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| These are Doctors Without Borders in Sierra Leone (Photo: Reuters) |
Ebola Virus Disease or EVD manifests itself in human beings as Ebola Hemorrhagic Fever. First identified in 1976, the disease afflicted relatively few people in Sub Saharan Africa. However, at the time, almost all of those afflicted, died. Those of us in nursing or medical school in the late seventies and eighties told ourselves that with the care available in the US that a much higher survival rate would occur. We now know that Ebola Hemorrhagic Fever still has about a 90% mortality rate, even when US styled intensive care unit facilties and intravenous capability and laboratories are available in support of these patients.. The ten percent of individuals who survive may also spread the virus to others for two months after their own apparent recovery. The virus remains in the semen of infected men for sixty-one days after infection.
The disease is thought to have spread from monkeys or from fruit bats (who are asymptomatic) to human beings. Body fluids of infected humans may also spread the disease to others. There are other types of hemorrhagic fevers and from symptoms, it can be easily confused with malaria or Marburg disease or others. Therefore a very specific test must be performed to confirm Ebola. Traditionally, we have been taught that this is not as easy to catch as the flu and that close proximity is required in order to catch this illness.
The illness itself starts with an exposure to the above and then, two days to a couple of weeks later, just like flu, begins with a sore throat, muscular aches, and headaches. Then it progresses to nausea, vomiting and diarrhea. Then the disorder progresses to liver and kidney failure. The liver failure is the cause of the bleeding difficulties. Of course, a patient leaking multiple types of body fluids, diarrhea, serous fluid, blood, and vomit, is a great hazard to his own family and to his physicians and nurses. Staff who care for patients with Ebola Hemorrhagic Fever are carefully dressed in protective garb and then generally the outside of the protective garb is washed with a germicide before they exit the patient care area.
There are often skin manifestations, neurologic manifestations such as delerium, agitation, and seizures. Death does not usually occur as a result of fluid volume loss, but usually of multiple organ dysfunctions and failures. The onset to death is normally about thirteen days, but has been noted to have continued as long as twenty-five days. Care is focused on support through each phase, intravenous fluids and correction of fluid and electrolyte imbalance. Then, support through whichever organs begin a cascading failure. With a failing liver, the amount of medications given for comfort must be carefully controlled as the patient cannot detoxify such medications Ebola is handled using something called Level 4 Bio Containment.
Recently, several physicians and some health care workers in Sierra Leone have died despite the best we have in precautions. Experts say that "it is simply a matter of time before Ebola travels from the continent of Africa to the United Kingdom via airplane, and then on to the United States. Experts claim that the disease is "difficult to catch" without very close proximity contact.
Still, a virally transmitted illness spread through body fluids with a 90% mortality rate is on its way, to the UK, to Canada and likely to the US and anywhere else with air travel, as well.
About all we can do is maintain our health as best we can. Possibly avoid handshakes. Wash our hands frequently. Avoid travel to the African continent for the time being. No immunization against Ebola Virus presently exists. There have been twenty-five village outbreaks of Ebola in Africa since 1976
http://www.cdc.gov/vhf/ebola/outbreaks/guinea/index.html
http://www.cdc.gov/vhf/ebola/
http://www.who.int/mediacentre/factsheets/fs103/en/
http://www.telegraph.co.uk/news/worldnews/africaandindianocean/10999981/Ebola-virus-outbreak-live.html
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I wonder if any of the children traveling into the US illegally through our porous Southern border have Ebola yet ? Perhaps it's time for the US to tighten its borders and take their obligation toward public health more seriously before 90% of our own towns and villages succumb to Ebola.
My posts on this subject which follow this one can be found at:
http://rationalpreparedness.blogspot.com/2014/08/two-ebola-sufferers-coming-to-georgia.html
http://rationalpreparedness.blogspot.com/2014/08/basic-strategies-for-safetyshould-ebola.html
13 comments:
Obama and his handlers are so intent on destroying America that their failure to do so financially has evolved into dependence upon America's bleeding hearts where hoards of invading children are concerned. I have no idea what value this country will have when we are broken financially, physically, and the entire country has to be sterilized or burned to the ground - but we won't be alive to find out.
