Ebola outbreak - general thread #1

[Lyra500]

Although at this point I believe this will be contained, yet, I can't help but wonder about future issues as flights to that part of Africa are allowed to continue.

I'm also concerned b/c my niece--age 28--has recently become involved in a charitable organization where she will be traveling to S. Africa this month to work with AIDS patients. I think it's crazy for her to be going, if it were my daughter I would be all but tying her to the bed rather than "letting" her go.

After staying in Africa for about 4 weeks, she will travel to Thailand, before she returns home, right before christmas.

Talk about 1 person potentionally wreaking havoc!!! I know I probably sound crazy paranoid, but I can't help it.

South Africa is over 3,500 miles away from Sierra Leone, 3,300 from Liberia and over 3,600 miles from Guinea.

The Ebola outbreaks in Nigeria and Senegal which are right next door to the 'Hot Zone' appear to be all but over due to effective contact tracing and isolation measures.

So I have to ask:

1. Why do people seem determined to expect Ebola to run rampant across the USA - are people really suggesting that US Public Health and public education are that much worse than Nigeria and Senegal. So incompetent and hapless that they cannot achieve what Nigeria and Senegal have achieved? Really?
   
2. Why would an infection outbreak in West Africa mean that someone should not travel to another African country with no record of ever having harboured Ebola and which is situated over 3000 miles away?

I understand that Ebola is scary, but I think we should try and remain rational about the whole thing.

PH will be working their way through the contact map that they have built up by tracing the movements of this individual. They will be approaching, interviewing and monitoring people in order of risk. They will be asking those people who they have been in contact with since they came into contact with the infected patient. All those people will be painstakingly recorded and monitored for the maximum potential incubation period.

This is how PH infectious disease control is done - laborious, but when done properly, it works.

 

[Yoda]

http://www.wfaa.com/story/news/heal...n-dallas-county-ebola-patient-cases/16524303/

 

[sloane7777]

Well I know several that have written off the hospital for sending him home. Under some local articles several woman have said they changed where they are delivering their babies. One was scheduled for a c-section on Fri. This nurse is now the scapegoat for the hospital's huge mistake, to make people feel safe about continuing going there.

I have no faith this is the same hospital that put me on the wrong meds causing me to be deathly ill for weeks before Medical City Dallas caught it!

 

[SweetT]

I would guess that they would be in isolation for 21 days once back on our soil to be safe and sure. I hope they do anyway.

What I understand with other countries that are sending volunteers they're promising to bring them all back to their respective countries for treatment should they become ill.. Don't know about our military but I'd guess they get the same.

 

[SallyLu]

Pert of an article from the NYTimes:

The patient was identified by Liberian health officials and The Associated Press as Thomas Eric Duncan, a Liberian national.

Mr. Duncan worked at a shipping company in Monrovia, Liberia, but had just quit his job, giving his resignation in early September, his boss said. He had gotten a visa to the United States and had decided to go, his neighbors said. He lived alone, but has family in the United States, they said.


Mr. Duncan may have become infected after his landlord’s daughter fell gravely ill. On Sept 15, Mr. Duncan helped his landlord and his landlord’s son carry the stricken woman to the hospital, his neighbors and the woman’s parents said. She died the next day.
Soon, the landlord’s son also became ill, and he died on Wednesday in an ambulance on the way to the hospital. Two other residents in the neighborhood who may have had contact with the woman have also died. Their bodies were collected on Wednesday as well.
Health officials in Dallas said Wednesday that they believed Mr. Duncan came in contact with at least 12 to 18 people when he was experiencing symptoms. So far, none has been confirmed infected.

Read more at link: http://www.nytimes.com/2014/10/02/u...-contact-with-patient.html?smid=tw-share&_r=1


http://heavy.com/health/2014/10/thomas-eric-duncan-ebola-patient-texas-mai-wureh/
http://heavy.com/health/2014/10/thomas-eric-duncan-ebola-patient-texas-mai-wureh/

 

[Lyra500]

I understood that it was a drug given to hiv patients seems it should be already fda approved right? Ugh idk

Yes, but it will only be licensed for use in HIV.

Use in Ebola would be 'off licence' - but I would have thought in the current circumstances that the usual rules governing these things might be relaxed as with ZMAPP.

