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Ebola Patient Coming to U.S.
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By Bahamut.Baconwrap 2014-10-12 14:12:43
This (among many reasons) is why Western countries should be trying to get this outbreak under control now.
Getting an outbreak under control when there isn't an effective treatment is pretty difficult. The realistic solution is quarantining the area and allowing those infected to die off, that's the sad reality edit: given its communicability and mortality rate. Obviously, experimental drugs can and should be used on patients.
At this point Western countries are essentially sending physicians and researchers for developing an effective treatment, not helping these people so much.
 Bahamut.Milamber
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By Bahamut.Milamber 2014-10-12 14:15:34
Bahamut.Baconwrap said: »I feel that the author is an idiot.
The author, Jack Chow, has a pretty impressive background in public health, especially in global health. That's great. Then he should have a pretty good idea of how a system that relies upon self-reporting and active symptoms, with a possible delay of up to three weeks before having active symptoms, can be porous.
Or how misdiagnosing and releasing a patient back into the general populous could be problematic.
Which, to be fair, he covers. Saying it was unforseen that such things could happen is false, misleading, and absolutely silly.
Unless you have an extremely low false-positive/false-negative emperical test that is able to detect the disease in asymptomatic people, your screening method will be porous, and you are relying on isolating anyone that comes in as quickly and as completely as possible.
And again, there was no reason for the misdiagnosis and subsequent release of the patient. That, and the responses issued by the hospital, is more telling about the professionalism/focus of the hospital. It isn't that anyone didn't forsee the consequences of misdiagnosis.
Now, you could say that no one expected the level of competence to be so poor. Which is an issue that isn't focused on enough, despite the fact that this is where the critical difference lies.
Which is what he comes to in meandering conclusion, although he uses the word readiness instead of competence.
The concept he throws out regarding "Ebola refugees" is pretty much irrelevant to the entire discussion. Hell, the care, feeding, and treatment for all of the Ebola victims so far is probably less than the ISIS deployment. The only thing it can generate is some expectation that there would be more potential cases....which is true until the breakout is controlled.
And given in the US how often people will see a doctor when they have flu-like symptoms, and how often they will continue to go to work, I would be far more worried about your fellow citizens' approach to managing their health (and the impact it has on yours).
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By Bahamut.Baconwrap 2014-10-12 14:18:40
Unless you have an extremely low false-positive/false-negative emperical test that is able to detect the disease in asymptomatic people, your screening method will be porous, and you are relying on isolating anyone that comes in as quickly and as completely as possible.
Not really. We could ban all flights from those nations as some have suggested. British Airways has already placed restrictions on their flights to the infected areas.
Bahamut.Milamber
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By Bahamut.Milamber 2014-10-12 14:19:21
Bahamut.Baconwrap said: »Unless you have an extremely low false-positive/false-negative emperical test that is able to detect the disease in asymptomatic people, your screening method will be porous, and you are relying on isolating anyone that comes in as quickly and as completely as possible.
Not really. We could ban all flights from those nations as some have suggested. British Airways has already placed restrictions on their flights to the infected areas. Which is still porous.
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By Bahamut.Baconwrap 2014-10-12 14:21:51
Really? We are going to have people swimming across the Atlantic or possibly via paddle boats?
Bahamut.Kara
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By Bahamut.Kara 2014-10-12 14:26:38
Bahamut.Baconwrap said: »
Really? We are going to have people swimming across the Atlantic or possibly via paddle boats? You will see them swimming and taking boats to Italy.
With the other refugees who do that on a regular basis.
 Ragnarok.Hevans
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By Ragnarok.Hevans 2014-10-12 14:27:31
Bahamut.Baconwrap said: »
Really? We are going to have people swimming across the Atlantic or possibly via paddle boats?
or riding a train, car, truck, motorcycle, or unicylce across an uncontrolled border or two to a that doesn't have flights blocked?
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Bahamut.Milamber
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By Bahamut.Milamber 2014-10-12 14:28:39
Bahamut.Baconwrap said: »
Really? We are going to have people swimming across the Atlantic or possibly via paddle boats?