Jane, Ebola is a big worry here. Our borders are riddled with gaps and crossing into the country is thus easy. Add to that the fact that foreigners come here for their health care... The risks of it surfacing here are enormous.
Then I send prayers for you and yours too. I think we are all at risk.
If Ebola gets to the US, this could be the match that lights it all.
This really frightens me. Two children live in McAllen, TX and both are school teachers. Surely, the schools will close if ebola rears its ugly head there. They are minutes from Mexico. The other daughter in NYC works in a hospital and has a child in 8th grade and a college student. Even though she has no contact with patients, I worry. I am going to suggest she home school her daughter at the first sign of trouble. Of course, the college student will think he is invincible. He is working this summer in a deli where he would have lots of contact with people.
None of my family live in the Heartland where maybe they could be safer. Of course, with air travel, no one is safe, but I feel all of my children are in unsafe places.
Can you tell us if antivirals taken ahead of time will help? Yes, maybe a whole post. Thanks.
Linda,
I am as concerned as you. I don't wish to alarm people, but there is cause for concern especially with our porous Southern border. I think this post has done a good job in identifying the problem. I am working on a future post as to strategies to help avoid viral infections, especially Ebola. Prevention is all we can do just now. If Ebola gets to the US, then we may see masks on everyone that leaves their home, along with vinyl gloves, as is sometimes the case in China and other nations during SARS outbreaks. I plan to make another post on this soon. Thanks for reading.
Jane,
Now that Ebola has a widespread footprint in the human population - and with countries likely suppressing their statistics - and with new protocols in place at Lungi Airport ( Sierra Leone ) for ' thermal scanning' and the country now declaring a state of Emergency as death tolls are rising including newly infected doctors - it's a very grim and frightening scenario. Let's hope this isn't World War Z !
The entire situation certainly has very horrible possibilities. Now, more than ever, we need to examine and enforce the protection of US borders. I'm sure Canada already has.
I spoke to my daughter today. She says she is terrified. As an RN/BSN in charge of the pulmonary unit in a Louisville Hospital, that is a good hub for incoming flights. My niece is six months pregnant and was examining a child that had been sent to her within the hospital where she works. As she was finishing, she was advised the child had meningitis. If she had been told, she would have suited up, but even the 'powers-that-be' fluffed off her concerns. Here, a surgical unit was shut down for ten days when they discovered their surgical instruments had not been autoclaved after operating on a patient with true, mad cow disease of the brain. Many more patients had been operated on using the same instruments.
It's not bad enough we're allowing people into our country that would not be allowed elsewhere, but the requirements in the medical fields are falling below acceptable conditions due to sloppy hiring and training procedures.
I am going to risk sounded like my grandmother here. In all things, the US and the world have become sloppy. We are sloppy in some aspects of law, in law enforcement, in medicine, in public health, in welfare, air travel, immigration, etc. The result will be deaths that would not otherwise have occurred. Let the buyer, the consumer, and the citizen beware. The slackers are now running our country.
Correction: I meant "sounding" like my grandmother ! Please add public education and universities to that long list, along with the financial industry.
Sorry to take up so much space here, but because Dr. Kent Brantly is thirty three years old, a young husband, a physician and a father of small children, it shows a lack of common sense on his part to risk himself and his family's welfare to do such a thing. I feel all precautions have been taken to keep these particular patients in isolation.
It's the hoards of travelers who refuse to miss out on their vacation, or refuse a business meeting, who put us all at risk. Add to that, the other hoards of people who would happily expose themselves and children to Ebola or any myriad of deadly diseases, to purposely destroy us from within. THAT is the threat.
Many of us who have undertaken a mission trip of some kind feel that we will be protected doing important work while we are there. In addition, Dr. Brantly may have bought the CDC line that "as long as your technique is good a normally healthy person shouldn't succumb. The reality is that some risks we take work out well, and other risks we take might not. I have never bought the CDC line completely anyway.
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