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 
As an infectious disease epidemiologist (I think the chef analogy is probably more appropriate for me), I can attest that some of the information in this article is factually inaccurate. First, there is fairly good evidence that influenza is an airborne pathogen (http://rsif.royalsocietypublishing.org/content/early/2009/09/17/rsif.2009.0302.focus.short); where airborne here is defined as agent that is acquired through inhalation of ‘suspended cloud of small, dried droplets’). Whether or not something is airborne depends in part upon the size of the particle that is transmitted. The particle size required for ebola transmission is thought to be much larger than that for influenza, and most (good) epidemiological studies suggest that very close close contact is necessary for a transmission event to occur (for a scientific discussion with real citation see here. http://virologydownunder.blogspot.com.au/2014/08/ebola-virus-may-be-spread-by-droplets.html).
It’s also important to keep in mind that the reproductive number (which is a measure of virus transmissability) depends not only the on individual probability of acquiring infection per contact but also on the structure of the contact network itself. It is therefore a setting specific estimate. While we often use estimates from other locations to gauge risk in new settings (for instance using R0 from Liberia to assess US risk) it is critical that we note that the nature of contacts in the US is very different (i.e. #s sharing house/beds, burial ceremonies with touching).
Lastly, if you’re going to pretend to be an infectious disease epidemiologist you do need to actually cite you work (because you are a nurse in an ID ward does not make you an epidemiologist). I’m actually very sad that someone who works in the health field has not taken the time to appropriately inform him/herself before posting on such a timely and critical topic. Perhaps such misinformation is why the ebola patient was initially sent home from the hospital? Education of our health care workers should be a priority in fighting this epidemic domestically.
Also, tuberculosis is far from being eliminated!
Kate
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I referenced the same article in prior comments, its a good one, but you are focusing on the airborne aspect of it, the Ebola virus is close to a micron in size, its a huge virus. A prior commenter on a different site is a virologist who focuses on transmission and she discussed that in smaller droplets, the fast evaporation destroys the virus. But in the larger droplets, that I discussed, can land and dry on surfaces, and be spread by contact. I have no concern about distance and clouds of droplets. I’m concerned about the people in the doctors office coughing on frequently touched surfaces. Just like in my addendum, I’m concerned with fomites, not aresolization
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Thanks Dustin. The author of the blog post focused on this particular point with her comparison to influenza (see more discussion here. http://virologydownunder.blogspot.com.au/). There is little is known about transmission via fomites, but one (and only one to my knowledge) prior study suggests that with good infection control practice risk can be mitigated (http://www.ncbi.nlm.nih.gov/pubmed/17940942). What that means for the average person, I don’t know…I did see one report of possible fomite transmission from West African epidemic, though I emphasize the word “possible”. http://www.flutrackers.com/forum/showpost.php?p=465818&postcount=265
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Who the hell cares about the flu technically being an airborne pathogen, that wasn’t the point of the article. As someone who hasn’t studied medicine, this was a good reminder to be careful when I go to the doctor of touching my face (or in public in general) and wash my hands afterward (which is a habit anyways, but still a good reminder). I had also been one of the probably many that was writing off Ebola as a problem in Africa that wouldn’t really effect the US, so for me this article did its job in getting me to change my view of reality a bit. Even the possibly arbitrary numbers on virus survivability don’t bug me. What I got was, “Ebola can spread fairly easily and shouldn’t be taken lightly.”
Seriously, I don’t care if the author was off on whether or not the flu spreads through the air. For all practical intents and purposes, it mostly seems like semantics to the average Joe. Nothing you told me about airborne pathogens changes my perspective on the post or how I well subsequently go about my life after reading your reply.
Thank you epidemiology expert.
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Thanks for the support
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Thank you for what you do and for breaking this down for us.
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I think your article is wonderful, I’m a nurse that works on an infectious disease floor, where we take med surg, tele patients that have resistant, or anything highly contagious, (CDiff) so I started reading out of curiousity, but this is an amazing article and you wrote it well that the “average Joe” could read and understand. I personally don’t care what the WHO or CDC say, you can give the flu away to you neighbors before you know it, no reason why you can’t give this virus away the same way. thr problem is this virus is running so rampid in a very under privledged country no one really knows what is and isn’t going on. People are doing the bare minimum trying to keep people alive as long as they can. They don’t have time for research. I think the WHO and CDC are saying things to keep Americans calm. We as Americans are aweful about, it can never happen to us, well get ready, it’s here, and this flu season if in Dallas everyone that doesn’t go get checked the minute they feel achy or get the sneezes, it will spread like wild fire.
