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 
Actually the main concern is…how long off the Ebola infected person does the virus last.? This is REALLY crucial.seconds compared to?? 4 days..lot more chance of spread the longer it is on objects.Love the article But I think we need to know the true time line ..not I think..
Obviously contagious more easily than has been reported or so many experts dealing with patients wouldn’t be contracting it as they know the risk seen the horrible deaths and are well suited up very careful….so how do professionals contract it?
This article sadly makes sense
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Ive seen different studies, depending on circumstance its anywhere from less than a minute to 50 days. Most of these studies are on old outbreaks, and have serious collection method flaws, so its hard to say with any true certainty. But the studies I’ve had the most faith in, that generally involved blood in ambient conditions, were anywhere from 3 days to a week
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Not even the so called ‘Experts’ can give a timeline. As with any virus it manifests from time of exposure to weeks! Improper removal & disposal of their protective equipment has been biggest source of transmission.
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I heard up to 18 days, depending on many factors. Such as temperature, surface, etc….
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Interesting article… I find it strange that little to no attention has been given to the passengers sharing a flight with the man from Dallas… where’d they end up?
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He wasn’t symptomatic until days after he arrived in TX so the folks on the plane should be fine.
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Thank you this made more sense then anything we have heard
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Excellently written and a way to make all of us on the front lines rethink our jobs
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Thank you for this article!!!! I have a two children and I’m very scared of this virus. So I need some advise! What can I do to keep from getting this horrifying virus into my family!? Should I buy lots of tissues, lysol? Keep the kids at home for the most part? Should I limit company? Should I freak out in public by keeping my kids from touching everything and myself? Keep our hands clean by washing frequently? Germex a GREAT thing to keep handy? UGHH I’m sorry for the questions!!!! Please forgive me! I will protect my family with everything and all I can!!
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Im pretty sure this article was written to give the general population outside of the medical field a general understanding from EXPERIENCE and PERSPECTIVE as the title clearly states. Most people NOT in the medical field will NOT understand the medical terms used through out the media for i.e. droplet VS. airborne and so forth. This is NOT some scholarly written article! Quit criticizing on the technicalities!! In opinion, it was well explained for a basic understanding, (additionally, with good analogies) which is exactly how your taught to explain to your patients!! KUDDOS!! PS. explaining a negative pressure room in concern of a TB patient is irrelevant to the point of this blog. Your missing the analogy here. lastly, clinical setting is totally different than textbook if you cant interpret analogies, or relationships you wont succeed. People now have a basic UNDERSTANDING and can further research the relevant/irrelevant technicalities themselves. YOU CANT CITE EXPERIENCES as that would violate hippa. go do your own research and or produce your own blog and cite your own sources instead of spinning wheels arguing back and forth about it. and if you already have done that…then no need to further waste your time & continue to comment on what you feel is “wrong” about someones PERSPECTIVE !
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Lol, if you need a few hours of entertainment go look through the comments, I think some of these people need citations to decide which toilet paper to buy.
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Lol It’s absurd!! Def had some time to kill D..Nice post btw!! Very informative & easy read!! Your patients are lucky to have you!! I’m impressed that ya read & respond to your comments as well! Much love from GA!
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I am pushing 42 years old…I have been taking care of people medically as a profession for over 25 years. I am now in college working towards my Bachelors simply to put that piece of paper behind the experience and further my education for caring for others. I do completely understand your mindset on wanting to inform people…and I TRULY appreciate this article. If folks would stop nitpicking and actually read and understand what you are doing here, it would be a million times easier to educate the general public. Unfortunately many feel the need to rip apart those who have the best interest of others in mind. I think you have done an excellent job putting this together in terms most an easily understand if they choose to do so. Thank you for taking the time to write this…I will be sharing it as much as possible…education is the key to survival…I imagine you must be one hellofa nurse and your patients are lucky to have you!! Good luck, stay healthy and GOD bless!!
