Ebola, news and discussion

[*Anya*]

I don't only have concerns about Ebola but also about Marburg.

Anyone read this news item in CNN? There was nothing about it in the news. As easily as Duncan came into the USA, anyone can. I do not have a lot of faith in the airport "screening".

If someone is not running a temperature when they get here, they could be in the prodomal stage (interval from onset of nonspecific signs and symptoms- to more specific symptoms. During this time, microorganisms grow and multiply, and the infected person may be more capable of spreading disease to others).


"99 in Uganda quarantined after Marburg virus death

From Samson Ntale, for CNN
updated 9:29 AM EDT, Wed October 8, 2014

STORY HIGHLIGHTS
30-year-old male health worker in Uganda dies of Marburg
Marburg is an Ebola-like hemorrhagic fever
99 put into isolation
At least 11 test negative

Kampala, Uganda -- (CNN) -- Three days after a fatal case of Marburg hemorrhagic fever was diagnosed in Uganda, 99 people have been quarantined in four different locations across the East African country, as field epidemiologists and surveillance officers continue to closely monitor all people who got into contact with only victim.

More than 60 health workers form the bulk of people under quarantine after they were identified as having contact with a 30-year old male health worker who died September 28 of Marburg -- an Ebola-like hemorrhagic fever.

"As of today, a total of 99 contacts are under follow up. All the contacts are still in a healthy condition," Dr. Jane Ruth Aceng, director general for health services in Uganda, said in the latest update on the outbreak on Tuesday.

"The National Taskforce through the field epidemiologists and surveillance officers continues to closely monitor all people who got into contact with this confirmed case," she noted.

"However, for those who continue to have signs, tests will be run again after three days," Dr. Aceng said.

Among those who tested negative include are the brother of the deceased; two health workers from a children HIV/AIDS hospital; seven persons from Mpigi Health Center IV; and two relatives of the deceased who participated in the burial.

Marburg virus was first identified in 1967, when 31 people became sick in Germany and Yugoslavia in an outbreak that was eventually traced back to laboratory monkeys imported from Uganda. Since then the virus has appeared sporadically, with just a dozen outbreaks on record, many -- including the current situation -- involving just a single patient.

Marburg virus causes symptoms similar to Ebola, beginning with fever and weakness and often leading to internal or external bleeding, organ failure and death. The death rate runs as high as 80 percent, although it was significantly lower in the initial outbreak when patients were cared for in relatively modern, European hospitals.

The most recent outbreak, also in Uganda, in 2012, killed four out of 15 patients, according to the Centers for Disease Control and Prevention. On Tuesday, CDC Director Thomas Frieden pointed to the most recent Marburg case as an example of how a deadly virus could be contained.

"I mention this, because oftentimes in public health, what gets noticed is what happens and it's hard to see what doesn't happen," Frieden continued, noting that there have so far been no additional cases. "That may not make headlines, but it does give us confidence that we can control Ebola in West Africa."


http://www.cnn.com/2014/10/07/health...marburg-death/

[femmsational]

Normally things don't bother me but this has me terrified.

The CDC isn't educating ANYONE as they should.

The administration doesn't seem to realize the danger that is poses to us if we don't rethink how we are reacting to travel from the countries hit the hardest with this thing. And if there are cases popping up in countries we have open travel with......we have to be honest about the risks.

My main problem is the lack of urgency shown by the CDC. The more they minimize it, the more ignorance is going to be the cause of this spreading. I'm not advocating creating a major scale panic by any means but if the treating team at a hospital doesn't understand how to keep themselves safe, how is the general public supposed to understand.

I'm sure most people would think this is totally stupid but I've dealt with at least 15 outbreaks of Equine Encephalitis. It's spread exactly as the CDC and medical professionals say Ebola is. It is a major problem. The danger point is when it hasn't quite been diagnosed. That horse, or person in this case is contagious and nobody knows about it. There is a strict protocol on how to deal with it after it's diagnosed. A specific way to don protective gear and an even stricter one to take it off. Bleach, disinfectant and quarantine are vital to kill the pathogen. I think if people want to know how to stay safe with Ebola if they are in a zone where it's visable, they should research Encephalitis protocol. As weird as that sounds.

As for what I'm doing differently?? So far I'm not overly concerned about me or the immediate family around here. It's AJ I'm worried about. He's driving all over the country in a semi-truck having to touch all kinds of things that the general public touches everyday. Less than sanitary to say the least. He's got gloves, germ-x and bleach. And when he has his home time in three weeks I'll be teaching him how to disinfect stuff and to put on, but more importantly, take OFF protective gear.