Thank you for the article I feel it was very well put and explains very easily how virus’ are transmitted and maybe people will understand just how easy this is transmitted, and how fast this can get out of hand no matter what the WHO or CDC says. I look forward to most posts from you
And for everyone hating on him. The WHO and CDC are great things, but someones government or private organization is paying them. 😉
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I know that everyone is really scared about Ebola right now, and justifiably so. However, we must make sure that we are properly educated and spreading the right information to keep people safe. Viruses do spread in different ways – HIV is a virus and does not spread like the flu. You cannot compare Ebola to the flu just because it is another virus. The CDC has been studying Ebola for decades and probably has a pretty good handle on how it spreads — it is not as contagious as the flu, and you cannot spread it before you show symptoms. We definitely need to take this seriously, but spreading false information can lead to panic and overwhelm a medical system who then has to deal with false alerts instead of being able to deal with those who are really at risk. The best way to help contain this thing is to spread accurate information.
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Please read my addendum on spreading
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Sorry, another nurse here! Her information appears to be pretty darn accurate to me. The big point here is that they are contagious as soon as they show symptoms. Which could be a headache. Ever get one of those? If you have Ebola you may now spread it. The virus is not going to wait for you to be diagnosed. There is a reason there was such concern over the Dallas patient’s vomit on the ground and the patients who entered the ambulance after him. Ambulance, bus seat… Ebola doesn’t care.
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His* information 🙂
But yes, we are near Dallas, and my wife has had a headache for 2 days now, I’m 100% confident she does NOT have ebola, lol
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Very informative. Good article.
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As the situation in Texas proceeds, we will get an idea of how easily or not this disease progresses and whether your theory is a concern. The Texas patient was in very close quarters for days with a number of people, including children who then went on to be in contact with other children in school. If no one outside the immediate family contracts ebola in Texas as a result of this patient, then your fomite scenario (the possibility of picking up the ebola virus from touching magazine and then passing the virus to your child from your fingertips) becomes much less probable. Let’s hope so. We should know by Thanksgiving.
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Thank you for the explanation on the sequence of transmission concerning the ebola virus and what we need to know. We need to educate ourselves and we need to listen. This is the hard line and I am thankful to have read this.
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I wasn’t debating hand washing, I just said that several of your objective facts are incorrect – like someone can spread the disease before they are symptomatic. That’s a very big fact to report wrong! It is great that you are passionate about reporting on this disease, just make sure that your facts are correct. Your article has a strong angry ‘subjective’ feel. Objective reporting is needed if you are discussing something of this magnitude. You don’t want to scare people needlessly. Go through your article and see how many times you use subjective phrases like: “I feel” “It pains me” “I think” etc Those kinds of phrases inform the reader that this is a subjective article and people won’t take you as seriously as they would if you just use objective phrases. And, of course, getting your facts correct. That is all I was saying. Congrats on starting out in a brilliant career like Nursing. It will enrich your life – in my subjective opinion. 😉 That’s all I have to say so I’m letting this discussion drop. No more responses here. I’ve got to get back to my own blog where my friends and I are trying to get a drunk driver locked up, who killed my 20-yr-old friend a week ago. Rock on!! .
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It is subjective because it is their opinion. Hence the title. Learn to read prior to making the assumption that this is all factual. Also, in re your statement “I wasn’t debating hand washing, I just said that several of your objective facts are incorrect – like someone can spread the disease before they are symptomatic. That’s a very big fact to report wrong!” HPV is a great virus for that, many people go there ENTIRE LIVES without once ever showing one symptom, many woman find out because of a PAP smear and would have had no idea! Ergo, you are very “Subjective” to say that is a false statement.
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Thanks for having my back, but look up fomites, that’s more of what I am concerned with. But you are right, during the latent phase, most viruses can be spread by blood to blood contact, its much more difficult, but possible.
