So a few months ago the country was enthralled with the idea of a few patients, infected with the Ebola virus, coming to the United States. Up until this point, we had been safe from Ebola due to the fact that bats can’t fly over the Atlantic. Some people were completely indifferent, while others had seen Outbreak one too many times. Most were a healthy mix, somewhere in between, but what bothered me the most was both the lack of education and the poor information that was spreading more virulently than the virus could ever hope to.
First, I want to stress that I am a nurse, not a virologist, and hopefully throughout my post you will see that I am not pretending to be one. I have a Bachelor’s in Nursing and am currently a graduate student. I have worked extensively with Infectious Disease Specialists. I have been exposed to almost every infectious disease known to the modern world. I have taken courses in Biology, Microbiology, Anatomy, Physiology, Pathophysiology, Advanced Pathophysiology, Pharmacology, and an assortment of others. However, I am not and will not pretend to be an expert, just an experienced professional. When it comes to an epidemic of any sort, my first focus is on the patient, protecting and healing them, my second focus is on protecting the community. I don’t care about which strain does what, or what we can do with in lab. As a nurse, I concern myself with the current patient and future possible patients. I feel the first thing we should examine is Ebola itself. It is foreign to the US, both literally and figuratively. What it does to people and how it harmonizes with nature are both things that most westerners have little concept of. It is a virus, not a bacteria. This means that it is not its own organism. It is actually much smaller and basic than you can imagine. It is nothing more than a few pieces of DNA/RNA and some proteins. No cell wall, no cytoplasm, no metabolic functions. This is both their advantage and their downfall. Viruses require a host. For this example I will use the HIV virus. HIV gets into the human body and invades the host’s white blood cells, T4 cells to be exact but I won’t get that involved. The proteins help get the virus into the cell and those few small sequences of DNA/RNA write themselves into the host DNA/RNA. Now instead of the white blood cell attacking invaders, it is nothing more than an HIV factory. All of its metabolic functions are redirected at producing more of the virus, which pours out of the white blood cell like a sieve until eventually the host cell dies. This is why HIV infected patients have poor immune systems. The virus re-writes the DNA of the host cells. This is not something we can stop. New viruses are pouring out of the white blood cells at a rate of millions a day. We cannot filter them out. We cannot “kill” a little chunk of DNA and we don’t know enough about the human genome to correct the DNA sequences. This is why a lot of viral infections like HIV, Herpes, and Hepatitis are life long infections. HIV invades the white blood cells, Herpes invade the nerve roots, and Hepatitis invades the liver.
Now that we have a better grasp of viruses, we will focus on Ebola a bit more. In tropical Africa, Ebola naturally lives in bats. It is nice to the bats and doesn’t cause them many issues. It is rumored that there are many viruses humans carry our entire lives and have no idea because they show zero symptoms. Therefore, they have never been studied. If this sounds crazy, just remember that it was in recent years the we discovered there was a virus behind cervical cancer. A virus that men can carry and spread without ever knowing they have it. Where the problem arises is that in tropical Africa, people like to eat bats. Sometimes they get infected with Ebola and it spreads. This process is called Zoonosis and can be true of bacteria or viruses. Racoons carry Rabies, Armadillos carry Leprosy, Birds carry the Flu, Bats carry Ebola.
When I said Westerners don’t really understand Ebola, the primary aspect that I am talking about is the patient. We don’t ever see what Ebola does. Our media is too censored, we hear how many died, and see people in haz-mat suits. Speaking of suits, we’ve all seen the pictures. Rubber gloves are adequate for AIDS and hepatitis, a simple mask (N95) stops Tuberculosis, but this requires space suits, just keep that in mind when you think its no big deal. So here is what happens when you catch Ebola, I figure you’re getting bored with reading right about now, so I’ll spice it up. First the virus gets into your system, I’ll elaborate on that later. Then, it hangs out for a few days, even up to 21, growing, multiplying at a rate of millions a day, and guess what, you’re infectious. Now at this point it would pretty much require a straight blood to blood interaction so the only real threat here is for IV drug users who share needles. Just like with the flu or hand foot and mouth disease, you can be spreading it to others before you show a symptom*(apparently not many see the *, so please read the elaboration at the bottom). Remember, nurse mind set, protect the community. At first it’s not bad, little nausea, some sweating, diarrhea, much like a stomach bug. But then the virus really starts to build up in your liver and adrenal glands, after it has saturated your blood cells, the lining of your vessel, your skin, and bones. Hepatocellular necrosis occurs, which is fancy term for your liver starts to decompose.Your liver is what regulates blood clotting. This causes your blood either clot up and turn to jelly in your veins, stay liquid and bleed profusely, or a combo of both. The adrenal glands then do the same, causing your blood pressure to drop. This requires lots of IV fluids to keep your circulating volume up. At the same time inflammatory cytokines are released which causes vascular leakage. Cells don’t do a good job of holding things together so it all becomes a bloody goop. Anywhere in your body that blood vessels are shallow, like your nose, ears, gums, throat, GI tract, urethra, vagina, rectum, all start oozing fluids and bleeding because the tissues that normally keep it contained are disintegrating. So now you bleed from every orifice, including your eyeballs. Every time someone or something touches you, your tissue gets damaged which further the cycle, so a shot in the arm can turn into a massive blood blister. Those who survive are left with massive scarring. Since the adrenals cannot keep your blood pressure up, and you are losing blood and fluids, we have to put IV fluids in to keep you out of hypovolemic shock. This in turn reduces your blood concentration, lowering your oxygen carrying capacity, which causes your heart to race. So you lay in bed, oozing fluids from everywhere, all while feeling like you just ran a marathon, with bloody diarrhea, oh and did I mention pain? Lots and lots of pain, but you can’t have any pain medicine because your liver and kidneys have failed. This why it pains me when I see this outbreak ONLY has a 50% death rate, when in Africa it is up to 90%…ONLY 50%. That is literally worse than cancer, and people are blowing it off. Imagine if cancer was infectious, and you lived in a country with zero cancer, and someone thought it would be a good idea to fly a few people in. I think there would be a different attitude.
