Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas - Died

[Drakkonmax]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

First time poster here! One thing I have not yet seen brought up is the fact that Ebola does not only infect humans. What about the animal reservoirs that have been one of the major factors in Africa becoming infected in Texas or elsewhere ? Texas has huge populations of both bats and feral pigs. If those populations are infected they could become major and permanent vectors of Ebola transmission could they not ? I do not want to imagine a world where a feral pig could wander into your yard and leave behind an Ebola laced landmine on your driveway.

 

[JimO]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

First time poster here! One thing I have not yet seen brought up is the fact that Ebola does not only infect humans. What about the animal reservoirs that have been one of the major factors in Africa becoming infected in Texas or elsewhere ? Texas has huge populations of both bats and feral pigs. If those populations are infected they could become major and permanent vectors of Ebola transmission could they not ? I do not want to imagine a world where a feral pig could wander into your yard and leave behind an Ebola laced landmine on your driveway.

Welcome to FT Drakkonmax and you bring up an excellent point. I haven't heard any discussion of ebola potentially becoming endemic in an animal population outside of Africa via a human vector. I'm not sure I want to think about the consequences of that scenario.

 

[JimO]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Alert found this http://www.flutrackers.com/forum/showthread.php?p=548382#post548382

Wow! If the details of his exposure had been communicated to hospital staff during his first visit on 9/26, then something is seriously wrong. If the gentleman was not forthcoming with this information, then I can see how this came about. The greatest danger, I think, is fear and denial that could lead individuals to withhold critical information. Right now the most critical piece of information that will allow us to differentiate early ebola symptoms from dozens of other common diseases in the US is travel history and potential recent exposure information. We have no fall-back position if someone does not provide this information short of testing everyone with a fever for ebola.

 

[AnnaLisa]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

He knew he had exposure yet he boarded a plane. I guess that makes me question his integrity in terms of when he first got symptoms as well. This entire situation is very upsetting. Ball dropped along the way several times. I am sure they will get a handle on this but, the failure of the system up to this point is concerning.

 

[alert]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Maybe he didn't believe in Ebola, or thought the woman had some other disease. Perhaps he didn't recognize his exposure as high-risk?

 

[JimO]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Even though he helped transport her to an ebola clinic?

Maybe he didn't believe in Ebola, or thought the woman had some other disease. Perhaps he didn't recognize his exposure as high-risk?

 

[curiosity]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Even though he helped transport her to an ebola clinic?

Maybe he just thought it couldn't happen to him.
Maybe he just thought he could go to a country that will give him the best chance for survival if he does get sick.
Maybe he thought if he has to die then he can see his family one last time.
Maybe he thought ...

 

[Chicagogal]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

This is not an unexpected development. The PLOS paper from early September predicted a high likelihood of a case in the United Kingdom or the U.S. by last week.

You have to consider it from the viewpoint of the people living there - if you were surrounded by Ebola and had a chance to get to better healthcare, would you turn it down?

 

[Emily]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

He knew he had exposure yet he boarded a plane. I guess that makes me question his integrity in terms of when he first got symptoms as well. This entire situation is very upsetting. Ball dropped along the way several times. I am sure they will get a handle on this but, the failure of the system up to this point is concerning.

This is the second case of a man infected with Ebola who seemed to have good ethics and altruistic tendencies prior to infection, but afterwards crossed an international border and inexplicably endangered others.

The reasons for this are likely very complex.

http://www.flutrackers.com/forum/showpost.php?p=432959&postcount=2

 

[AnnaLisa]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

I think I would have bolted a long time ago. I don't know how they have endured this long. Given this is human nature, I assume this will be global shortly. I can't imagine it isn't other places as well.

 

[MHSC]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

I think it comes down to the attitude of "it won't happen to me/it won't happen here". I see it all the time at work.

The nurse asked the right question, but didn't relay the information well enough. Maybe the nurse had too many patients, maybe the doctor didn't listen, or maybe he had 3 people talking to him at once. Maybe the nurse was at the end of a rough 12 hour shift, and was exhausted. There are many reasons why, I'm not the least bit surprised it happened. ER's can be chaotic. What I am surprised about is that the EMS crew put on masks, I rarely see that!

 

[sharon sanders]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

So...

a couple of years ago the CDC twitter account started doing chats. I was intrigued. I logged on at the right time (as FluTrackers) and I made a couple of comments and posted links to some CDC pages at the beginning of the chat. I forget the topic now. But as the chat progressed I noticed there were 3 or 4 twitter accounts that were strongly supporting everything the CDC said. It seemed odd. There were not many participants so this stood out. After the 1 hour chat concluded I looked up a couple of the entities behind the twitter accounts. They appeared to be CDC "partners" located in Washington D.C.

