Tag Archives: Ebola virus

Straight, No Chaser Update: Remember Ebola Virus?

December 10, 2014Infectious DiseaseWordPress, Straight No Chaser, SterlingMedicalAdvice.com, Sterling Medical Advice, Ebola virusJeffrey Sterling, MD

This post is made with all due respect and condolences to those families affected. So…Have you noticed that we’re not talking about the Ebola virus anymore? This shouldn’t come as a surprise to you. It seems as if our community goes through this every year; remember bird flu and swine flu? Probably not.
Let’s update you on the latest information provided by the Centers for Disease Control and Prevention on the impact of the Ebola virus in the United States.

At least twenty cases have been treated in Europe and the United States. Many of the affected were health and aid workers who contracted Ebola in West Africa and were transported back to their home countries for treatment.
Of the ten treated in the United States, eight have recovered, and two died. The latest patient in the United States to have the disease arrived on Nov. 15 and died three days later while being treated in a biocontainment center in Omaha. As a reminder and means of comparison, there were over 35,000 deaths last year from influenza.

So there are a few points to be made regarding the national obsession with Ebola.

Ebola virus was never going to be a massive epidemic. Once the threat was known, the fact that the disease prominently announces its arrival through its symptoms made it easily diagnosed by competent medical personnel.
The chances of an infected and unrecognized person infected with Ebola making it to the U.S. through commercial air travel were always infinitesimal. One unintentional case of the millions traveling since the onset of the Ebola outbreak in Africa remains statistically impressive.
Over $100 million in medical support is being provided by the WHO and CDC to combat this outbreak. The efforts to prevent and contain within the United States were massive. It was always fair to say that once the threat became real, it was the beginning of the end of the threat. In fact, the head of the CDC states that the estimated time to defeat the outbreak was within 3-6 months.

ebola virus PPE outbreak
So as attention heads in other directions, be reminded that many diseases even more deadly than Ebola virus are present in hospitals across the country. I’d suggest you remember two points around that fact.
You have a massive public health infrastructure in place meant to prevent, identify and treat deadly diseases. Many disease that once wiped out massive numbers of us now are rendered to the study of medical history.

You have a role in maintaining your own safety, because despite it all, Ebola still exists and is still taking lives, particularly back in Africa. The point here is for all such diseases, healthy habits, including obtaining recommended immunizations, hand washing, avoid risky behaviors involving transfer of blood and other bodily fluids, and getting prompt medical attention when appearing sick is a relatively simple set of tasks to ensure your health.
We end this post as we have previously with this reminder of early comments from the Director of the CDC:

“Although it will not be quick and it will not be easy, we do know how to stop Ebola.”
“Ebola poses little risk to the U.S. general population.”

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook atSterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser In The News: Ebola Virus on U.S. Soil

October 2, 2014Public Health, Infectious DiseaseEbola virusJeffrey Sterling, MD

One or possibly two cases of Ebola have been identified in Dallas, Texas, USA after an individual acquired it on a trip to Liberia in West Africa. First, here are pertinent facts related to the case. Remember, Ebola is contagious only if the infected individual is experiencing active symptoms.

The patient did not have symptoms when leaving Liberia but developed symptoms approximately four days after arriving in the U.S. on Sept. 20. This means those on the plane with the patient are not considered at risk for contracting the disease. As such the US Centers for Disease Control and Prevention (CDC) does not recommend those individuals undergo monitoring.
The person fell ill on Sept. 24 and sought medical care at Texas Health Presbyterian Hospital of Dallas on Sept. 26. After developing symptoms consistent with Ebola, he was admitted to hospital on Sept. 28 where treatment continues.
On October 1^st, local health care authorities suggested an additional contact of the first patient is developing symptoms likely to be confirmed as Ebola.

Upon learning of the case, I had three immediate thoughts, none of which likely align with your first thoughts.

Citizens have no clue how many deadly pathogens reside in hospitals all day every day.
The presence of Ebola on U.S. soil likely marks the beginning of the end of Ebola. Once the U.S. public health and medical apparatuses get mobilized, this will be effectively addressed – not only in the U.S. but around the world. That likely was already the case once President Obama initiated numerous healthcare initiatives based on identifying Ebola as a national security threat.
I wonder if folks realize just how many conditions they personally are currently walking around with that not only are diagnosed in 1-2 people in a few days but kill more than 1-2 individuals every day. In other words, there are a lot more dangerous diseases right in front of us than Ebola.