The biggest part of the discussion is how Ebola is spread. I will say two things on the topic, no, it is not airborne, and yes, basic hygiene plays a HUGE factor. But while on the topic of whether it is or is not airborne, the definition of an airborne contagion is one that can freely float in the air, survive lengths of time, and infect someone else. VERY few things fit in this category, most have been eradicated, Small Pox, Tuberculosis, Measles. Things that are also NOT airborne, are the flu and the cold. For the flu, you have to come into direct contact with the patients body fluids. How then, do you explain why people catch it and have no idea how. Well for one, people can spread it before they show symptoms, just like Ebola, and one other HUGE factor…droplets….let that word really sink in. The virus may not be airborne, but the droplets are. I’m going to digress for a second and get back to HIV and Hepatitis, while I let droplets dwell in your mind. Everyone knows that HIV and Hepatitis are spread by blood contact, and sexual fluids, I don’t mean a drop of blood on the skin, or even a mucous membrane, it has to get INSIDE of you. This is why only gloves are required. HIV and Hepatitis are not found in urine, stool (Some forms of hepatitis are, but you have to eat the stool to get infected) saliva, sweat, tears, or mucous. This is where some viruses are different. The flu gets into your mucous and other secretions, Ebola tends to stay in the blood, but remember, every one of your bodily fluids are full of blood now. So a person with the flu sneezes, and now millions of little droplets (remember those guys?) shoot out of their nose at nearly mach 1, all across the room, same for a cough, all it takes is a little microscopic droplet to land in your eye, nose, mouth, or the unlikely scenario of an open wound, and you’ve now been infected, because you came in CONTACT with their bodily fluids. I see the word contact thrown around a lot, but most people think of mass amounts of contact with blood, but what they don’t realize is that contact also includes microscopic mucous and saliva droplets, each one chock full of Ebola. Bacteria can survive for long periods of time without a host because they are their own organism. They can feed on just about anything and be happy. Viruses lifespan without a host is much shorter. Their goal is to infect, replicate, and spread, if they cant replicate, they die. Measles only lives 2 hours. But Ebola, depending on what data you look at, can survive for several days.
So with all this information, lets have some role play, so that you can see exactly what this means, to a nurse, in the real world. Imagine it as a cheesy PSA or lifetime movie. You go to see your doctor because its that time of year, you need some blood drawn and refills of your blood pressure med. You sit patiently in the waiting room, thumbing a magazine while your 2-year-old plays with her toys. Like all two year olds, she touches everything, and everything goes in her mouth, toys, pens, her own fingers. She is a 22 lb drool factory and you love her to pieces. You see the doctor, get your goodies, and go home. A week later your angel starts vomiting blood and within 3 days she dies because her heart raced so fast it finally gave up while trying to maintain a blood pressure. Her eyes are blood red and demonic, her skin falls off in sheets. What you don’t know is that 3 days before your visit, someone thought they had the flu. It is October you see and they sneezed while thumbing through that very same magazine you thumbed through. The same thumb you grabbed her pacifier out of your purse with in the waiting room. The people caring for Ebola patients wear space suits, and burn the bodies, yet it still spreads. Here in America, we have much better protocols, and much better hygiene. So if it spreads, it will be contained much better. Still, it spreads prior to symptoms and survives will outside the body, just like the flu. Despite vaccines and good hand washing, thousands still get the flu every year. But while the flu kills 1-2% of its victims, Ebola kills 50% on a good day, and spreads the same way. So please, do not write it off as hype. It is a real thing and it is here.
The case in Dallas has been confirmed. The patient had contact with five children and adolescents prior to admission. Those five kids attend four of the largest schools in Dallas. One sneeze and we could already have thousands of people, who don’t know it yet, infected.
Thank you for reading. Please feel free to comment.
Symptoms* I have had a lot of comments in regards to this. I picked my words carefully, but I never imagined getting thousands of views an hour, or my article getting picked apart, but I will try to elaborate now. I said spread, the virus, I did not say you were contagious. What I meant by this, was the summation of two concepts. To fully explain everything I could write a book, but this is meant to be short and sweet. The first concept is that of a fomite. We have established that the virus can survive for an unspecified amount of time outside the host, and we have established that sneezing/coughing is a perfectly logical method of transmission. So if patient A is infectious/contagious, they sneeze on patient B, but then patient B goes home and picks up their sisters 1 6 month old, who rubs his face, and licks all over your shoulder, he could very well have just orally consumed large quantities of the virus, therefore become patient C. Patient B never got sick, the virus never entered their system, yet they are responsible for spreading the virus to someone else. This is why the 5 exposed kids are so important, there may only be a 2% chance or whatever that they’ll get sick, but if they went to school, and each rubbed up against 500 kids in the hallways, you now have 2500 exposed kids, 50 of which will statistically become infected, 25 of which will probably die. No I do not have a source for the 2%, that is just an EXAMPLE number used to represent the relatively low likelihood of contracting the virus if exposed, granted the R0 factor of R2 is correct. Remember, heal the patient, PROTECT the community. The second concept of this is defining “symptom”. Lets assume it means anything other than your baseline condition. That means the first signs of being contagious, are also the more mild symptoms, sneezy, achy, nausea, flu-like symptoms. So who is going to wake up, feel a little under the weather, and think, crap, I have Ebola, better get quarantined, no, THAT’S how you start fear mongering and mass panic. Again, flu season is upon us, the initial stages of Ebola are like the flu, and its human nature to be in denial, so many people, if infected, would hope its just the flu and wait it out, they are not showing symptoms indicative of Ebola, but they ARE symptomatic of something, and therefore, by the CDC definition, would be contagious. Its also normal procedure for people to be symptomatic BEFORE seeking medical care, so technically, everyone will be contagious, BEFORE knowing they have Ebola. But like I said before, I omitted this lengthy explanation because I didn’t feel it was necessary for the point of the article.