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Not trying to be funny in the least bit, as I do take my health very seriously. Your reply sounds like it has a bit of a, “a strong angry ‘subjective’ feel” to it. I think what DT was trying to get across is simply, at basis, that it(Ebola) could become a serious matter in our nation if not handled seriously by ALL. In addition, DT did clarify that these are not facts but an opinion based on the knowledge aquired over years of nurse work in related fields as it sounds you may have as well, so it SHOULD be subjective as any other opinion would be. Let’s look at what matters Shira, there are americans concerned about this matter, so if there is mis information in this article we don’t need to attack the author, if anything kindly inform and you may be taken more seriously..
P.S. My most sincere condolences for your friend. i hope the drunk asswhipe gets what they deserve!
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Thanks for having my back, you are one of the few who truly gets my article
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I, too, felt it was a very timely, apt, article. Only a nurse could put it so succinctly and understandably. Yeah, I saw a few grammar mistakes but they did not interfere with the information you gave.
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Thank you very much for your concise article. It is very helpful!
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So the people the media say are ok and well now, are they over it, or carrying a virus that is just dormit in there body. In other work is the virus in their body, dead or alive
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Once you’re healed, you’re healed, the only issue afterwards is men can still transmit it sexually for up to 2 months, but its like the flu in this aspect, once its gone, its gone
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I think this is a great article for everyone to read- information and education are power and can really make all the difference. However, it is mentioned that transmission is through blood-which is an obvious place for concern especially since in Ebola you’re just emitting a big painful blood puddle- BUT, it is then stating that you initially have flu symptoms (again true and important for when you start showing onset to get checked out and to have those around you on precautions) and that when you’re coughing on things people can now become infected by touching said coughed on items and not washing their hands… So are we saying that saliva/mucous is also a transmitter, as well as, blood?
I am just attempting to clarify- it is stated in this article, and many others that I have read, that saliva/mucous is not a means for transmission. So technically, you wouldn’t be spreading Ebola until you start bleeding, correct?
If it is just a means to be cautious, I can respect that greatly and scaring people to wash their hands more is a wonderful byproduct of this information.
My concern for the information provided by the media is that they are trying to keep the public calm because it has been theorized that humans cause mass panic when fearful of their lives.
Again, I’m not trying to downplay the seriousness of Ebola, just looking at this from all angles and trying to clarify. If it is of any importance I am also a nurse, I have my BSN, a BS in psychology, and study public health and infectious disease in preparation for applying to graduate school.
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Its spread in all bodily fluids, even sweat
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Very well written and informative regarding viruses in general. However, the Ebola virus is a single-stranded RNA virus. Not DNA. Guess it doesn’t really matter from a nurses’ perspective. I look at it from different views because I was once a nurse , and now a MD.
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Yeah I was trying to keep it 6th grade level, the way I would explain things to someone who just got the diagnoses, they don’t care about DNA vs RNA..
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You’re right! It was explained at a level us non-medical people can understand! I’ve always believed when someone sneezes or coughs without covering their mouth, those droplets, that you talk about, are in the air for the rest of us to catch from the person that just sneezed/coughed! I hate it when people do that! Does the Lysol spray help at all with that?? Or just a “perfume coverup.” I use Lysol a lot whenever we have sickness going through the family…and like you, I stress hand washing!
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Thank you! I was under the impression it a only a contact precaution disease. Now that I know a pt would be under droplet precautions as well, the “panic” makes much more sense. Theoretically it could spread like the enterovirus D68 has. *Yikes* the extra precautions of hazmats and negative pressure are by definition unnecessary but I’ve definitely gowned and masked up “unnecessarily” to protect me & mine before.
Just food for thought: TB is airborne & not eradicated! Healthcare professionals ( & students) get screened for TB at least once a year.
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I never said it was, but we’ve eradicated others. TB is WAY less prevalent now than 100 years ago
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To begin, I love this article! I knew Ebola was contagious but that’s all I knew. I appreciate the knowledge you are spreading for the people who don’t have a clue what’s going on. I have been trying to keep up via media but it’s nothing compared to the knowing of why, how, and where Ebola exists in our community today. Thank you for furthering my education and for taking the time to elaborate in detail on signs and reasons of the spread. You take pride in your work and for that I am grateful. There should be more people in this world like you!
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Thank you!!
