Ebola outbreak - general thread #5

[popsicle]

It seems to me nobody is leading a nationwide effort to train all medical personal in proper procedure for this particular highly contagious virus. We shouldn't be waiting until this is full blown. These peoe should be trained yesterday!! Who's in charge?!!! Is it the CDC guy? We need some leadership here!!

http://www.nationalnursesunited.org...dards-for-protective-equipment-including-haz/

[h=1]PRESS RELEASES[/h][h=2]Ebola–RNs Call for Highest Standards for Protective Equipment, including Hazmat Suits and Training[/h]National Nurses United Press Release, 10/12/14

 

[Elley Mae]

In an article published recently in this journal, McElroy and colleagues updated
previous studies of biomarker correlates of outcomes in patients seen during the 2000-
2001 EVD outbreak in Uganda [3]. They confirmed many well-known findings and
identified some that were new. Fatal cases were associated with severe abnormalities
of liver and kidney function, marked CD8 lymphocytopenia and elevated plasma
levels of several cytokines and chemokines (IL-1

, IL-1RA, IL-6, MCP-1, MCSF and
MIP-1

). Unexpectedly, higher levels of sCD40L
were seen in patients who survived
compared with those who died. (sCD40L is a member of the TNF superfamily that
has prothrombotic and pro-inflammatory
activities.) Evidence of endothelial
activation (elevated levels of sICAM)
was observed in those with hemorrhagic
disease, and abnormal elevations in biomar
kers of coagulopathy (thrombomodulin, D-
dimer) were seen in those who died. These observations of endothelial dysfunction
and coagulopathy confirm the findings of other studies of clinical EVD and
experimental Ebola virus infection of non-human primates [4]. Moreover, similar
findings are seen in experimental and human sepsis [4-6].

http://jid.oxfordjournals.org/content/early/2014/08/25/infdis.jiu474.full.pdf+html

 

[nomoresorrow]

As of Sunday (10/12/2014) mid-day, 2,000 RNs at more 750 facilities in 46 states and the District of Columbia have responded to the NNU national survey.

Current findings show:

76 percent still say their hospital has not communicated to them any policy regarding potential admission of patients infected by Ebola
85 percent say their hospital has not provided education on Ebola with the ability for the nurses to interact and ask questions
37 percent say their hospital has insufficient current supplies of eye protection (face shields or side shields with goggles) for daily use on their unit; 36 percent say there are insufficient supplies of fluid resistant/impermeable gowns in their hospital
39 percent say their hospital does not have plans to equip isolation rooms with plastic covered mattresses and pillows and discard all linens after use; only 8 percent said they were aware their hospital does have such a plan in place

:facepalm:

Link originally posted by Popsicle; http://www.nationalnursesunited.org/press/entry/ebola-rns-call-for-highest-standards-for-protective-equipment-including-haz/

 

[nrdsb4]

A friend put up a link on FB about an article called '' cdc has to admit ebola is airborne'. Said friend had a friend who said 'get your news from a reliable source' and put up a SNOPES article saying " false ebola is not airborne. But in the initial article my friend put up , it linked the CDC page discussing transmission .

http://www.cdc.gov/vhf/ebola/transmission/qas.html

'' Although coughing and sneezing are not common symptoms of Ebola, if a symptomatic patient with Ebola coughs or sneezes on someone, and saliva or mucus come into contact with that person’s eyes, nose or mouth, these fluids may transmit the disease.

So I thought a quick google on what is airborne might help ME, at least and I'm sharing with you .

http://wordnetweb.princeton.edu/perl/webwn?s=airborne transmission ''Noun

S: (n) airborne transmission (a transmission mechanism in the which the infectious agent is spread as an aerosol and usually enters a person through the respiratory tract)'''

So an airborne virus is one that can enter through the respiratory tract , spread by aerosol ( cough/ sneeze) But ebola, which can be spread by inhaling/ ingesting someone's cough or sneeze is not airborne? So this is a little word game, right?

