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 
Thank you for your candid opinion. I feel the same way – it only makes sense that it can be spread by a sneeze or a cough. It cannot be THAT difficult to get it if it is in such epidemic stages in West Africa. How in the HELL did we let this virus over here???/
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Great article!!! It is unfortunate that the people in leadership are to stupid to read this and bring the hammer down. I just hope we all survive this because the government could care less. Just less mouths to feed
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Does it survive below freezing temperatures?
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Its just a chunk of DNA, it doesn’t have any metabolic processes or cells to rupture
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I have to agree. I believe the gates have been opened and things will never be the same again. I mean once you let the horse out of the barn, it’s out of the barn.
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what do you think of using colloidal silver for a preventive or treatment of Ebola?
Great post we need more health professionals like you keep up the good work.
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I’d suggest looking into that one a bit harder, silver is typically associated with preventing bacterial infections, I don’t know about viral.
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Heres a question. From what I understand we can test for ebola relatively quickly. Cant we test without the patient being symptomatic?
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We can do an ELISA test, which is just a positive or negative. If its positive, it could be Ebola, but it could also be HIV, TB, Hep B, or some others. So if its negative, then we know they’re clean. But if its positive, we have to do other, longer tests that are disease specific. You are technically right, but why would an asymptomatic person get tested for Ebola? We could test exposed people, that would make sense to me.
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In follow up, im certain we have tested duncans family members.
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Thank you! Very well done! Too bad we can’t get our media to do so well.
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Thank you so much ! My daughters are both nurses in the Labor and delivery unit.I am sure they will enjoy reading this as I did. I am sure they will understand much better than I did. I thought it was very interesting. Again thank you .
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Great article! I am also a nurse. I would just laugh when hearing on the radio that is only spreads with intimate contact!! All you need is to be in contact with a droplet. Time will tell how this pans out!! It’s nice to participate in humanitarian projects, I have done so myself. But not to the point of endangering others and yourself.
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Wow you go girl… That was short and sweet and right too the point. I sure got an education… and appreciate your frankness. I had no idea what Ebola does other than kill people but didn’t know the gruesome facts. Makes me a bit more cautious and aware. So Thanks!
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Thanks so very much. I drive the city bus in a major city and am well aware of the power of “droplets” that spread through the recirculated air system on public transportation. I needed to know the truth. Thank you.
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It all seems like common sense to me. I guess the real problem is we have a lot of bobble heads and dancing Hawaiian girls on the dashboard just going with loco-motion. It’s really sad.
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I think you are a very articulate writer and glad that you share your experience in the “real world”. I have some experience working in the medical field and in hospitals and the misinformation the public has is regrettable. They put way too much faith in a system that is far from infallible. Always get 2nd and 3rd opinions on serious medical issues of any kind.
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Since Ebola is not truly “airborne” but may be spread by droplets, will an N95 respirator be sufficient? N/P100’s are so expensive I’m afraid most people will not be able to afford many. 100’s cost roughly $10 each whereas you can get a box of ten 95’s for that amount – or even 20 if you forgo the exhalation valve. Thank you for your article and your feedback.
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N95 should be sufficient, yes. N95 is what is used when coming in contact with patients with TB, which is an airborne virus.
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Citation? Remember, can’t pass off our opinions as fact
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And TB is a bacteria….it 2-4 microns in size, while Ebola varies from .05 -.3 microns…..much smaller
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you are correct. I mistyped as it it nearly 2 am and the topic at hand has been about a virus. It was a simple freudian slip.
here is your reference regarding the mask.
Click to access 99-143.pdf
page 5 is where it states that an N-95 mask is used for TB, which is under Airborne Precautions. Ebola is under Droplet Precautions indicating that anything that would be used for Airborne (which lies above [i.e. more severe] Droplet as far as precautions are concerned), would be more than sufficient for Droplet. And since I know how much you hate the CDC and don’t consider it reputable, here is a wiki reference more to your liking.
http://en.wikipedia.org/wiki/Transmission-based_precautions
Can we officially call it quits on the pissing contest now? My only concern the entire time has been for the spread of misinformation to stop. Luckily, the reproductive rate of misinformation far outweighs that of Ebola.
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it is*
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I quit reading after you said hepatitis is a life long infection. Two words: sofosbuvir and simeprivir.