Direct non-flight travel, sure. Or flights from neighboring countries. Or flights from countries which haven't banned flights from the area. Or flights from countries neighboring countries which haven't banned flights from the area. I'm sure you get the idea.
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By Bahamut.Baconwrap 2014-10-12 14:29:05
Bahamut.Baconwrap said: »
Really? We are going to have people swimming across the Atlantic or possibly via paddle boats? You will see them swimming and taking boats to Italy.
With the other refugees who do that on a regular basis.
Is illegal immigration to Europe from Africa a serious issue?
Bahamut.Baconwrap said: »
Really? We are going to have people swimming across the Atlantic or possibly via paddle boats?
Direct non-flight travel, sure. Or flights from neighboring countries. Or flights from countries which haven't banned flights from the area. Or flights from countries neighboring countries which haven't banned flights from the area. I'm sure you get the idea. That isn't something i had really considered.
Bahamut.Kara
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By Bahamut.Kara 2014-10-12 14:33:29
Bahamut.Baconwrap said: »This (among many reasons) is why Western countries should be trying to get this outbreak under control now.
Getting an outbreak under control when there isn't an effective treatment is pretty difficult. The realistic solution is quarantining the area and allowing those infected to die off, that's the sad reality. Obviously, experimental drugs can and should be used on patients.
At this point Western countries are essentially sending physicians and researchers for developing an effective treatment, not helping these people so much. Quarantining 3 countries in Africa is unrealistic. People will get out. Where there is will, there is a way.
1/3~ of Sierra leone has been under quarantine for weeks and cases developed outside that zone.
https://www.internationalsos.com/ebola/index.cfm?content_id=397&language_id=ENG
Quarantining a few people is easy. When it gets into the millions...that is very difficult.
Western countries have been sending in teams to build more hospitals, educate the populace, bury the dead properly, etc. However, it has been very slow in happening and the pace doesn't seem to be increasing at a very good rate.
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By Bahamut.Baconwrap 2014-10-12 14:35:24
Quarantining 3 countries in Africa is unrealistic. People will get out. Where there is will, there is a way.
This sounds all too much like Resident Evil 5 the part in Africa!
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Bahamut.Kara
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By Bahamut.Kara 2014-10-12 14:35:34
Bahamut.Baconwrap said: »Bahamut.Baconwrap said: »
Really? We are going to have people swimming across the Atlantic or possibly via paddle boats? You will see them swimming and taking boats to Italy.
With the other refugees who do that on a regular basis.
Is illegal immigration to Europe from Africa a serious issue? Yes.
Seha can tell you more about it. But here are some articles.
http://www.spiegel.de/international/europe/european-refugee-crisis-worsens-in-mediterranean-a-964304.html
http://www.theguardian.com/world/2014/jun/02/europe-refugee-crisis-un-africa-processing-centres
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By Bahamut.Baconwrap 2014-10-12 14:52:02
And again, there was no reason for the misdiagnosis and subsequent release of the patient. That, and the responses issued by the hospital, is more telling about the professionalism/focus of the hospital. It isn't that anyone didn't forsee the consequences of misdiagnosis.
Now, you could say that no one expected the level of competence to be so poor. Which is an issue that isn't focused on enough, despite the fact that this is where the critical difference lies.
This is not always the practitioner's or health systems fault. The advent of webMD and wikipedia has made diagnosis a more difficult process, ask any health practitioner that. Patients will falsify symptoms sometimes to their practitioner. It isn't always intentional, but often patients will read the symptoms list and start to think they actually have such symptoms.
Quote: Symptoms show up 2 to 21 days after infection and usually include:
High fever.
Headache.
Joint and muscle aches.
Sore throat.
Weakness.
Stomach pain.
Lack of appetite.
Ebola Virus - WebMD
Well that describes several possible conditions...
So it really isn't the fault of the health care system per-se, American patients are a huge headache within themselves. Hospitals, physicians, etc. can only do so much.
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By Odin.Godofgods 2014-10-12 15:16:27
Quote: Symptoms show up 2 to 21 days after infection and usually include:
High fever.
Headache.
Joint and muscle aches.
Sore throat.
Weakness.
Stomach pain.
Lack of appetite.
