Ebola

Ebola cases in Africa have increased from 82 to 1200 since Feb 2014.  It has been hypothesized that the first patient becomes infected through contact with an infected animal.
Humans transmit it to others by direct contact with the blood or secretions of an infected person, or exposure to objects (such as needles) that have been contaminated with infected secretions and not sterilized properly. 
It spreads through families and friends by coming in close contact with infectious secretions when caring for ill persons or activities that exchange body fluids. 
Exposure can occur in health care settings where hospital staff are not wearing appropriate protective equipment, such as masks, gowns, and gloves. 
Proper cleaning and disposal of instruments, such as needles and syringes, must be sterilized before being used again or the transmission will continue and amplify into an outbreak. 
Most places in Africa do not have disposable needles and they are not as careful in sterilizing. 
In Africa, the difficulties in containing the outbreak include the multiple locations across country borders, inadequate equipment given to medical personnel, funeral practices,
and public reluctance to follow preventive practices, including "freeing" suspected Ebola patients from isolation, and suspicion that the disease is caused by witchcraft, or that doctors are killing patients. 
There are only 150 doctors for the 4 million people in Libia so most ill people in Africa never go get care for fevers and such. 
Just like most illnesses, there are many cases of mild or subclinical illnesses that go unreported, especially in Africa where medical care is not readily available. 
The death rate has been estimated at 55-75% but I bet it is more like 10- 20% or less.  It is still a bad disease and we pray it does not make it to America where we have not had one case yet. 
It is not as widespread as the newsmedia presents it since 1-2000 out of 10 million is not "ravaging" Africa. 
The CDC and WHO is trying to contain it.   It is not time to worry about this.

Roger Knapp MD
August 1, 2014

 

 

Another comment about Ebola:

The head of the World Health Organization talked about Ebola:

 

 Yes, Ebola is a scary infectious disease. But the first thing you should know is that it's not very contagious -- the virus isn't spread through the air via coughs or sneezes like the common cold. It's spread through frequent contact with bodily fluids and can be spread only by someone who is showing symptoms.

So if they're not feeling sick ...

Many viruses can hide in the body and spread from person to person without causing any symptoms in the people it infects. Ebola isn't like that.

"Ebola doesn't spread before someone gets sick," Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, said Tuesday. "Ebola does not spread ... from someone who doesn't have fever and other symptoms."

Symptoms generally occur abruptly eight to 10 days after infection, though that period can range from two to 21 days.

As people with the Ebola virus become sicker, they become more infectious, experts say. The virus can also spread through bodily fluids after the patient dies.

And by 'bodily fluids,' you mean?

Blood, sweat, feces, vomit, semen and spit. Basically any kind of fluid that comes from the body. People in West Africa are avoiding hugs and handshakes because the virus can be spread through the sweat on someone's hand.

 

So we are trusting someone who says it can’t be spread by cough or sneeze.  But it can be spread by spit and sweat.  I kind of thought those were similar saliva contamination.  I am still not convinced that it is not contagious until there is fever.  HIV is contagious 5 years before symptoms.  I cannot find any reported medical studies that prove the time patients are contagious.  Who knows! 

 

I still think we do not know how many people in Africa get Ebola and not die.  Probably there in Africa Mortality is high but with modern therapy here it probably is less.  Mortality in Africa outbreaks have ranged from 37% to 80%.  It still is a bad infection and we don’t want it here.  I pray that none of the people exposed here come down with it.

 

I wonder how many healthcare workers, who are over cautious and still getting infections, are acquiring it from foods.  Their food handling sanitation is probably terrible in Africa. 

 

Do not be overly concerned about this disease at this time.

 

Roger Knapp MD      Oct 5, 2014.

 

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Well we finally had our first case of Ebola acquired in America.  You heard of the nurse that came down with it.  She went to the hospital with symptoms and after 1 ½ hours was admitted to isolation.   Spreading the virus for a time.  Why did she not call from home and say she was exposed and ill and to come get her.  They then could have put her is a suit at home and transported her safely to ICU and Isolation.  I wonder how long the first index case man who went to the ER, was sent home, then went back to the ER, and was finally suspected of having Ebola.  How long was he exposing  hospital workers until he was put into isolation.  This nurse either did not follow isolation techniques carefully or (as I think) was exposed to it before they put him into isolation.  Hopefully with our better therapy she will be OK.  And they are now starting human trials of a vaccine and it will be in high gear to rush to market through the FDA.

Roger Knapp MD  Oct 14, 2014