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I’ve never heard of those, I wasn’t aware anything had been developed that was non-interferon. But the reality of the situation is that the demographic who primarily carries hepatitis, C in particular, are not going to fork over the 100 grand for treatment, or make the necessary lifestyle changes.
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A sustained virologic response really only means that your body is able to keep the virus as less than 43 copies when tested six months after treatment and longer. There’s no test to say for sure that you have zero copies in your body. Your immune system is able to keep it in check by suppressing the virus, so the word cured for hep c is kind of false. It’s more like the virus is in remission.
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This is a Threat and, Your Help is Urgently Needed!
Ebola in USA – You and Your Family are at Risk! Here’s what you can do – Listen to Judge Jeanine Pirro!
Help Do Something – Sign this Petition Now! And, Help Spread the Word Not The Virus!
https://petitions.whitehouse.gov/petition/have-faa-ban-all-incoming-and-outgoing-flights-ebola-stricken-countries-until-ebola-outbreak/FFJHH9yX
The 1918 Flu Virus Pandemic infected over 500 million people across the world, including the USA, remote Pacific islands and the Arctic, and killed 50 to 100 million of them, that’s a 10 to 20 percent death rate.
A large factor in the worldwide occurrence of this flu was increased travel. Modern transportation systems made it easier for soldiers, sailors, and civilian travelers to spread the disease.
Now we have Jumbo Jets and the Ebola Virus….. With a 70 to 90 percent death rate!
Help Do Something – Sign the Petition Now! And Help Spread the Word Not The Virus!
You Can Help – Facebook it, Tweet it, Instagram it and ask your family, friends and co-workers to sign the Petition!
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Thank you so much for this information. Ignore the critics, most of us appreciate what you are saying.
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How about Olive Leaf it’ powerful stuff. Great article, very intelligent nurse unlike most leadership.
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Hoe about Olive Leaf, it’s powerful stuff. Excellent article, and a very intelligent nurse unlike most of the medical leadership. Thats why theyre asking for citations. Thanks for that wonderful article, and thanks for caring.
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I am all for educating people about the dangers of disease…however your “article” is doing more harm than good as it is full of conjecture and oversimplification. You talk of specificity in a second hand way and don’t express the complex chemistry associated with receptor mediated enrty. Also you allude to survivability of the virus outside the body “for something like 4days” SITE THAT SHIT! It depends on the medium the virus is in as well as environmental conditions…I appreciate as a nurse you want to educate the public of the hazards or infection…but you are spreading unsupported ideas and using the cloak of science to justify…get your facts strait and address the conditions and cultural practices of west Africa as a causative factor
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James, How can you tear the author apart when you in BOLD misspell, cite as SITE —it is with a C, as in citation–duh. And then proceed to tell the author to get their facts STRAIT when you cannot get your spelling STRAIGHT. Jeez….
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James may have misspelled a couple of words, but there are multiple erroneous statements made throughout this blog post, ranging from the precautions necessary to “stop Tuberculosis” to the incurable nature of Hepatitis, and the contractibility of Ebola. So while James might not be a good speller, he is accurate in his assessment.
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OK here’s the deal. The general public is going to stop reading somewhere along “receptor mediated entry” they don’t understand it, and they don’t care. Same with the discussion of RNA vs DNA, droplet size in microns, whatever else is under scrutiny. What harm can come from people making sure surfaces are clean? If the truth is that it usually lasts 30 seconds, people will be much more likely to be lax on cleaning, and then when the bug lasts a few hours, you get sick people. If I said it only lasts an hour, when its actually a week, that could pose a real threat. I don’t see how there could be any issue with being a little EXTRA cautious. I don’t care about the conditions and practices of Africa because I’m not there, I’m here, and now the disease is here, so we need to look at the conditions and practices here. My article is not about Ebola in Africa, its about Ebola in America.
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Not to be one of those that pick it apart like she mentions in the article. Because I DO believe the virus is deadly serious.
But, I am willing to bet that the “WHOLE lot of other things” are more like the thousands of U.S. originating cases of EV68 compared to the 3 EBOLA.
Better hope Europe doesn’t decide to block flights from America.
“Have I experienced Ebola first hand? Nope, have I experienced a WHOLE lot of other things that the majority of the population has not?”
http://www.usnews.com/news/articles/2014/10/02/enterovirus-not-ebola-is-the-disease-worth-worrying-about
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Thank you and now I believe they will only quarantine people before travelling from infected areas when the nurses group together and sue to stop it !!