ADDENDUM: Sadly, I feel the need to point out that the title of this blog is “Ebola, A Nurse’s Perspective”, not “A Nurse’s Guide to Surviving the Apocalypse”, or “How to Become an Ebola Expert in 15 minutes”. It could just as well be “Hamburgers, A Chef’s Perspective” and no one would be hounding me over grammar, a misplaced comma, or wanting citations as to why I say it should be on the grill 5 minutes per side of 7 minutes per side. The point is those things are irrelevant to the goal of the article, this is MY perspective (a particular attitude toward or way of regarding something; a point of view.) I don’t have to prove anything, the point of my article is to take what the uneducated (in a medical sense) journalists say, what the talking heads on TV say, and then let you know what the people say who are on the front lines. That’s like discrediting your grandads account of what happened when he stormed Normandy beach, because its not what your history teacher told you. Have I experienced Ebola first hand? Nope, have I experienced a WHOLE lot of other things that the majority of the population has not? You bet your ass I have, and I felt the need to take the time to hopefully help other people out a little. So please keep that in mind, I’m not perfect, but my experiences are my experiences, and I wanted to share them with you, to let you inside the head of a nurse for a minute.
dtolar 
Best written article on Ebola thus far! 🙂 Definitely shared with my nursing buddies
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As a nurse I would the you have some respect for the WHO and the CDC, both of whom say you are in fact NOT contagious until you have symptoms. Also, the flu can remain for quit some time. Currently it is said yes droplets could infect you but you would have to be very close to that person and the droplet would have to come in direct contact with a mucus membrane. Its scary stuff but while it seems like you dont have completely accurate info here
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WHO and the CDC were my primary sources for this article, I never said anything disrespecting them, just keep in mind that they are government entities and have their own agendas. It is debatable as to what “symptoms” compromise of, the earliest stages include muscle aches and nausea, those are indicative of lots of things and aren’t necessarily “ebola” symptoms. The variations in length of incubation time also play a factor. I have had the approval of independent virologists who do not work for the government so for the time being I will stand behind my statements. Thank you for the input though. 300 views an hour and 2 dozen countries, I was expecting an opposing viewpoint much sooner
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I must be failing to see your point, I specifically stated that the Ebola virus travels via droplets. Many articles I have seen state that it is contact precautions. In the hospital we have varying levels of isolation, droplet is different than contact. But yes, you are correct, Ebola droplets are larger, so they hang out in the air less time, but at the same time, larger droplets allow for increased longevity outside the host. Hence the reason my anecdotal role play focused on someone coming into contact with the large droplets that had landed on a surface.
The virologist and I did discuss the issue of droplet size and agreed that is it difficult to come to a firm conclusion on the transmission of viruses through areosolization because under lab conditions the viral integrity was largely disrupted while simulating a sneeze or cough. I really like the drawing though, I’ll have to save that.
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I think she did a DAMN good job of giving information in terms that the layman can understand. maybe she stretched a true or two. But by stretching the truth some, she can put the fear into some people so they are more cautious. I think it was GREAT INFO!!!!!!
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He* 🙂
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Amy, after seeing what’s happening in Africa, I would have to conclude that the author of this article probably has a pretty accurate understanding of how Ebola is spread, even though it may be at odds with what the CDC says. But, her theory will be tested here in Dallas. So far, no one else, who has come into contact with patient zero, here in Dallas, shows any symptoms of illness. However, several people (immediate family) have had close contact with the patient. So, those people are at high risk for Ebola even by CDC standards. So, lets just say, we’ll expect those people to get sick, okay? Now, what should not happen, if the CDC is correct about how Ebola is spread, is that no one else (who has been in contact with those immediate family members, but not in contact with the patient) should get sick. Because all of those immediate family members were put into quarantine before any of them showed symptoms of disease. In fact, even today, it is being reported that all of the immediate family members are asymptomatic (without any sign of illness, so not contagious). And so, everyone who has come into contact with them, outside of their apartment, should NOT come down with the illness. This includes; kids from the schools attended by the immediate family members, neighbors living nearby the immediate family members, or work colleagues of the immediate family members. Of course, excluded from this group would be anyone who has gone into the apartment or touched the patient, because, clearly, those people may have come into direct contact with Ebola infected body fluids. This includes; immediate family members, nurses, doctors, paramedics, etc. In addition, if the CDC is correct, no one else who had contact with the patient, before he fell ill, should come down with Ebola either. That means that the other passengers on the same flights as this patient should not become ill, because he did not have any symptoms while traveling. So, I guess we’ll have to just wait and see what happens here in Dallas…only time will tell.
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He* I’m a male nurse, Lol. No harm no foul. Even if the family does not get sick, that’s just a handful of people, what I tried to explain is the concept of fomites.
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OOPS, sorry, He.. Now I feel a bit stereotypical. Again, my apologies. lol
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Its been happening a LOT, people.don’t notice the author is “Dustin” but I honestly don’t take offense to it
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Because the size of the droplets generated by the flu virus vs the ebola virus is not the same. Your virologist friends should know that.
Here’s a drawing if words are confusing.
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Dustintolar? How do you explain that one?
