Ebola outbreak - general thread #4

[Gardenlady]

BBM I thought that was pretty much every state in the USA

Lol yes, probably hard in any state, but the article mentioned how it's particularly hard to prove in Texas given how the laws are written.


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[Isabelle]

Then I'll just reiterate that fever + the travel history he disclosed should have been enough of an alarm.



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I think that ER classed him as a GOMER! (get out of my ER)

 

[Isabelle]

They said they were R/O appendecitis, stroke etc... Oh, and it looks like he was afebrile when he left:

...an emergency room physician’s note dated Sept. 26 that said Mr. Duncan was “negative for fever and chills.” The note read: “I have given patient instructions regarding their diagnosis, expectations for the next couple of days, and specific return precautions. The condition of the patient at this time is stable.”

Problem: Why was he prescribed an antibiotic? What was diagnosis?

 

[okiedokietoo]

My Opinion -
I don't think anyone is trying to "cover" themselves. He was the first case of Ebola in the US.
There also has been conflicting reports about what was and wasn't said and done by medical staff and the patient.
In the neighborhood that he came from in Liberia, 72nd SKD Boulevard in Monrovia, the capital of Liberia, many people have Ebola or have died from Ebola.
I pray for his family for their loss and pray that they remain healthy. IMO His family is grieving right now and they are in a horrible situation where they are waiting to see if they get Ebola And there are people that are preying on them and pushing their own agenda.
And if they just wanted him out of the ER it is not a racial issue - unless it is an issue of ER, an entity, against everyone else, white and black. I was sent home from ER with diagnosis of stomach flu, returned days later for emergency appendectomy on verge of bursting and told by surgeon that was what I had when I was there the first time and had been misdiagnosed.

 

[chipmunk]

A business man set aside his company to develop and manage a plan to wipe out ebola in his former community in Sierra Leone. He included all parties into the plan including tribal chiefs and witch doctors. They beat ebola. Now there is a model others will no doubt follow:
http://www.washingtonpost.com/news/...the-last-ebola-free-district-in-sierra-leone/

 

[Yoda]

Questions- How often are people misdiagnosed with a milder illness at first and it turns out to be very serious illness? How often does a doctor/hospital not catch cancer or another deadly disease early enough? When this happens do patients/their families regularly sue? I am not in the medical world so I don't know if this is a common occurrence or not.
(This happened to a friend on mine's brother within the last six months. The family did not sue or even consider suing.) Tia

 

[Yoda]

Okay. Why is it so hard for people to STAY IN QUARANTINE??? Have we become such a self centered world? SMH

New Jersey officials issued a mandatory quarantine order Friday night for members of an NBC crew that was exposed to a cameraman with Ebola after they said a voluntary 21-day isolation agreement was violated.

The state Health Department told The Associated Press the crew remains symptom-free and that there is no reason for concern of exposure to the deadly virus to the community. Citing privacy concerns, department spokeswoman Donna Leusner would not give further details, including who violated the agreement and how the state learned of a violation.

http://www.deseretnews.com/article/...for-NBC-crew.html?ref=https://www.google.com/

 

[jjenny]

Questions- How often are people misdiagnosed with a milder illness at first and it turns out to be very serious illness? How often does a doctor/hospital not catch cancer or another deadly disease early enough? When this happens do patients/their families regularly sue? I am not in the medical world so I don't know if this is a common occurrence or not.
(This happened to a friend on mine's brother within the last six months. The family did not sue or even consider suing.) Tia

I don't know how often, but nurse in Spain was not diagnosed for a whole week.
We have to remember that the doctors never saw the case of Ebola before.
For whatever reason, it apparently didn't register with them that Mr. Duncan came from Liberia.
It doesn't appear they even suspected he had Ebola. In the beginning Ebola mimics a lot of other diseases.
For instance, the sheriff's deputy had similar symptoms to Duncan's.
He had a fever and stomach issues. But turned out he did not have Ebola.