Ebola Virus - WebMD
damn.. i have 6/7 on a daily basis just living. (Not being sick)
Then again... with all my medical issues...
Ive always said i was a scientifically formulated medical miracle.
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By Bahamut.Baconwrap 2014-10-12 15:26:07
Ive always said i was a scientifically formulated medical miracle.
Kinda like Mr. Burns!
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 Valefor.Sehachan
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By Valefor.Sehachan 2014-10-12 15:30:18
Hundreds of people of all ages arrive pretty much weekly in Lampedusa(an island at the bottom of Sicily), they all come from Africa in boats too small for them, as a matter of fact many die falling off and drowning or even asphixiated on board. It's a terrible thing that's been ongoing for many years and still no one seem to know how to fix.
Of course this can cause some really bad consequences with the ebola thing...
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Bahamut.Milamber
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By Bahamut.Milamber 2014-10-12 15:59:17
Bahamut.Baconwrap said: »And again, there was no reason for the misdiagnosis and subsequent release of the patient. That, and the responses issued by the hospital, is more telling about the professionalism/focus of the hospital. It isn't that anyone didn't forsee the consequences of misdiagnosis.
Now, you could say that no one expected the level of competence to be so poor. Which is an issue that isn't focused on enough, despite the fact that this is where the critical difference lies.
This is not always the practitioner's or health systems fault. The advent of webMD and wikipedia has made diagnosis a more difficult process, ask any health practitioner that. Patients will falsify symptoms sometimes to their practitioner. It isn't always intentional, but often patients will read the symptoms list and start to think they actually have such symptoms.
Quote: Symptoms show up 2 to 21 days after infection and usually include:
High fever.
Headache.
Joint and muscle aches.
Sore throat.
Weakness.
Stomach pain.
Lack of appetite.
Ebola Virus - WebMD
Well that describes several possible conditions...
So it really isn't the fault of the health care system per-se, American patients are a huge headache within themselves. Hospitals, physicians, etc. can only do so much. Well, yes and no.
Considering his recent travel information was provided, that moves the probability from being close to zero to being something that needed to be considered.
Pretty much two of the simplest questions that can be asked to get good data from a patient are:
- What is your occupation?
- When did you last travel, and where?
It takes extremely little time, and gives you an opportunity to have some rapport with the patient, while also giving you an opportunity to directly observe them.
What they answer may potentially be directly pertinent (for example, in the instance such as recently travelling to areas where other diseases are more common, or an occupational illness), or indirectly through how they respond.
And it shouldn't be just one level of question/response either; you should be re-verifying information obtained at earlier points.
The same thing goes for symptoms, beyond just accepting what they offer as a symptom, inquiring as to how the symptom feels can be revealing as well.
No one is perfect, and by Thor, some people can be significantly more difficult to observe/handle/treat than others. And yes, it may take somewhat more time per patient, and a correspondingly higher cost.
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By Bahamut.Baconwrap 2014-10-12 16:19:38
Well, yes and no.
Considering his recent travel information was provided, that moves the probability from being close to zero to being something that needed to be considered.
Pretty much two of the simplest questions that can be asked to get good data from a patient are:
- What is your occupation?
- When did you last travel, and where?
It takes extremely little time, and gives you an opportunity to have some rapport with the patient, while also giving you an opportunity to directly observe them.
Ebola isn't something most ER's have to encounter on frequent basis so it's easy to understand why they just sent him home with antibiotics, especially if his symptoms were as ambiguous as follows: Quote: High fever.
Headache.
Joint and muscle aches.
Sore throat.
Weakness.
Stomach pain.
Lack of appetite.
Especially for ambiguous symptoms as above you generally don't assume the worst. Even if he stated his travel dates, it could have easily be assumed it was a protozoan infection. Numerous infections/disease share similar symptoms. This isn't the first or the last time a physician incorrectly diagnosis someone initially based on ambiguous symptoms.
Also take in mind, ER or urgent care staff don't usually have an infectious disease specialist on staff. That's simply not usually part of whats necessary when staffing such departments.