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Thank you for writing this article on ebola, it was very informative im a homecare nurse, the lord recently told me to start double gloving, im taking it seriously, im hoping our president would start banning any flights from africa, syria, liberia to the U.S.A. to help stop the spread of this virus, i know God hears our prayers, i pray our leaders will listen to facts an follow them.
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I understand Ebola better now. Thank you for taking the time and the care to put this much needed PRESPECTIVE out there. Just wish the CDC could of let the public know about those airborne “DROPLETS”.
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They didn’t because it is not true.
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Hello, nurse:) You are awesome! I have been scratching my head on this matter since the origin of its arrival. Thank you for the clarification!
Trollers take a hike!
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“Still, it spreads prior to symptoms and survives will outside the body, just like the flu.”
This is not true. A person infected with Ebola is not contagious prior to being symptomatic and thus the virus cannot be spread.
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Read the * at the bottom please
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Thank you for the article. It was well written and even those not working in the medical community could understand it! You did not increase my fear I was already very nervous about it, you made me understand and prepared me a lil better! Thank you!
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Dustin,
This article was great!! I am starting nursing school in the spring and the thought of take any foreign body into my home scares me enough. Not sure that you will even read this and if you do I am sure you have heard this already but anyone that criticized your article is probably just hoping that you are wrong!!! I don’t know you from Adam but I trust that you “are who you say you are” because your information is acurate even just comparing to the small amount of scientific schooling I have had. Really appreciate you taking the time to post this and thank you for your work and the impact you have on people’s lives.
God Bless,
Jacob
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I read every one of my comments. Enjoy nursing school its tough for guys, but it was the best time of my life.
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Very informative, easy to understand and enlightening. Thank you for writing this article.
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I read that the person had to show symptoms before he was contagious. Is this not true?
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Read the * at the bottom
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http://www.necn.com/news/health/Patient-Isolated-for-Ebola-Symptoms-in-Braintree-Mass-278946321.html
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Thanks for a GREAT article. I sent it to family and friends.
My thought: I’ve been studying enough biostatistics math to get worried. Why did the CDC elevate the Ebola detection threshold? Was it their intention to reduce false positives in favor of false negatives? I’m looking for scientists and mathematicians and all I find are politicians in both camps.
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Im not that caught up on it, I can’t really answer….link me?
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Wow! I didnt really want to take all that time to read but when I started, I couldnt stop! This is just so informative! Thank you so much for sharing this with everyone. Im sorry people gave you crap over it. I understood. Keep sharing, you prospective and I will keep reading! No I didnt read all the comments but keep it up and again THANK YOU! From someone who catches so much and then my daughter gets it and we just spread it back and forth for months, I never even thought of the flu in “droplets”…lol I changed my way of thinking now. If someone gets sick again, Im sure gonna pay more attention!
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Thank you! I hope many more people read this!
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thank you so much for sharing this with the rest of the medically uneducated people. I now have a better understanding of what happens to the body and also how this Satanic virus can be spread. You told us more in 15 minutes than I have heard since this outbreak started overseas. Thank you for the first information that has actually made sense.
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Thank you for an explanation understandable to the public .I am a nurse retired and unfortunately did not truly understand .
Some times the medical profession is not forthcoming.
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Great explanation, we can only hope that it does not spread and become an outbreak in Australia.
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Your natural fauna will kill it off….y’all already have enough competition for deadliest thing in Australia….
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An article written by a nurse who claims to have seem every disease known to man writes this and its gospel…give me a break…the worlds leading expert on Ebola in Africa contracted the virus and died…this article isnt worth the website its on because guess what shes not virologost and virologists admit the really dont know much about the disease because everytime it spreads it mutates and changes….
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he* I’m a dude….and your right, that’s why I didn’t cite anything or post any “hard facts” I simply tried to put things into laymens terms to simplify the viral process.
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And honestly if this nurse hasnt experienced Ebola at all first hand then well it makes the article an opinion piece not a fact based piece
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Exactly, that’s why it says perspective in the title.