Also I found this very interesting, excuse the redundancy.

http://www.cdc.gov/flu/about/disease/spread.htm FLU can be spread ''up to about 6 feet away// droplets made when people with flu cough, sneeze or talk. // droplets made when people with flu cough, sneeze or talk. Less often, a person might also get flu by touching a surface or object that has flu virus on it
http://www.cdc.gov/vhf/ebola/transmission/qas.html EBOLA can be spread ''direct contact with body fluids //Ebola coughs or sneezes on someone//Ebola on dried on surfaces such as doorknobs and countertops can survive for several hours; however,''.

Also previously was said to stay further than 3 feet away from an ebola patient and is saying within 6 feet you can catch the FLU. Says surfaces of counters and doorknobs can have the live virus on it for several hours but does not LIST this as a way it can be transmitted but on the FLU transmission page it does. Its' a very sloppy page,t he ebola one for CDC. It seems to be lacking a lot of common sense information that I did find on the common cold and flu pages on the CDC. Maybe that is because its' been an African virus the CDC did not think would be coming here or did they update the page since it got to the US?
So from what I gather above from the 2 pages Flu vs. Ebola page from CDC. Both viruses can be spread essentially the same way but they refuse to class Ebola as airborne, right? Please if I'm reading it or understanding it incorrectly, someone show me TIA

No, it's not "a little word game." BBM in that sentence. There is a difference between droplet transmission and airborne transmission. In a nutshell, droplet precautions use the 3 foot distance as a measure because these respiratory droplets are heavy and incapable of being spread far into the air. In airborne transmission, the infectious organisms can travel far, much farther away than by droplet transmission.

One airborne spread illness is chicken pox. It is a VERY contagious disease spread via the airborne route. You could be in aisle 8 of the grocery store. In aisle 6 or 7, a person ill with chicken pox is looking through the case for some Tylenol. They sneeze a few times. You end up with chicken pox and are totally confused. "I don't know anyone who has had it! How did this happen?!" Airborne route is how.

 

[CARIIS]

Wow----and what has transpired at Emory compared to Dallas when given "training" seems to help! Knock knock Washington - no worries . they govern after they have missed the mark. So much money will be coming (propable will be thye have to hold acomittee hearing , which results in another committed needing to study the committee reccomendations, which result in a final committee to start writing a report whihc ends up being 454 pages long, which noone reads, and ends up in the library of congress!

But IMO Dallas paradoxically may overall end up being helpful - Dallas was not prepared for this, and as a result mistakes happened. An IMO this is such a hot potato - they will stop by from their 6 week vacation, throw money at it (half of which will end up being used fradulently ) but hey at least some of it will get training rolling, supplies etc!!! IMO

As of Sunday (10/12/2014) mid-day, 2,000 RNs at more 750 facilities in 46 states and the District of Columbia have responded to the NNU national survey.

Current findings show:

76 percent still say their hospital has not communicated to them any policy regarding potential admission of patients infected by Ebola
85 percent say their hospital has not provided education on Ebola with the ability for the nurses to interact and ask questions
37 percent say their hospital has insufficient current supplies of eye protection (face shields or side shields with goggles) for daily use on their unit; 36 percent say there are insufficient supplies of fluid resistant/impermeable gowns in their hospital
39 percent say their hospital does not have plans to equip isolation rooms with plastic covered mattresses and pillows and discard all linens after use; only 8 percent said they were aware their hospital does have such a plan in place

:facepalm:

Link originally posted by Popsicle; http://www.nationalnursesunited.org...dards-for-protective-equipment-including-haz/

 

[popsicle]

National Survey of Nurses Shows Heightened Ebola Concerns

http://www.nbcnews.com/storyline/eb...urses-shows-heightened-ebola-concerns-n224491

And it goes national.

