Ebola

[ComradesTrue]

I searched and didn't see a thread on this.

The first US transmitted case of Ebola has been confirmed at Presbyterian Hospital in Dallas. The 26 year old nurse contracted the virus while caring for Thomas Eric Duncan.

Are you satisfied with how the CDC is handling this? Are you concerned that this will be a much larger epidemic than they are indicating?

I have not been happy with Presbyterian's handling of this from the get-go. They initially blamed the ER nurse for not communicating that Duncan had come from West Africa. When she pulled up her patient documentation she had clearly indicated such. Then the hospital blamed the EMR for not communicating that info to the physician. That, too, has been refuted by the IT staff. Yet, even though it is the MD who writes discharge orders, at no time has Presby laid blame there.

I have no idea what to think about the types of PPE (personal protective equipment) that the staff caring for Duncan was required to wear. Was it just the standard yellow isolation gown, a blue gown, or more of the "hazmat" type gear? The CDC was QUICK to blame this nurse for a lapse in protocol in catching the disease.

Finally, on a personal note, the nurse has been identified by family as Nina Pham. She is a Sigma Kappa, according TCU's online alumni database.

[IUHoosiergirl88]

Lapses in protocol happen daily, when the stakes are much lower--how often have you been prepped for an injection with a sterile alcohol wipe, but then the nurse wipes the excess off with an open cotton ball? Or how often are you prepped for an IV by a nurse wearing gloves? In these cases, the stakes are fairly low--it's unlikely the nurse will be infected by anything, even though protocol states that those things aren't the right thing to do.

In this case, a 'lapse' in protocol can be as simple as taking gloves off improperly (contaminating the hands) followed by a subconscious touch of the face. How many times do you touch your face daily without thinking? When the stakes are high, the penalty for even a relatively minor lapse can be infection, simply because the viral load of the patient is so high. Also, all the protocol in the world doesn't always account for the fact that humans are imperfect, even when they KNOW what the impact of error/failure is.

Many people are quick to say that because the CDC is blaming lapse in protocol, that means it's a coverup that the virus is actually airborne, when that's simply not true. Earlier this year, a team at the Broad Institute in Cambridge, Mass published their data looking at the number of mutations in this current form of Ebola versus previous strains of Ebola Zaire (EZ). In 10 years, this specific strain of EZ has accumulated roughly 400 mutations--relatively high, but not outrageous. EZ is a type of virus that has a highly error prone replication, so this actually makes sense. None of them have been in regions of the genome that might make it airborne, nor do they currently look to be contributing to the size of this specific outbreak.

[MaggieXi]

^^^I want to learn more from you IUHoosiergirl88!

I am not in medicine, but am captivated (might not be the right word) by the Ebola and Enterovirus outbreaks. Outbreaks scare me, but I also find them interesting. My latest question is - if Ebola can only be spread by contact with the fluids of an infected person, how is it whem a person with Ebola sneezes, and creates a mist, that is not contagious?

I also find the blame shifting on the nurse as a knee-jerk, cya, attempt on the part of the CDC mouthpieces. The hospital failed and that is where the blame should be. We also should not be blaming the first person in the US to contract Ebola on US soil, instead we should thank her for doing her job and praying that she gets better!

Now what are everyone's thoughts about individuals coming into our country from countries who have a high rate of Ebola infections right now?

[IUHoosiergirl88]

The answer to your first para is kind of complicated, as the definition of an 'airborne' virus/bacteria/fungi seemingly would include aerosols generated by an Ebola patient sneezing or coughing. But unlike influenza, measles, or other truly airborne viruses, Ebola doesn't stay airborne a particularly long period of time because the aerosol particles are too large. Influenza, for example, can float through the air in teeny tiny (think 1-10 picometers) for up to almost 3 hours, some studies show. That's why you can catch the flu or the common cold just by being near someone who has it.

Honestly, even if you stop flights from Ebola-stricken countries, it's not going to do much good for a few reasons. First, there aren't a lot of direct flights from those nations to the USA--most transit European hubs. Second, if you do stop entry of anyone originating from West Africa, that is going to induce immigration officials in those countries to just not stamp passports to keep travel flowing. Visitors/tourists have money, and money is important in that area. Third, corruption is rampant.

You'd have to screen travelers from ALL international flights, regardless of country of origin...and even that's not going to help, as you won't catch passengers who are currently asymptomatic or still incubating.

[IUHoosiergirl88]

I also wanted to add a little bit on the 2012 pig/monkey aerosol study that's currently floating around and being misinterpreted by people who aren't familiar with virology/aerosols.

The tl;dr version is that monkeys being housed in cages next to pigs infected with Ebola got Ebola. Since correlation always =s causation, therefore this means the monkeys were infected by an airborne (see the definition of airborne above) Ebola virus, right?

