Ebola in Texas

[SmilingBluEyes]

Confirmed, a case in Texas.

[h=1][/h]

http://www.washingtonpost.com/news/to-your-health/wp/2014/09/30/cdc-confirms-first-case-of-ebola-in-the-u-s/

[Jolie, BSN]

Perhaps because the conditions under which he was treated stateside are well-known and well-observed, and the staff of the bio-containment unit have proven reliable about adhering to monitoring requirements, a vast difference from the nurse in Maine who refused to cooperate with measures intended to protect her fellow citizens when she presented at the airport with a fever.

Dr. Salia was ill with Ebola-like symptoms for 2 full weeks before a test finally came back positive for the virus, a requirement for the transport program to be put into effect.

"It's not unusual to see false negative tests for Ebola in the early stages because the amount of the virus in the bloodstream is still low, said Dr. Phil Smith, the infectious-disease expert who leads the Nebraska Medical Center's biocontainment unit.

The U.S. government warns doctors to be wary of possible false negative tests for Ebola." AOL - News, Sports, Weather, Entertainment, Local & Lifestyle

This is precisely why it was not unreasonable for the nurse to be placed in isolation or under quarantine until it could be definitively determined whether or not she had Ebola. It remains beyond my comprehension how someone who was willing to risk her own life to care for those in need was unwilling to protect her fellow citizens upon return home.

[toomuchbaloney]

She refused to cooperate?

She certainly was verbal, but she was at the airport for hours and then was detained in a tent before she was allowed to return to her home.

She followed the accepted standards for self monitoring while continuing to advocate for calm and practical application of scientific standards for quarantine of SYMPTOMATIC patients.

What part of that is uncooperative? Maybe the part where she didn't just shut up and do what the frightened people wanted her to do when she knew that it was ridiculous, unnecessary, and a violation of her rights?

It was not reasonable to quarantine an asymptomatic individual. We just demonstrated that even a symptomatic ebola victim does not have adequate viral burden to even test positive, much less spread the disease through casual contact. If they are not symptomatic they cannot give you the disease.

[herring_RN, ASN, BSN]

New California Ebola Mandate Sets National Model for Highest Protections, Say RNs

Following a worldwide day of actions of 100,000 registered nurses and health workers demanding substantial improvements in safeguards for Ebola virus, California officials announced landmark mandatory Ebola guidelines that should be a model for federal and state action for all U.S. hospitals, National Nurses United said.

NNU, which has sponsored two months of actions to upgrade Ebola protections, and its California affiliate, California Nurses Association, praised the new standards released last week by the California Occupational Safety and Health Administration (Cal-OSHA) under the leadership of Gov. Jerry Brown.

"These rules are a testament to the outspoken efforts of nurses who have repeatedly pressed for the highest level of mandatory safety precautions to protect nurses, patients, and the public. Nurses have raised their voices, and California has now listened, acted, and once again set a benchmark for the nation," says NNU and CNA executive director RoseAnn DeMoro.

The new California standards, an elaboration of existing Cal OSHA regulations on Aerosol Transmissible Disease and other existing regulations, go well beyond the faulty procedures and protective gear employed by hospitals across the U.S., and the current, unenforceable recommendations of the federal Centers for Disease Control and Prevention.

By contrast, California regulations are mandatory. The guidance under existing standards, which are effective immediately, stipulate the optimal level of personal protective equipment, rigorous training and drills, and break additional ground in identifying modes of possible transmission of the virus and when safety precautions must be engaged for nurses and other front line health workers who encounter patients with the deadly Ebola virus.

"With the hospital industry dismissing the concerns of the nurses, and the federal government failing to order the hospitals to implement the optimal level of Ebola protection, California, under the stewardship of Gov. Brown, has heard the voices of nurses, and established a model that all should follow," says CNA co-president Zenei Cortez, RN...

http://www.infectioncontroltoday.com...s-say-rns.aspx

[Jolie, BSN]

Attributing negative results to insufficient viral loads is inconsistent with the reports that Dr. Salia was visibly ill, which we know equates to being infectious. There is a greater likelihood that the tests were somehow flawed. Not unusual, as every established medical test has known false positives and false negatives.

A negative Ebola test in a person who has exhibited symptoms can not be trusted to indicate freedom from disease. In this case, the only sure way of ruling out infection is to wait out the incubation period.

And yes, she violated quarantine by leaving her home and her neighborhood to ride her bike in an orchestrated attempt to gain press attention.

[toomuchbaloney]

Attributing negative results to insufficient viral loads is inconsistent with the reports that Dr. Salia was visibly ill, which we know equates to being infectious. There is a greater likelihood that the tests were somehow flawed. Not unusual, as every established medical test has known false positives and false negatives.

A negative Ebola test in a person who has exhibited symptoms can not be trusted to indicate freedom from disease. In this case, the only sure way of ruling out infection is to wait out the incubation period.

And yes, she violated quarantine by leaving her home and her neighborhood to ride her bike in an orchestrated attempt to gain press attention.

There was no reason to quarantine her.

Riding a bicycle placed no person at risk for getting ebola from an asymptomatic individual.

She had permission to ride her bike when she did.

It was an important fact that this nurse continued to verbalize appropriate, evidence based, and science based rational for self monitoring without isolation while she was asymptomatic. That "press attention" was sorely needed in a time when hysteria was winning the public dialog.

We KNOW that even when we isolate several individuals in a small apartment which contains the grossly contaminated linens and clothing of an acutely ill ebola patient (who subsequently died only days later) the people are not guaranteed to come down with the disease. In fact none of them caught it. It was a nice little experiment that the TX officials conducted with Thomas Duncan's primary contacts.

So, do you think we should be requiring quarantine of every HCW who cares for ebola patients in the USA?

[No Stars In My Eyes]

Let's just have a mandatory National Quarantine Month and get it over with for everybody all at the same time. Yuh.

[TiffyRN, BSN, PhD]

Oh wait! Wait!

Can I be quarantined during Thanksgiving & Christmas holidays? Not the kind where I'm locked up in my house but rather not allowed to care for patients? Me! Me!

[Mulan]

Nurse Kaci Hickox, boyfriend open up about the forced quarantine battle, leaving Fort Kent — Aroostook — Bangor Daily News — BDN Maine

"And what about that bike ride?'

"“For us, it was definitely a lovely outing,” Hickox said. “We had not been out of the house in days, and we’d been through a lot.”"

"The couple stressed, however, it was indeed an act of civil disobedience aimed at forcing LePage’s hand with regards to the court order."