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Explain what? That the droplets are different sizes? Well if you look in the pink highlighted area, denoted the range of Ebola Zaire, you can see 6 red dots in a cluster, 2 of each, 100 microns, 10 microns, and 5 microns. The way this diagram is drawn would lead me to believe that droplets containing Ebola can be of any size, afterall, even a 5 micron droplet is HUGE compared to a single viral strain, Ebola happens to be on the large side of viruses, but is still less than 1 micron, other viruses are down in the nanometer range. From my understanding, droplet size has to do with surface tension, and not the sediment contents within the liquid, but I may be wrong. Regardless, in a very fine mist, mist smaller than the human eye can see, a single drop may still contain hundreds of viral strands. This is where it gets interesting, and what Eff did not feel the need to explain. in droplets in the 5-10 micron range, the liquid evaporates within a split second of being expelled, whether this is a sneeze, cough, whatever. and then the individual viral strains are left suspended in the air, where gravity doesn’t have much affect on them. This is why it differs from true airborne viruses that leave the host and float away, these were expelled from the body, and deposited in the air, its different. the flu survives quite well once in the air, and floats around, where it can be inhaled by others, sans droplet. It needed the droplet to get in the air, but after that its free. Ebola is too large and heavy, the expulsion and evaporation process tends to kill it, and if it survives, it falls to the ground relatively fast, unless of course there is a decent breeze. The larger droplets, 50-100 microns do not evaporate so fast, and since the droplet is WAY heavier than the virus, it falls to a surface relatively quickly, and dries up. IT is not common for the virus, sans droplet, to freely float in the air. Eff seems to have been trying to prove this point to me, despite the fact that I never said it does float freely. This is the reason that my example in the doctors office describes a scenario in which an object within 3 ft was touched with bare hands, and then touched a mucous membrane, nothing airborne about it. once planted on a surface, the virus can live for several days, and in our world, I can send a piece of mail anyway in the US overnight. So a sneeze here in Texas, could infect a person in Maine by tomorrow, not by droplet, not airborne, but by contact, which is what has been misrepresented all over the news. Since Eff did not cite his source for the diagram, I will do it for him, and you can read the article on your own. Nowhere does it say that Ebola can only be found in larger droplets, but we can assume so. But at the end of the day, is it worth the risk to find out?
http://virologydownunder.blogspot.com/2014/08/ebola-virus-may-be-spread-by-droplets.html
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You may find my response to RLAND insightful.
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Hey Dustin, it’s Becca from HHS 🙂 I just want to say well written but there are a couple of problems. Ebola can live for an extended time outside of the body however before a person is symptomatic they do not spread the virus. It can however be spread through semen for up to 3 months after the symptoms disappear should the patient survive. Just a tidbit from my virology class/ the biolab on campus.
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Thats where it depends on what a symptom is, is that symptom of ebola, or anything outside the norm? what about blood values. If someone is in the hospital, the sed rate and lymphocyte count skyrocket before any clinical symptoms arise. Same goes for a UTI, we can determine a UTI based on lots of factors in the urine, long before any foul odor or burning. A person may have nausea and muscle aches from ebola, those could mean anything, or nothing, could be allergies, could be cancer, its deviated from the norm, but is far from screaming EBOLA!!!
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Wow, very eye opening. First thought was the bats mentioned in the beginning, remembering that bats carry rabies and spit virus laden droplets while they fly. is it possible for a similar spread with ebola ?
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That’s been speculated, and there have been anecdotal reports of bats dropping fruit mid flight, and gorrilas eating the dropped fruit, and getting sick. But I think worrying about US bats becoming carriers is far fetched
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This was very enlightening I have been watching CNN and have noticed how guarded they have been with information. If I understand you correctly… the four days of no systems could have traveled on the plane from Africa, because he was not systematic – Am I correct? If this is not a Big Deal – why is there so much coverage on one person from Africa? Thank you for putting it in simple reading. .
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I try to not watch main stream news as much as I can but yes you are correct, he was asymptomatic on the flight over, but he also lied on his customs screenings about where he’d been. He went to the ER for flu like symptoms and was sent home, then came back a few days later more severe. That’s where “symptoms” is debatable, because a stomach ache and soreness could be anything, I wouldn’t say that’s Ebola symptoms, but that’s how it starts.
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Dustin, it is my understanding that the woman he helped may not have known, or he may not have known, that she had Ebola. As you point out, the symptoms can be indicative of many things. So it’s not clear that he “lied.”
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Not sure, I haven’t even turned on my TV this week so I’m a bit behind on the particulars of his case.
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Thank you so much for this. As soon as I saw that this article was written by a nurse I delved in. I am in the medical field myself (Radiology as an MRI & CT Tech) and was trying to explain, not as eloquently, the exact same thing to my boyfriend the other night. I remember working in the hospital years ago and suiting up prior to entering the quarantined areas…what we see and know as medical professionals is often very different from the CNN reports.
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By your own admission though you say that a patient isn’t actually contagious until blood starts breaking through membranes into the mucous, so really a person isn’t at risk of infecting someone else until that happens. So muscle aches or nausea symptoms don’t make the patient a risk to others. It’s only when the virus has progressed to the point of actually breaking down tissue. So a person could have the virus in early stages and they could sneeze or cough and not be contagious right? which should also mean that any of those children you mention or anyone he came in contact with would not be contagious during the incubation period. As long as those who are at risk have been quarantined, the virus should be contained to that group of people at this point, right?
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I didn’t say that, I’m sorry if it came across that way. the point I was attempting to make is that Ebola IS present in saliva and mucous, to the best of my knowledge. but once the tissues break down and blood gets mixed it, it is MUCH more virulent. What that breaks down to in real world scenario, is that if they aren’t bleeding, they aren’t THAT contagious, once they’re bleeding, they’re MUCH more contagious. Hopefully that makes sense, I’m tired. So even if someone is convinced that only the blood is contagious, most Ebola patients will have blood in all their body fluids.
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very informative article. I am a retired nurse but I was a nurse educator before I retired. I will say that here in America we have become very lax with our infection control procedures. People don’t wash their hands as much as they should and will use hand sanitizer even on visibly dirty hands. I’ve also seen people transporting patients in isolation and they will have on gowns and gloves and masks, and they use those gloves to push buttons in elevators, open doors, pick up phones etc. All with the same gloves they are caring for the patient with. Now with a third world country they are much worse. They actually reuse gloves, masks, gowns and they wash them. We are not that bad, but we need to get better or bad things could be coming our way.