I know I sound like a crazy person but seriously, if anyone's dealt with an encephalitis outbreak at a major equine center, they'd understand why I sound like a cracked nut.


Sorry, I rambled.

[Sweet Bliss]

Would you mind explaining to us how to safely remove protective gear? Do you dispose of it? How? Can you wash it?

Handling things others have touched makes my skin crawl. (During these super cootie days) think about it.... fast food ... groceries ... magazines in offices...ewwww.

This is enough to make you get your zombie apocalypse gear ready.

[femmsational]

Originally Posted by Sweet Bliss

Would you mind explaining to us how to safely remove protective gear? Do you dispose of it? How? Can you wash it?

Handling things others have touched makes my skin crawl. (During these super cootie days) think about it.... fast food ... groceries ... magazines in offices...ewwww.

This is enough to make you get your zombie apocalypse gear ready.

Sorry I missed this.

It's a detailed process that I don't feel comfortable trying to explain on a website. I'll try to tell you the best I can but don't quote me on it or rely on it. The bottom line is you have to remember that the pathogen is alive. So you have to kill it.

When I was dealing with the horses, I had a quarantine area, a room to put on the equipment and a separate room to remove it. We worked in twos at the minimum. I had buckets of bleach that we stepped in when coming out of the quarantine area and buckets to dunk our gloves into. I also had a stack of those thick gauze bandages soaking in a vat of bleach.

So what we did was coming out of the quarantine area we put our bagged feet into the buckets on the floor. We took the bags off our feet as we stepped out. then dunked our gloved hands in the hand bleach buckets. Then we had our buddy hand us a bleach soaked gauze to remove one glove and it was removed by placing the bleached gauze around the top lip of the glove and pulling it inside out. Then it was placed it in a lined bucket. Repeat. Buddy hand another bleached gauze to remove the second glove. Removed it so it was inside out. After all that I had people sprayed down with a 50/50 mix of bleach and water.

To dispose I got an approved container and burned it FAR away from the horses.


There are going to be significant differences in how this needs to be handled such as masks, suits and the importance of not having exposure to skin especially if there are cuts or scrapes. I'm almost positive that what happened with the nurse is that she removed gloves and without thinking reached up to remove her mask and somehow infected herself. Sad.

For the most part the problem won't be with the putting on of the stuff. People who are scared are going to suit up. It's remembering to stay alert while taking it off.


There doesn't need to be panic but there sure as hell needs to be honesty and education.

And if we think we can control this by trusting other people to be honest with us we're crazy.


LOL, I must sound like a crazy person. Sorry.

[Kelt]

I am having a bit of a problem understanding some of the reactions in the US to problems controlling an infectious disease, particularly in hospitals. Obviously, in countries in the midst of the breakout, things are well past dire so I confine this thought to the United States.

When I watched the video interview attached to the story out of Kansas I was glad that the Dr pointed out that 22 thousand people in the US died of the flu last year and yet folks are blasé about even getting inoculated against it. He also put up the thought that if 22 thousand people died of Ebola there would be rioting in the streets. I agree.

When it comes to protocols in hospitals for dealing with this; what is the surprise? Nosocomial diseases are rampant. These are hospital acquired infections (HAI), illness either bacterial or viral you come out with that you didn't have when you went in. They infect 700,000+ per year and kill over 75,000. Eblola is an infectious disease but thankfully much more difficult to transmit than flu, C.diff and others.

Only a couple of hospitals in the US are designed for containment. Just as many hospitals do not have trauma centers, or specialize burn units, etc. Why do we all of a sudden start thinking all hospitals should be equipped for something that has never happened here before? It is clearly demonstrated most cannot handle regular prevention of common bacterial spread.

I am not trying to minimize the danger to healthcare workers and do believe that a ramp up of training and equipment beyond what was previously provided is prudent and urgent at this time, things will likely get worse before they get better. But all of these 'representatives' screaming about how far behind or unprepared we are must have only just now taken off their blinders and are looking for targets to blame.

[MsTinkerbelly]

Originally Posted by Kelt

I am having a bit of a problem understanding some of the reactions in the US to problems controlling an infectious disease, particularly in hospitals. Obviously, in countries in the midst of the breakout, things are well past dire so I confine this thought to the United States.