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Thank you so much for taking the time to explain in a manner I can understand. The media drives me crazy with the misinformation and changing the information. I understand this is extremely serious and EVERYONE needs to wake up and pay attention. I kept thinking about the “not airborne” concept and wondered how they (media, CDC, WHO) could make that statement. As you point out coughing or a sneeze – spewing spittle onto anything then touched by someone else and you’ve got it spreading around. Makes sense that’s how we get colds and flu and sometimes worse. Again, thank you, and I am sorry you are getting negative comments. This was passed on to me by a nurse and I take her serious, she thinks this is worth looking at, I do it.
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Possible, yes… Anything is possible. Probable. No. VERY LOW probability that what you described could or would happen.
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In that scenario my only thought, is that if it were your little baby…is it worth the risk? If research says 3 ft is far enough, are you 100% comfortable sitting your infant 4 ft away?
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It is more of a trail of 3 foot bubbles rather than a single bubble right?
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I’m a critical care nurse with 20 years experience in the highest level of care areas of the profession. I think an open dialogue is a good start to address what we can do to impact this crisis with intelligent ideas from those of us who are genuinely in the frontline. My concern is I see blind faith on the part of officials like Freiden in our system, yet I witness isolation breaches on the regular. What happened in Dallas unfortunately is more of a reality in healthcare than most of us would like to admit. We need to take an initiative to seriously look at our protocols. As an example, I’m not sure taking temps at the airport is that indicative. When a person applies for a visa the screening process should begin. The ability to just hop on a plane from areas hard hit should be curtailed. Passengers should be required to apply, plan, be screened and required it isolate oneself prior to boarding. Preventive measures are always more effective than containment efforts.
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Thank you this was a very informative article.
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They said , don’t worry about HIV , & yet , right here in Florida , we found a cook at , a well known restaurant , who sweated , & cooked food for people, How do we know , how many people contacted aids from Him ? I think all planes ,should stop flights to Africa , , there is no way , people can , be screened , coming , out of Africa if they are ill , with EBOLA ,
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HIV can’t be transmitted through sweat or saliva. Only blood, sexual fluids, and breast milk. There is no risk to touching them, eating food they prepared, sharing dishes or clothes or blankets with them, or living with them.
Banning all people traveling to and from Africa isn’t a long term viable solution. I live in southern africa, and ebola is thousands of miles away from me.
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Those people forget just how HUGE Africa is, and that it is a continent, comprised of several countries, A flight from South Africa poses no greater threat than a flight from Canada.
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Thank you for the phenomenal education in layman terms for older ones to understand and for answering the question I have heard and had myself, where did it come from and what does it do? Thank you for your honestly arming us with the fact; honest awareness sometimes is 50% of the cure and protection from spreading. We carry with us always disinfectant spray for our hands, disinfectant gel for our hands and sad to say, do not shake hands like we used to or hug like we used to. So very sad to see this happening to mankind!!
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Appreciate your article, and sorry that some people give you crap for being kind enough to share your opinion. I have shared this with my wife, who is an RN running an ICU just south of Dallas. Her hospital provided her with an Ebola fact sheet with the following information:
Symptoms: •Fever (greater than 101.5) •Severe headache •Muscle Pain •Weakness •Diarrhea •Vomiting •Abdominal (stomach) pain •Unexplained hemorrhage (bleeding or bruising •Symptoms may appear anywhere fro, 2 to 21 days after exposure but the average is 8-10 days. •Transmission occurs through unprotected contact with blood or body fluids of an infected person such as broken skin or unprotected mucous membranes. Ebola DOES NOT [their emphasis] spread through casual contact such as shaking hands or being near an infected person. Ebola is NOT [their emphasis] spread through the air, water, or general food. TRAVEL SCREENING” 1) Ask if the patient has traveled to or been around anyone who traveled to the following locations in the past 21 days: Guinea, Sierra Leone, Liberia, Lagos Nigeria, Democratic Republic of Congo. 2) If yes, immediately put a mask on the patient and put them in a negative pressure room in Contact/Droplet Precautions.
I’m not an RN, but it sounds fishy to read how Ebola is transmitted, then read that a suspected Ebola patient must immediately wear a mask and be put into a “negative pressure room in Contact/Droplet Precautions.”
The hospital where my wife works has numerous black patients, many of whom walk into the Emergency Room for treatment because they do not have family doctors or insurance. The hospital, by law, must treat every patient that comes through the door. When the first patient diagnosed with Ebola went to Presbyterian Hospital in Dallas, he was treated with antibiotics and did not come back for two days. Just another black guy with the flu, right?
