Ebola outbreak - general thread #9

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The first of several teams is ready to fly out to Sierra Leone.

I am very proud to see the NHS doing its bit in the effort to control the outbreak. Sierra Leone seems to be suffering the most at the moment with cases still increasing.

http://www.bbc.co.uk/news/health-30148979

Chief medical officer Dame Sally Davies said: "I have been really impressed with the numbers of NHS workers who have stepped forward to help the communities that have been devastated by Ebola.


"The fact that more than 1,000 have come forward so far is a real testament to their commitment to public service."
 
http://www.cbc.ca/player/Shows/ID/2612759355/

"The Passionate Eye | Season 2014-2015 | Nov 23, 2014 | 42:47
Ebola Frontline

For the first time ever specially designed goggles and wrist cams provide a ‘doctor's eye view’ inside the fight against Ebola in Africa. Cutting-edge technology worn by volunteer medical teams working round-the-clock provides an extraordinary view of the impact of the deadly disease".
 
http://www.bbc.co.uk/news/health-30260532


The number of people killed by the Ebola outbreak in West Africa has risen to 6,928, the World Health Organisation (WHO) says.

The toll has increased by over 1,000 since the WHO's last report on Wednesday, but it includes unreported deaths from earlier in the outbreak.

Experts say the infection rate is more significant that the death toll, as it reflects how the virus is spreading.

Infection rates are decreasing in Liberia, but are high in Sierra Leone.

There have been over 16,000 reported cases in Guinea, Sierra and Liberia.


Here is a link to a photo story on the WHO website giving a taste of how a community in Sierra Leone is dealing with the epidemic. It is so saddening to see that in areas where they really have a reason to be worried, there can be healthcare workers caring for Ebola patients without personal protective equipment.

Anyway, this community is really pulling together with support from WHO to build there own community Ebola isolation and treatment centre. This will help to fee up capacity so that those patients with malaria, obstetric problems etc. who are currently going untreated will once again be able to attend the long-standing local clinic which got filled up with Ebola patients.

http://www.who.int/features/2014/ebola-community-care/en/
 
INTERVIEW WITH SPANISH NURSE WHO SURVIVED EBOLA

El Pais reports:
http://politica.elpais.com/politica/2014/11/30/actualidad/1417352658_256914.html

Translation:


Teresa Romero, the Spanish nurse who overcame Ebola, gave an interview on Saturday to the program Un tiempo nuevo (Telecinco), in which she wanted to make clear some points regarding her contagion. Romero said that "the preparation came down to a talk in which they learned how to wear the suit." In addition, the nurse said "there had to be always be someone ready, to keep an eye on how one takes off the suit" and that night when she had cleaned the room of the priest Manuel García Viejo [who died of Ebola], she received instructions of a colleague who was not prepared.

Teresa Romero has been emphatic in stating that up to this day she does not know how she became infected and she has been very critical of the lack of information she received before being taken to hospital Carlos III. "To me no one tells me I have Ebola, I suspected it, because they stopped coming into the room".

The assistant said she is proud of not becoming a source of transmission of the disease. "Fortunately I can say I have not infected anyone, for me that's important." In addition, the nurse has been very critical of the actions of the company responsible for disinfecting her home. "They were eleven days disinfecting my house and I find that in my house 90% of my stuff is missing and the other 10% is out of place. What criteria did they follow when throwing things? My expensive coffeepots have disappeared and they have left me the plainest ones. They left me the top of a bikini and threw away the bottom ".
 
Thank you to the leadership of these hospitals for stepping forward for the public good and safety and of course for the benefit of afflicted patients.
 
Mich. hospitals don’t make Ebola treatment center list

Karen Bouffard, The Detroit News 10:29 p.m. EST December 2, 2014

No Michigan hospital made the list of 35 Ebola treatment centers announced Tuesday by federal officials, but one or more could be added following inspections planned for January, according to state officials.

The hospitals nearest Michigan, designated by the Centers for Disease Control and Prevention, are in Illinois, Minnesota and Wisconsin. Several Michigan hospitals, including University of Michigan Health System, have said they would welcome Ebola patients, although Michigan nurses have complained some hospitals have not provided adequate training and protective equipment to keep health workers safe.

“We believe at the University of Michigan that we are ready to care for Ebola patients,” Denise Gray-Felder, chief communication officer of University of Michigan Health System, said late Tuesday.

“We anticipate that when the CDC comes here (next month), they will add additional hospitals to their list, and there will be some in the state of Michigan. I think it’s premature to say that this is a reflection of our capabilities or something’s wrong with the process. They’re going to continue to add sites to the list.”

Even now, an Ebola patient could be treated at a Michigan hospital if state and federal health officials agree, according to the state’s Chief Medical Executive Dr. Matt Davis...

http://www.detroitnews.com/story/ne...ls-make-ebola-treatment-center-list/19812653/
 
NBC’s Snyderman apologizes for Ebola violation

David Bauder, Associated Press 9:21 a.m. EST December 3, 2014

New York — NBC News medical reporter Nancy Snyderman apologized on the “Today” show Wednesday for violating her quarantine for Ebola exposure, saying she failed to appreciate how frightened Americans were of the disease.

It was Snyderman’s first on-air appearance in a month and a half, and she followed her talk with Matt Lauer by reporting a story on women and depression. NBC had kept her off the air following an angry public reaction to her broken promise: After saying she’d stay in her New Jersey home until the danger for symptoms of the disease had passed, she was spotted in a car getting takeout food...

http://www.detroitnews.com/story/news/nation/2014/12/03/nbc-snyderman/19825789/
 
I was just coming here to post the good news and see that others have already posted on it. Another article.

www.bizjournals.com/atlanta/morning_call/2014/12/emory-among-35-hospitals-designated-an-ebola.html?ana=twt&page=all

More than 80 percent of returning travelers from Ebola-stricken countries live within 200 miles of an Ebola treatment center, the CDC added.

