Posts Tagged "Ebola"

The US Food and Drug Administration (FDA) is warning consumers that fraudulent treatments for Ebola virus disease are being marketed online.

Although some experimental therapies and vaccines are in early phases of development, no products for treating Ebola infection have been approved by the FDA.  So far, only limited data are available about the safety and effectiveness of the products being tested, and only small supplies are available, according to the agency.  Experimental therapies were used to treat 2 US health care workers who were moved to Atlanta after they became infected by Ebola virus while caring for patients in West Africa, where there is an ongoing outbreak.

The US Center for Disease Control and Prevention says there is little threat of Ebola spreading in the United States.  But some online marketers have seized on global concern about the illness to sell fraudulent products, according to the FDA.  It is illegal for companies to market unapproved products claiming to cure or prevent disease.  The FDA is asking the public to report suspect claims about Ebola-related products (https://1.usa.gov/1mS3T3P).

(JAMA)
Read more here.

The Presidential Healthcare Center’s preventative programs include emergency preparedness advice to keep you safe and healthy no matter where you travel.

Dr. Elting appeared on News Channel 8 this past Wednesday, October 22^nd, with Bruce Depuyt to discuss Ebola virus. Depuyt asked Dr. Elting, an infectious disease specialist, for insight into the virus; particularly focusing on ways the virus can be contracted, and how we may be at an increased risk when using air travel. 

From the broadcast:

Up first – Answering your questions about Ebola.  The news of late has been good.  The people who came into contact with those who cared for patient Thomas Duncan are said to be symptom-free.  And the potential cases of Ebola that we’ve seen on the news, those have turned out to be false alarms.  Nonetheless, we know there is anxiety about the Ebola virus – how it is spread, how it is treated, and whether it’s likely we’ll see more cases in the days, weeks, months ahead.

Joining us now is Dr. Jeffrey Elting.  He’s former head of infectious disease control and response for the DC Hospital Association.  He is now the Medical Director at the Presidential Healthcare Center in the National Capitol region. 

“The public health sector has stepped up its game” Dr. Elting said.  “It is important to keep everything in perspective by taking into account that someone dies every 34 seconds of a heart attack.  We have 30,000 people killed in motor vehicle accidents each year, and we have influenza that kills millions of people.  Comparatively, we’ve had 1 person unexpectedly come to the US with Ebola who unfortunately died from the virus, but aside from some initial missteps, the rest of the cases have been managed quite well and people are recovering.” “Ebola is a special case and more deadly than others,” he said.  “That’s why we have decontamination units, isolation rooms, stockpiles of medication, protective suits and face masks.”

Dr. Elting also spoke about how the Ebola virus is transmitted.  “The transmission
method for Ebola is generally from contaminated fluid from infected patients.  It’s not transmitted by respiratory droplets like the flu or a cold.”

He also addressed the symptoms experienced after contracting Ebola.  “The initial symptoms are going to be somewhat flu-like.  You’re going to have a fever, headache, muscle aches, irritation of the throat, and then it will progress.  Ebola is a hemorrhagic virus, therefore, it can cause bleeding into the eyes, lungs and intestinal system.  Distinguishing patients with Ebola may become more challenging as the flu season approaches.”

View the entire interview here.

The Presidential Healthcare Center’s preventative programs include emergency preparedness advice to keep you safe and healthy no matter where you go.

As questions of how many people the second Dallas nurse infected during her journey to and from Dallas throw scary possibilities, a WHO situation assessment report gives more cause for concern by stating that the incubation period of the virus has been seen to extend to as long as 42 days in some cases.

It says that recent studies conducted in West Africa have demonstrated that 95% of confirmed cases have an incubation period in the range of 1 to 21 days; 98% have an incubation period that falls within the 1 to 42-day interval.

For WHO to declare an Ebola outbreak over, a country must pass through 42 days, with active surveillance supported by good diagnostic capacity and no new cases detected in the period.

The organization has also criticized rapid determination of infection within a few hours, noting that two separate tests 48 hours apart are required before discharging a patient or a suspected one as Ebola negative.

In assessing the situation in West Africa, WHO says fresh cases in Guinea, Liberia and Sierra Leone show that the outbreak is not showing any sign of being controlled.

