Ebola coming to the US

[MarissaNicole]

My initial reaction was torn (horrified by the thought but I know its what I would want if it was my loved one). But if it is only contagious through fluids I feel more comfortable with it. I cant help but think the US has much more sanitary conditions and should be able to keep it contained.

Wife of a PGY-5

[ides]

I thought I read something about how they think this strain is airborne through tiny droplets in the air as it's getting into the lungs? I think its a terrible idea to bring them here. Personally I would think its a death sentence to go to an area and treat those with Ebola. If someone wants to take that chance they have to live or die with those consequences.

[scrub-jay]

Ebola coming to the US

My initial reaction was torn (horrified by the thought but I know its what I would want if it was my loved one). But if it is only contagious through fluids I feel more comfortable with it. I cant help but think the US has much more sanitary conditions and should be able to keep it contained.

Wife of a PGY-5

We seem to still struggle with Rotovirus, Norovirus, and historically Poliovirus. Hand washing hygiene is pitiful, even (especially?) in hospitals, many QI projects in hospitals right now are to improve hand washing. Hand sanitizer does not work on all viruses either (no idea of Ebola) and that is what's used primarily.

We've got clean water sources though and that's a HUGE advantage.

[scrub-jay]

I thought I read something about how they think this strain is airborne through tiny droplets in the air as it's getting into the lungs? I think its a terrible idea to bring them here. Personally I would think its a death sentence to go to an area and treat those with Ebola. If someone wants to take that chance they have to live or die with those consequences.

Droplet transmission and airborne transmission are different, it's all about the size of the droplet and how long it stays in the air. Minuscule droplets can stay in the air much longer and that is generally regarded as "airborne," most of what I've read has been taking liberties with epidemiological definitions to encourage scare tactics IMO.

Many of these scary articles also link to a 2012 monkey study where authors thought *could* have been an airborne Zaire, but the authors admitted may have also been cage contamination or droplet transmission too.

[Sheherezade]

After just listening to a long podcast on this Ebola outbreak (road trip!), I've got two things to add. Apparently the heat is a huge factor in transmission to health care workers as the average daily temp is over 105 and the protective clothing they wear can't be worn long at that heat. It leads to errors in removing the garments which is apparently a chief source of transmission to docs. Sad, but that's what these docs said. Here, that wouldn't be an issue. Also DH also listening said it would be a hell of a lot easier to keep someone alive here compared to in the facilities he has in South America. Apparently it's mostly fluid support since dehydration is what kills them in the end. Most scary of all is that the docs said only half the patients presented with anything hemorrhagic, it was mostly vague flue like symptoms that in 50% cases had bloody vomit or diarrhea. I'm ok with the transport, sounds like they can contain it better here than there, frankly.

[scrub-jay]

That makes oodles of sense! Thanks to Dr. Sheherezade for his perspective too, I knew we had some docs around here with really relevant experience.

[medpedspouse]

DH said that he is not privy to any more info. than what the you can get on the media/CDC outlets. Given what he knows, he said he is more worried about chikungunya but added that his opinion is based on the fact that he does not have all the facts regarding this case. How's that for a vague answer?

[MrsC]

Now I'm reading that the CDC is helping with transport, which makes sense since it's right near Emory. Apparently their isolation units are like no other. I asked DH about this and he is surprised that they would transport such critically ill patients such a long distance. From a critical care standpoint, they have a better chance of survival here, if they make the journey ok. Very sad.

[scrub-jay]

Ebola coming to the US

From what I can tell MrsC, the CDC said that they didn't recommend transporting gravely ill patients. However, when it looked like the group was moving forward, the CDC offered to transport bc they are probably one of the most qualified organizations to establish a proper isolation unit. Emory is taking one patient, but two are flying here...any idea of other hospitals that have isolation units similar to Emory?

[scrub-jay]

Ebola coming to the US

Oh, I meant to tell you all playing along and who have maybe started worrying about me...I have an MPH and public health is my passion. I try to stay informed because an uninformed public health degree is not very useful.

[MrsC]

Looks like they're both going to Emory
http://m.us.wsj.com/articles/atlanta...10226?mobile=y

I have no excuse, I just find this kind of stuff interesting.

[scrub-jay]

That was a really good article, thank you! Most of the early reports said there were two patients and one was going to Emory. Loose and sloppy reporting just to get the story out. I'm comforted they'll both be at Emory, from what I read, they have very good facilities for this.

[GrayMatterWife]

And GMW as her hubby is at Emory correct?

Sorry--the last four months of my professional life have been MISERABLE. I don't get to check in here as often as I would like.

Those TV news crews are blocking the d*mn sidewalk! Please move your vehicles out of the way. I almost fell over trying to jog today. Seriously.

This is hardly a surprise. If you are going to fly these people back, Emory is where you'd bring them. It really wasn't even a close call. The CDC is here, down the street. Yeah, there are three other facilities in the US that can handle these kinds of cases, but Emory is the choice.

I don't mind them being here, as long as people know what they are doing. I do wish the media would cover this from a medical/legal/ethical angle, instead of as a personal interest story. These poor people--they went for a medical missionary work, and are now suffering the indignity of bleeding to death from every hole in their bodies in front of the entire world.

Interesting tidbit: Hubbie is pretty sure that their specially equipped rooms are on the same floor, and fairly near...the cafeteria.

**????!!!**

Well, if hospital food wasn't already by definition a deterrent from eating...

[GrayMatterWife]

Either way, I have great respect for the folks that risk their lives doing missionary work. Truly amazing.

This.

[PrincessFiona]

DH surprised me by saying he felt like it was a good move for the patients. He feels we have good containment here and that there is a low risk of spread. When he was a medical student, he did an optional 9 months of work in Africa. He described the medical care as "catastrophic". I'm sure someone here will jump in and say they experienced the exact opposite, but where he was in South Africa, the care was poor. He suggested that an American citizen deserved to return home to care that would be more likely to support him (like dialysis, etc).

So ... I was surprised. I thought he would be totally against it.

Kris