Ebola - The Bleeding Edge. Part 3.

             The Dallas Hospital Staff that discharged a patient who had recently been in West Africa, with a fever, headache  and abdominal  pain was guilty of an egregious mistake.  The initial excuse was that the electronic entry into the medical record made by the nurse did not appear on the doctor's screen and was therefore missed and the patient inappropriately discharged.  This, in fact, was no excuse at all and was later retracted.  The doctor patient relationship depends on the doctor talking to the patient and taking a medical history, the first and vital stage in any medical  encounter. If that was done he could hardly avoid arriving at a conclusion that would be apparent to any first year resident.   Of course I don't know  the  details of this particular case, but I  would strongly suspect that this patient was not seen by a physician at all. 
              I  am surprised at how quickly  this issue seems to have dropped from the radar, because a mistake such as this could result in wide dissemination of the  infection.  That makes me wonder about the lack of any effective travel controls from  the danger areas into the United States and the rather glib assurances given by some physicians that it is impossible to get the disease from from a person who is not febrile.  While this  is  unlikely, anyone who has practiced medicine for a number of years knows full well that no such absolute assurances can be given. 
              So, while there is no need for panic, there is need careful surveillance and appropriate precautions and care.  One of those precautions should certainty be travel restrictions from infected areas.