Not so fast. First, piggies catch Ebola in a way different than humans do. It's actually a respiratory infection that resides in the lungs (vice the liver in primates), so Miss Piggy coughs/sneezes much more than a human or primate infected by Ebola does. Think more like bronchitis. The study also couldn't determine if the virus was transmitted via giant globs of spit (like it is in human -> human transmission) or via teeny tiny aerosolized particles. So one can't draw the conclusion that the virus is airborne because the study wasn't designed to determine that, nor are the animal models (pig + primate) realistic for true human to human or primate to human infection.

[sigmagirl2000]

Just as a side note, she isn't listed in the database as a member of Sigma Kappa (under that name).

That doesn't mean I feel less for her and what she must be going through.

[ComradesTrue]

Originally Posted by sigmagirl2000

Just as a side note, she isn't listed in the database as a member of Sigma Kappa (under that name).

That doesn't mean I feel less for her and what she must be going through.

Thanks for the update. From what I gather, the TCU alumni directly takes the names based on initiation lists submitted to the Greek Life Office at the time of initiation, and if members resign that is not always reflected in the alumni database. Based on several social media posts that I have seen I do think at one time she was a Sigma Kappa at TCU, but perhaps that is no longer the case.

It is sad all the way around. All our health care workers put themselves at risk for many illnesses day in and day out. This young woman was no different. May she be granted comfort, peace and healing in the days/weeks to come.

[pinksequins]

I am not in the fields of medicine/health care/bio research. I've seen several articles stating that Louisiana is refusing to take Texas Ebola patient-related waste (ashes). Biohazard materials (incinerated or not) must be disposed of in a special disposal site (extra linings against leaching) and not in one that takes municipal/standard waste. I am not at this point seeing how Louisiana can legally bar the waste, but, as a practical matter, are there no biohazard disposal sites in Texas?

[Smile_Awhile]

I am, so far, satisfied with the CDC and the medical responses. I am not satisfied by how sensationalized the media has made this medical case. Yes, we should be hearing about the thousands infected in Africa, and we should be aware that there are cases here in the US.

Last Friday, a local news station went nuts over a "Ebola scare". An individual was being monitored at a local hospital for "Ebola-like" symptoms, but was cleared within an hour or two of that first report being released. That didn't stop them from talking about it all weekend and whipping scared members of the public into a frenzy. Awareness is good. Sensationalization is not.

[Phrozen Sands]

I just can't understand why this disease was allowed into this country! Before we know it, there's going to be all kinds of folks sick with it. Mark my words.

[candygirl200413]

Originally Posted by Phrozen Sands

I just can't understand why this disease was allowed into this country! Before we know it, there's going to be all kinds of folks sick with it. Mark my words.

no. no. no. I mean I'm personally surprised it took this long for Ebola to enter the US, because this isn't the first outbreak. It's just the first major outbreak that has resulted in so many deaths.

As a public health major, this REALLY interests me, and also finally gets me closer to thinking what I want to do for grad school down the road. IUhoosiergirl I love all the information you provided!

As for what the CDC has been doing, I personally think they're doing fine! I feel like lapse like this were bound to happen.

I also did hear that Texas Presbyterian did NOT have the hazmat like suits, it was like they were covered, but like not as covered compared to wearing a hazmat suit.

[Just interested]

Just to clarify. It was announced on the Dallas Panhellenic Facebook page that Nina Pham is indeed a member of Sigma Kappa and was an initiate of their chapter at TCU. It asked for prayers for Nina and her family.

[sigmagirl2000]

Actually, Sigma Kappa posted on multiple social media outlets today that Nina was a member for a short time, but no longer is. However, that still doesn't change that we all hope she recovers fully and soon. Affiliation has little to do with the situation at hand. Thinking of her and everyone involved during this hard time.

[DubaiSis]

I am working on a family group for fall 2015 going to Berlin, Barcelona, a Med cruise and then a few days in Athens. Nice trip. I got an email today asking if they need to be worried about ebola or beheadings.

You will be glad to know I did not say LADY, have you looked at a map? And who in the history of EVER went to Saudi Arabia for vacation? And yes, I suppose it is POSSIBLE that a person could contract ebola, go to Berlin, come into close personal contact with one of these travelers and give it to them. But do you cancel a vacation based on that microscopically minute possibility? I also haven't found the polite, professional way to tell them to turn off the friggin TV. All the world's problems will magically disappear.

[Benzgirl]

I'm heading to Italy Friday. I have bigger worries about the Mafia and the Roma than Ebola and ISIS. Heck, Ebola is closer to my house in Ohio than in Rome and Florence.