It is actually encouraging that the public is showing an ongoing interest in the story of Ebola. It’s not so much a good thing that the interest is being driven by fear. Let’s address the above thoughts one at a time.

When I was a medical student, I recall the notion that older patients would often mention: “I don’t go to hospitals; that’s where the diseases are.” There’s a measure of truth to that statement. Newborn babies, the elderly and those with reduced immune systems should be selective visitors to hospitals. Hospital acquired infections are a very real concern. That’s not a comment about contracting Ebola – it’s an observation that there are many diseases about which we should be concerned, and we would do well to learn basic preventive measures that would prevent many diseases.
The reality of the identified case is it has been identified. Basically once it’s been identified, it is going to be contained. Anyone that is going to be infected has likely already been infected, and this group is going be limited to family members and individuals that have had close contact with the source patient.
One or two cases does not make an epidemic, no matter how much media attention is being given. There are real epidemics before our eyes. Obesity. Cigarette smoking. Preventable cancers. Hypertension. Trauma. Diabetes. Asthma and COPD. There are literally dozens more. Take inventory of your health and your risk factors, and divert some of your curiosity to those health concerns that will more likely impact you and your loved ones.

I do not take lightly the reality that there has been a public health failure in allowing the return of what simply had to be an infected (and thus identifiable) individual back into the U.S. from a region in the midst of an actual epidemic. That part of the story does bear exploration and explanation. We certainly wish the best for those affected by this tragedy.

Finally: regarding Ebola, it has only now joined hundreds of other diseases that can kill us if we are exposed to it and don’t get proper evaluation and treatment. Placing this in perspective may calm your concerns; maybe not. I would advice those of you with ongoing concerns to relearn the risks, symptoms and additional considerations previously discussed on Straight, No Chaser and elsewhere. Here are links to previous posts on the topic.
Straight, No Chaser In The News: Ebola Virus – Likely Not Coming Soon To a City Near You
Straight, No Chaser: Ebola Virus
Straight, No Chaser In The News: The Latest on the Ebola Virus Story (August 8^th, 2014)
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook atSterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Ebola Virus

August 2, 2014Health Prevention, Public Health, Infectious Diseasehemorrhagic fever, Straight No Chaser, SterlingMedicalAdvice.com, Sterling Medical Advice, shock, Ebola virus, disseminated intravascular coagulation, Conditions and Diseases, 844-SMA-TALKJeffrey Sterling, MD

Ebola virus has been in the news quite a bit lately. The disease it causes illustrates the ongoing value of basic measures of prevention and the difference in implementing strategies of prevention in the United States compared with some other countries (and to be fair, the luck of not having the same population of fruit bats that carry the disease). The disease caused by Ebola virus is called hemorrhagic fever. It’s a disease that occurs in humans and primates such as monkeys and gorillas, and it’s fatal up to 90% of the time. Straight, No Chaser has previously discussed the unlikelihood that the Ebola epidemic will spread beyond its current locations. In this post, we review some basic facts about the virus and the disease.

How do I catch the Ebola virus?
There are two main ways in which Ebola virus is spread to and between humans:

From infected animals and animal materials
By close contact with infected body fluids or through infected needles

Is the Ebola virus everywhere?
The human disease caused by the virus has been limited to parts of Africa. However, one of the types of the virus (there are five) has been found in the Philippines. The reason for this can be found in the geographic distribution of the virus’ natural host, the fruit bat.

What are the symptoms of Ebola virus?

During the incubation period (when the virus goes from simply being present to being present in high enough levels to cause significant disease), symptoms can include arthritis, chills, diarrhea, fatigue, fever, headache, low back pain, malaise, nausea, sore throat and vomiting. This period can last between 1-2 weeks after initial infection.
Later symptoms include bleeding from the ears, eyes and nose, bleeding from the mouth and rectum, eye swelling, genital swelling, increased feeling of pain in the skin, rash over the entire body that often contains blood and redness of the roof of the mouth.
Severe symptoms may include coma, a disruption of the clotting system known as disseminated intravascular coagulation (DIC), and shock.