The additional facilities supplement the three national bio containment facilities at Emory University Hospital, Nebraska Medical Center, and the National Institutes of Health (NIH), which will continue to play a major role in our overall national treatment strategy, particularly for patients who are medically evacuated from overseas, the CDC said.
 
Emory University said the American healthcare worker from West Africa who may have been exposed to the Ebola virus has been transferred to Emory University Hospital’s Serious Communicable Diseases Unit. He will be tested and observed to see if he has an infection.

The patient arrived at the hospital at about 5:45 a.m., officials said. Phoenix Air provided transport from West Africa.

http://www.wsbtv.com/news/news/local/possible-ebola-patient-arrives-emory-hospital/njLXn/

I wonder if this is actually a confirmed exposure (i.e. needle punture of the PPE or something along those lines) with subsequent Ebola like symptoms, but the individual has tested negative thus far? Haven't all the other patients flown to the U.S. been confirmed with the Ebola virus prior to being flown out for treatment? MOO.
 
http://www.cdc.gov/vhf/ebola/hcp/interim-guidance-emergency-medical-services-systems-911-public-safety-answering-points-management-patients-known-suspected-united-states.html
Interim Guidance for Emergency Medical Services (EMS) Systems and 9-1-1 Public Safety Answering Points (PSAPs) for Management of Patients Who Present With Possible Ebola Virus Disease in the United StatesDecember 2, 2014

What’s New: This version of the guidance has been updated to clarify the minimum PPE levels for EMS personnel and first responders. The updated information reflects the PPE guidance described in other CDC guidance documents such as “Identify, Isolate, Inform: Emergency Department Evaluation and Management for Patients Who Present with Possible Ebola Virus Disease” and “Guidance on Personal Protective Equipment To Be Used by Healthcare Workers During Management of Patients with Ebola Virus Disease in U.S. Hospitals, Including Procedures for Putting On (Donning) and Removing (Doffing)” to keep workers safe when responding to patients with suspected Ebola.

........The guidance provided in this document reflects lessons learned from the recent experience caring for patients with Ebola in U.S. healthcare settings.

.....Prior to working with patients with suspected Ebola, providers should have received repeated training and have demonstrated competency in performing all Ebola-related infection control practices and procedures, and specifically in donning/doffing proper PPE.
RBBM
 
MONROVIA, Liberia (AP) — A U.N. peacekeeper who contracted Ebola in Liberia will be flown to the Netherlands for treatment, a Dutch Health Ministry spokeswoman said Friday.The Nigerian soldier is expected to arrive in the Netherlands this weekend and will go into isolation.
This is the third infection for the mission, which comprises about 7,700 troops and police. The previous two died.
Sixteen people who came into contact with the Nigerian soldier have been quarantined, the mission said.

https://www.sungazette.com/page/con...tests-positive-for-Ebola.html?isap=1&nav=5022
 
http://time.com/3622735/ebola-emory-university-hospital-ian-crozier/
Emory’s ‘Sickest’ Ebola Patient, Now in Recovery, Reveals Identity Dec. 7, 2014

http://www.nytimes.com/2014/12/08/health/ebola-doctor-ian-crozier-return-from-the-edge-of-death-.html?_r=0 is a lengthy New York Times article...some highlights below.
Dr. Crozier, 44, contracted the disease in Sierra Leone while treating Ebola patients in the government hospital in Kenema. He was evacuated to Emory University Hospital in Atlanta on Sept. 9, the third American with Ebola to be airlifted there from West Africa. He had a long, agonizing illness, with 40 days in the hospital and dark stretches when his doctors and his family feared he might sustain brain damage or die. His identity was kept secret at his request, to protect his family’s privacy....Now, for the first time, he is speaking out. His reason, he said, is to thank Emory for the extraordinary care he received, and to draw attention to the continuing epidemic. He and his family granted their first interviews to The New York Times, and gave permission to interview his physicians.

The medical record, from an Ebola case, made for grim reading, but Dr. Ian Crozier could not put it down. Within days of the first symptom, a headache, the patient was fighting for his life. He became delirious, his heartbeat grew ragged, his blood teemed with the virus, and his lungs, liver and kidneys began to fail.

“It’s a horrible-looking chart,” Dr. Crozier said.

It was his own.​

The viral load in his blood was extremely high, more than 100 times that of the other patients Emory had treated. And he was becoming delirious, a sign of encephalitis.

A nurse who had also been infected in Kenema, Will Pooley — whose evacuation Dr. Crozier had supervised — flew to Emory from England and donated several units of plasma. Survivors have antibodies that may help fight off the virus, and a number of patients have been given such transfusions. Dr. Crozier’s virus levels began dropping, but his kidneys failed, and he was connected to a dialysis machine. He had swelled up with 20 pounds of excess fluid, and all that his relatives could see through the window were tubes, machines and a bloated face they barely recognized. He had begun having abnormal heart rhythms. Doctors warned that he might not survive.
Continue reading the main story

He was on the ventilator for 12 days, and on dialysis for 24

Doctors say his recovery has taught them that aggressive treatments, even life-support measures like ventilators and dialysis, can save some Ebola patients. Dr. Bruce S. Ribner, who leads the Emory team, said that until recently the general practice was not to bother intubating Ebola patients or put them on dialysis, because if they got that sick they were going to die.

“One of the things Ian taught us was, guess what, you can get sick enough to need those interventions and you can still walk out of the hospital,” Dr. Ribner said. “I think it has sent a message to our colleagues around the world.”
jpDOCTOR1-articleLarge.jpg
 

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