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This article is fine but You never talk about how to prevent it? So how do you?
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You’ll have to elaborate. Prevent it at the bedside, prevent it in the community, or prevent the epidemic?
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How do I keep my children and myself from getting this?
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Good hand hygiene, and avoiding heavily populated areas will prevent MOST exposures. You don’t have to bathe in sanitizer, just stay clean.
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I live about two blocks from where he was staying. Should I go stay with friends or family until this blows over?
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At this point I’m sure you’ll be fine, 2 blocks may as well be 2 states when were talking about 1 patient
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Good work!!!! I’m a nurse also and I don’t like the way things are going. I told my daughter the same thing and told her most of the public does not understand all the things you mentioned. I broke it down for her the same way you did. I’m glad you took on this issue and I will be sharing your article.
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This is great article, very factual, yet worded very eloquently! I am a nurse and it is going to be on the ED staff to really be thorough screening these folks. Makes me a bit nervous as symptoms are extremely vague until severity hits. Also if anyone is traveling on a plane, it wouldn’t hurt to wear a mask and gloves…you will look ridiculous but you’ll be safer. : X
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Thank you. I had High Schoolers talking about this issue here in the central TX area tonight. One young man said, “they have a cure for ebola or they wouldn’t have brought those 2 Doctors back from Africa to cure them.” There is a false sense of “cure” amongst the High Schoolers. They don’t realize the side affects a person has even if they are a survivor. It’s better not to get Ebola. Why are our politicians allowing flights from those affected African countries. It seems mindless.
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The media scare and purposefully misinformation of Ebola is as bad, if not worse, than that of the HiV and AIDS epidemic.
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Sadly, what I’m seeing a lot of, is excessive downplaying of Ebola. I’m not concerned with the mechanism of an epidemic, I just wanted to educate on how the virus itself works inside the human body.
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I’m going to go off topic for a minute if you will kindly indulge me. I am a nurse with a 10 year old that has asthma symptoms sporadically. Any news on why RV-D68 is putting children in the ICU? I’m almost more inclined to be more worried about this than Ebola simply because it spreads easier and there is no early detection. That and the news is making it sounds like the CDC is stumped on why it’s causing such severe illness. Not to say that Ebola doesn’t scare me. I just know that everyone is watching very closely to contain it.
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That hasn’t really occurred in my area, none that I know of actually, so I can’t really speak on the topic. Sorry
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Thank you for your frank and candid information, if only thr CDC would give us the information we need and attempt to down play this. I always had confidence that that tje CDC would have it together should an event of this magnitude would occur. But it appears that the CDC is being run by a bunch of Keystone Kops, at atime when America and the world need their leadership and expertise.
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I agree, most of their information is good, if you know where to look, probably 75% of my content can be sourced back to them, but in the end, they’re a govt entity that has people to please who do NOT have the publics best interest at heart, so I take their recommendations with a bit of skepticism
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What are some of the best ways to boost your immune system. I’m talking quickly and efficiently. Lots of folks out there who are asking.
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Most Americans have the proper dietary intake of everything we need to supply our immune system with everything we need. So unless you know of some way to increase your white blood cell production, I’m stumped. The research behind Vit C wasn’t the most accurate, and our dietary intake is adequate as is, you just pee out all those supplements. Good hand hygiene is the best measure.
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Reblogged this on Sicangu Scribe and commented:
An interesting read. Please take precautions!
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Thank you for taking time to explain the virus. It was extremely helpful and full of information that will show people how serious the matter is and the proper precautions. I will share this piece with everyone I know. Thank you again for sharing your knowledge!
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Losing, not loosing. If you don’t spell well, have someone proofread who does. It’s discrediting.
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It was proof read for grammar, spelling, and punctuation 3 times. Were still human and we still make mistakes. If a typo is all you took from my article, then my concern for your well-being is exponentiated
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what is “exponentiated” ?????
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http://www.thefreedictionary.com/exponentiated
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Great read! And a topic of converstaion pre-shift every night. I will be passing it along.
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Thank you for a good explaination of Ebola. One little correction from a veterinarian. Of course you know and described well what a carrier was. . Which makes canines a terrible carrier for rabies. They die about as quickly as we do from a rabies infection. Bats, skunks, and raccoons carry rabies, and each rabies variant with its specific carrier species has its own geographical distribution. Thanks again.
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Yeah my dad is a Vet. 🙂 I was trying to keep my article short(ish) and to the point, so I was just making generalizations that most people would understand, just to make the point. When I’m really trying to explain viruses to people, I usually talk about optimal host temperature ranges, and how Horses run hot, Opossums run cold, Etc. That’s why you never hear of a rabbit Opossum. But I honestly did not know who the “natural” host of rabies was, but again, it was just for illustrative purposes.
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Good article.
For the naysayers. Those first two Americans that were flown back from Liberia, what was their professions? Oh yeah, they were Professional American Healthcare Providers. They both knew they were dealing with Ebola, they both took precautions, they both used PPEs, and what happened? They both came down with Ebola. Let that soak in. Two trained healthcare providers, taking the proper precautions came down with Ebola anyway. You want to be really scared ask you local paramedic, how many full body PPE suits they carry on their ambulance. Ask your local RN that works in an Emergency Department how many suits they have in their ER. The answer is going to scare you.
Now on to the case in Dallas. The news is blaming the nurse for this. That an ER nurse knew the patient came from Liberia, a hotbed of Ebola, and didn’t tell the poor ER doctor. This is the scariest thing I have heard. Apparently ER doctors don’t do assessments anymore? Then it was a system malfunction, and the MD couldn’t see the nurses assessment? Especially in Texas, being close to Mexico, any nausea, vomiting, diarrhea should warrant the question, have you been out of the US? People pick up all sorts of parasites south of the border. Sounds like the hospital is covering itself. Sounds like sloppy work to me. I feel real bad for that ambulance crew, did they use a full body suit on this call, or just their pressed blue uniforms?