At least this is a drug which has undergone clinical testing and received a licence, albeit in a totally different cohort of patients.

 

[nrdsb4]

Pert of an article from the NYTimes:


Mr. Duncan may have become infected after his landlord’s daughter fell gravely ill. On Sept 15, Mr. Duncan helped his landlord and his landlord’s son carry the stricken woman to the hospital, his neighbors and the woman’s parents said. She died the next day.
Soon, the landlord’s son also became ill, and he died on Wednesday in an ambulance on the way to the hospital. Two other residents in the neighborhood who may have had contact with the woman have also died. Their bodies were collected on Wednesday as well.


Read more at link: http://www.nytimes.com/2014/10/02/u...-contact-with-patient.html?smid=tw-share&_r=1


http://heavy.com/health/2014/10/thomas-eric-duncan-ebola-patient-texas-mai-wureh/
http://heavy.com/health/2014/10/thomas-eric-duncan-ebola-patient-texas-mai-wureh/

You really have to wonder why this man did not tell the ER staff that not only had he traveled from Liberia, but that he had had DIRECT PHYSICAL CONTACT with a dying ebola patient. Did he think he would have been turned away had he revealed this extremely relevant information? Knowing that he'd been exposed, wouldn't he have wanted the staff to know this so he could receive proper treatment?

This doesn't excuse the hospital for their own errors, but it certainly does not put this man in a good light. I wondered before if this man deliberately came here to get treatment, knowing that he was putting others in harm's way-only to be told "not to go there" by another poster. Clearly my speculation remains a possibility, and it wouldn't surprise me in the least to see more people attempt it, especially if this man's life is saved by the care he receives here.

 

[Le Singe]

As already said, we don't know if they didn't ask or if he didn't answer honestly.

If they didn't ask, that's on them. And it should be a wake up call for all triage personnel in ERs, because it probably is frequently NOT ASKED. So many illnesses present with the exact symptoms every single day in ERs across the country. It's never been ebola before-so it is not even remotely likely to be that rather than any of the countless numbers of illnesses which show up daily. However, it was inevitable to happen, so it should have been more in the forefront.

If he lied-well, you can't blame the staff.

unfortanately as im sure we are all now aware they ask he told them and yet he still got sent home .... He was not even an american citizen I don't know how they could have not known.

 

[Le Singe]

I concur that it's at panic level, not that we should panic(I know you didn't mean that either) but we have to act fiercely and quickly!

I worked in a lab with infectious disease and I will tell you it's not to be taken lightly, and I am far from a germa-phobe. In fact my background convinces me the more germs the better, but I am not joking when I say I will purposefully be avoiding going out for the time being unless absolutely necessary. This could get very ugly IMO. But if we work hard right now and contain it, it could be stopped right away. However, i do believe it will continue popping up in random areas until it's contained in Africa.

I totally agree with this (minus the not going out part but thats a personal choice for each of us), but to me what you are describing is not panicking it's a measured response!

 

[nrdsb4]

Pert of an article from the NYTimes:

Health officials in Dallas said Wednesday that they believed Mr. Duncan came in contact with at least 12 to 18 people when he was experiencing symptoms. So far, none has been confirmed infected.

Read more at link: http://www.nytimes.com/2014/10/02/u...-contact-with-patient.html?smid=tw-share&_r=1
.

http://heavy.com/health/2014/10/thomas-eric-duncan-ebola-patient-texas-mai-wureh/
http://heavy.com/health/2014/10/thomas-eric-duncan-ebola-patient-texas-mai-wureh/

They have 2 weeks from today to wonder if they are next. Pretty awful. The fact that he knew he'd been in contact with a dying ebola patient-how could he bring himself to put his family members, children among them, at risk like this? I find it next to impossible to believe that he wasn't aware he was at risk. This is one of the more bizarre things I have ever read.

 

[Betty P]

unfortanately as im sure we are all now aware they ask he told them and yet he still got sent home .... He was not even an american citizen I don't know how they could have not known.

Yes, he did tell them. It would have come up when they asked for his Social Security number - he didn't have one. But the information wasn't shared with health care staff.

It's mind boggling that they sent him home.

