Tuesday 14 October 2014

Ebola - The Bleeding Edge - part 4.

                While your chances of dying from Ebola in this part of the world are far less than  from being hit by a texting driver, the panic factor would suggest otherwise.
                 Ebola, or Ebola hemorrhagic fever is caused by a type of virus called an ebolavirus, of which there are five species belonging to the filovirus family.  The initial symptoms are typical influenza like symptoms which commence a couple of days to three weeks after contacting the virus.   After several  days of fever, sore throat, myalgia (muscle pains), malaise and headaches, vomiting and diarrhea and signs of liver and kidney failure develop.  This is followed by bleeding both internally and externally.
                  Now, unless there is a history of the patient having been to parts of Africa where the disease is endemic or having been in  contact with  someone from those areas, there would be no reason in the  early phases to suspect this to be other than influenza.
                   Until now, the experts have suggested safety measures that appear to be more for optics than serve any useful purpose.  The 'Experts' tell  us that there is no danger of contagion from anyone who  is not running a fever at the time, when the most they can say is that it  is much less likely.   The categorical statement that since it is transmissible only in body fluids belies the fact that if you are close to an infected person who coughs on you that saliva, a body fluid my be sprayed on your skin and penetrate it.  The temperature measurement technique they are recommending for airport screening may be better than nothing, but not much.  The myth that unless the patient is running a temperature that he cannot shed the virus is not supported by any evidence.  Ask yourself how they would  handle the numbers even during even mild influenza or other seasonal respiratory  outbreak, unless they are prepared to commandeer all of the hotels in the region, after staffing them with especially trained personnel!   One U.S. report stated 85 %  of nurses have not received any sort of in-service (in-hospital training) in managing this sort of patient and talking  to a nurse from one of the major Canadian hospitals, I was informed that there was no training and apparently no appropriate hazmat equipment.available.   Despite this lack of protocol there was an implication from the CDC Director that the infected nurse was guilty of  some sort of breach  of protocol.  There was no evidence offered to support that allegation.   The outcry from Nursing Associations is justified.  They received no training in coping with situations that most nurses have never had to deal with.
                     There are two vaccines under development that may be promising.  One is being developed in Winnipeg.
                    While the risk of a general  outbreak of  Ebola is unlikely, its consequence would be so severe that it is essential to establish a plan.  Here's mine:
                      1.  In-service training so all staff will know what to do and who to contact when a possible case is being considered.
                       2. Intensive training and dress rehearsals for all staff in close contact.
                       3. Sufficient easily available hazmat equipment for all who might need it.
                       4. Embargo on all flights from infected areas.
                       5. A clearly designated chain of command, military style, that makes it clear who is responsible for what.
                     Comments?

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