"He had visited a clinic in Frisco because of stomach pains. But when his temperature read 101.7 degrees, Monnig said, his Ebola fears began to feel real."

http://www.wfaa.com/story/news/heal...ptoms-apartment-frisco-dallas-texas/17043997/

 

[chipmunk]

Is Nancy even eligible to donate? She had malaria in the past.

I'm not a clinician of any type. But my guess is a special approval would be given due to being given to a severely ill ebola patient. Also that to my knowledge malaria is treatable.

 

[chipmunk]

Not true, if you have a temp that high, they should be giving you IV antibiotics.

It partly depends on the person's history, medical condition and whether or not a virus is suspected. Each patient is different.

 

[chipmunk]

I'm also curious as to what they were looking for with the CT - med professionals, any opinions? I know he indicated high abdominal pain (8/10), but what would they have been looking for? Only thing I can think of would be stones/kidney issues (but wouldn't that be more characterized as flank pain rather than abdominal??).


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Severe Headache, fever: meningitis?? Other, I don't have enough info on what localized part of body complaint.

 

[Lyra500]

Questions- How often are people misdiagnosed with a milder illness at first and it turns out to be very serious illness? How often does a doctor/hospital not catch cancer or another deadly disease early enough? When this happens do patients/their families regularly sue? I am not in the medical world so I don't know if this is a common occurrence or not.
(This happened to a friend on mine's brother within the last six months. The family did not sue or even consider suing.) Tia

There seems to have been much discussion and criticism about Louise and her family suing the hospital - does anyone have a source or link to confirm this is actually happening?

 

[Lyra500]

This is from the CDC checklist for evaluating potential Ebola patients:

http://www.cdc.gov/vhf/ebola/hcp/clinician-information-us-healthcare-settings.html

Upon arrival to clinical setting/triage
‰ Does patient have fever (subjective or ≥101.5°F)?
‰ Does patient have compatible EVD symptoms such as headache, weakness, muscle pain, vomiting, diarrhea, abdominal pain or hemorrhage?
‰ Has the patient traveled to an Ebola-affected area in the 21 days before illness onset?

Upon initial assessment
‰ Isolate patient in single room with a private bathroom and with the door to hallway closed
‰ Implement standard, contact, & droplet precautions
‰ Notify the hospital Infection Control Program at ________________________________________
‰ Report to the health department at ___________

 

[Sonya610]

Would it be illigal to cremate someone without contsent??? Seems like Hippa might have a thing to say about that, no?

Consent comes from the next of kin. I don't believe HIPPA has anything to do with it.

I would assume the son (next of kin) agreed to the cremation. He likely had a choice, let the state/hospital cremate the body at no cost OR find a funeral home that is willing to accept and transport the body and then pay for a hermetically sealed casket, burial plot, and the burial itself. All of that would likely be several thousand dollars out of their own pocket and it would probably have to be arranged and paid for VERY fast so the body is interned within a couple of days.

 

[Elley Mae]

Lawsuit may be coming in Ebola victim's death, family friend says

http://www.dallasnews.com/ebola/hea...n-ebola-victim-s-death-family-friend-says.ece

A spokeswoman for Thomas Eric Duncan’s family said Friday they may sue Texas Health Presbyterian Hospital Dallas for its treatment of Duncan, who died of Ebola on Wednesday.

Saymendy Lloyd also said that Duncan’s 19-year-old son, Karsiah, has been indefinitely barred from Angelo State University, where he attends college. University officials denied that, saying he could return whenever he likes.

Lloyd, speaking with reporters in Washington, said the family may sue the hospital when they finish mourning.

“At the moment they are in a grieving process,” she said.