When I watched the video interview attached to the story out of Kansas I was glad that the Dr pointed out that 22 thousand people in the US died of the flu last year and yet folks are blasé about even getting inoculated against it. He also put up the thought that if 22 thousand people died of Ebola there would be rioting in the streets. I agree.

When it comes to protocols in hospitals for dealing with this; what is the surprise? Nosocomial diseases are rampant. These are hospital acquired infections (HAI), illness either bacterial or viral you come out with that you didn't have

when you went in. They infect 700,000+ per year and kill over 75,000. Eblola is an infectious disease and much more difficult to transmit than flu, C.diff and others.

Only a couple of hospitals in the US are designed for containment. Just as many hospitals do not have trauma centers, or specialize burn units, etc. Why do we all of a sudden start thinking all hospitals should be equipped for

something that has never happened here before? It is clearly demonstrated most cannot handle regular prevention of common bacterial spread.

I am not trying to minimize the danger to healthcare workers and do believe that a ramp up of training and equipment beyond what was previously provided is prudent and urgent at this time, things will likely get worse before they get better. But all of these 'representatives' screaming about how far

behind or unprepared we are must have only just now taken off their blinders and are looking for targets to blame.

Well said Kelt, well said.

[SleepyButch]

Originally Posted by Kelt

I am having a bit of a problem understanding some of the reactions in the US to problems controlling an infectious disease, particularly in hospitals. Obviously, in countries in the midst of the breakout, things are well past dire so I confine this thought to the United States.

When I watched the video interview attached to the story out of Kansas I was glad that the Dr pointed out that 22 thousand people in the US died of the flu last year and yet folks are blasé about even getting inoculated against it. He also put up the thought that if 22 thousand people died of Ebola there would be rioting in the streets. I agree.

When it comes to protocols in hospitals for dealing with this; what is the surprise? Nosocomial diseases are rampant. These are hospital acquired infections (HAI), illness either bacterial or viral you come out with that you didn't have when you went in. They infect 700,000+ per year and kill over 75,000. Eblola is an infectious disease and much more difficult to transmit than flu, C.diff and others.

Only a couple of hospitals in the US are designed forN containment. Just as many hospitals do not have trauma centers, or specialize burn units, etc. Why do we all of a sudden start thinking all hospitals should be equipped for something that has never happened here before? It is clearly demonstrated most cannot handle regular prevention of common bacterial spread.

I am not trying to minimize the danger to healthcare workers and do believe that a ramp up of training and equipment beyond what was previously provided is prudent and urgent at this time, things will likely get worse before they get better. But all of these 'representatives' screaming about how far behind or unprepared we are must have only just now taken off their blinders and are looking for targets to blame.

Nosocomial diseases are usually those infections/viruses contracted by patients in the hospital who are already immunocompromised. This does not related to hospital staff, which I think is what the big deal is over. The surprise is as nursing/healthcare staff, we should know how to prevent ourselves from being infected with anything, whether that be ebola, HIV, tuberculosis, etc. Unfortunately, as I mentioned in a previous post, we are all human and as humans we make errors. Now you have nurses who have been infected, taking care of patients in a hospital. To me that is a huge deal. I'm not so much worried about the person that they encounter in the grocery store.

While every hospital doesn't have to be prepared for this type of thing, what happens when a person comes into any ole hospital with symptoms that may not scream ebola or do for that matter. What's that hospital to do? They all need to be prepared for any type of infectious disease scare in my opinion, which to me means protective garb and a negative pressure room. Also they should have yearly training as part of continuing education, which we all need to have anyway. Unfortunately though, hospitals are busy and short staffed so this kind of training doesn't occur.


I agree that we shouldn't be pointing fingers. We just need to get everyone on the same page and try to contain it as much as possible and save as many people as they can.

[Kelt]

Originally Posted by SleepyButch

Nosocomial diseases are usually those infections/viruses contracted by patients in the hospital who are already immunocompromised. This does not related to hospital staff, which I think is what the big deal is over. The surprise is as nursing/healthcare staff, we should know how to prevent ourselves from being infected with anything, whether that be ebola, HIV, tuberculosis, etc. Unfortunately, as I mentioned in a previous post, we are all human and as humans we make errors. Now you have nurses who have been infected, taking care of patients in a hospital. To me that is a huge deal. I'm not so much worried about the person that they encounter in the grocery store.