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It is misleading, and irresponsible.
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Right, I should have labeled it “a nurses guide to surviving the impending Ebola death wave” and then people would have known its just an opinion piece
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Thank you for this article, I was most afraid when I heard about the patient in the first place. My immediate thought was, please don’t let him have had contact with children. I hope for the best in our current situation.
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Great article. As a peds nurse myself, I understand and wish people would get it. “The Public”, as we affectionately call them, always presents challenges!
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Psh, the public has loved my article, its the anonymous “experts” that have been challenging….I’ve seriously had complaints about the speed of a sneeze actually being 39 mph, not mach 1
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Ebola has RNA not DNA. You don’t even know the fundamentals of this disease yet you preach like we are all oblivious to what Ebola is. People posting crap they really dont understand is probably more dangerous than our “censored media”.
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99% of people have no idea what RNA is, it is irrelevant to the treatment of the disease from a nursing standpoint, and irrelevant to the what the general public needs to know to keep themselves safe. I didn’t mention a lot of things about Ebola, because it is not relevant to the purpose of the article….you’re exactly right, posting things they don’t understand is dangerous….that’s why I posted things they DO understand. Look back through the comments and you’ll see how many people commended the writing style I utilized.
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Whether anyone else knows what it is or not is irrelevant. My point was that YOU are the one writing this thing and you fall into the category of ignorant know-it-all’s. I’m glad you feel good about yourself. PS, it is crucial for the treatment of Ebola because most common antiviral drugs that we use are for DNA based viruses, so the fact that Ebola differs on the most fundamental level is actually quite important in providing/finding treatment.
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Did I talk about treatment? No. Is the general going to be finding a cure? No. I picked what’s in my article, and what’s not in my article carefully and for specific reasons.
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All I’m trying to say I guess, is that I dislike when people post things online like this and have inaccuracies. For me you lose all credibility, but I’m smarter than most. Others will believe anything they read. Look at all the idiots ruining the lives of their kids because they read vaccinations will cause Asperger Syndrome . I applaud that you are trying to help inform people, but I disagree with how oversimplified this is. Its not cut and dry and trying to turn something this complex into something so basic I think is going to incite panic. In actuality there is very little to fear here in the States given protocols in place already both here and abroad.
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You are in denial! Just believing everything you hear on tv. Obviously, “protocols” are not enough if others are still becoming infected!
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Jesus, this guy sucks. Author, I’m sorry for his unneeded bashing. Credibility IS relevant when being concerned about the most recent evidence based practice, relevant to a patho/treatment regimen for a specific disease/maladaptive physiologic response…This is a perspective! As the dude clearly points out. It is to inform the ignorant public of the very basics of how a virus works. You clearly have no perception of articulating how something like this happens to the general public, which in turn, needs to be at a fourth grade reading level in order for the general pubic to comprehend it. But I am sure you already knew that and have written a book titled “medical problems, including the very simple innate immune, humoral, and cell mediated responses to those pesky viruses we all know about”. I have never posted a response to a thread before; I have read thousands, of course not specifically and constrained to medically relevant topics, but this one had my head shaking.. It isn’t even a funny “trolling” of the thread or comment. It is solely just an asshole comment attempting to derail and prove the author wrong, feebly…Well joke’s on you, its not a research article. It’s a perspective, from experience! The article was very well written for its purpose, clear, and easily understandable for the general public. Nice job dude. Not you Zach, you’re a penis.
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Absolutely. Please stop spreading misinformation and fear mongering!
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And my point was if this is an informative piece, have the facts straight. Caleb, how extensive do you think the authors experience actually is with ebola? People believe the first thing they read, I’m only trying to get people to use their heads and think, formulating their own opinions. Caleb, maybe you should use that useless lump of shit on top of your neck a little bit more too.