[FONT=proxima_nova_rgregular]Other nurses' groups have [/FONT]downplayed the survey percentage numbers[FONT=proxima_nova_rgregular], pointing out that infection prevention — for Ebola or any other contagious disease — is standard education in nursing.

[/FONT][FONT=proxima_nova_rgregular]That is seriously flawed thinking imo.[/FONT][FONT=proxima_nova_rgregular][/FONT]

 

[Elley Mae]

Airborne and droplet transmission both technically travel through the air to infect others; the difference lies in the size of the infective particles. Smaller droplets persist in the air longer and are able to travel farther- these droplets are truly “airborne.” Larger droplets can neither travel as far nor persist for very long. Fomites are inanimate objects that can transmit disease if they are contaminated with infectious agents. In this study, a monkey’s cage could have been contaminated when workers were cleaning a nearby pig cage. If the monkey touched the contaminated cage surface and then its mouth or eyes, it could have been infected.

Author Dr. Gary Kobinger suspects that the virus is transmitted through droplets, not fomites, because evidence of infection in the lungs of the monkeys indicated that the virus was inhaled.

http://healthmap.org/site/diseasedaily/article/pigs-monkeys-ebola-goes-airborne-112112

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

While the virus has thus far only been shown to be transferred via bodily fluids, Sanders argues that it could become airborne.

"It can enter the lung from the airway side," Sanders said. "So this argues that Ebola is primed to have respiratory transmission.

http://www.theindychannel.com/news/local-news/purdue-professor-says-ebola-primed-to-go-airborne

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

Because the natural reservoir host of Ebola viruses has not yet been identified, the manner in which the virus first appears in a human at the start of an outbreak is unknown.

http://www.cdc.gov/vhf/ebola/transmission/

 

[SCHMAE]

We all defer to the CDC on all things virus and germ related. But does the rest of the world? Is there a body bigger or more competent than the CDC? Also is there a central disease body for continental Africa? If so, I'd like to see their page on ebola and its spread.

 

[jjenny]

BBM - if this is true, this person was in one of the special isolation units. Extra precaution was observed and I will bet the nurse did not have a filmsy PPE on. JMO

Exactly. What could be safely done at biosafety level 4 containment unit, might not be safe at a regular hospital.

 

[jjenny]

Quoting my post to show health care treated Duncan for 2 days before donning proper attire,(hazmat suits).

This is where I think (jmo)that she and others were vulnerable.

I don't think that article is even accurate. CDC guidelines don't call for hazmat suits. All the reports I've seen say the nurse was wearing gown, gloves, face shield (and not a hazmat suit)

 

[CARIIS]

[h=1]Tychem TK Level A Suits[/h]

$2,105.34

Qty:


Bloomberg’s Pimm Fox examines how the Ebola virus scare is benefitting Lakeland Industries, pushing shares to record highs for the manufacturer of hazmat suits. He speaks on “Market Makers.”

http://www.youtube.com/watch?v=pyvUYViDJFc

[h=1]Haunting truth: Hazmat suits better for Halloween than Ebola in U.S. but interest is up[/h]
A suit won't have much use other than as a Halloween costume."

Amazon explains the outerwear doesn't guarantee protection -- "A great combo pack that may help to protect against Ebola" -- but it also notes that the entire package of 1 Tyvek suit with built-in hood and booties, 2 pairs of gloves, 2 surgical masks, comfortable safety glasses and duct tape to form a seal between the suit and the gloves is "small enough to keep one in your home and one kit in your car for a quick get away."

if it goes airborne, not exactly sure where anyone is getting away "to"

worked in Sierra Leone for more than 10 years, told NPR that being inside the suit is "like being in a steam room" and "an exhaustive process" because of the heat, mask, boots, goggles and focus that's required.