Treatment

There is neither a known cure for nor a vaccine effective against an Ebola virus infection.
Treatment is limited to hospitalization and supportive measures while in intensive care, such as intravenous (IV) fluids and medications.
Bleeding problems resulting from the disease and the DIC that may develop can require transfusions of blood and platelets.

Prognosis
Ebola virus has a death rate as high as 90%. The cause of death is usually low blood pressure (shock). Blood loss worsens the shock but usually isn’t bad enough to cause death by itself.
Are there long-term complications in survivors?
Survivors may have unusual findings such as hair loss and sensory changes.
When should I be suspicious of having or having been exposed to Ebola virus?
If you have traveled to Africa, and you develop any of the symptoms described above or develop any illness, it’s worth getting evaluated. Keep in mind the disease have a 90% mortality rate, so early diagnosis and treatment give patients the only real chance at survival.

How do I prevent catching the Ebola virus?
I want to present this as simply as possible, because based on what we know, prevention is rather simple and appropriate measures dramatically reduce the risk of transmission.

For starters, avoid traveling to areas in which there are epidemics.
If you are in such an area, measures must be taken to reduce the risk of wildlife-to-human transmission. Contact with infected fruit bats or monkeys/apes and the consumption of their raw meat must be avoided. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
Beyond that, standard precautions are recommended and effective in the care of all patients regardless of their perceived or confirmed infectious status. These precautions include the basic level of infection control—hand hygiene, use of personal protective equipment to avoid direct contact with blood and body fluids, prevention of needle stick and injuries from other sharp instruments, and employing environmental controls.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser In The News: Ebola Virus – Likely Not Coming Soon To a City Near You

August 1, 2014Infectious Disease, Public HealthWorld Health Organization, WHO, Ebola virus, Center For Disease Control and Prevention, CDCJeffrey Sterling, MD

We must be doing something right when so many of you are asking about Ebola virus. I say that because of the incredibly high probability that neither you nor I will ever see a case of Ebola. In the news is an outbreak of the Ebola virus in West Africa. In this Straight, No Chaser, we will discuss the threat and spread of Ebola, and in a subsequent post, we will review the disease itself.
The basis of concern of diseases such as Ebola is we have become a global community. Worldwide travel now imports and exports diseases in a way not previously common, exposing far-flung populations to seemingly esoteric and rare conditions. The concept that a deadly disease such as Ebola virus is simply a plane ride away is a scary one.

According to the Center for Disease Control and Prevention (CDC), Ebola has infected 1,323 people and killed 729 people in the current outbreak, which includes Liberia, Guinea and Sierra Leone. The Director of the CDC has described this outbreak as follows: “This is a tragic, painful, dreadful, merciless virus. It is the largest, most complex outbreak that we know of in history.” Notably, as the World Health Organization (WHO) has mobilized medical attention and support to those in need, some of those providing care have become infected. As such…
Your concerns are straightforward:

Is Ebola “coming” to my country?
Can I become infected by the Ebola virus?

Focusing on the United States, the answers to both questions are yes, but the risk of your becoming infected are so remote that you should simply understand how to avoid the threat. Furthermore it is important to understand that bringing an infected American home for treatment (as is occurring in Atlanta) is not the same as exposing the population to the disease.

And so, here are some quick facts for your consideration:

Ebola virus is not transmitted like the cold or flu. It requires significant exposure to blood or bodily fluids.
Prior to that contact, you’d be most likely be aware of its presence. Those infected with Ebola are so ill so quick that it’s obvious.
The chances of an infected and unrecognized person infected with Ebola making it to the U.S. through commercial air travel are infinitesimal.
Over $100 million in medical support is being provided by the WHO and CDC to combat this outbreak.
Medical management of Ebola is not especially complicated once identified.
It is estimated the current outbreak will be defeated within 3-6 months.

What should you do? Continue the same diligence you should be applying to your health everyday.

Engage in healthy habits, including hand washing and maintaining a level of health to support a vibrant immune system.
Avoid risky behaviors involving transfer of blood and other bodily fluids.
Get prompt medical attention for those appearing sick, particularly after recent travel to areas affected by disease outbreaks.

We end this post with another two thoughts from the Director of the CDC:

“Although it will not be quick and it will not be easy, we do know how to stop Ebola.”
“Ebola poses little risk to the U.S. general population.”