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Thank you for the article. It matters not you did not cite your comments. The point is the media is claiming US citizens shouldn’t be worried ant Ebola isn’t airborne. They say an outbreak here is highly unlikely. Indeed we should be very concerned. This can end up disastrous for us if they don’t get a hold of it and discontinue receiving flights from the infectious countries. God bless America… We need it as does the world.
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Look at the actual news. Worry about the children who are actually dying. EV68 is here in the states in the thousands but EBOLA is practically non-existent here in the U.S.
Don’t just take mine or this website’s word for it. Look at your local news. EV68 NOT EBOLA is the current threat. The TSA are handling the outbreak in Africa. You know it did not start yesterday. So after so long and we only have 3 cases of EBOLA. One of those ended in death. But we have millions of cases of EV68. Not all turn out to be more serious than a respiratory problem but the newest strain is deadly. No cure, no vaccine.
Don’t disregard EBOLA but DO prioritize your concern. EBOLA is not the current most threat.
http://www.usnews.com/news/articles/2014/10/02/enterovirus-not-ebola-is-the-disease-worth-worrying-about
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And maybe worry about this
http://baltimore.cbslocal.com/2013/11/07/alarming-trend-more-people-coming-down-with-deadly-diseases-like-measles-and-mumps/
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Feel free to write a blog on EV68 if its so concerning :p. I was actually planning to do it next, but my pedi experience is limited so I’d need to do a lot more homework
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Dustintolar – I just saw your post about writing my own blog about EV68. I felt I needed to say what I said here. I feel both diseases are serious but one is more urgent at the moment. But as for the blog. I was already going to create a Facebook page. 🙂 I will leave you alone now. Not that I was trying to bother you at all. It was a debate at times but I don’t feel it was heated. I hope no hard feelings. Bye.
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EV68 is here in the states in the thousands but EBOLA is practically non-existent here in the U.S.
A few months ago, EV68 was non-existent too. At one point, there was only 3 cases of it as well.
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EV68 was discovered a long time ago, its just not been very prevalent. It causes a lot of illnesses, but few deaths. Ebola is newer, but has a much higher mortality
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^yea you don’t need to sit sources right because facts don’t matter only conjecture and speculation…the ignorance of the general public is astounding
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Like I’ve said a dozen times, these are my opinions and how I see things in real world scenarios. If this was chef writing about his opinion on cooking hamburgers, no one would hound him for sources….if you would like to contest anything I’ve said, please feel free to do so
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You’re right, if it were a chef talking about burgers he probably wouldn’t be asked to cite anything. However, their would likely be a multitude of people disagreeing with him and then likely dismissing his opinion on how to cook the best burger if he claimed that hamburger comes from chickens. Many would probably look at that op ed piece and say “this guy doesn’t even know that hamburger comes from cows! why should I give any credence to his opinion on the best way to cook a burger?” The difference here is that you aren’t dealing with a topic that is general knowledge for the mass majority of the population. You are speaking on a subject that most people have absolutely zero working knowledge about. So you unfortunately have the “benefit” of being able to tell people that the proverbial hamburger comes from chickens and they will believe you because they have never seen a cow, or a chicken, or hamburger, and also have no working knowledge of the proverbial kitchen (i.e. no background in medical science).
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there*
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As a self-proclaimed graduate student, you should understand the importance of citing sources. The practice lends credibility and credence to your claims….the lack of citation on the other hand weakens any argument you hope to convey. In addition to some of the ideological and scientific errors that are present in your blog, I find your discount of the importance of citation most disturbing as you are representing yourself as a professional nurse. The modern profession of nursing, by its very nature, must be dependent upon a sound scientific knowledge base.
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That is why this is an “expert opinion” and would be classified at level 6 data, only a fool would take anything I say as hard fact. That is why this has “perspective” in the title. I was writing this with general population audience in mind who don’t care a single bit about citations. “The CDC” in my opinion is not credible, I want to look at raw research. Had I rattled on and on about that, I could have lost my audience in the first paragraph. Read through most of the comments and you’ll understand. Had this been directed towards a medical audience, well of course I would have cited it. Secondly, this is a personal blog, not a medical journal, not a proffesional association. Lastly, there is no high level data out there for this outbreak, we can only look at prior outbreaks, and since this is behaving very differently, and skipped over 1000 miles of Africa to different people in a different culture with different climates, anything not published in 2014 is not relevant, so anything citable, could easily be counter cited by someone else. So I avoided that all together.