...................................

http://www.nbcnews.com/storyline/eb...-lawsuit-success-unlikely-experts-say-n221591

Thomas Eric Duncan, the Ebola patient in Dallas who died Wednesday, may have been sent home while ill with the disease, and the doctors and nurses treating him may have failed to act on his report of coming from West Africa. But will those health-care providers or their hospital be legally liable? Not likely, Texas legal experts say. Legal changes in Texas since 2003 have made it one of the most difficult states in which to bring a medical malpractice suit, said Charles Silver, a law professor at the University of Texas at Austin. "I doubt that you could find a plaintiff's attorney to even take this case unless it was solely for the publicity value," Silver said.

 

[Elley Mae]

On Friday MSF reported a sharp increase of Ebola cases in the Guinean capital, Conakry, dashing hopes that the disease was being stabilised there.

Meanwhile in Mali, an experimental serum is being tested on volunteer health workers.

http://www.bbc.co.uk/news/world-africa-29577175

bbm

 

[Elley Mae]

Liberia: 41 UN staffers under Ebola observation

http://hosted.ap.org/dynamic/storie...ME&TEMPLATE=DEFAULT&CTIME=2014-10-11-07-01-00

The mission said in a statement late Friday that the measures were precautionary and that none of the staff members had shown signs of Ebola.

 

[Sophieandme]

Officials Admit a ‘Defeat’ by Ebola in Sierra Leone
By ADAM NOSSITEROCT. 10, 2014
NY Times
http://www.nytimes.com/2014/10/11/w...t-a-defeat-by-ebola-in-sierra-leone.html?_r=0

snipped
FREETOWN, Sierra Leone — Acknowledging a major “defeat” in the fight against Ebola, international health officials battling the epidemic in Sierra Leone approved plans on Friday to help families tend to patients at home, recognizing that they are overwhelmed and have little chance of getting enough treatment beds in place quickly to meet the surging need.

"It’s basically admitting defeat,” said Dr. Peter H. Kilmarx, the leader of the federal Centers for Disease Control and Prevention’s team in Sierra Leone, adding that it was “now national policy that we should take care of these people at home.”

But many patients with Ebola are already dying slowly at home, untreated and with no place to go. There are 304 beds for Ebola patients in Sierra Leone now, but 1,148 are needed, the World Health Organization reported this week.

Nobody knows exactly how many have died from Ebola in this country. The government figure of 900 to 1,000 is thought by international officials to be a serious underestimation. Even some senior government figures have suggested it is untruthful, and the situation in holding centers and cemeteries suggests the government number is far from reality.

 

[Sophieandme]

On Friday MSF reported a sharp increase of Ebola cases in the Guinean capital, Conakry, dashing hopes that the disease was being stabilised there.

Meanwhile in Mali, an experimental serum is being tested on volunteer health workers.

http://www.bbc.co.uk/news/world-africa-29577175

bbm

http://www.nytimes.com/2014/10/10/w...click&contentCollection=Africa&pgtype=article

snipped
The aid group said in a news release that there had been 22 new patients admitted to the Ebola management center at Donka on Monday alone, and that the center is now exceeding capacity. Stephane Hauser, the group’s field coordinator at Donka, noted that cases had increased steadily since August and that there were new transmission chains “whose origins we don’t know at the moment.”

 

[Lyra500]

Snipped a bit more

Officials Admit a ‘Defeat’ by Ebola in Sierra Leone
By ADAM NOSSITEROCT. 10, 2014
NY Times
http://www.nytimes.com/2014/10/11/w...t-a-defeat-by-ebola-in-sierra-leone.html?_r=0

snipped
But many patients with Ebola are already dying slowly at home, untreated and with no place to go. There are 304 beds for Ebola patients in Sierra Leone now, but 1,148 are needed, the World Health Organization reported this week.

Nobody knows exactly how many have died from Ebola in this country. The government figure of 900 to 1,000 is thought by international officials to be a serious underestimation. Even some senior government figures have suggested it is untruthful, and the situation in holding centers and cemeteries suggests the government number is far from reality.

One of the video clips accompanying this journal from a BBC correspondent who visited Sierra Leone mentions 120 deaths in one day so there is no way those government figures can be accurate.

http://www.bbc.co.uk/news/health-29507673