Ebola in Texas

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Specializes in L & D; Postpartum.

A photographer for NBC has tested positive now and he will be flown back to the US. Dr. Nancy Snyderman and her team (of which the camera man was part) are being flown back too, and will be in isolation.

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Minute by minute changes . . . still, this is not easily passed from person to person without contact with bodily fluids.

Good show on NYU Docs tomorrow morning about Ebola and Enterovirus D68 at 10:00 a.m. for those of you with Sirius Radio. Channel 81.

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Specializes in Community, OB, Nursery.

The fact that it's not spread unless there is direct contact with blood/bodily fluids is the reason I haven't been flipping out so far.

Viruses are good at mutating, though, and I don't want to be the one affected when Ebola/Marburg/filavirus du jour decides to go airborne.

I still don't want to sit next to someone on the airplane who might have Ebola, but to be fair I'd rather not sit next to someone with norovirus either.

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I think this is the same as sitting next to someone who is HIV positive. You aren't going to catch it by sitting by someone.

Think of me in the morning - I get to do a teacher training day. I know ebola and enterovirus D68 will come up.

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Specializes in Community, OB, Nursery.
I think this is the same as sitting next to someone who is HIV positive. You aren't going to catch it by sitting by someone.

Except that people with HIV aren't going to be vomiting or have diarrhea or bleeding out of orifices. That's the whole point. Sitting next to someone in itself is not the issue; it's that sitting next to someone who may start puking or bleeding makes it a whole lot more likely that you'll come into contact with their fluids. If they are not symptomatic, fine.

But again, viruses mutate. When airborne-transmissible Ebola manifests I'd like to be far away from it if possible.

If you want to sit next to anyone who's throwing up, be my guest. ;)

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Specializes in Med nurse in med-surg., float, HH, and PDN.

Seems there are two responses in America both stemming from ignorance: Denial or Panic.

In the WEEK magazine there is always a segment titled "Health Scare of the Week". Sometimes it's real, sometimes it's ridiculous.

Though the circumstances are different ( we didn't have a clue vs. knowledge is available) I keep harkening back to the 1980's AIDS Debacle, and hearing Frank Zappa singing "It Can't Happen Here".

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Well, I was wrong about the time of the meeting. One principal has her staff meeting before school but this one has it after the kids leave for the day so . . .I've got lots of time. ;)

I did listen to the hour of information from NYU Docs and it was good.

One thing mentioned was by Dr. Marc Siegel, who brought up HIV and Ebola. He mentioned that he had a column out today as well. The difference between HIV and Ebola is that HIV has no manifestations for a long long time so you can spread the virus through body fluids without having any idea that you are sick.

Ebola comes on rapidly. Although the entire hour the doctors said you need a large viral load for this to be infectious unlike something like norovirus, which takes very little. And that it isn't respiratory. One of the last calls though was tricky - a woman mentioned a family coming from West Africa not realizing one the members is sick until they get on the plane and someone has diarrhea. If it is someone who doesn't clean up after themselves well, is there a risk?

The current Ebola Zaire strain is essentially the same one first discovered in 1976. Like HIV, it is a relatively stable virus. So, according to Fauci, it’s unlikely to “go airborne” — that is, to mutate into a more easily transmissible form.

And that’s why you shouldn’t fear: Unlike HIV and lucky for us, you have to be sick to spread Ebola.

Here's the article:

Ebola and AIDS: A tale of Two Viruses | New York Post

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Specializes in L & D; Postpartum.

The Red Cross is supplying the family with food. They refused to quarantine themselves, as I understand it, and therefore, the legal order for them to stay inside. It may seem harsh, but I feel a necessary precaution.

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Specializes in Community, OB, Nursery.
One thing mentioned was by Dr. Marc Siegel, who brought up HIV and Ebola. He mentioned that he had a column out today as well. The difference between HIV and Ebola is that HIV has no manifestations for a long long time so you can spread the virus through body fluids without having any idea that you are sick.

Ebola comes on rapidly. Although the entire hour the doctors said you need a large viral load for this to be infectious unlike something like norovirus, which takes very little. And that it isn't respiratory. One of the last calls though was tricky - a woman mentioned a family coming from West Africa not realizing one the members is sick until they get on the plane and someone has diarrhea. If it is someone who doesn't clean up after themselves well, is there a risk?