Your article takes it from there in an intelligent manner that just about anyone could understand. Good job, good timing, and thank you.
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Lol to the MD that was once a mere nurse….it was a doctor that was first infected…maybe they should teach hand hygiene in MD school instead of emphasizing RNA/DNA? Just saying…
Good article and congrats on furthering your education. All of you fellow nurses…remember please to build each other up…not tear each other down…this puts us one step closer to obtaining the respect we nurses deserve as professionals! Oh and I apologize “in advance” got and grammatical or iPhone errors!
TexasNurse MSN, BSN, RN
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You ma’am or sir, have won the internet points for best comment so far.
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Kate…is “flutrackers” an evidenced based website or journal?? The only credible site I am familiar with out of the ones u posted is NCBI…
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I know right, people think they can source anything, and it be credible, no source is better than a crappy source.
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Alishmarie…who’s to say someone walking around in public is not having s/s of Ebola and unaware they are. A person does not bleed from every orifice initially and can have s/s as subtle as abd pain and low grade temp (guy in Dallas…I initially) . The point of this is to make people aware to OPEN THEIR EYES!
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Thank you, thats all I meant by comparing it to the flu
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First of all, your article would have way more credit if you had sources. Speaking from a nurse’s perspective with 5 years of ED experience and 2 years of pediatric experience at Level I and III trauma centers, you should really know your info before you spread it to the public. You should know that Ebola is NOT contagious until the patient is symptomatic. (http://www.who.int/mediacentre/factsheets/fs103/en/) This fact has also been shared all over the news. Therefore, there are not hundreds of people that may be spreading the virus as your post suggests. Your article is creating unnecessary fear; I suggest you look up your information and correct it. The nurses at the emergency departments do NOT appreciate patients that are coming in because they were given faulty information. In fact, an FDA representative appeared on Fox news and feared one cause of exhaustion of resources would be multiple people showing their faces in the ED with flu-like symptoms, thus creating a massive use of Ebola resources. This would be unhealthy for our population. Again, please reconsider and research your information and correct it.
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RN, I agree with your post. Correct information is good but incorrect information is a stumbling block to learning what we all need to know in situations such as this one.
The author of the above article states that Ebola and HIV are DNA viruses. They are not. They both belongs to a class of viruses known as retroviruses, which contain RNA (ribonucleic acid) as their genetic material. After infecting a cell, it is known that HIV uses an enzyme called reverse transcriptase to convert its RNA into DNA (deoxyribonucleic acid) and then proceeds to replicate itself using the cell’s machinery. I have not at this time found any peer-reviewed scientific journal article that gives proof that Ebola RNA performs in the same manner as the HIV RNA.
I am a retired RN who worked in MICU/CCU and also had experience working with infections diseases.
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Thank you for making up my mind even more than ever about the current health care profession. I would think that the nurses working in any department would have empathy towards people who are in duress, whether it be from ebola or a common
cold. It irritates me these days to see the degree of nonchalance health care
providers of any form have towards their patients. I will apologize ahead of time
just in case I ever have to come into your ED based on feeling unwell and concern
over current virulent strains. I certainly would not want to inconvenience you or your kind.
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Good to know, but this is an opinion article, sources would make it a correlation study, or a systematic review of case studies, then to receive legitimate credibility, it would have to submitted to a peer review board, then published to some scholarly publication, of course by then it would be next summer and pretty irrelevant. I guess you didn’t read the article very closely, I tried to write it on a 6th grade level, but you cant please everyone, but I did not say that you are contagious with out showing symptoms, I said you could spread it. I’ll assume you are an RN, so I will re-iterate here. If you clean a wound on a patient with MRSA, and don’t wash your hands well, then do trach care on another, and a few days later that guy has MRSA in his neck, its safe to assume that you gave it to him, you acted as a fomite, do you have MRSA? No, will you show symptoms? No. Were you contagious? No, but YOU still spread it, due to poor hygiene, which I stressed heavily as a big factor in this outbreak. There’s more to good hygiene than just running water and bleach wipes.
