.com/news/article/penn...n-south-border

(CNSNews.com) – Marine Corps Gen. John Kelly, commander of the U.S. Southern Command, predicted last week that the Ebola virus will not be contained in West Africa, and if infected people flee those countries and spread the disease to Central and South America, it could cause “mass migration into the United States” of those seeking treatment.

“If it breaks out, it’s literally, ‘Katie bar the door,’ and there will be mass migration into the United States,” Kelly said in remarks to the National Defense University on Tuesday. “They will run away from Ebola, or if they suspect they are infected, they will try to get to the United States for treatment.

“The potential spread of Ebola into Central and Southern America is a real possibility,” the article written about the general’s speech and posted on the Department of Defense website on Wednesday stated.

In his speech, Kelly cited the Centers for Disease Control and Prevention’s prediction that 1.4 million people could be infected with Ebola by the end of the year, with 62 percent of those infected dying from the disease.

“That’s horrific,” Kelly said. “And there’s no way we can keep Ebola [contained] in West Africa.”

Kelly said the scenario of another widespread breakout is particularly possible if the disease reached countries like Guatemala, Honduras or El Salvador.

“It will cause panic, and people will flee the region,” Kelly said.

Kelly also spoke about the danger of transnational criminal networks smuggling people into the U.S. that could be infected with Ebola.

He spoke about his recent visit to the border of Costa Rica and Nicaragua with U.S. Embassy personnel where they saw men lined up waiting to enter Nicaragua.

“The embassy person walked over and asked who they were and they told him they were from Liberia and they had been on the road about a week,” Kelly continued. “They met up with the network in Trinidad, and now they were on their way to the United States -- illegally, of course.”

Kelly said the men could make it all the way to New York City within the incubation period for Ebola of 21 days.

The D.O.D. article stated that Kelly was in “close contact” with his counterpart in the U.S. Africa Command.

Go Devil · 10-14-2014, 04:48

More warm and fuzzy about our gift from the heart of darkness.

http://www.cidrap.umn.edu/news-persp...otection-ebola

mugwump · 10-14-2014, 08:21

Quote:

Originally Posted by PedOncoDoc

Those are protocols for research on the ebola virus(es) - not for clinical management of patients with ebola.

Those are the protocols for not catching Ebola in a lab where the virus is tightly controlled. The infection/fatality rate in health care workers who are following the clinical protocols would indicate that they're somewhat lacking.

PedOncoDoc · 10-14-2014, 09:34

Quote:

Originally Posted by mugwump

Those are the protocols for not catching Ebola in a lab where the virus is tightly controlled. The infection/fatality rate in health care workers who are following the clinical protocols would indicate that they're somewhat lacking.

Your expectation of protocol adherence and my daily observations are unlikely to be concordant.

Are you proposing we relocate any patient that may have ebola (which starts with very nonspecific symptoms) to a BSL4 facility? What means of transport and precautions used during transport? Feasibility and cost are entirely preventative.