Ebola Updates

In an attempt to keep up with this current outbreak, I will be posting updates on this new page. If you are looking for general information regarding this disease, you can read all about it on my previous post – What is Ebola?  There you will find basic information about the disease, how it is transmitted and other pertinent data.

Please check back often as I will be updating this page as new information becomes available. It is IMPERATIVE that we stay informed, especially the health care workers. We are dealing with a viral outbreak that is unprecedented. I will also post links to where I have obtained the current information and my analysis of the information, if warranted.

I had the opportunity to participate in a discussion regarding the current Ebola situation with some other nurse bloggers. You can watch that video HERE.

IMPORTANT WEBSITES

Ebola Updates

Ebola Updates

10/23/14

  • I appologize for the delay in updates – unfortunately my work schedule has prevented me from updating. I like to thoroughly check and cross check all information, which takes time. Here are the latest updates as of this evening.
  • Both infected nurses are recovery well. In fact, yesterday news reports began surfacing that Nurse Amber Vinson’s blood was negative for the virus per her family, however, I could not verify this has been confirmed. USA Today
  • The biggest news story now surfacing is of a Doctors Without Borders physician who was caring for patients in Africa has tested positive after returning to the US. Officials are concerned about this particular case as the physician did not self-quarantine himself, potentially exposing other NYC residents while traveling from Brooklyn back to Manhattan. He was reported to no be feeling well for a few days, however, did not contact Doctors Without Borders until his fever was 103. Authorities are going to great lengths to assure the public that their risk of infection is low. (Notice, not impossible, but low.) CNN

10/16/14

  • As of today, the first nurse infected with Ebola, Nina Pham, is in the process of being transported to the NIH facility in Maryland for further care and treatment. There are no reports today of her status. NBC
  • Unfortunately another nurse, Amber Vinson, is reported to be positive for Ebola. This further increased the concern of how prepared the American hospitals are as the CDC has been reporting. Most disturbing are reports that during her self monitoring period for fevers and signs of infection, she needed to fly to Cincinnati.  According to reports, she called the CDC agency reporting a fever of 99.5, however was given the go ahead to fly since her fever was not 100.4 or higher. The day after flying home to Dallas, she developed further symptoms and was admitted and subsequently tested positive. She was transported to Emory in Atlanta for further care and treatment. CBC News
  • OPINION – clearly, these four facilities are the most appropriate places to care for these types of patients. They have and are doing it successfully without any further transmission of infection. We really need to consider moving these patients immediately to appropriate treatment centers in an effort to adequately contain this virus. It is completely unreasonable to expect EVERY hospital in America to be functioning at the same level of these bio-containment centers. Please remember, their staff has trained for years – doing drills and practice runs to ensure the protocols & systems work well and safely. It makes no logical sense to expect a community hospital to function safely at this same level – and now, these two nurse are paying the highest price.
  • According to the WHO situation report of Oct 15, “It is clear, however, that the situation in Guinea, Liberia and Sierra Leone is deteriorating, with widespread and persistent transmission of EVD.” Most of the wide spread transmission is in the capitol cities. Current totals in outbreak areas of confirmed/probable/suspected cases are 8973 (2816 in the last 21 days, increase of 31%) with 4484 deaths = 49.97% mortality rate. WHO
  • Various reports are coming out regarding the available personal protective equipment (PPE) that was available and used to care for the patients in Dallas and specifically the inadequate removal of medical waste. Again, confirming the concerns of front line workers, specifically nurses who are being placed in harms way due to inadequate supplies and / or training. It is everyone’s responsibility to become educated so you can make appropriate decision and protect yourself. A recent video demonstration by Dr. Sanjay Gupta shows how difficult the management of the PPE is for someone not trained and experienced in its use. Also he makes a good point, as many have been saying, when exiting the care area, need to decontaminate and also use the buddy system. Be smart, get educated!  CNN Video
  • The Nebraska Medical Center is doing a fantastic job educating nurses and other health care providers on how to safely don & doff their PPE. Please take a moment to educate yourself and hopefully your facility. Please not that they PRACTICE! As well as the use of a buddy system. Nebraska Medical Center
  • There has been a lot of chatter regarding the concern for airborne capabilities of this virus. Although it is not considered “airborne” in that it doesn’t travel in a cloud. However, should some one sneeze, cough or vomit it can travel via velocity onto someone else for possible transmission. Believe it or not, Snopes has a great analysis of the facts and rumors. Snopes

10/12/14

  • Texas Health Dept & the CDC have confirmed preliminary results that a nurse who cared for the deceased Ebola patient in Dallas has tested positive for the virus. The CDC is adamant that there was a preach in protocol by the nurse which resulted in the exposure. There are a few concerning aspects of this issues – first, health care workers are becoming infected at an alarming rate for a virus that is transmitted via contact of infected fluids. HIV is contracted the same way and in no way is it spread at this alarming rate. This continues the speculation that this virus is contracted through other means that they are not making public for concerns of hysteria. Secondly, considering the stringent protocols that are necessary in caring for these patients, why wasn’t the appropriate personnel brought in or have him transported to an appropriate facility? An accident was inevitable. And sadly, once again, the nurse will be blamed, not the system. Fox News