On the positive side, it is all set to declare later this week that Senegal is Ebola-free, if no new cases are detected.

Nigeria will also get the green signal once it passes the requisite 42 days, with active surveillance and no new cases till Monday, 20 October.

Tracing of people known to have contact with an Ebola patient reached 100% in Lagos and 98% in Port Harcourt, a crucial step in controlling the spread of the virus.

In the case of the American nurse who took a commercial flight with 132 other passengers, the risk factor is multiplied with every contact she made, beginning with the immediate co-passengers, flight attendants and airline baggage handlers to the family members she met.

The Ebola virus is believed to be able to survive outside the body for a week or more during which time anyone who comes in contact with contaminated surface can pick up the virus.

The death rate in the current Ebola outbreak has increased to 70% with the toll at 4,447. There could be up to 10,000 new cases of Ebola per week in two months, WHO has warned.

Source: International Business Times

CDC confirmed on September 30, 2014, through laboratory tests, the first case of Ebola to be diagnosed in the United States in a person who had traveled to Dallas, Texas from West Africa. The patient did not have symptoms when leaving West Africa, but developed symptoms approximately five days after arriving in the United States.

The person sought medical care at Texas Health Presbyterian Hospital of Dallas after developing symptoms consistent with Ebola. Based on the person’s travel history and symptoms, CDC recommended testing for Ebola. The medical facility isolated the patient and sent specimens for testing at CDC and at a Texas lab participating in CDC’s Laboratory Response Network. CDC and the Texas Health Department reported the laboratory test results to the medical center to inform the patient. Local public health officials have begun identifying close contacts of the person for further daily monitoring for 21 days after exposure.

The ill person did not exhibit symptoms of Ebola during the flights from West Africa and CDC does not recommend that people on the same commercial airline flights undergo monitoring, as Ebola is only contagious if the person is experiencing active symptoms. The person reported developing symptoms several days after the return flight.

CDC recognizes that even a single case of Ebola diagnosed in the United States raises concerns. Knowing the possibility exists, medical and public health professionals across the country have been preparing to respond. CDC and public health officials in Texas are taking precautions to identify people who have had close personal contact with the ill person and health care professionals have been reminded to use meticulous infection control at all times.

We know how to stop Ebola’s further spread: thorough case finding, isolation of ill people, contacting people exposed to the ill person, and further isolation of contacts if they develop symptoms. The U.S. public health and medical systems have had prior experience with sporadic cases of diseases such as Ebola. In the past decade, the United States had 5 imported cases of Viral Hemorrhagic Fever (VHF) diseases similar to Ebola (1 Marburg, 4 Lassa). None resulted in any transmission in the United States.

Source: CDC

Airports in Guinea, Liberia and Sierra Leone are relying on a familiar tool to stop the spread of Ebola: the thermometer.

Airport staff are measuring the temperature of anyone trying to leave the country, looking for “unexplained febrile illness,” according to the Centers for Disease Control and Prevention, which is advising these countries on their exit screening processes.

Other countries that are far from the infected region are screening passengers arriving from West Africa or who have a history of travel to the region. Temperature takers include Russia, Australia and India.

Travelers who exhibit an elevated fever, generally over 101.4 degrees Fahrenheit (though it varies by country), are stopped for further screening. That could mean a questionnaire or medical tests.

Critics of exit screening have pointed out the flaws in using thermometers: fever can lay dormant for two to 21 days in someone who’s been infected with Ebola, and low-grade fevers can be lowered further by simple medications like Tylenol or Advil.

While they can’t predict symptoms before they emerge, the CDC is prepared to thwart those trying to mask a fever with a pill.

“Airline and airport staff are trained to do visual checks of anyone who looks even slightly ill,” says Tai Chen, a quarantine medical officer from the CDC who returned from Liberia this past Tuesday. “And most airports are using multiple temperature checks, starting when you arrive on the airport grounds in your car until you get on the plane. Even if you take medication, your fever will likely have manifested by then.”

Here’s a look at the three methods that can be used in airport exit screening.

Ear Gun Thermometer:

Looks like: An electric toothbrush without the head.

How it works: The pointy end, covered with a plastic cap, goes in the patient’s ear while the other end is held by the airport employee six or eight inches away. After each use, the cap is discarded and replaced.