Here's the article:

Ebola and AIDS: A tale of Two Viruses | New York Post

Exactly. Since the symptoms are sudden-onset, what if it happens in the middle of a flight/grocery store/name your enclosed space? I don't carry enough PPE with me everywhere I go to deal with that. On a trans-Atlantic flight, exactly where will they make an emergency landing to offload the passenger and decontaminate as needed?

Regarding its being stable since 1976, that's less than 40 years and in the scheme of history, really no time at all. It's undoubtedly been around much longer than that and no one really knows what changes it went through prior to discovery. It's made the jump from bats to apes to humans....I'm just saying. We've been studying it since then, it just hasn't made national headlines much like HIV has. Richard Preston wrote about it 20+ years ago.

Retroviruses - like Ebola and HIV - mutate all the time. It's just that some (most?) of the mutations aren't biologically relevant. Just like most of us probably carry several mutations on our genome that don't cause any issue.

Again, I'm not freaking out about it but don't feel the need to tempt fate either.

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Specializes in Maternal - Child Health.

Perhaps someone can help me understand a few things that aren't quite clear to me.

Ebola is spread by direct contact with infected body fluids, as is HIV. In order to contract HIV, virus from infected body fluids must enter the body via a "port of entry" such as a cut, puncture wound or direct contact with a mucous membrane (sexual intercourse or splash of blood in the eye, for example.) If I were to touch infected blood of an HIV patient with healthy, intact skin, I would not contract HIV. I certainly wouldn't recommend this experiment, but we do know from scientific evidence and anecdotal examples that this is true. I could thoroughly clean my healthy, intact skin post exposure and not develop HIV.

Is the same true with Ebola? Or does the Ebola virus somehow gain entry thru healthy, intact skin? I guess what puzzles me is reports of people who have had passing contact with Ebola patients becoming ill. Nowhere have I read that a person infected by an Ebola patient had a dramatic exposure to projectile vomit, uncontrollable diarrhea or suddenly spurting blood. The gentleman diagnosed in Dallas helped to carry his Ebola-infected neighbor to the hospital. I can picture him being dampened by the woman's perspiration, but still can't quite understand how that caused him to become infected if indeed Ebola is spread in the same manner as HIV. I'm not hearing reports of him having open wounds that came in contact with his neighbor's perspiration, or that she was bleeding profusely and splashing blood into the face of the man carrying her. So why, despite the same mechanism of transmission as HIV, is Ebola seemingly so much more contagious?

Secondly, we are told that a person with Ebola becomes infectious when their symptoms appear. So is the man sitting next to you on an airline flight with an unrecognized temperature elevation of 101 degrees contagious? What about from the first moment his stomach begins to feel upset, perhaps hours before he first vomits or has diarrhea. What about the morning before he boarded the flight, when his throat began to feel a tiny bit scratchy? It seems a bit disingenuous to me that we are reassured that without symptoms, no fear of contagion need exist. How can that be true and forthright when few, if any would truly recognize the earliest symptoms?

Thirdly, without travel restrictions imposed by our own government, how do we plan to prevent individuals who may privately know of exposure to Ebola from boarding planes in the hopes of arriving on our shores pre-symptom so that when they fall obviously ill, they will have access to our healthcare system. Granted, there are probably not swarms of people living in Liberia or Sierra Leone who have the means to travel on short notice to the U.S., but desperate times make for desperate measures. Perhaps it is my natural skepticism, but I believe that may be the case with the gentleman in Dallas.

Not that I begrudge life-saving medical treatment to anyone, but I believe that our current handling (no travel restrictions, very little screening and no detainment of new arrivals) of the Ebola crisis will encourage risky behavior that will ultimately expose thousands, if not more people unnecessarily to this deadly disease.

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Specializes in Maternal - Child Health.

One thing mentioned was by Dr. Marc Siegel, who brought up HIV and Ebola. He mentioned that he had a column out today as well. The difference between HIV and Ebola is that HIV has no manifestations for a long long time so you can spread the virus through body fluids without having any idea that you are sick.

OK, but people with HIV don't really go around "spreading the virus" through body fluids, because it is a somewhat difficult virus to transmit. It must come into contact with the "victim's" mucous membranes or open skin. Without some kind of remarkable interaction, you are never going to contract HIV from your seatmate on an airplane, or even your roomates.

Apparently the same can not be said for Ebola. Why? What is the difference in the mechanism of transmission that makes Ebola seemingly so much more contagious than HIV?

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Specializes in Med nurse in med-surg., float, HH, and PDN.

Good questions, Jolie.

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