10/11/14

  • The current death toll in West Africa has crested over 4000 people – WHO report of October 10, 2014 – 8376 confirmed/suspected/probable cases with 4014 reported deaths in the countries of intense transmission = 47.9% mortality.
  • The infected nurses’ assistant in Spain is reported to be feeling better after receiving the experimental medication Zmapp (this is the same medication given to the doctor and nurse who were cared for in Atlanta. NY Daily News.
  • Nurses in Spain are refusing to care for the now isolated Ebola observation patient as they feel they are not being provided adequate protective equipment. El Pais.
  • One of the doctors who is working with the infected patients in Nebraska wrote of a very interesting story on what it was like leading up to the time receiving their first patient. Washington Post.
  • The NBC news crew that was traveling with the now infected 2nd patient being treated in Nebraska had previously made a deal to self-quarantine themselves for the 21 day incubation period. As of today they have been issued a forced quarantine by the NJ Health Department. NJ.com via AP.

10/9/14

  • NYC hospitals are being proactive in training their staff. They are using “fake patients” to test the staff in their knowledge & timing of their protocols to identify and isolate any suspected person. Considering this is a new, highly virulent disease, most health care workers have not practiced this type of scenario to level of need. Considering NYC’s high immigrant and tourist population, this is a necessary step in protecting this highly populated region. New York Hospitals Prep for Ebola – WSJ
  • New information is surfacing in the case of the infected “nurse” in Spain. It has now been revealed that she was in fact an “auxiliary nurse” or assistant. She apparently became infected when she touched her face after taking off her isolation material – clearly she was NOT educated on the severity of the situation or how to appropriately keep herself safe. The Health Ministry of Spain continues to be under attack for the poor response in this situation. It is also reported that her condition is worsening. This article also contains a great map of all the cases outside West Africa. Condition of Spanish Nurse with Ebola Worsens, Officials Say.

10/8/14

  • The Dallas patient who was diagnosed with Ebola has expired. A sheriff who was in his apartment is now being monitored as he is experiencing Ebola like symptoms. First Ebola Patient Diagnosed in US Dies
  • The infected nurse in Spain (who it turns out is a nurse’s assistant) continues to be in isolation. Today the Health Ministry of Madrid announced that her family dog has been euthanized out of fear it may be a potential vector for spreading the disease.  Save Excalibur Fails – CNN.
  • Dr. Brantly, the first American brought back to the US and survived has donated his blood to be administered to the news journalist currently hospitalized in Nebraska in hopes to receive his antibodies. He has also received the experimental drug brincidofovir. Brantly Gives Blood to NBC Freelancer with Ebola.
  • The US will begin screening travelers arriving from West Africa in five major airports – JFK, Washington Dulles, Chicago O’Hare, Newark and Atlanta Hartfield. Screening will begin this Saturday at JFK followed by the other airports next week. Five US Airports to Enhance Screening.

 

10/7/14

  • A nurse in Spain is the first patient outside of the current outbreak in West Africa to have transmitted the disease human to human. She apparently had cared for the two infected, missionary priests who were transported back to Spain for treatment. They are still investigating how she had contracted the disease in a modern health care facility with specialized equipment. This furthers the thoughts that it is transmitted much easier than just direct contact with infected body fluids. She is currently in isolation and her husband has also been isolated, although he has no reported symptoms. Another nurse who also cared for the infected patients presented themselves to the hospital with complaints of diarrhea, but no fever. The second nurse is also admitted and in isolation.
  • 4000 American troops are being sent to West Africa to assist in containment. According to reports, they will be monitored several times a day and will be wearing protective equipment. If one of our soldiers should become infected, they will be transported back to the US for treatment. Stopping the disease is the core mission.  Washington Post
  • Currently there are NO travel restrictions for entering the US, however, President Obama stated today that the White House is developing protocols to screen passengers. Obama: Extremely “low odds” of Ebola outbreak.
  • WHO reports as of Oct 3 – 7470 probable/suspected/confirmed cases with 3431 deaths = 45.97% mortality.

10/2/14

  • Initial reports were that the nurse who triaged the Dallas patient did not communicate to the physician of his travel history. The hospital has now disclosed that their electronic medical record may have contributed to the communication error. Apparently, when the nurse enters travel history into the electronic medical records, it does not appear on the physician’s workflow screens. The patient did inform the nurse he had been in Africa in the past four weeks, however denied he was around anyone ill. It was further reported by the NY Times he had been assisting a very ill Ebola patient just days prior to boarding a plane to the US.

9/30/14 – On Sept 30, 2104 the first case of Ebola was diagnosed in the United States. Although the case is ongoing, the patient is noted to be in serious condition and had an estimated 100 contacts prior to his hospitalization after his symptoms became severe. Many questions have surrounded why he was not identified earlier as he presented to the hospital 2 days prior, however, he was not flagged as a possible Ebola patient and was discharged into the community. It has not been learned that he did disclose recent travel however denied being around sick people recently. Initially the nurse was blamed for not communication this information, however the hospital now recognizes there was a break in the electronic medical record work flow. I could go about this forever… but for now, lets stick to the facts. As health care providers, we have to vigilant and aware to identify these patients – it is EVERYONE’s responsibility to do due diligence in screening patients. Be educated!!

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