What it measures: The human ear drum’s temperature closely mimics the body’s internal temperature. The closer the thermometer can get to the ear drum without touching the fragile membrane, the more accurate the reading.

Is it accurate? The average ear gun thermometer doesn’t get close enough to the membrane to give a true reading, says Marybeth Pompeii, chief clinical scientist at Exergen, a thermometer company. Instead, it averages nearby temperatures and applies “an algorithm to produce the final temperature.” But Dr. Amesh Adalja, a public health expert for the Infectious Disease Society of America, says this margin of error won’t matter when it comes to catching Ebola patients: “Ear thermometers are accurate within a reasonable range. If you have a fever, these thermometers will register it.”

Other concerns: Because the same thermometer is used on many passengers, the device could become contaminated. All those plastic caps add to the expense. And the airport staff with the thermometer is in close proximity with potentially infectious passengers.

Also, the thermometers need to be calibrated correctly — which could explain how NPR correspondent Jason Beaubien registered a cool 91 degrees Fahrenheit in Sierra Leone last month. This temperature indicates extreme hypothermia, but was of little concern to the airport workers, who were looking for dangerously high temperatures, not low.

Full-Body Infrared Scanners

Looks like: It’s a camera, sometimes mounted on a tripod. A passenger probably wouldn’t even notice it.

How it works: Its heat-sensing abilities will turn you into a heat map on a computer screen.

Bonus: The scanner can assess a group of passengers and they don’t even have to stop to be screened.

What it measures: External body temperature. Passengers who show up as green and yellow – the colors for normal body temperatures — are cleared for travel. Anyone with a red forehead is stopped for further screening.

The full-body infrared scanner depicts body temperature with colors on a computer screen. China used the device during the 2003 outbreak of the respiratory virus SARS. Some airports have turned to the scanner as part of Ebola screening.

The full-body infrared scanner depicts body temperature with colors on a computer screen. China used the device during the 2003 outbreak of the respiratory virus SARS (pictured, above). Some airports have turned to the scanner as part of Ebola screening.

Is it accurate? These machines measure skin temperature as a proxy for core body temperature, which isn’t always reliable.

“They measure the heat radiating off of someone,” says Adalja. “That’s not quite the same as internal body temperature.”

Pompeii thinks they are too easily fooled.

“You can just go to the ladies room and splash some water on your forehead. You’re going to exhibit evaporative cooling, even if you have a high fever. And you’ll just sail through,” says Pompeii. Meanwhile, she notes that rushing to catch a flight or having an alcoholic drink could raise your external temperature.

The FDA hasn’t approved full-body infrared scanners for use in the U.S., but they were popular in Asia during the SARS and Avian flu epidemics.

According to a 2011 study in the journal BMC Infectious Diseases, these machines correctly identify a passenger as febrile or non-febrile less than 70 percent of the time. This means healthy passengers could be stopped unnecessarily, and infected passengers could be getting on a plane.

Handheld Infrared Thermometer:

Looks like: A handheld ray gun.

How it works: From a distance of about six inches, the airport employee points the laser at a passenger’s hand or forehead and the infrared technology can estimate the body’s internal temperature. Originally invented for industrial use to measure the temperature of extremely hot or cold items, the handheld thermometer has obvious appeal in a disease outbreak.

“You don’t have to touch anyone,” says Francisco Alvarado-Ramy, a medical officer for the Center for Disease Control. “The risk of cross-contamination and infection is less, and you spend less time worrying about disinfecting the tool.”

The process is also less invasive than the ear gun and more thorough than the full-body infrared scanners.

Is it accurate? “When you are holding something away from the individual, there is dust, air current, humidity, and these things can affect the temperature measurement,” says Pompeii. “And your inch is different than my inch, which means everyone is measuring slightly differently.”

Despite these variances, the FDA approves most handheld infrared thermometers for use in medical settings. They are also the thermometer of choice for the U.S. government, which donated 30 of these infrared scanners for use in the Nigerian airport on Aug. 24.

“The move in hospitals is toward these infrared thermometers,” says Adalja. “They are within the range of the most accurate temperatures.”

Postscript: There is one way of checking temperature that is far more reliable than the rest.

“The most accurate temperature is achieved with a rectal thermometer,” says Pompeii. “But I don’t think airlines can do that.”

Source: NPR.com