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Thank you for taking the time to write this article. It was informative and written in layman’s terms I could easily follow. You have a knack for writing with just enough humor to keep an audience. Good Luck in your fight.
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I am an LPN and I appreciate your thorough explanation of Ebola because I am not in a position to educate anyone on infectious disease or have any great knowledge about it. I am concerned also but I keep it at a low concern because those that aren’t educated in healthcare are watching the news and are becoming panicked. Panic is not going to get us anywhere..educating ourselves..good hand hygiene and covering our mouths when we sneeze or cough will go a long way. My hope that this article you wrote gets around quickly to as many people as possible because prevention is nine tenths of the battle. I would appreciate you writing an article on how nurses can protect themselves because we are on the frontlines and there is a higher rate of us being exposed. And we don’t have a choice. We became nurses to take care of sick people..we must carry on. Any advice?
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Not really
I’ve read up on the CDC guidelines for the clinics in Africa and its pretty nuts, double layers of everything, clothing seams duct taped, respirator with over a mask, rubber apron, waterproof boots duct taped to your pants…its nuts
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And of course it’s “nuts” there, not only do they not have all the proper PPE’s, it is RAVAGING their country right now! We are a developed country…..ER’s across the U.S. have the proper PPE’s.
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I’m worried about the general communities, not the hospitals. Were im at during nov-feb we run at max capacity due the usual COPD exacerbations, pnuemonias, and flus, so IF it gets out of hand even just 100 cases in our area would be a bad situation.
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What they do in Africa, they do because of the magnitude or rather quantity of infected and because of the LACK of other methods of protection that you would findin a 1st world country. They are 3rd world. They live in huts with dirt floors. Not discriminating, just the truth. The only ones that have been able to afford flights to America have been U.S. residents and survived because they were treated with modern medicine.
As for self education, I monitor CDC reports as well as the WorldHealthOrganization, MayoClinic, NIH.gov, etc.
Panic is not going to help anything regardless of the situation. Again, 3 cases of EBOLA and thousands of cases of EV68. Do the math. Most are focused on the wrong disease.
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If you look at the CDC website, you can find information.
Click to access ppe-poster.pdf
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Thank you.
This is the best summary and explanation about Ebola that I have seen. I have tried explaining this but am not good at it.
Now I can just send your link to people. 🙂
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DUSTINTOLAR – I’m not exactly contesting but let me ask you this. You said your are usually at capacity with cases such as COPD. That is a respiratory illness. Ebola is spread by touch and fluid transfer. EV68 is airborne. Which is most likely to further complicate COPD? EV68 is often misdiagnosed for upper RI. EVERYONE is going to be looking for Ebola. So now the chances of Enterovirus 68 being overlooked has greatly increased, right? As a nurse, what have you heard lately about EV68? Please. I really would like to hear from someone in the trenches such as yourself.
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OK so you are WAY off track. Let me break it down a little more. Let’s say my facility has 500 beds, and were usually around 75% capacity. That leaves 125 beds empty at any given time. Ebola patients MUST be hospitalized, so in theory, we could handle a recent sized outbreak, should it occur. During the fall and winter months, COPD patients tend to get I’ll, with the ups and downs in temp, rain, etc. So suddenly we have an influx of COPD patients that we don’t normally get, same for flu, once that season starts, we get a lot of flu patients that we don’t normally have, so during the winter months, we run at 90-100% capacity. 5 or 10 empty beds at most. To the point we have to turn away people at the ER and reroute ambulances. So if this were occurring in April, it’d be no big deal, but in the fall/winter, the hospitals will not have enough rooms to put the Ebola patients in…make sense? I’m not worried about catching different things. And if EV8 hit our area, we don’t have a children’s hospital so serious cases would go to Dallas. I’m not worried about COPD patients catching Ebola, I’m worried about hospital logistics. Contrary to popular belief, hospitals don’t have endless rooms, nurses and doctors.
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Ok so honestly you are way off track and totally missed my point.