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Our government is not going to stop the planes from Liberia any time soon due to ” wanting to get help in to the affected areas”. This is not forward thinking. We can still send in planes for aide workers and stop passenger planes. I am also an RN and have been for 26 years. Your article is a great way of putting medical minds together as I believe we are going to need a way for communication regarding this outbreak of Ebola. I was a manager for 7 years and spent many a meeting with our infection control nurse talking about how America is not ready for any large scale outbreak that we are now facing. People are still coughing in to their hands so we have not even done our job in teaching them to cough in to their elbows. Ignorance goes a long way in the distruction of man kind. People are in strong denial until the panic hits. I hope we can continue to have this dialog and learn what each of us should be doing as nurses both in Liberia and here at home. There should be a team formed, and maybe one has been, of professionals who can begin going around the country and other countries teaching the best ways of prevention. I know they have made great strides in Liberia by removing the bodies in a safer manner, but as this article points out the truth is not fully being spread about the seriousness of the matter.
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Excellent. Thanks for posting.
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Generally speaking, the fatality rate is determined by which Ebola strain. This particular one has a fatality rate of 50% (doesn’t matter where you live.) There are other strains that have much higher fatality rates. This is an informative link: http://www.who.int/mediacentre/factsheets/fs103/en/
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The only thing I didn’t like about prior mortality rates, which I saw in a diagram somewhere, didn’t account for infection rates, so in like, 1982, there was an outbreak with a 100% mortality rate…but when you did a little deeper, the outbreak consistent of ONE patient…one guy got it, and he died, 100% mortality…..this is why you can’t trust numbers.
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This article is all over my Facebook and being shared by people who aren’t in the medical profession which tells me that you are speaking to a crowd that sorely needs education. Having said that, I see that going viral (pun intended) had exposed you to criticism that you neither invited nor deserved. It is an opinion piece people!! It is nicely backed up with data that’s easy to understand for the common man. Geesh, I had no idea that there were so many self righteous RNs in the world.
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I know right? I’ve gotten more praise than criticism from RNs/medical people, but then again most of the criticism I DID get, was from medical people. But It’s ok, I expected it. But 300,000 reads, with about 75 negative comments, I can live with that.
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But it’s not an opinion article. You present things as facts. Even editorials use facts to support one’s position.
Frankly, your response is basically, “I just made this shit up on vague feelings! And I’m scaring you! Hahaha!”
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If that’s the way you feel….but what no one done so far is present any evidence that contradicts anything I’ve said. I tried to keep this on a 6th grade level, if not this would be an hour long read. I could have gone into long, boring epilogues, but that’s what actual peer reviewed research is for. The fact is that most people are not going sign up for Ebsco or even utilize NCBI. Most people get their info from CNN or FOX, or huffpost, and I felt that how this infarction is seen from a real medical professional could answer some questions and alleviate some anxiety. Ive had 10X the number of people tell me I reduced their fear, than those who said I instilled it. But again, if you would like to debate any facts, provide your evidence and I will review it
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Thank you…I blog and realize the time involved to post articles. Thanks so much for the information. It is very appreciated.
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Thank you, I spent about 3 hours writing it, and another hour editing, but since I have spent probably 3-4 hours per day maintaining.
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Thanks for the article and the dialogue from all. As a fellow nurse it makes me go and do my research as we all should. But reading this post shows just how “we” in the medical field differ and can at least have a dialogue about it. Thanks, for getting it started and great article.
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Thank you, this article/blog post is well done! I disagree with you on one little detail: this is not just an opinion peace or just your perspective. This persuasive writing that is intended to educate us lay persons, and aid us in modifying our behavior despite the efforts to get us to not think about the possibilities this virus poses to us.
I appreciate the time and effort put into this, and it really is laden with facts, not one of which has been countered with a citation from the doubter that posted it.
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Exactly, I posted this as an opinion article, which is why there’s no citation. If I had cited anything, it would attract even more criticism, unless of course I cited the hallowed CDC, who is apparently the ONLY competent government agency. We don’t trust the FBI, the CIA, DHS, or even expect our mail on time, but I’ll be damned if someone doesn’t trust the CDC.
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Great article….let’s get educated and informed and not rely on the Government and the CDC to give us the straight truth! I am also a nurse.
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You presented a great article that was informative..Don’t waste your time answering to the internet snipers.
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If I may, I would like to shed a bit of a light on the REAL problem here. It has nothing to do with a lack of citation or any opinion based comments that may or may not be present. The problem is clearly outlined in the rise up of objections toward what was written. In what way you ask?
