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Sunday, October 12, 2014

Ebola is dangerously infectious - appears resistant to infection control puts caregivers at risk

Health care workers are especially well trained about how to practice infection control protocols. Consequently, it's very alarming to learn today, October 12, about a nurse at Texas Presbyterian in Dallas, who tested positive for the dangerous Ebola virus infection, after having cared for Mr. Thomas Eric Duncan who died from the disease last week.  

As a nurse myself, I suspect the Ebola virus is more virulent than the Centers for Disease Control (CDC) or any other infectious disease experts understand.  

Unfortunately, the nurse who now has the Ebola diagnosis was wearing protective gear throughout her time caring for the deceased Mr. Duncan because he had already been diagnosed.

The nurse was involved in Duncan's second visit to the hospital, when he was admitted for treatment, and was wearing protective gear as prescribed by the CDC: gown, gloves, mask and shield.

The nurse had "extensive contact" on "multiple occasions" with Duncan, Dr. Tom Frieden, the director of the Centers for Disease Control and Prevention in Atlanta, said Sunday.

Therefore, "At some point, there was a breach in protocol, and that breach in protocol resulted in this infection," he said at a news conference Sunday.

A "close contact" who knew the nurse has been "proactively" placed in isolation, reports CNN.

The hazardous materials unit of the Dallas Fire Department has cleaned up and decontaminated the public areas of her apartment complex, Mayor Mike Rawlings said. Police are keeping people out of the area and are talking to residents nearby.

Although the experts who are evaluating this most recent Ebola exposure are seeking a breech of protocol as a cause, the fact remains that the caregivers are contracting the disease, in spite of using infection control procedures. Physicians and nurses are contracting the Ebola virus infection, when we know how to implement isolation and infection control procedures. 

In my opinion, there must be some kind of poorly understood virulence associated with transmitting Ebola. 

Perhaps any exposure at all to the bodily fluids of an infected Ebola patient puts a person at high risk, more so than touching alone. This means, being exposed to an infected person's sweat, sneezing, urine, blood, semen, saliva or any product associated with these fluids. Evidently, dumping a patient's urine, starting an IV or even giving a bed bath must create a very high risk of exposure, regardless of the infection control precautions taken to prevent the spread of the disease.

If caregivers are at risk while caring for Ebola patients, there's no doubt about how the disease will spread. Family members will try to fill the caregivers' gap and they will undoubtedly become ill doing so....and so forth.  Therefore, the only way I can foresee for stopping the  spread of Ebola is to isolate the patients as quickly as possible and minimize any exposure to the bodily fluids of the person who is ill. This means, don't draw blood or dump urine unless it's absolutely vital to do so. Urine can be dumped once very  24 hours rather than every 8 -10 and blood doesn't need to be drawn at all. Meanwhile, it's essential to develop a vaccine to prevent the future outbreaks of this lethal Ebola virus.  

Public health money, of course, is needed to stop Ebola from becoming a pandemic. Also, government corruption in African nations contributed to this now out of control outbreak. 

Of course, my dear readers, money and competent government control of the problem are the subjects of other blogs.....

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