I was not impressed. So I have not wasted my time again.

Today the CDC is on twitter announcing an ebola chat for tomorrow so I tweeted them:

CDC ‏@CDCgov 5h 5 hours ago
CDC confirmed 1st #Ebola case in US. Join #CDCchat tomorrow at 4PM ET to get answers to your questions.

FluTrackers.com ‏@FluTrackers 3h 3 hours ago
@CDCgov Can real people participate and not just the CDC contractors?

FluTrackers.com ‏@FluTrackers 14s 14 seconds ago
@CDCgov Ok. I guess silence is an answer.


It is a big mistake if the CDC thinks it can control the ebola message.

 

[AnnaLisa]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

As a health care provider with public health background, I am finding the spin by the CDC concerning. I'm glad to hear I am not the only person who feels there is spin going on. I'm coming here for the facts.

 

[JimO]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

This is not an unexpected development. The PLOS paper from early September predicted a high likelihood of a case in the United Kingdom or the U.S. by last week.

You have to consider it from the viewpoint of the people living there - if you were surrounded by Ebola and had a chance to get to better healthcare, would you turn it down?

I honestly don't blame him, but once he was here and started getting sick, I don't understand why he wouldn't have told the ER staff his recent history, especially since some of them could die as a result. We are extremely vulnerable to persons infected with ebola passing it on to others if they don't give a full account of their recent potential exposures. He apparently did tell someone that he recently travelled to Africa. Perhaps medical staff in ERs and critical care centers need to be much more aggressive in questioning anyone who reports travel to Africa.

 

[curiosity]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

I think it comes down to the attitude of "it won't happen to me/it won't happen here". I see it all the time at work.

The nurse asked the right question, but didn't relay the information well enough. Maybe the nurse had too many patients, maybe the doctor didn't listen, or maybe he had 3 people talking to him at once. Maybe the nurse was at the end of a rough 12 hour shift, and was exhausted. There are many reasons why, I'm not the least bit surprised it happened. ER's can be chaotic. What I am surprised about is that the EMS crew put on masks, I rarely see that!

Now might be a good time to reoffer that training you wanted to put together for your hospital MHSC.

 

[JimO]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

People need to realize, especially medical staff in EDs, that what makes this so much different is that errors on their part can kill them or others. An infectious ebola patient who is not diagnosed poses far more risk than someone with flu, measles, cholera, TB, or even SARS. Even though it isn't as contagious as any of these diseases, the odds of surviving an infection are much worse. And, in a healthcare setting with an infectious case, ebola probably is as contagious as the others due to the nature of the contact.

I certainly don't want to see people act irrationally out of panic, but the CDC needs to clearly communicate the risks and give detailed guidance, not only on how to isolate and treat cases, but on how to identify cases. We all know that there are going to be people fleeing West Africa who are infected, and that some of those people might not have the knowledge, understanding, or the integrity to protect others with whom they come into contact. In fact, the possibility even exists that certain people might have malicious intent and deliberately expose others without telling them. We have to develop a strategy to identify these cases in order to protect the front line medical professionals and other patients. This is a true public health matter where public health concerns trump individual rights.

 

[Dani]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Hello- I have been following this (terrific!) website for a few months now. I'm a physician with a background in ethics (not in ID or public health, however) and do a considerable amount of travel.

I find this sentiment quite alarming:

As a health care provider with public health background, I am finding the spin by the CDC concerning. I'm glad to hear I am not the only person who feels there is spin going on. I'm coming here for the facts.

I also feel there is spin going on. As one small example, the highly paternalistic decision not to disclose the flights the patient took. While it's unlikely that anyone on those flights acquired Ebola (after all Patrick Sawyer was much sicker and apparently did not spread it to anyone whose sole contact with him was in-flight). However, the CDC had to know the public would eventually find out & in the end they've made the public trust them just a little less, which could do a great deal of harm in the long run.

The CDC seems awfully sure Mr. Duncan was not infectious during those flights. I'm not sure we can trust either the patient or our knowledge regarding transmission quite that completely.

 

[JimO]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Hello- I have been following this (terrific!) website for a few months now. I'm a physician with a background in ethics (not in ID or public health, however) and do a considerable amount of travel.

Welcome to FT Dani! It's always great to have members of the medical profession participate.

 

[sharon sanders]

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Welcome bwilde!

 

[JJackson]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

The reasons for this are likely very complex.

http://www.flutrackers.com/forum/showpost.php?p=432959&postcount=2

Thanks for linking to this old post of yours it is a fascinating interview which I did not pick up on first time around. JJ