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Good article. Well written. Totally agree. Only one comment though..TB has not been eradicated. It remains epidemic with over 3 billion cases annually. Yes that is billion. It is airborne and can be fatal if left untreated.
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3 billion? That’s half the worlds population…
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Let’s export the ebola virus to all the Muslim countries in the world. In that scenario we can get rid of one billion Islamic terrorists without firing a single bullet.
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Thank you for this information. I appreciate you.
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NOVA had a great hour on Ebola on PBS. They said scientifically most of what you said. You may have made some errors but your basic message is this in more contagious than they are telling us. The death rate they give us is accurate but they will not put on TV the details of the patient’s death. Thank you for your opinion. We need to be thankful the virus has been identifed and there is a test for it. 1979-1981 we did not have even that for HIV.
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Thank you for writing this article. I have tried to express the dangerous nature of this virus and mant act like I am stupid because I’ve never seen Ebola in person. I am not ignorant, I too have a bachelor of science in nursing and have been extremely concerned that the CDC was not educating/ training medical person ell about Ebola. Without education it spreads faster. Without education we will have chaos. Thank you for helping to educate the country so thy may know the true facts about this virus.
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So here is the thing….first thank you so much for the information because I am so scared for my children especially my 19 year old who is studying abroad in Australia so not only do i have that threat on her but she did an excursion to Thailand in September and guess what yup they had a breakout there on September 2nd or a case not sure which stories vary seems nobody wants to be 100% truthful anyways she is back in Australia under threat still and will be coming home in a month but guess where i live yup good old Braintree Ma who happened to have a case reported just today. I am freaking out on the inside so she could get killed by a bomb or a weapon or get killed by a virus or catch or have caught it already. My question is why are we allowing our citizens to fly to Africa and then return? If they are not a doctor or specialist that deals in that then why? We are risking our citizens …sorry but i am really scared there is so much in one basket here for my daughter its horrifying
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Thank you very much for informing the public of what to look for and what we should expect in the coming days or months. I am very grateful to you for taking the time to express your concerns.Thank you again and I hope we can get through this with the knowledge you have given us. God watch over us and bless us, amen.
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Definitely worth reading and I sent it to group message to all family members.
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Actually it is 1/3 of the population. Pretty scary huh! Look at the CDC website. Most people don’t think it even exist any more.
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Here is an excerpt from CDC.gov.
TB is one of the world’s deadliest diseases:
One third of the world’s population are infected with TB.
In 2012, 9 million people worldwide became sick with TB disease, most of whom (80%) live in one of the 22 high burden countries for TB.
TB is a leading killer of people living with HIV (PLHIV).
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Ty for taking the time to share this information..this pediatric RN enjoyed the way it was written!
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Thank you so much for this article and don’t mind all the idiots who criticize every word!
I’ve been getting more and more angry about the media and all I’ve been reading about how this is spread. For example, how can people really say this is only spread AFTER someone shows symptoms!? I guess it may make sense to the lay person, but letting people believe that kind of thing is only going to get more people infected!
As an ER nurse, I am the front line, and I’m scared! It’s not like we’re going to walk around in space suits, and we’re not going to know if someone is infected with Ebola, or enterovirus for that matter, or it’s just the common cold or flu before we are all infected or carrying it home to our kids. Scary!
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This article is fabulous, as I nurse I give all my patients hand sanitizer, then I tell them to take it put it in the car, because kids and ppl are putting their hands all over everything. If the cdc was soooo concerned or the AMA, it would be mandatory in every hospital that there were hand washing stations that you were mandated to wash your hands before Leaving any hospital, clinic or likewise. …keep up the fight to protect our family and friends. ..Dawn LPN…19 years…
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Well written…I’m a nurse to and appreciate the perspective and feel as if I now have a better understanding of
The situation at hand. Thank I for ur time:)
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You pretty much summed up just about everything I’ve been thinking ever since I first started following the outbreak. And it’s scary.