BECAUSE THIS IS A BLOG POST!
People, stop reading any link that someone posts on any number of social media sites and mistaking it as a credible source. Take the opinions and facts here and if they alarm you DO SOME RESEARCH. This is not hard. Read something beyond Facebook and Twitter and Tmblr. Look into sources that are credible and unbiased. Stop being sheep. That’s right, I said sheep. A blog is not the same as an article, an article isn’t always credible and cited, citations aren’t always credible…. So on and so forth.
Stop picking apart this blog post, go read, do research and form your own opinion from that.
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THANK YOU. If I wanted to make a scholarly, citable article, I would have, it wouldn’t be the first. I wanted to write something from my heart, not regurgitating a bunch of statistics. But IF you really want to get specific, there is no credible data for this outbreak because it is so recent. Yes this strain has been seen before, but it jumped several countries and is WAY more virulent. Data from prior outbreaks may be credible, but its not relevant. The majority of the people who comment are positive, and its well known that people who disagree comment a lot more than people who agree, so out of 300,000 reads, and only about 75 negative comments, I’d say I’m doing OK in the eyes of the public.
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What you’re doing is exactly what you said you weren’t doing. Fear mongering. “Ebola starts out like the flu and it’s almost flu season.” Thank you for giving the world a prime example of a post hoc logical fallacy. If you’re going to be spewing this kind of bullshit you had better prove your point and site your sources. This isn’t a hamburger you’re cooking, it’s mass panic and you’re a jerk for doing it. The odds of people coming into contact with an infected Liberian is slim and you’re being an ass. Do the world a favor and retire because you are doing everyone a disservice.
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Retiring before I’m 30 would be fantastic, but it wouldn’t last very long. According to the CDC, symptoms of the flu include; fever, headache, muscle aches, vomiting, diarrhea, fatigue. Symptoms of Ebola include, fever, headache, muscle ache, vomiting, diarrhea, fatigue. I know its a hard stretch, but I think most people would agree there are some similarities there. There is a difference in fear-mongering, and removing the sugary coat. Without Googling it, can you tell me the physical manifestations of Ebola, do you know what the roof of their mouth looks like? I do. Do you know how to identify infections based on their smell? I do. The point is, When someone has profuse diarrhea, I’ll stick my face down in the bowl and take a big whiff, I’ll go knuckle deep to remove impacted stool, I’ll hold the two broken halves of a leg together while the physician works. When it comes to medicine, I say and do whats necessary, and I don’t appease to those who feel uncomfortable about it, because whether you like it not, reality happens.
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Nyteshayde, Your comments are sad and make me sad for the ignorance your comments reflect. Much of the public lives in denial and has a ” it won’t happen to me” belief. The fact is that it just might happen to any of us. This was a well written post and presented the issue realistically. I too am an RN with my bachelor in Nursing, 27 years practicing, over 10 of those in management. Despite all the efforts we make as healthcare providers, we are never as ready as we want to be and always striving to do better. If this post helps to educate one person, and that person educates another, and so on, lives can be saved.
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Great article thank you dont care if it is RNA DNA don’t know why people have to try and tear everything apart I beleive it was some great information that we should all know thank you!
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Thats why I kept it simple, the more specific I got, and the more specific sources I used, the MORE people would be trying to tear it apart
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Reblogged this on Health care and us and commented:
A true understanding of the infectious nature of our world at large.
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Thanks for the share
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As a fellow nurse, I appreciate your effort to educate all of us. Thank you.
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Thank you for this article . I have gained a lot of info . I am sorry that people want to tear this apart . So many people would not know that they had symptoms for Ebola , but think it is the flu . I live in Pennsylvania and both ends of the state have Ebola cases . My husband and I both take blood thinners , if we get scratched , we bleed easily . Yes we are going into the flu season and I live in a neighborhood of older people , who have heart trouble and diabetes , so this is good info .
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I anticipated a certain amount of criticism, to me its like modern art. People look at a Pollock painting and say, “I could do that”, and probably make fun of it, but they didn’t, and never will, he did, hes the one impacting lives, and hes the one who will be remembered, not them.
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Thank you for writing this article and voicing your opinion. It is obvious that you are
thinking very deeply on the issue. I would believe it’s better to be over cautious than to be lax in preventatives. Again, thank you!
