A couple of months ago I completed a continuing education course on Ebola. It was actually somewhat reassuring given these 2 claims: 1) It is transmitted through blood and body fluids 2) The patient is not contagious until they are symptomatic. So these sound simple enough, right? Right, if we're talking HIV or hepatitis which are not characterized by vomiting or hemorrhaging. Ebola presents with headache, vomiting, and fever. These are fairly common symptoms so what raises the flag that they can be life threatening? It's a simple matter of determining where the patient has been and who they've been exposed to over the past 3 weeks.
Therefore, if someone with Ebola vomits, bleeds, or urinates on a surface, how long does the virus remain alive? According to the CDC www.cdc.gov/vhf/ebola/hcp/environmental-infection-control-in-hospitals.html, the Ebola virus can remain viable on a solid surface "with concentrations falling slowly over several days." We in the medical profession are interested in "viral load." This is the amount of virus in a specified amount of blood. Some illnesses require a high viral load to be considered infectious. This does not seem to be the case with Ebola which requires a "low infectious dose" and those infected have the "potential of high virus titers in the blood." This means an infected person has lots of the viral organisms and it doesn't take a lot for someone to contract the disease.
There are reports that nurses are stating they feel their hospitals are unprepared to deal with Ebola. I can certainly understand this. And that is in medical settings with all of the PPE (personal protective equipment), disinfectant and sterilization policies, and trained staff for whom "universal precautions" are supposed to be routine. Think about the times you have been a patient in an emergency department. Was there carpet and upholstery? Were the staff and other patients outfitted in masks, gloves, gowns, and eye protection? Were you given these items? Were the people who accompanied you given these items?
Just the idea of flying on an airplane concerns me. So the airlines are screening people as to their possible contact with infected persons. They are questioning passengers about current symptoms such as fever and may even take the passengers' temperatures. Consider that you have an airline ticket you paid more than $1000 for and a trip you have been planning for weeks or months. Then you come down with a fever, headache, and possibly an upset stomach. Would you try to cover up that fact? I have heard that people are taking Ibuprofen to mask fever so they can board the plane. While these scenarios may be unlikely they are very possible.
The CDC article recommends that hospitals remove the draperies, carpets, and upholstery from rooms that house patients with Ebola. I have flown on many airplanes. They have upholstery and carpets. So do airports, medical waiting rooms, hotels, taxicabs, and rental cars. Supposedly the Ebola is considered to be enveloped, which makes it more susceptible to most disinfectants. That is good news but how confident are we that contaminated surfaces have been immediately disinfected?
It's been 38 years since I became a registered nurse. I have seen a lot of changes during that time including the discovery of HIV, and Hepatitis C, D, and E. Nosocomial (hospital acquired) infections such as antibiotic resistant staph infections have become more widespread and costly. At a time when we have more technology and pharmacology (drugs) than ever before, our risk of acquiring deadly diseases continues to be very real.
My knowledge of Ebola is not extensive and thank goodness I have no personal experience with it. However, common sense dictates that we should focus on good nutrition, good hygiene, and avoid exposure to sick people. I will not lay awake at night worrying about this but I will stay informed and alert. I pray that leaders in government and healthcare use wisdom, knowledge and courage to confront this disease. I also pray that healthcare workers ask questions and demand answers concerning Ebola now.
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