Bahamut.Kara
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By Bahamut.Kara 2014-10-12 18:57:48
Bahamut.Baconwrap said: »
Also take in mind, ER or urgent care staff don't usually have an infectious disease specialist on staff. That's simply not usually part of whats necessary when staffing such departments.
At least in FL an infectious disease nurse has to be available per so many hospitals.
My mother-in-law is an infectious disease nurse and she had to rotate between three hospitals.
Iirc, there are state and federal guidelines for this.
 Leviathan.Chaosx
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By Leviathan.Chaosx 2014-10-12 19:20:28
So Boston is having a scare atm, could be next...?
By Jetackuu 2014-10-12 22:09:26
Bahamut.Baconwrap said: »tl;dr not every Hospital has all their staff be like House. good enough?
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By Asura.Kingnobody 2014-10-12 23:11:48
Welp, time for bed.
If I don't die in my sleep from Ebola tonight, you can thank Obama for failing yet again!
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Bahamut.Milamber
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By Bahamut.Milamber 2014-10-13 02:12:03
Bahamut.Baconwrap said: »Well, yes and no.
Considering his recent travel information was provided, that moves the probability from being close to zero to being something that needed to be considered.
Pretty much two of the simplest questions that can be asked to get good data from a patient are:
- What is your occupation?
- When did you last travel, and where?
It takes extremely little time, and gives you an opportunity to have some rapport with the patient, while also giving you an opportunity to directly observe them.
Ebola isn't something most ER's have to encounter on frequent basis so it's easy to understand why they just sent him home with antibiotics, especially if his symptoms were as ambiguous as follows: Quote: High fever.
Headache.
Joint and muscle aches.
Sore throat.
Weakness.
Stomach pain.
Lack of appetite.
Especially for ambiguous symptoms as above you generally don't assume the worst. Even if he stated his travel dates, it could have easily be assumed it was a protozoan infection. Numerous infections/disease share similar symptoms. This isn't the first or the last time a physician incorrectly diagnosis someone initially based on ambiguous symptoms.
Also take in mind, ER or urgent care staff don't usually have an infectious disease specialist on staff. That's simply not usually part of whats necessary when staffing such departments. A C reactive protien test would be a good start at differentiating between bacterial/viral infection.
Of course, it comes with the associated risk for biohazard, as you are taking the patient's blood.
By Jetackuu 2014-10-13 02:16:13
He was sent home on the 26th, that gives her only about 2 weeks, it takes longer than that for it to incubate... Something seems amiss. No it doesn't.
2 days is the minimum amount of time up to 21 days. My bad, continue.
 Quetzalcoatl.Bloodpool
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By Quetzalcoatl.Bloodpool 2014-10-13 02:26:13
Blow that ***up... Chernobyl peoples ***'... Population control is a great idea... especially in a third world area of the world... Differing opinions?
 Cerberus.Pleebo
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By Cerberus.Pleebo 2014-10-13 02:31:11
Quetzalcoatl.Bloodpool
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By Quetzalcoatl.Bloodpool 2014-10-13 02:43:18
clearly... I apologize
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By Asura.Kingnobody 2014-10-13 07:02:06
I survived another night without getting Ebola.
Thanks Obama!
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By Bismarck.Dracondria 2014-10-13 09:58:44
 Fenrir.Atheryn
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By Fenrir.Atheryn 2014-10-13 15:22:54
Quote: Nina Pham identified as Dallas nurse with Ebola
DALLAS — The Texas nurse who contracted Ebola while caring for the first person to die of the virus in the U.S. has been identified as 26-year-old Nina Pham.
Health officials have not released the nurse’s name, but Yahoo News identified Pham through public records and a state nursing database.
Then on Monday, Pham’s family confirmed her identity to local Dallas ABC News affiliate WFAA.
Pham, a critical care nurse at Texas Health Presbyterian Hospital, is one of at least 50 people who cared for Thomas Eric Duncan before he died last Wednesday.
Pham has been in isolation since late Friday. The CDC confirmed her Ebola diagnosis on Sunday. It is the first time the deadly virus has been transmitted in the United States.
The Dallas resident is a 2010 graduate of Texas Christian University and has been a nurse since June 2010, according to state records.