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I think it is a great article and a valid opinion. Just a layperson but the political line and the facts on the ground do not line up. Now I have a better idea of why that is so. Thank you very much!!!! I hope we as a nation, state or community will not have to battle the virus or the fear.
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So if everything you’re saying is true regarding it living on surfaces and therefore being easily transmitted from person to person that way, are we as a nation completely screwed then? I live in Michigan and if I or either one of my kids has a bout or two of diarrhea and/or starts vomiting and gets a fever what am I to do? Quarantine my kids and myself for 21 days? Rush to the ED and give them my symptoms? They wouldn’t test me or my kids for Ebola because there is no way that we would meet the criteria for testing. But we could still have it and be spreading it because we think we only have the flu. I’m not saying you’re wrong in your article but I would say that along with educating people you have instilled fear. I am now irrationally (perhaps??) fearing that my kids are going to start showing symptoms any day now because they go to daycare and the doctors office and grocery stores and it’s impossible to wash their hands that frequently or use hand sanitizer especially when you are out and they are running all over and putting hands in mouth constantly. I probably don’t even catch every time they do. Nor can I wash my hands, clothes, etc. every time my five month old spits up on me. I guess you can say I am panicking a little because of all the horrible scenarios you presented. My baby spit up alot this evening and I kind of have a headache. Before this I wouldn’t have been worried but after reading your words, it doesn’t seem impossible that it could be all the way north where I am. So I ask again-what is the general, not having traveled to Africa, population supposed to do if these symptoms arise?
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Thank you so much for your perspective on Ebola, your need to share this information with others, and the facts. This is much more serious than people realize, and to hear a medical professional give their detailed description of exactly what Ebola is and how it spreads is very helpful for the rest of the population. You are doing anything but fear mongering. You are simply giving the facts. Much appreciated.
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Thank you
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Thank u for sharing this with all of us. Im very thankful to have read this. Im 35 with a 6 yr old and my husband is a truck driver that drives all over. Is there anything I may can do that will help from getting this ebola. I work at a hotel and im very scared. We just had a man check out of our hotel that was from africa. I know it doesnt mean he has it but is there precautions that me and my son can take to try to keep from getting this? Thank u again for sharing your article with us.
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Nothing more than what you could do to prevent the flu. But so far everything is contained as far as we know. If it gets loose I’m sure there will suddenly be new info given to the public
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Thank you VERY much for this post. I am currently 5 months pregnant after 3 IVF tenements and I told my family I’d be wearing a face mask while flying on 4 different flights in a few weeks. They all thought I was crazy, until this. I can’t think of a more saturated place of different people than an airport or closer confinements than an airplane.
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First off I want to say thank you for writing something I can understand. Second/ I am a mother of two boys, and yes it would be impossible to wash their hands every time they touch something or take them to the doctor for a few flu symptoms Or every time they got a headache, but it doesn’t take your article to scare me into doing my best ( Hygiene ect.)and what I feel is right as a mother(like take them to the doctor if i feel somethings not right). The virus is out there, and thank you again for shedding some light 🙂
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Another nurse here – 30 years. I’ve seen a lot, the human body & disease never fail to impress me. Great article. Makes us all think about and question the trajectory of this serious viral player making it’s mark on the world scene. I have grown so tired of the WHO & CDC canned remarks to keep calm. We must all be critical thinkers and not settle for being spoon fed the company line. I agree with you; “protect the community” & one way to do this is to start a discussion. The CDC & WHO have us convinced we are only capable of fear and panic when confronted with the facts. I disagree. My prayer is that the CDC & WHO are correct about the low probability of Ebola viral spread in our country but, my reality whispers in my ear . . . “not so”.
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Good article, you have got it out in open and making people research the virus. You have to remember no matter what you say or write there will always be critics. Down playing it like the government and DC is doing is exactly how this kind of thing gets out of control. The point you were making was good and the others who think they are more inteligent need to elaborate on your article and give it more info not focus on tearing it up. Good job and yes I’m also a nurse, 20 years in Operating Room, Director of Surgery, when others start arguing points and tryin FBT o prove they are smarter makes others discontinue reading and nothing gets accomplished.
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Thanks, I appreciate your support. I’m almost to 300,000 views, and 1000 fb shares, those would be nice numbers to reach
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