Thomas Eric Duncan went to a Dallas emergency room Friday and explained that he was visiting the U.S. from Liberia. He was sent home with antibiotics, according to his sister, Mai Wureh.

After his condition worsened, he returned two days later to the same ER at Texas Health Presbyterian Hospital and was admitted.

Dr. Mark Lester, who works for the hospital's parent company, said a nurse asked Duncan whether he had been in any part of West Africa, where Ebola has killed thousands of people. But his answer "was not fully communicated" throughout the hospital's medical team.

Read more here: http://www.star-telegram.com/2014/10/01/6164131/ebola-case-stokes-concerns-for.html#storylink=cpy

BBM

 

[Lyra500]

Pert of an article from the NYTimes:

The patient was identified by Liberian health officials and The Associated Press as Thomas Eric Duncan, a Liberian national.

Mr. Duncan worked at a shipping company in Monrovia, Liberia, but had just quit his job, giving his resignation in early September, his boss said. He had gotten a visa to the United States and had decided to go, his neighbors said. He lived alone, but has family in the United States, they said.


Mr. Duncan may have become infected after his landlord’s daughter fell gravely ill. On Sept 15, Mr. Duncan helped his landlord and his landlord’s son carry the stricken woman to the hospital, his neighbors and the woman’s parents said. She died the next day.
Soon, the landlord’s son also became ill, and he died on Wednesday in an ambulance on the way to the hospital. Two other residents in the neighborhood who may have had contact with the woman have also died. Their bodies were collected on Wednesday as well.
Health officials in Dallas said Wednesday that they believed Mr. Duncan came in contact with at least 12 to 18 people when he was experiencing symptoms. So far, none has been confirmed infected.

Read more at link: http://www.nytimes.com/2014/10/02/u...-contact-with-patient.html?smid=tw-share&_r=1


http://heavy.com/health/2014/10/thomas-eric-duncan-ebola-patient-texas-mai-wureh/
http://heavy.com/health/2014/10/thomas-eric-duncan-ebola-patient-texas-mai-wureh/

BBM - what a heart-breaking vignette of what life (and death) is like in Liberia. The Landlord lost two children in as many weeks.

 

[Le Singe]

This is the most outrageous thing I have heard in a long time. I knew when they first started talking about Ebola being so bad in Africa then sending people here to be treated that it wouldn't be long before it was on American soil.

the bolded and the fact that ebola is here are totally unrelated.

This is very scary stuff. I don't mean to set off a panic, but come on......how are they going to contain it now????

It shouldn't be impossible they will trace down contacts and isolate them. They can control it as long as they avoid any more huge screw ups

How many people was this man in contact with...the flight, the ER, going home, then to the ER again. This can become widespread very quickly. Dallas is a place that people come in and out of a lot. Next we will see a case in another region.

no way did he infect anyone on the flight if he was sick at that point he'd likely be dead before yesterday.

 

[SallyLu]

You really have to wonder why this man did not tell the ER staff that not only had he traveled from Liberia, but that he had had DIRECT PHYSICAL CONTACT with a dying ebola patient. Did he think he would have been turned away had he revealed this extremely relevant information? Knowing that he'd been exposed, wouldn't he have wanted the staff to know this so he could receive proper treatment?

This doesn't excuse the hospital for their own errors, but it certainly does not put this man in a good light. I wondered before if this man deliberately came here to get treatment, knowing that he was putting others in harm's way-only to be told "not to go there" by another poster. Clearly my speculation remains a possibility, and it wouldn't surprise me in the least to see more people attempt it, especially if this man's life is saved by the care he receives here.

Ahhh, it was you who said that. I'm sorry I didn't give you the credit.

Look at the timeline. He got his Visa at the beginning of September, packed in his home and job and was here on September 20th.

 

[bettybaby00]

South Africa is over 3,500 miles away from Sierra Leone, 3,300 from Liberia and over 3,600 miles from Guinea.

The Ebola outbreaks in Nigeria and Senegal which are right next door to the 'Hot Zone' appear to be all but over due to effective contact tracing and isolation measures.

So I have to ask:

[*]Why do people seem determined to expect Ebola to run rampant across the USA - are people really suggesting that US Public Health and public education are that much worse than Nigeria and Senegal. So incompetent and hapless that they cannot achieve what Nigeria and Senegal have achieved? Really?