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I appreciate your perspective and don’t want to sound disrespectful. However, I think it is irresponsible of you as a self-admitted non-expert to sound off on a complicated disease some people spend their entire lives studying. They have published a great deal of information that people should be reading instead of lay opinion. I most take issue with your thoughts on Ebola’s method of transmission.
You make several erroneous statements in your paragraph describing Ebola’s method of transmission. Primarily, there is no known case of Ebola being spread through the air in a matter similar to your description.
Source: http://www.who.int/mediacentre/news/ebola/06-october-2014/en/
Most cases have been spread through improper hygienic practices. Additionally, sneezing and coughing are not even common symptoms of Ebola, rendering the possibility of such a transmission extremely remote.
Additionally, the cold and influenza are ABSOLUTELY viruses that are spread through airborne transmission. The flu can be acquired through the inhalation of just one drop of infected fluid that is the size of one micron. A micron is one millionth of a meter. This has never been observed in Ebola.
Fortunately, epidemiologists calculate something called R0, or the basic reproduction number to calculate how contagious a particular disease is. The R0 for Ebola is 1-2, meaning each person that has the disease will spread it to 1-2 other people on average. It is important to keep in mind that this R0 figure includes the beginning of the outbreak, when people are not aware they should be taking precautions. Additionally, the R0 is much lower in countries with good public health systems, such as the U.S. In this case, the R0 should easily drop below 1, meaning Ebola will not spread throughout the population. This is exactly why the CDC and hospitals are taking so many precautions. We should be taking precautions; we should NOT be panicking.
If it makes you feel better, in the time since one person in the U.S. has died from Ebola, here are some things that have killed Americans:
Heart disease= 13,144 people
Lung Cancer= 3,491 people
Diabetes= 1,620
Flu/Pneumonia= 1,110
Motor Accidents= 740
Guns= 705
Accidental Falls= 605
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Thank you. You would think a nurse would know how influenza is spread. Frightening.
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I recently learned the RO for Ebola and Hep C. I don’t see how they can be the same. Maybe you can explain that to me. My mother had Hep C for 30 years and spread it to no one. No one was in danger of contracting the disease by being near her in any stage of her illness. The Dallas Ebola patient infected one other person, that we no of, wearing a hazmat suit! Again, how can they have the same RO?
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That’s because, as I explained, to spread Hep C, you have to have sex with the infected person, or get their blood into your blood stream, such as sharing a needle. Hep C can be in the body for a long time and not cause enough liver damage to cause any symptoms, so she COULD have spread it sexually and the recipient not know for 10 or 20 years, but I won’t speculate on your moms sex life. Ebola on the other hand is an acute illness, it causes the body to leak fluids, and it is in all bodily fluids, even sweat. So Ebola patients are shedding the virus in large quantities, its in the clothes, in their bedding, on their eating utensils, its everywhere. Hep C is a chronic illness, it stays in the blood. My intent was to imply that Ebola and Hep are very different types of viruses, if it didn’t come across that way I’m sorry.
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That’s because, as I explained, to spread Hep C, you have to have sex with the infected person, or get their blood into your blood stream, such as sharing a needle. Hep C can be in the body for a long time and not cause enough liver damage to cause any symptoms, so she COULD have spread it sexually and the recipient not know for 10 or 20 years, but I won’t speculate on your moms sex life. Ebola on the other hand is an acute illness, it causes the body to leak fluids, and it is in all bodily fluids, even sweat.
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Not sure if you were replying to my comment or to the article. To answer your question, the R0 can be the same or similar. Think about it this way: R0 is a measure of how many people a diseased person will infect during the course of their disease, not a measure of how contagious a disease is.
Since Hep C. sufferers live with the disease, they have years to spread it. Ebola either kills its patients or they recover in a much shorter time frame, meaning the disease is not contagious for as long. Additionally, unlike Ebola, Hepatitis C can be spread even when a person is asymptomatic. Being asymptomatic leads people to take fewer precautions, since they don’t even know they have contracted it. If you are bleeding out of your eyeballs, people are going to stay away from you, wash their hands, avoid touching their face, etc.; if you have a more subtle disease (HIV, Hep. C) people will continue to share needles or have unprotected sex.