Goods article.
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Yeah we’re pretty far from the border, but we always ask about recent travel during admissions. This guy also lied on his customs paperwork, so he probably lied in the ER as well.
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Several points of correction:
1. The virus cannot be spread during the latent period of the disease. Only those exhibiting symptoms are infectious. -CDC
2. Ebola on dried on surfaces such as doorknobs and countertops can survive for several hours; however, virus in body fluids (such as blood) can survive up to several days at room temperature. –CDC
3. Once someone recovers from Ebola, they can no longer spread the virus. However, Ebola virus has been found in semen for up to 3 months. People who recover from Ebola are advised to abstain from sex or use condoms for 3 months. – CDC
4. Hepatitis B virus can survive outside the body at least 7 days. During that time, the virus can still cause infection if it enters the body of a person who is not infected. –CDC
The children that were exposed in Dallas were not symptomatic and therefore were not infectious, but thank you for the attempt at causing wide spread unsubstantiated panic.
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Thanks for your input, I specifically did not cite any sources because I intended this to be anecdotal at best, I simply wrote the article, I’m not one of the several thousand others who agree with me and share my article. IF you’ll notice, this is the first thing I have ever written.
But onto your “corrections”
1.) This is debatable, define symptoms, and give me a standard latent period. Two people may contract the disease at the exact moment, and one person may be dead before the other shows and signs of illness. There are several phases to the disease, would you consider someone who feels tired and nauseated to be symptomatic? Those are the earliest signs, and while technically correct, I highly doubt anyone is going to quarantine themselves over feeling a little under the weather, THAT is how you cause wide spread panic. A fellow nurse who over thinks things almost went to the ER yesterday because shes had a headache and nausea for 3 weeks, before the Dallas patient even arrived. Speaking of him, he went to the ER, which implies symptoms, was discharged, and came back 2 days later, so by your definition, he was in the public, contagious, and undiagnosed. I feel it is safe to assume that most infected people will begin showing some forms of infection, long before they seek treatment.
2.) This is exactly what I said, I don’t see how this is a correction.
3.) I never mentioned anything about survivors and how they may spread the virus, I specifically limited this article to the specific disease process.
4.) I never mentioned a specific Hepatitis, and did not attempt to educate on that illness, I simply used it as an example of other viruses that do NOT behave like Ebola, and one that is more familiar to Western Society. IT was meant to be an education tool on how viruses differ from bacteria. But thank you for the addition.
Lastly, at the time this was written, the children were recently exposed so of course they didn’t show symptoms, they still may now for another 2 weeks. But here is what you fail to understand about infection control. We have established that “patient zero” was in public, while showing symptoms, and therefore was likely contagious. Lets say he sneezed on a kid, weather in Texas right now is kind of nice 70’s and 80’s, breezy, I live just outside of Dallas. Well as you stated, the virus can live for hours, or up to days at room temp, and right now outdoors is close to room temp. BTW it requires temps of 140 to kill Ebola, so even in a Texas summer it would survive. Millions of sneeze droplets, each carrying 10’s to 100’s of viral strains are now on the kids shirt, and now he goes to school, where his clothes rub up against hundreds of other kids, it’s not a big jump from clothing to mucous membranes. Therefore the initial 5 exposed kids may never get the virus, but served as vectors to possibly infect dozens of others. You as a nurse should understand this concept. If you have a patient with MRSA in a wound, you clean it, don’t properly wash up, then clean another patients wound, they may get MRSA, while you, the vector, never got the infection because it was only on your skin.
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I am an English teacher; and, yes, there are errors in the essay. More importantly, you have given valuable, understandable information. Thank you for taking the time and effort.
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When I initially posted, my wife read it from the next room and almost had a stroke. I am HORRIBLE about run on sentences, and never know when to use a colon, semi colon, hyphen, etc. My wife, an Art Major, does my editing. 🙂 In high school I got perfect math and science scores on my ACT exam, but horrible in the writing section. But my cumulative score was still high enough to exempt me from all my college English courses, so I never took any. In graduate school, we have mostly moved away from paper writing, and focus more on presentations. So In 9 years of college I’ve only written 2 or 3 papers, and even then they are more focused on citations and content. But then again, I’m a nurse, not a writer. This is the first public thing I’ve ever posted. In 30,000 views I’ve only had a handful of complaints. I’ve I’m sure you would be equally as clumsy in the operating room 😛
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I love how simply you broke this down, I couldn’t care less about your grammatical errors. I appreciate that you actually took the time to give your input and while answering everyone’s questions AND criticsms, you are still pretty polite. Its your point of view, and seems to be a very educated one. Its better than what I have found elsewhere and trust me I have looked. That being said- one question, at what point in this Ebola situation, would you stay indoors and keep your kids home for a bit? Just YOUR OPINION? Thanks again!
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Finally someone is telling the truth about transmission dangers!!!! Thank you for elaborating that this can easily become an ugly uncontrollable disaster!!! They should have banned all travel from Africa as soon as the outbreak started!!!! The CDC and the WHO are controlled by Politicians who don’t want to see a breakdown of the world economy!!!!! They seriously have their own agendas in this situation, not the best interest of the public!!!!!!! You don’t have to work in the health care industry to understand the difference between airborne viruses and contact exposure!!! The flu and the common cold are spread through contact and droplet contact. I’ve never heard of a human being going throughout their lives without having caught the flu or a cold no matter how vigilant they are about hand washing!!! I am such an aggressive hand washer that I have a constant nasty case of contact dermatitis on my hands from excessive hand washing, and I still get sick!!! We should all be very very afraid of this!!!!!