I don't know if there is a perception that it could "run rampant in the US." Yes we have a superior healthcare system, but it certainly failed the first step in this particular case. That failure can also be described as "incompetent" IMO

[*]Why would an infection outbreak in West Africa mean that someone should not travel to another African country with no record of ever having harboured Ebola and which is situated over 3000 miles away?

When I first became concerned about this situation with my niece, I thought, well the 2 regions aren't exactly near each other.....yet now we learn of a man who had direct contact with infected people and had the ability to get on a commercial aircraft traveling half way across the globe. So yes I understand that she's not taking a huge risk by traveling to SA, but if this man could leave an area that is currently deep into this, what's stopping others from doing the same?

I understand that Ebola is scary, but I think we should try and remain rational about the whole thing.

I'm trying

 

[nursebeeme]

who did he breathe on when he was released? to include all those in the waiting room that he passed by?

it seems to be here now doesn't it. IMHOO very poor job of containment by the WHOO and the CDC. I do not fault ER employees.. they are thinking the guy has a fever and give him a zpac and send him home but no.. the guy has EBOLA.

If every guy with a fever in the ER was suspected to have EBOLA we would have to build entire isolation buildings to triage all these people!

Very sad day to hear that here it is in the US but when we brought those other patients over it was clear to me, in my opinion, that it was just a matter or time.

 

[Sonya610]

They have 2 weeks from today to wonder if they are next. Pretty awful. The fact that he knew he'd been in contact with a dying ebola patient-how could he bring himself to put his family members, children among them, at risk like this? I find it next to impossible to believe that he wasn't aware he was at risk. This is one of the more bizarre things I have ever read.

It is not bizarre at all. More like expected behavior from some people.

In many African countries the men eat first, the women and children eat what is left (if there is any). When the men start to starve the famine is considered "severe".

In addition if you have ever watched shows about combating HIV in Africa, many men will NOT get tested if their wife is informed of the results. It is none of her business, kwim? The female is only his wife, no reason for her to get info about his HIV status.

 

[sloane7777]

who did he breathe on when he was released? to include all those in the waiting room that he passed by?

it seems to be here now doesn't it. IMHOO very poor job of containment by the WHOO and the CDC. I do not fault ER employees.. they are thinking the guy has a fever and give him a zpac and send him home but no.. the guy has EBOLA.

If every guy with a fever in the ER was suspected to have EBOLA we would have to build entire isolation buildings to triage all these people!

Very sad day to hear that here it is in the US but when we brought those other patients over it was clear to me, in my opinion, that it was just a matter or time.

I agree a matter of time , but I still think its stupid for all sick med personnel help to return to their own country for treatment ( really lets just make sure and spread it everywhere!) I dont claim to have a soultion though!

 

[SallyLu]

This is so hard to read:MONROVIA, Liberia — A man who flew to Dallas and was later found to have the Ebola virus was identified by senior Liberian government officials on Wednesday as Thomas Eric Duncan, a resident of Monrovia in his mid-40s.
Mr. Duncan, the first person to develop symptoms outside Africa during the current epidemic, had direct contact with a woman stricken by Ebola on Sept. 15, just four days before he left Liberia for the United States, the woman’s parents and Mr. Duncan’s neighbors said.
In a pattern often seen here in Monrovia, the Liberian capital, the family of the woman, Marthalene Williams, 19, took her by taxi to a hospital with Mr. Duncan’s help on Sept. 15 after failing to get an ambulance, said her parents, Emmanuel and Amie Williams. She was convulsing and seven months pregnant, they said.
Turned away from a hospital for lack of space in its Ebola treatment ward, the family said it took Ms. Williams back home in the evening, and that she died hours later, around 3 a.m.

I'll let you read the rest of this heartbreaking story here:




http://www.nytimes.com/2014/10/02/w...m-texas-thomas-eric-duncan.html?smid=tw-share

My heart is not breaking for Mr Duncan though.

 

[Le Singe]

Ahhh, it was you who said that. I'm sorry I didn't give you the credit.

Look at the timeline. He got his Visa at the beginning of September, packed in his home and job and was here on September 20th.

he wasn't exposed until the 15th I'd say he clearly already had his trip planned. You can't decide to leave and have a visa ready in 4 days.