1) You just stated “During the fall and winter months, COPD patients tend to get I’ll, with the ups and downs in temp, rain, etc. So suddenly we have an influx of COPD patients that we don’t normally get, same for flu, once that season starts, we get a lot of flu patients that we don’t normally have, so during the winter months, we run at 90-100% capacity.”
So you if it is seasonal and you already know about as you just predicted what would happen with certainty then how is it that your hospital is not prepared for Flu and common illnesses that have been around for a 100+ years?
2) I was not saying you should worry about mixing illnesses but on that note, as a nurse you should understand synergistics where 2 + 2 = 6. The effects of mixing illnesses is exponential instead of linear. Wow I love to hear myself talk. I guess that is because I make the most sense. << that was to the smarty pants that posted early
3) I was trying to say that COPD and EV68 are BOTH respiratory. They affect the same area of the body, have more of the SAME symptoms and therefore could possibly be much hard to detect. I am also saying that since everyone is paniced about Ebola, we are more likely to miss cases of other diseases like EV68
4)YOU just confirmed point number 3 by saying it is mandatory to admit patients if you even suspect Ebola. Take into consideration the 3 cases of our 400 million citizen population and that means you are probably admitting people with the common cold and flu and COPD just out of fear not precaution.
5) The UNHEALTHY fear mentioned in #4 means you stuff your hospital rooms with non critical patients UNNECESSARILY
6) I would like for you to reiterate you point about not citing reference because that would just cause more people to argue and debate? So if you post credible information from reputable organizations you're are saying those facts won't speak for themselves? If people would like to argue against the CDC and WHO then let them. How is that any skin off your nose?
I may be getting a little rushed with these posts. It is getting ridiculous though.
No ope said to ignore Ebola. No one said to play down Ebola. No one said Ebola is not serious. Those people must not have read or understood the word "prioritize".
7) Go ahead and get ready for your flu season in a few MONTHS from now while EV68 is ravaging the U.S. right NOW. People go ahead and play down EV68 which mostly affects children, elderly and immunodeficient people and then send you kids on to school worried about Ebola which is not airborne. Make sure to duct tape the seams of their clothes and cover their shoes because we know that we all breathe through our feet and armpits. Geez people. Sorry for getting frazzled but come on.
8) No one is saying NOT to stop airplanes ALTHOUGH since EV68 originated in the US, I hope other countries like Europe don't start rejecting our planes from landing there when whichever virus goes, well, viral.
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You’ve still missed it, you’re over thinking it….let’s do math…if my hospital has 500 beds, and there’s 375 sick people…how many are empty? 125….if 100 people come down with Ebola/EV68, and all of them cone to the hospital, we now have 475 sick people, and 500 beds….that’s the spring scenario. Now for the fall scenario…. we have 500 beds, and 490 sick people, we now have 10 empty beds. So if 125 people get Ebola/EV68, and all come to the hospital, we now have 615 sick people, and still only 500 beds….see the problem? It doesn’t matter what the illness is, its the wrong time of year for hospitals to handle a new disease, whatever it may be.
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Ok. Yes the math for the hospital situation makes sense. What are your honest thoughts about the chances of even 100 having Ebola in your area by flu season? Straight up question. Not challenging. Have you had any of either EV68 or Ebola?
Inquiring minds want to know. 🙂
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No need to have to explain yourself…it’s like a news conference and the speaker went over all the detail needed, but you have those who didn’t listen or want to listen and have to ask a question that was already addressed… and those who just don’t take what you said for your opinion and knowledge to date and twist it so they can just hear themselves. You did a good job…and yes…people need to be aware of “droplets”.
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The ones posting that have CHILDREN are pretty much in derilict of their parental duties as far as I am concerned. If you are sending your child to school with a reasonable thought that they are having sex, sharing needles or doing very heavy petting then by all means you should also worry about Ebola more than EV68. You probably still don’t know what it is even though it has been in the news and is mainly affecting and sometimes killing children I am not saying this to get a knee jerk reaction. It is true. Read up on it. Anywhere you prefer to get you credible information.
EV68 is a child killer and it is killing right now. Ebola is a potential threat that we see coming from a mile away.