U.S. State Department alone putting out a bid for 160,000 suits,


http://www.freerepublic.com/focus/f-news/3203566/posts

The problem is when you use those you have to take them off in very deliberate fashion," Dr. John Torres said. "You have to take the suits off in reverse order, somebody helps you take them off, you wash constantly while you're taking them off so nothing gets transmitted. If a person takes their gloves off and hasn't washed their hands, rubs their nose, rubs her eye, if the gloves are off and they're taking the gown off and they peel it back and the outside of the gown touches the skin, it can get on the skin that way."

http://www.krdo.com/news/latest-cas...otective-gear-used-to-treat-patients/29082374



[h=3]Hazmat suits come basically in two variations: splash protection and gastight suits

Gas/vapor protection[/h]Splash protection

http://en.wikipedia.org/wiki/Hazmat_suit

 

[Gardenlady]

One airborne spread illness is chicken pox. It is a VERY contagious disease spread via the airborne route. You could be in aisle 8 of the grocery store. In aisle 6 or 7, a person ill with chicken pox is looking through the case for some Tylenol. They sneeze a few times. You end up with chicken pox and are totally confused. "I don't know anyone who has had it! How did this happen?!" Airborne route is how.

Sbm and sort of off topic -

This irritates me to no end, because when my oldest got chickenpox back in the mid 90s when there were "questions" (read: rumors that scared a new young mum like me) about the new chicken pox vaccine, I tried like heck for my daughter to catch it too so she wouldn't have to have the shot. I had her drinking from the same cup, sharing utensils, they shared a room and toys as usual in our tiny apartment.... And yet...She never got it. :facepalm: :crazy:

Of course now I'm older and not as prone to rumors and she had the shot before school and of course everything is fine, but it's just so funny to me that I tried so hard for her to get this easily transmitted virus and she never did!


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[Lato]

http://www.cdc.gov/vhf/ebola/index.html

CDC Information on Ebola updated through 10/12/14 (a website with information - both current and historical)

Signs and Symptoms
Transmission
Risk of Exposure
Outbreaks
For Healthcare Workers
Diagnosis
Treatment

2014 West Africa Outbreak

Communication Resources

Information for Specific Groups

and Other Useful Links (WHO, USAID)

 

[nrdsb4]

Sbm and sort of off topic -

This irritates me to no end, because when my oldest got chickenpox back in the mid 90s when there were "questions" (read: rumors that scared a new young mum like me) about the new chicken pox vaccine, I tried like heck for my daughter to catch it too so she wouldn't have to have the shot. I had her drinking from the same cup, sharing utensils, they shared a room and toys as usual in our tiny apartment.... And yet...She never got it. :facepalm: :crazy:

Of course now I'm older and not as prone to rumors and she had the shot before school and of course everything is fine, but it's just so funny to me that I tried so hard for her to get this easily transmitted virus and she never did!


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Well, can't explain that except to say: Sometimes kids can get a very very very mild case of chickenpox-perhaps they get only one or two in places where they aren't noticed, like the scalp, underneath a head of hair. Somehow your kid either had the disease or for some reason her immune system was able to fight it off successfully. Because it is normally one of the most contagious diseases we know of. My stepmom once had to drop off an Avon purchase to a woman back in the day. Little sis was with her and simply stood on the porch while her mom walked into the home to give the product to the purchasing Mom, who was home nursing a chicken pox kid. Yep, sis showed up with chicken pox shortly thereafter, while none of her friends or schoolmates had been sick.

My kids were "strep throat" kids. Had it so many times I lost count. I've been exposed directly so often that it's just uncanny that I have NEVER once had strep. Can't explain that either.

 

[Gardenlady]

Well, can't explain that except to say: Sometimes kids can get a very very very mild case of chickenpox-perhaps they get only one or two in places where they aren't noticed, like the scalp, underneath a head of hair. Somehow your kid either had the disease or for some reason her immune system was able to fight it off successfully. Because it is normally one of the most contagious diseases we know of. My stepmom once had to drop off an Avon purchase to a woman back in the day. Little sis was with her and simply stood on the porch while her mom walked into the home to give the product to the purchasing Mom, who was home nursing a chicken pox kid. Yep, sis showed up with chicken pox shortly thereafter, while none of her friends or schoolmates had been sick.