Again, please do not listen to a nurse about these issues. The ability of spreading Hepatitis C through sexual intercourse is possible in some cases, but there is no evidence it is spread through heterosexual partners where other conditions (HIV, genital ulceration) are not present. In fact, only 1.5% of Hep. C cases in the U.S. have come from any kind of sexual activity, and this estimate does not account for the possibility that some of the 1.5% are omitting possible IV drug use.
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Heart disease is attributed to lifestyle choices, poor diet, lack of exercise, etc. Lung cancer mostly comes from smokers, a few from chemical exposures and rarely from radion, but mostly smokers, another personal choice. Type 1 diabetes is a autoimmune disorder that destroys the function of the pancreas. Type 2 diabetes is like heart disease, primarily from poor lifestyle choices. Flu/pneumonia are things we are actively fighting, although “pneumonia” is not attributed to any particular virus or bacteria, but is an umbrella term for a number of conditions involving fluid on the lungs. Ebola on the other hand, is an infection, innocent people get it by no choice of their own, there is zero reason that any person should go through Ebola. But in a way you’re right, and you would think that after experiencing flu season year after year you would understand the concern behind keeping it out of our country. Imagine if I had written this about AIDs 30 years ago? It was written off as “gay cancer” and the known death rate in the US was single digits. Now the death toll is over 25 million. At one point it was also only seen in small villages with small death tolls. And there’s only been 1 flu death this year.
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Many of your arguments about these diseases are misleading; for instance, a 30 second Google search would tell you that 2,900 people who have never smoked a single cigarette die of lung cancer every year. That’s about 14% of lung cancer deaths.
I appreciate the need to take precautions to prevent the spread of Ebola. Of course I wouldn’t want it to spread in this country or anywhere. That said, many people are reading this blog and you have a unique opportunity to educate them. When you make erroneous statements about any disease, you lose an opportunity to educate people. You also make them more or less fearful of a given disease than they ought to be.
I notice your blog still claims colds/influenza cannot be transmitted through the air. I know you have seen this fact but you have not corrected it. I am not criticizing your entire piece and it’s great that you have people reading it. I just wish you would correct some of the factual errors to make it better.
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Thankyou for taking the time and effort to try and help us to understand Ebola a bit better. I feel that I know alot more than I did before I read this. Thankyou once again for taking the time to write this article. Even though I do not know everything or even truely understand it all, I do have more information than I did>
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Thank you for your post and the discussion that it has started. You are not responsible for developing a drug for this RNA virus. You are not responsible for the lab procedures. This virus has been known by the CDC since 1976. You are not in the ivory tower from which many of the persons on TV are speaking. You are however on the front line if you are working in the ER or the ICU Isolation unit where the patients are likely to enter and be cared for. When you see a patient crashing there may be breaks in technique that would protect you in you PPEs. Getting out of your PPEs can cause contamination with one break. That is why it takes another set of eyes watching you to help. Being on the front line can be scary, but being a little scare may help you not make mistakes.
I would like to mention a couple of things to be thankful for. One: The virus has been identified and there is a test and confirmatory test for the virus. Sadly, until this current out break, there have not been enough cases for those who can develop drug to really get busy. They are really busy now.
Be thankful that contact investigation is actually occurring. HIV was an STD but not handled like other STDs.
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Dustin, thank you so, very much for this article. I thank God that you care enough to try to inform us. I cannot count on this government, nor do I trust this government to tell us the truth. Especially since we have a lying President. He started out saying there was NO CHANCE at all that the Ebola Virus would get to America. Now that it’s here, he said the chance of it spreading is extremely, extremely small. Now that it’s spreading, he said the chance of a big outbreak is very minimal. Our “so called” President wouldn’t know how to tell the truth to save his life! This is an extremely bad virus and people are scared…including me. We need and deserve to be told the truth. So from the bottom of my heart, THANK YOU! GOD BLESS YOU!