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I doubt that will happen, but basically for me, it will be when the hospitals fail, be it from being full, running out of supplies or whatever. But hospitals tend to run at 80-90% capacity, so if things get very bad, they’ll get full fairly fast.
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Laurie – I totally agree with you. This CDC definitely has their own agenda. I do understand that they are trying to avoid panic, but we are entitled to be educated and informed in a realistic way about the potential for this disease, and how it is
spread.
Also, flights from affected countries should have been stopped immediately, as this is the fastest course to an epidemic.
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I’d like to point out the CDC is trying to NOT cause a panic and may not be as truthful as they should be and also politics are involved in this concerning amnesty for illegals and open borders by a certain President, secondly I’d like to point out this strain seems to be different compared to past outbreaks and I would like to point out the former Soviet Union and the US both tested weaponized Ebola in this same region and its not unheard of batches could have gotten into the wild by accident or on purpose (ex containers of smallpox were found at former Soviet bases just sitting in a closet) point being to many things do not add up and throw this into the mix ISIS has stated they have plans to send infected people into the US via Southern border to spread Ebola….
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At this point I don’t think anything has intentionally be done, but I to have seen stuff about weaponized Ebola, including the US patents from the patent website. So at this time.nothing would surprise me
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It may not be intentional which is just as frightening as either they do not take it seriously or its sheer incompetence or it could be just political. Another concern as with all viruses it mutates as its a copy of a million copies and somewhere down the line bits of DNA change and bamo we have a airborne version .
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Going airborne is actually a pretty big jump, a lot of it has to do with the sheer size of the virus, Ebola is relatively huge, so gravity has a decent effect.
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True it is a large virus but reality is sometimes stranger than fiction. By did you happen to catch the Dallas news conference? Unbelievable. They are more concerned about not panicking people than public safety. Is Ebola a level 4 pathogen or is it not? I guess we’ll know in about 2 weeks if Ebola was all hype from the beginning or if the people in charge now are full of crap. That said, there are many bodies in W. Africa right now of individuals who poopee’d this disease who are are dead. Just saying…
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Its nice to get an opinion rooted in knowledge. I’m a nursing student and I’m really surprised at the derisive comments from people. I think you did a fantastic job laying out facts in a way that the general public can understand. Thank you for taking the time. I don’t see this as an article aimed at causing panic at all. Just an eye opener for those whi don’t want to listen to the media. Something as simple as hand washing can truly, honestly save lives. It can’t be stressed enough. Great info.
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I think WHO has a more honest appraisal of Ebola and dangers of it, like I said the CDC is hampered by its political bosses on giving out truthful information.
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Thank you, Dustin, Speaking and writing about a life or death subject in words people can understand is one of the most valuable services you can provide. Though your nursing skills are equally valuable. I’m a writer who dislikes wrong use of words, but I think minor things in this context are just that, minor. Keep on writing.
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Ive heard a few times now…care to point out a few examples?
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Great post! Thank you for sharing 🙂
http://www.tealtomato.com
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Some of what you said does go against the media portrayal of this virus. That being said, medical professionals allowed the dallas man to leave while symptomatic and did not contact the CDC. The family did according to reports. I think the media must try and balance a serious situation and inciting panic in the US. I think the CDC should come to the public and if fear is needed to protect humans everywhere from spreading this virus then as long as its true, dont sugar coat it because you dont think I can handle the truth. I have questions about the mutation rate of this virus. What is it so far and how quickly does it mutate? There may be another strain on the way that we dont yet recognize. I say lay the truth out there, no one is getting educated by sugarcoating the truth. I dont trust the CDC for several reasons. One of which my family had to persist and almost harass the CDC to pick up the body of a family friend that died of mad cow disease. They are government funded and there is a lot of passing of responsibility to the other guy in that agency as well as others.
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As far as I know, there are 3 strains of Ebola since the first recorded outbreak in 1976, so it appears to not mutate as fast as simpler viruses like the flu that have dozens of current variants, and mutate every year.
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Thank you for your article. I for one don’t believe that the CDC or government has given us all the information that can be helpful. They want us to NEED and believe them to be our “saviors”. I also believe that the powers that be think of us as “expendable and a way to control our bursting at the seams population” To dress to the gills in hazmat gear and then tell the public “no need to be alarmed or worry” is crazy.
I want to say THANK YOU from an “invisible” mom of two living in mid America, who is a beginning Prepper and minus the past 3 years have traveled the world following my husband as he was military (so we are WAY behind with our prepping..lol). I will sending this to my daughter who is 21 and living on her own for the first time and knows everything and thinks mom worries to much!!!! THANK YOU!!
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Thank you for the informative article! As for the The individual saying they don’t know anyone who hasn’t had the flu or cold…. I’ve NEVER had the flu and I’m 30.
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I’m 27, no flu here, and thus is my first year to get the flu shot, hospital made me. I believe in letting your immune system do its job
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It was not a hard read. There is a lot to be said to those in the health care profession. At work we will be wearing PPE but out in the “real” world not so much. I went to school to care for people and their families. This is a virus as scary as it may be they need our help. Unfortunately the screen question’s information did not get to the whole “care team”, but you are right there are other people on the “team” that should have picked up on similarities or read the chart. Yes, the next few weeks will be telling. Can only imagine the people in the waiting room that evening. Do not know about Presby’s waiting room but mine is almost alway full. Prayer and action is where I am, do no know about everyone else. Where is the exact origin of this strain. Well, at this point does it matter. Thank you for the information, sorry if my grammar is not perfect.
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I say we quarantine the whole state of Texas. They don’t want to be part of the U.S. anyways. Lol just kidding! Come on my fellow Americans. Let’s beat this virus and get on with our lives!