While every hospital doesn't have to be prepared for this type of thing, what happens when a person comes into any ole hospital with symptoms that may not scream ebola or do for that matter. What's that hospital to do? They all need to be prepared for any type of infectious disease scare in my opinion, which to me means protective garb and a negative pressure room. Also they should have yearly training as part of continuing education, which we all need to have anyway. Unfortunately though, hospitals are busy and short staffed so this kind of training doesn't occur.


I agree that we shouldn't be pointing fingers. We just need to get everyone on the same page and try to contain it as much as possible and save as many people as they can.

I couldn't agree more and should clarify that I was not talking about healthcare staff individuals. My thoughts are more about admin policies that allow for training and basic equipment to be inadequate for regular encounters with the sick public. The reactions are as though it was somehow new.

Anytime you put a lot of sick people in a small space things are going to spread. This time of year especially lots of folks will present with fever and who knows where they came from? I don't have the answers but also wish everyone could stop looking for targets and and coordinate getting sensible precautions in place. A possible positive outcome would be that facilities will have the needed supplies and training going forward beyond whatever this outbreak brings.

A surprise to me or maybe I'm misunderstanding... I though all hospitals in the US would have at minimum PPE and a negative pressure room. Is that not true?

Note; my background is not medical at all. I come from the biohazard/HAZWOPER side of "keeping tiny bugs out".

[MsTinkerbelly]

Originally Posted by *Anya*

I don't only have concerns about Ebola but also about Marburg.

Anyone read this news item in CNN? There was nothing about it in the news. As easily as Duncan came into the USA, anyone can. I do not have a lot of faith in the airport "screening".

If someone is not running a temperature when they get here, they could be in the prodomal stage (interval from onset of nonspecific signs and symptoms- to more specific symptoms. During this time, microorganisms grow and multiply, and the infected person may be more capable of spreading disease to others).


"99 in Uganda quarantined after Marburg virus death

From Samson Ntale, for CNN
updated 9:29 AM EDT, Wed October 8, 2014

STORY HIGHLIGHTS
30-year-old male health worker in Uganda dies of Marburg
Marburg is an Ebola-like hemorrhagic fever
99 put into isolation
At least 11 test negative

Kampala, Uganda -- (CNN) -- Three days after a fatal case of Marburg hemorrhagic fever was diagnosed in Uganda, 99 people have been quarantined in four different locations across the East African country, as field epidemiologists and surveillance officers continue to closely monitor all people who got into contact with only victim.

More than 60 health workers form the bulk of people under quarantine after they were identified as having contact with a 30-year old male health worker who died September 28 of Marburg -- an Ebola-like hemorrhagic fever.

"As of today, a total of 99 contacts are under follow up. All the contacts are still in a healthy condition," Dr. Jane Ruth Aceng, director general for health services in Uganda, said in the latest update on the outbreak on Tuesday.

"The National Taskforce through the field epidemiologists and surveillance officers continues to closely monitor all people who got into contact with this confirmed case," she noted.

"However, for those who continue to have signs, tests will be run again after

three days," Dr. Aceng said.

Among those who tested negative include are the brother of the deceased; two health workers from a children HIV/AIDS hospital; seven persons from Mpigi Health Center IV; and two relatives of the deceased who participated in the burial.

Marburg virus was first identified in 1967, when 31 people became sick in Germany and Yugoslavia in an outbreak that was eventually traced back to laboratory monkeys imported from Uganda. Since then the virus has appeared sporadically, with just a dozen outbreaks on record, many -- including the current situation -- involving just a single patient.

Marburg virus causes symptoms similar to Ebola, beginning with fever and weakness and often leading to internal or external bleeding, organ failure and death. The death rate runs as high as 80 percent, although it was significantly lower in the initial outbreak when patients were cared for in relatively modern, European hospitals.

The most recent outbreak, also in Uganda, in 2012, killed four out of 15 patients, according to the Centers for Disease Control and Prevention. On Tuesday, CDC Director Thomas Frieden pointed to the most recent Marburg case as an example of how a deadly virus could be contained.

"I mention this, because oftentimes in public health, what gets noticed is what happens and it's hard to see what doesn't happen," Frieden continued, noting that there have so far been no additional cases. "That may not make headlines, but it does give us confidence that we can control Ebola in West Africa."


http://www.cnn.com/2014/10/07/health...marburg-death/

Thank you for alerting us to the Marburg virus, and the reminder that we need to act as if there is something we can catch right now!

Wash your hands frequently! Don't touch your face, mouth, eyes etc unless you have clean hands.

If nothing else, the flu will be here soon and you will be prepared!