Ebola in Texas

Nurses COVID

Published

Specializes in Critical Care.

The transmission of Ebola and HIV aren't exactly the same, Ebola is arguably more easily spread person to person. One difference is the bodily fluids that can contain each. Ebola can be transmitted through sweat, HIV cannot. Oral (saliva) transmission of HIV is extremely rare, but with Ebola saliva is much more likely to transmit the virus. Same with emesis which isn't known to transmit HIV, unless it contains blood, but is known to be a way of spreading Ebola even if it doesn't contain blood. Add in the fact that ebola often causes hemorrhaging, vomiting, and diarrhea and the potentials for transmissions are more common for Ebola.

While it's true it's not something that just travels from person to person through the air, it is managing to spread fairly quickly. The doubling time of the virus (the amount of time it takes for the number of people infected to double), is only about one week in some parts of Africa.

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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?

I think the doctor was referring to sexual contact or IV contact (sharing needles), etc., when talking about HIV. That's how it spread to so many - no one felt sick.

Yes, there are a lot of questions.

I do think we need to be more restrictive about travel - very good point Jolie.

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Specializes in Maternal - Child Health.

Thanks, Muno. I appreciate the information. It is precisely what has been lacking in the statements made by public health officials and carried by the popular press. I understand the desire to avoid widespread panic, and of those of us old enough to remember the early days of the HIV/AIDS epidemic certainly don't want a repeat of the unnecessary isolation those patients endured out of ignorance and unfounded fear. But on the other hand, whitewashing the truth is more than counter-productive. It is downright dangerous. And apparently, the standard line that Ebola is transmitted in the same manner as HIV is not entirely truthful.

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Specializes in PACU, ED.

There is one thing I've noticed that seems incongruent. On the CDC website, health professionals are advised to use standard contact and droplet protection. In my area that would consist of a blue gown, gloves, N95 mask, and eye protection. However, whenever I've seen news reports the workers are in full hazmat suits. I can understand adding leggings and booties for the fluids but the hazmat suits seem over the top, unless they are truly needed.

Just hoping we are able to do a better job of protecting our health care workers. Africa has lost hundreds of their doctors and nurses.

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Specializes in PACU, ED.

Comparing transmission to HIV seems disengenuous at best. We don't isolate or consider at risk people who have had casual contact with a HIV+ person. Also, we don't wear biohazard suits to escort someone who is HIV+.

Ebola patient in Dallas takes turn for worse | Reuters

On Saturday, CDC officials dressed in biohazard suits escorted two passengers off a United Airlines jet that landed at Newark Liberty International Airport in New Jersey because they were believed to be from Liberia and exhibiting signs of illness during the flight, WABC-TV and the Record newspaper reported.

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Specializes in NICU, PICU, Transport, L&D, Hospice.

I agree that the images are unnerving and are reminiscent of apocalyptic movies.

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Specializes in L & D; Postpartum.

I am still unclear about how one gets infected with Ebola....can one get infected from simply being in contact the the bodily fluids of one who is infected? Do the bodily fluids from one infected simply have to touch you, even if there your skin in intact and not mucous membranes?

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Specializes in Critical care, tele, Medical-Surgical.
i am still unclear about how one gets infected with ebola....can one get infected from simply being in contact the the bodily fluids of one who is infected? Do the bodily fluids from one infected simply have to touch you, even if there your skin in intact and not mucous membranes?
Centers for Disease Control and Prevention:

...ebola is spread through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with

  • blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with ebola
  • objects (like needles and syringes) that have been contaminated with the virus
  • infected animals
  • ebola is not spread through the air or by water, or in general, by food. However, in africa, ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. There is no evidence that mosquitos or other insects can transmit ebola virus. Only mammals (for example, humans, bats, monkeys, and apes) have shown the ability to become infected with and spread ebola virus.
  • Healthcare providers caring for ebola patients and the family and friends in close contact with ebola patients are at the highest risk of getting sick because they may come in contact with infected blood or body fluids of sick patients....

Transmission | Ebola Hemorrhagic Fever | CDC

World Health Orginization:

Transmission

It is thought that fruit bats of the pteropodidae family are natural ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. Bedding, clothing) contaminated with these fluids.

Health-care workers have frequently been infected while treating patients with suspected or confirmed evd. This has occurred through close contact with patients when infection control precautions are not strictly practiced.

Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of ebola.

People remain infectious as long as their blood and body fluids, including semen and breast milk, contain the virus. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.

WHO | Ebola virus disease

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Specializes in L & D; Postpartum.

Thanks for that information. With that, it begs the question, for me, as to why Dr. Nancy Snyderman and her crew will be going into isolation for 21 days. Unless they all had broken skin/mucous membrane contact with infected body fluids from someone known to have Ebola.

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Comparing transmission to HIV seems disengenuous at best. We don't isolate or consider at risk people who have had casual contact with a HIV+ person. Also, we don't wear biohazard suits to escort someone who is HIV+.

Ebola patient in Dallas takes turn for worse | Reuters

Thanks for that information. With that, it begs the question, for me, as to why Dr. Nancy Snyderman and her crew will be going into isolation for 21 days. Unless they all had broken skin/mucous membrane contact with infected body fluids from someone known to have Ebola.

I just think they are going overboard like when we first started treating HIV patients. Hopefully, once we get a better handle on this, it will calm down.

I hope.

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Specializes in PACU, ED.

Dallas Hospital Changes Its Story

The hospital has changed it's story once again. IMO their first response was to throw the nurse under the bus. Then, they blamed the software but that actually lays responsibility on the hospital. Now they are in damage control mode.

Late Friday officials at Texas Health Presbyterian Hospital said that the nurses and doctors who initially treated and released an Ebola patient knew that the man, Thomas E. Duncan, had recently arrived from Liberia.Earlier the hospital claimed the its electronic health record used separate workflows for physicians and nurses so that the travel history in the nursing section "would not automatically appear in the physician's standard workflow."

In its latest statement "the hospital effectively retracted that portion of its statement, saying that 'there was no flaw' in its electronic health records system. The hospital said 'the patient's travel history was documented and available to the full care team in the electronic health record (E.H.R.), including within the physician's workflow, ' "according to The New York Times.

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