The people here and in Africa that are wearing all those hazmat suits, well I would venture to say a “part” of that reason is to show the public that they are being responsible. But of course the public sees it as a big conspiracy to protect rich doctors (who aren’t even out there in the real world of Ebola). Lets say this does AND IT WON’T come to an apocalyptic climax. Do you want the trained medical personnel to die before they get to you because they did not follow procedure. Or maybe you want them to be nice and sick while they are inserting that IV into your vein. Melodramatic? Well it is getting to be that way from all of you.
The nurse, Dustin, did a fine job. Sure. Its just the people who take this bit of information and look no further for ever changing facts. Grab a little info and stick your head in the sand. Nice.
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For those who care about their children.
http://www.cdc.gov/non-polio-enterovirus/about/EV68-infographic.html
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Synergy which Is taught in community college health class.
syn·er·gism (sin’ĕr-jizm)
Coordinated or correlated action of two or more structures, agents, or physiologic processes so that the combined action is greater than the sum of each acting separately.
Compare: antagonism
Synonym(s): synergy.
You mix one nasty respiratory illness with another and you don’t get the effect of two illnesses. You most likely die.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6336a4.htm?s_cid=mm6336a4_w
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Enough of the ignorance! There are three cases of ebola and millions of Chicken Littles running around crying that the sky is falling.
Sure be cautious about Ebola but don’t turn a blind eye to the virus that is already in your schools, churches, WalMarts, airports, fastfood rest., everywhere!
Quote
“The United States is currently experiencing a nationwide outbreak of enterovirus D68 (EV-D68) associated with severe respiratory illness.”
http://healthvermont.gov/prevent/enterovirus/ev68.aspx
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The ONE person that has died in the US from Ebola was not an American. LIved his whole live surrounded by that virus and probably dozens of other viruses. Go figure.
“Duncan landed in Dallas on September 20 after traveling from his home in *Monrovia, Liberia*. He is accused of lying to airport screeners about his contact with Ebola patients, though his family and friends say he had no idea he had been infected.”
Read more: http://www.dailymail.co.uk/news/article-2785923/No-one-died-Ebola-U-S-Outraged-family-eyes-lawsuit-America-s-patient-zero-succumbs-initially-turned-away-doctors-later-refused-blood-transfusion.html#ixzz3FsRJmXxz
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Hey but these are just facts. Please ignore them and shut down America’s airlines.
People already complain about paying for an extra carry-on and having to take their shoes off in the airport. Lets see how they do with the airports closed down. I mean if the virus is at the airport it no longer matters where you are going or coming from. Shut them all down!
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Thank you. This is very good information. I worked in the fast food industry for many years. It was stressed that handling money is a quick way to spread disease — but there are no precautions for the diseases that may be passed from one customer to the next because of cash. Much like the magazine you mention here. Again, thank you. Please know that there are many people that can not comprehend because they are afraid of what they may have to accept as possible.
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John, do you have any medical or hospital experience? Or just a well- educated idiot?
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I like your article. No criticism on punctuations, spelling or grammar. I am an advanced practicing RN. Disease, infections, microbiology, A&P, Patho, it all interests me for your same reason, “heal the patient, protect the community”. I am not a public health nurse, but operate in public health. I appreciate what you succinctly put together, your science, your logic and most of all the ability to turn down for those without the health literacy level of healthcare professionals. I only hope panic is not taken from this, rather caution. This is scary, scarier is that this is not the only threat here or to come, and our country better start pulling a strategic plan together. Thanks for sharing your perspective.
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I’m so glad to see that other professionals can read this and take it for what it is.
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Reblogged this on stefania1006 and commented:
I just find it kind of scary as a nurse since we are the front liners. It is flu season and many people are admitted for flu like symptoms. We do not wear Haz-Mat gear for this. If it happens to be Ebola, then that is very scary for our own well being. Also, we take food trays out of the room (people w the flu aren’t usually in isolation) and put it in the galley or soiled utility room. Then other nurses and food service touch it…it goes on from there. I have not freaked out yet over this Ebola stuff, but it is scary to know that as nurses on a unit, we are not sure yet if it is Ebola. The only thing my hospital has done as far as Ebloa is to change the admitting question of ‘Have you traveled out of the US in two weeks?” to three weeks. Great going on protecting the healthcare, Administration!
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Thank you very much for sharing your perspective. I, too, am a nurse, and I know all too well just how horrific this can and probably will become. My whole being is sickened by the knowledge.