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Please leave the topic of Ebola to the experts, as you have admitted you’re not one. Spreading misinformation as you are doing is helpful to no one.
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Dr Stacy, have you taken care of a case or suspected case of Ebola? Have you been on the front line in a space suit cleaning up bloody stool or bloody vomitus. Have you started the IV, intubated an Ebola patient. It is the informed and misinform that are getting Eboli.
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No, I have not personally cared for an Ebola patient, but I’m not particularly worried about it, either. Before medical school, I studied virology in graduate school and actually know what I’m talking about. Just about everything in this piece is blatantly wrong.
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Thank you so much for taking the time to write this. It’s very enlightening.
(Not in the med. field.) Linda
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Further, polio has not been eradicated, nor is it usually spread via droplets- it’s spread through the fecal-oral route. American children are required to receive the polio vaccine before they can go to school. And I don’t know where you live, but here in Southern Virginia tuberculosis is alive and well. Does your employer not require that you have a PPD every year to test you for exposure to TB? Were you not fitted for a respirator in case you have a TB patient to care for?
Again, the very basic information that is blatantly wrong in this piece is shocking. Perhaps you need to go back to school. You are doing your patients and your community a great disservice through your ignorance about very basic healthcare topics.
Oh, and I CAN site my sources:
http://www.cdc.gov/polio/about/index.htm
http://www.cdc.gov/tb/statistics/default.htm
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I do get fitted for an N95 mask, but we wear them for many types of patients, not just TB, and yes we get skin tested every year, I’ve actually been tested 4 times in the last year, for various reasons. The US does not vaccinate against TB like some countries do, we have a large Filipino population here, and they get inoculated there, so they don’t do the skin test here. I have never once seen a a nurse test positive. I have only seen one actual TB patient in real life, had one test positive, but we figured out he had just been exposed and had had antibodies, but had no active TB. Another tested positive, but that’s because her father had TB, in the 1950s, and exposed her as a child. all subsequent tests were also negative showing she had exposure, but never active TB. The most recent, which was over 2 years ago, was the only true, TB patient. My unit had the neg pressure so we got all the respiratory illnesses. One hospital that I have worked with specializes in chronic respiratory diseases and has some of the countries top pulmonologists at it, never cared for a TB patient there either. Being this close to mexico we are considered a relativel high risk area for TB, as many immigrants come over with it. Eradicated is a strong word, but today, in America at least, TB is far more suppressed from where it was 100 years ago. Same with Polio, it still exists, but the last true case in the US was in 1979. Before you and I were born.
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So after all is said and done what can we do to keep our family’s and self safe when shopping and being in places where others are do lysol wipes help by wiping surfaces clean b4 you touch anything or is it gonna get so bad that we are all having to live in bubbles???
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Awesome editorial, in plain everyday people-speak! Lets hope it reaches the right demographic… I will share it on my page, and hope it goes, (pardon the pun) VIRAL!!! I am an ECSTATICALLY retired RN, with a 34 year background in this incredibly draining and demanding career, with 20 of my 34 years spent in Critical Care….8 in Medical ICU, and 12 in Level 1 Trauma Center EMERGENCY Room settings…. Do I miss it? HELL NO!!! I only miss the wonderful people I worked shoulder to shoulder with, running headlong into impossible situations, and coming out the other side, victorious, MOST of the time…We were FEARLESS!!!! Wouldn’t want to be on those front lines now though, so I pray for ALL that are, to be safe, and protected from harm as they continue the daily fight to save humanity from itself!!!
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I commend you for having the guts to come forward and offer what you know, and defend your right to do so, as well…. I also, however, condemn all the negative people on here who are saying you have no right to speak out!! Let those who say you are wrong, open their well educated mouths and correct what they spout is wrong with what you have said….
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