The CDC director, Dr. Thomas Frieden, said Pham is in stable condition at Texas Health Presbyterian. An unidentified person Pham had close contact with last week is also being monitored, but Frieden said that individual has shown no symptoms of Ebola.
Investigators have not determined how Pham specifically contracted the disease from Duncan, who died on his 10th day of intensive care at the hospital.
"If this one individual was infected and we don't know how — within the isolation unit — then it is possible that other individuals could have been infected as well," Frieden said during a press conference. "We consider them to be at risk, and we are doing an in-depth review and investigation."
A day earlier, Frieden characterized the transmission from Duncan to Pham as a possible breach in safety protocols. On Monday he apologized for those remarks.
"Some interpreted that as finding fault with the hospital or the health care worker, and I'm sorry if that was the impression given. That was certainly not my intention," Frieden said. "What we need to do, is all take responsibility for improving the safety of those on the front lines. I feel awful that a health care worker became infected in the care of an Ebola patient. She was there trying to help the first patient survive."
Tom Ha, a longtime friend of Pham's family, told the Dallas Morning News that it is in the nurse's genes to go out of her way to assist others.
"I expect, with the big heart that she has, she went beyond what she was supposed to do to help anyone in need," Ha told the newspaper.
(This story was updated at 2:05 p.m. ET.)
Reuters.com said: A U.S. aid worker who was infected with the deadly Ebola virus while working in West Africa will be flown to the United States to be treated in a high-security ward at Emory University Hospital in Atlanta, hospital officials said on Thursday.
The aid worker, whose name has not been released, will be moved in the next several days to a special isolation unit at Emory. The unit was set up in collaboration with the U.S. Centers for Disease Control and Prevention.
CDC spokeswoman Barbara Reynolds said her agency was working with the U.S. State Department to facilitate the transfer.
Reynolds said the CDC was not aware of any Ebola patient ever being treated in the United States, but five people in the past decade have entered the country with either Lassa Fever or Marburg Fever, hemorrhagic fevers similar to Ebola.
News of the transfer follows reports of the declining health of two infected U.S. aid workers, Dr. Kent Brantly and missionary Nancy Writebol, who contracted Ebola while working in Liberia on behalf of North Carolina-based Christian relief groups Samaritan's Purse and SIM.
CNN and ABC News reported that a second American infected with Ebola was to be flown to the United States. CNN identified the U.S.-bound patients as Brantly and Writebol. Reuters could not independently confirm the reports.
Amber Brantly, the wife of Dr. Brantly, said in a statement: "I remain hopeful and believing that Kent will be healed from this dreadful disease."
Earlier on Thursday, White House spokesman Josh Earnest said the State Department was working with the CDC on medical evacuations of infected American humanitarian aid workers.
The outbreak in West Africa is the worst in history, having killed more than 700 people since February. On Thursday, the CDC issued a travel advisory urging people to avoid all non-essential travel to Guinea, Liberia and Sierra Leone, the epicenter of the outbreak.
Brantly and Writebol "were in stable but grave" condition as of early Thursday morning, the relief organizations said. A spokeswoman for the groups could not confirm whether the patient being transferred to Emory was one of their aid workers.
CDC Director Dr. Thomas Frieden said in a conference call that transferring gravely ill patients has the potential to do more harm than good.
Meanwhile, the National Institutes of Health plans in mid-September to begin testing an experimental Ebola vaccine on people after seeing encouraging results in pre-clinical trials on monkeys, Dr. Anthony Fauci, director of the NIH's allergy and infectious diseases unit, said in an email.
In its final stages, Ebola causes external and internal bleeding, vomiting and diarrhea. About 60 percent of people infected in the current outbreak are dying from the illness.
Writebol, 59, received an experimental drug doctors hope will improve her health, SIM said. Brantly, 33, received a unit of blood from a 14-year-old boy who survived Ebola with the help of Brantly's medical care, said Franklin Graham, president of Samaritan's Purse.
Frieden could not comment on the specifics of either treatment but said: "We have reviewed the evidence of the treatments out there and don't find any treatment that has proven effectiveness against Ebola."
Source
Not really sure how I feel about this.
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