Our hospital has added several more screening questions upon admission, however, we see so many illegal immigrants coming to the states to have their “anchor” babies, and I seriously doubt they will all tell the truth initially. I expect a few to deny recent travel, birth their baby, and they say, “Oh, yes. I just got here a few weeks ago.”
God bless us all, and get ready folks. It’s going to be hell.
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I’m not educated in any of these deceases as most of you. But the average person isn’t either. But what I do believe, without a doubt, that prayer with Faith in the Lord God is the strongest protection mankind has against all this. He will guild you and your family through the valley of death. He is all merciful and Almighty. I know most will see me as some religious quack and I wont counter your ridicule.But I know for sure, that what is impossible for man, is possible with God. Salvation in this life and the eternal one is only through God’s Word (Jesus Christ)
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I’m with you, I have to completely put my trust in the Lord’s hands. This is a pestilence and the bible talks about this in Mathew 24. I’ve found such comfort in Psalms 91 where it talks about His protection, but we must stay close to Him and His word. Thanks for sharing your faith!
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Amen
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One thing to keep in mind that the author doesn’t touch on is the staffing and supply levels of your local hospital. I’ve worked in healthcare for about a decade and a half. If I compare staffing and supply levels from 2000 to what they are now , it’s two different worlds. I work in a two hospital town, we have 150 bed facility, and a 230 bed facility. Both places run the absolute minimum of clinical to operate. Over the last 5 years most of the per-diem positions have been eliminated due to the high cost of benefits. Drug shortages have become the norm in this country, and we no longer overstock any supplies. This is the new standard practice for most regional hospitals now, we’re all in survival mode and bracing for the loss of revenue that’s coming soon. If something truly reached epidemic proportions in this country we don’t have the staff or supplies to deal with it.
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So the nurse in Dallas that took care of Duncan who (the nurse) wore the appropriate hazmat gear is now positive. Is anyone’s institution coming up w new protocols for handling any patients that come in ‘flulike’?
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Very well said. Our government is so chldish about such things. They don’t want anyone to do anything to get rid of the problem. As though silence will cause the disease to disappear. How ludicres (sp?). I enjoy the article.
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Funny watching the news conference about this second Ebola patient, looked like someone stepped over the medical expert’s graves as they were white as ghosts….
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Thank you for this article! I am also a nurse and work in a major hospital. I am very concerned about what is NOT being relayed by the CDC to the public about this deadly disease and what is NOT being done to prevent more potential Ebola carriers from entering this country. The CDC understands the risks of this deadly Ebola virus and what it means now that it is on American soil, and what it could mean to an already overburdened health care industry. However, now that it is here, the public needs to know and understand what this virus does to those that are unlucky enough to be infected. The public has to understand what it looks like to have Ebola, as you described in your article, and how rapidly death can occur – within 2 weeks of infection, to put the pressure on the CDC and the government. I understand why they are not being explicit about the disease as fear of a wide-spread panic can occur, however if the CDC and government gave as much concern to stopping the spread of this deadly virus via travel here by infected patients, as they do to controlling the public reaction to it, people would feel more confidence in how this issue is being handled. As a health care worker I am amazed at what little is being relayed to the public about Ebola. Hospitals are not equipped to deal with an Ebola outbreak – they have neither the resources nor the appropriately trained staff to handle a large outbreak or epidemic. Hospitals must stay open to the general public, to treat trauma victims, surgical patients, birthing of babies, and other acutely ill patients. Ebola patients are handled differently and must be in strict isolation in a negative pressure room if possible. When an Ebola patient dies, they are still infectious. An Ebola outbreak would literally shut down hospitals cutting off needed resources for others. Not to be an alarmist but these things must be talked about and faced to be better prepared should an outbreak occur.
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Thank you for the very educating article! I learned alot from you. As a person with a graduate degree, I too would like to see sources cited, if only to dot the i’s & cross the t’s. Thanks again!
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Hi Joe – In writing my comments about to the article – they are based on my opinion and my readings on the Ebola Virus. Please see ‘Professional Guide to Diseases, Eighth Edition, Lippincott Williams & Wilkins, Ebola virus infection, Pages 253-255, Copyright 2005. Please read for more information on the Ebola virus. Although not very current, has some good information on the virus. I also constantly check the CDC’s website for additional current information on this virus.
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Ah yes, good ole Lippincott
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