My kids were "strep throat" kids. Had it so many times I lost count. I've been exposed directly so often that it's just uncanny that I have NEVER once had strep. Can't explain that either.

Oh I totally believe you, and know how contagious it is - just more laughing over my "luck" and trying so hard with no success!

I am like you with strep only with stomach viruses - I have only ever had one in my life (and that was more than enough!) but my kids get em all the time, husband always catches them, etc, but I never do. Which sucks because then I am the parent that ends up getting cleanup duty every time one comes through the house. :help:


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[Hiandmighty]

My husband's hospital has sent out a few emails regarding ebola. After the Dallas patient, the docs started reviewing among themselves what to do, how to handle it; they asked the pathologists about what tests to order, etc.

I've been talking about "the biohazard suits" with a couple of people and they said "sure the hospital has some" and I responded "but do you know that for sure?" And everyone realized they don't know for sure. This hospital has been declining in recent years-- poor husband is hanging on waiting for the turn around... I very seriously doubt they have any suits.

Thank God for the nurses, because I'm betting the nurses are the ones who get these things handled.

 

[Detective Klimpt]

If we (USA) continue to allow 'visitor' Africans into this country, in short order it is going to affect the care USA citizens deserve and need. Now, every African that shows any sickness on a plane is going to be treated as an Ebola possibility. That presents a huge mess for everyone that has to get involved with said person. This is time spent on a non-usa-citizen that could be spent on someone else that belongs here. Further, what is going to happen when this new health check results in a passenger showing symtoms that does end up being Ebola. That is yet another person our hospital personnel have to risk their lives to help. I don't see why USA can't ban incoming passengers from those Ebola country at least until we iron out all the protocols, etc. that we need to be able to deal with this. Texas is already in a frenzy over it. We do not need more problems. We do not need health care people quitting their jobs over this, and that is likely. We do not need more immigrants coming into the country that don't have health car, jobs, money, and just want to leech off our government. Every time I see that photo of Duncan in the green shirt, my stomach gets in a knot.

 

[popsicle]

NBC News ‏@NBCNews 55s55 seconds ago
COMING UP: CDC holds briefing on latest Dallas Ebola case http://nbcnews.to/1sxzOMn

 

[popsicle]

If we (USA) continue to allow 'visitor' Africans into this country, in short order it is going to affect the care USA citizens deserve and need. Now, every African that shows any sickness on a plane is going to be treated as an Ebola possibility. That presents a huge mess for everyone that has to get involved with said person. This is time spent on a non-usa-citizen that could be spent on someone else that belongs here. Further, what is going to happen when this new health check results in a passenger showing symtoms that does end up being Ebola. That is yet another person our hospital personnel have to risk their lives to help. I don't see why USA can't ban incoming passengers from those Ebola country at least until we iron out all the protocols, etc. that we need to be able to deal with this. Texas is already in a frenzy over it. We do not need more problems. We do not need health care people quitting their jobs over this, and that is likely. We do not need more immigrants coming into the country that don't have health car, jobs, money, and just want to leech off our government. Every time I see that photo of Duncan in the green shirt, my stomach gets in a knot.

We have admitted a patient with common flu-like symptoms (but no fever) who is being tested for Ebola on the basis of self-reported casual contact with a West Africa traveler. This patient is in isolation and is being monitored closely for their protection as well as the safety of our team members and the community."

http://www.wtsp.com/story/news/health/2014/10/13/fl-patient-being-tested-for-ebola/17189203/

 

[popsicle]

FOX 5 Atlanta ‏@FOX5Atlanta 5m5 minutes ago
WATCH LIVE at 12:00 - CDC officials discuss Texas nurse diagnosed with Ebola: http://youtu.be/kATYnziJPdA via @YouTube