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I know there are probably some unreported cases in West Africa, but for the most part I feel like they have relatively accurate head counts. The first case in this outbreak was tracked back to last December and didn’t start making the news for months after that. Since March, the outbreak has been carefully monitored by the international community. They have had thousands of cases in the past 7 months in three countries and a handful in Nigeria and Senegal, where it appears they were able to control the spread. Nearly 22 million people live in the affected region, where they have little infrastructure, education, and knowledge of the virus, what causes it, how it spreads, or even what a virus is for that matter. They live in cultures that are very tight knit, they touch, feel, and share. If the Ebola virus is as contagious as you claim, that you could sneeze on a letter in Texas and send it to Maine overnight, then why are there only thousands of cases in this region of millions in a 7 month period of time? And since 1976, why was the largest outbreak prior to this one contained after 425 cases, in Uganda where they also had a very limited infrastructure to control the spread? I am also not an expert, as you said in the beginning of your article, but my sense is telling me that while this virus is horrible and very dangerous if you contract it, I should not be panicking, especially in a country where we have great infrastructure and information chains to help control the spread. I trust that the people working on this in Dallas are doing an excellent job, and while we all wait to see what happens with the quarantined people, I will not be panicking that the virus is on it’s way to me as I type this response. I only wish the people that were contacted and the healthcare workers all the best and hope there are only a hanful of cases of this terrible virus before it is contained.
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You have valid points, but in countries with infrastructures as poor as you say, do you really think everyone who gets sick seeks help? I’m sure many stayed home and died. The point about the letter traveling is that our infrastructure could make us or break us, over there its easier to keep the virus contained geographically, but not so much over here. And the death toll with this current outbreak is in the thousands, and that’s in an area that has dealt with it before, we have not. The population of Liberia is 4 million, DFW has 6.2 million, MUCH denser population, and much greater chance of fomite travel, rather than direct infection.
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Great article! I just wanted to ask if normal antibacterial soaps and Purell hand sanitizers are known to kill the virus?
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Well obviously antibacterial soaps won’t kill viruses, but they do help to mechanically remove the virus from your skin, I’m not so sure about alcohol based sanitizers, most are pretty good at killing viruses, but Ebola is pretty tough. If it were me I would rely on good ole fashioned hand washing
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This is the first Ebola outbreak in any West African country, so they have not dealt with it before. Also, while the population of Dallas is greater, there are very different living conditions in Liberia, Sierra Leone, and Guinea (combined pop. of nearly 22 mil) where people are in much closer contact with each other. Visit a market in a developing country on “market day,” and you will come into close personal contact with waaay more people than you would ever be comfortable with in the US. The imaginary bubbles of “my space, your space” don’t exist there. Also, I am sure that there have been unreported illnesses and deaths in this outbreak and others in less developed countries, but likely not in the thousands or even hundreds.
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I guess you’ve never been to Dallas. The population density is 3,645 people per saw mile. Sierra Leone, Liberia, and Guinea are 217, 82, and 102, respectively. I have friends and family from/in Sierra Leone, and Benin. Conakry has a much higher density for that city, but the worst hit areas have been rural so population densities are hard to assess.
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I think you did a wonderful job explaining ebola. If a worse case scenario happens & it spreads from the patient in Dallas to passengers on the plane from Washington to Dallas, school children from the children that were around him, health care workers who treated him before he was put in isolation, etc. do you think we could avoid exposure by traveling within the next month to a foreign country & living there for years until the USA is out of danger? I see as many people who can afford to travel here lying at the West Africa airport to get to the U.S. for better medical treatment.
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I’m a Master’s prepared nurse and teach at the ADN level. Exceptionally well written and argue the comments made by others very well. Very informative and will definitely share with my nursing students. Thank you!
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Greatly appreciated…you can use this to emphasize the reach a single nurse has, I’m just a regular BSN staff nurse but in 72 hours that s has been read by 55,000 people in 80 countries on every continent.
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I grew up outside of Dallas. I wasn’t speaking to population density, rather the differing cultural norms that provide much more actual contact as opposed to physical proximity. The point of my comments is really just to say that I’m sure the workers in Dallas are doing everything they can to control the spread and prevent an outbreak, and while Ebola is a serious virus, people in the US should not be panicking. Of course, behavoiral changes like washing hands frequently and reducing physical contact via handshakes and hugs would not hurt.
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HIV is a RNA virus. Otherwise nice article fir getting the bigger pic out to the non healthcare community.
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I was just using HIV as an example of a virus that doesn’t transfer through mucous/ saliva, and one that people are familiar with, but yeah its a little more complex but I wanted to keep in 6th grade level.
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Then can someone answer why the doctors/nurses are using Hazmat suits??
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Exactly…not only that, wearing hazmat suits and still getting sick, even when they’re American doctors with American resources.
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That was a really awesome post. I have a four year old and a two year old whom like to touch everything, and after reading this my original idea to wrap them up in a bubble doesn’t seem so bad!
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Great article, thank you for all the information! In your opinion, is there a point in time where you would keep preschool/elementary age kids (where germs are spread profusely regardless of hand washing) home from school for their safety? I realize that is a personal decision, just curious as to your thoughts.
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I wouldn’t think so, from my experience parents are a little more protective of their kids and will keep them home from school if they have fever, vomiting, etc…but you’re the parent, I’m not a parent so I can’t really say
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I live down the street from the Presbyterian and in the community as the Ebola patient. Let’s just say we probably shop at the same walmart and target. I have been very concerned that the media is downplaying this for several reasons that don’t have anything to do with the best interests of the public. I was finished reading your article when I stepped off of my porch to talk to an elderly neighbor. Of course I brought up my Ebola concerns and she then reminded me that she and her husband were in the same ER as the Ebola patient just hours after they dismissed him the first time on the 26th. Presby called them last week and asked them general questions like what room were they in etc. I say all of this bc I am baffled at how easily this can spread. It’s likely my elderly neighbors came in closer contact than me and they hardly leave their house. I think what’s done is done but I can tell you that I will be praying fervently over the next two to three weeks that no one else has been transmitted. Thank you for this article.
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