View Full Version : Ebola patient sent away from E.R. with antibiotics.........
Wasn't sure if I should post this here or in Public Policy.
I'm sure you've all heard about the man from Liberia who went to an E.R. in Texas with flu-ish complaints and they released him with antibiotics. Then he came back 2 days later and was diagnosed with Ebola. The hospital's "excuse" was that the patient only told the nurse that he was visiting from Liberia, and she didn't tell anyone else. What a crock of B.S.! The doc who saw the patient should have known to ask a few questions. They threw the nurse under the bus.
And I got to thinking about Ebola symptoms.......Now that we're heading towards influenza season, it's going to be quite a challenge to sort through people with the flu, versus Ebola. :(
I think we need to face the fact that we have to have much stricter regulations about people coming into our country who possibly have this. I know the U.S. takes pride in it's "Free-for-all" stance on everything.......but it could come back to bite us hard.
Miss Cellane
10-2-14, 9:01am
From what I've read, they did screen this patient, and all the passengers boarding flights out of Liberia, for signs of Ebola. But this patient wasn't showing symptoms yet, so he wasn't caught in the screening. He didn't develop symptoms until 4 days after he arrived.
The fact is, with air travel so prevalent these days, an Ebola patient in the US was not a "maybe" or "worst case scenario" but a question of when it would happen.
Short term, more restrictions, until the current crisis in Africa is over, might help. But long term, we have to realize that diseases travel as freely as people do. And we need to be prepared for that. No disease is "local" anymore. They are all just waiting for the chance to go global.
Big news here as the lab that tested the patient's blood sample for Ebola is about a mile from our house.
I realize the horse is out of the barn Miss Cellane. But.....I don't believe the U.S. is screening anyone upon arrival. Also.....the guy had gone through another airport in Africa, before flying here.
Probably the biggest risk of being infected would be the bathrooms on the planes.....and who sits in his seat afterwards, and who handles his dirty food/drink tray, etc., etc. But....I don't have much faith in receiving reliable info from the CDC, or anywhere else these days. Seems like too much info is a CYA type of reaction. I would love to have been a fly on the wall at that hospital that turned him away the first time. With this going on, everyone should be asking E.R. patients "have you traveled anywhere in the past month?" Like I said earlier......that nurse is just one big scapegoat.
sweetana3
10-2-14, 12:10pm
1. Apparently symptoms dont appear for about 3 weeks. They only thing they can really screen for is elevated temperature and whatever the patient discloses, unless they are exhibiting dramatic symptoms.
2. How many people travel to Africa? This is almost a needle in a haystack issue.
3. Did the hospital advise all its staff to question people about flu symptoms or travel issues? Was she on leave or at home when they did it?
4. Last, there are a lot of people out there who dont pay any attention to the news and have zero idea what is going on with Ebola. And did the nurse even have a clue where Liberia is on the map?
lots of assumptions floating around.
gimmethesimplelife
10-2-14, 12:18pm
Given that I am very opinionated regarding health care, this may come as a surprise. On this one I am speechless. And more than a little afraid. As Sweetana3 stated above, there are lots of assumptions floating around and I don't know that anyone really knows how vulnerable we are or are not to a global epidemic or to a large North American outbreak. Scary stuff any way you slice it is my take. I'm taking more vitamin C and perhaps will take a clove of raw garlic every night as a preventative - supposedly garlic is not only anti-biotic but it anti-viral, too. Rob
I think we need to face the fact that we have to have much stricter regulations about people coming into our country who possibly have this. I know the U.S. takes pride in it's "Free-for-all" stance on everything.......but it could come back to bite us hard.
Are you advocating that US citizens who've been travelling in West Africa be denied entry on their return? Maybe everybody who enters the US, regardless of ethnicity or citizenship, should be quarantined for a month? How far back to go - because a plane that flew to France today may have been in Liberia last week?
I don't think there's need for panic. Ebola is not airborne. Infection is through direct contact with body fluids, excreta, or vomit. As with most viruses, the most common means of transmission is from hand to face. The US has clean water, a health-care network, good access to information, and has cultural norms that avoid the handling of the dead. Persons travelling in West Africa should avoid sex with unknown people - though that holds true here too!
Washing hands frequently and avoiding touching one's face with unwashed hands are effective means of protection - for flu, too. People who are starting to feel sick (or actually ill) should stay home, regardless of ailment.
http://www.kptv.com/story/26672284/salem-doctor-who-treated-ebola-us-outbreak-unlikely
http://www.nationaljournal.com/health-care/why-there-won-t-be-an-ebola-outbreak-in-the-united-states-20141001
Being an R.N., I know all about handwashing......which is probably why my hands get so dry. But........I would venture to say that's not true for most people. And how many people, while they're out of their home, itch their eye or nose, or touch their mouths?
And how about washing your hands after using a public toilet.......do you turn off the dirty faucet handle after you wash your hands? Do you open the door with your hand?
I'm just saying that there are tons of germs out there everywhere. And coming in contact with most of them probably even stimulates our immune systems to be even healthier........but as far as stopping a deadly disease, I'm not so sure.
I don't know what the answer is. I'm fairly pessimistic about alot of things these days..........too many people, too many invasive things (trees, insects, birds, diseases, etc.) caused by our globalization. I see humankind's choices as leading us down several roads of self-destruction. You might say I'm really sad about how human's have handled things from the beginning. Am I a downer? Yes. But that's how I see it.
It's not something I enjoy, but can't seem to come to more hopeful conclusions, based on the reality that's out there.
Among other things, I am a medical first responder, in an area that gets a *lot* of foreign tourists.
I pretty much assume everyone I encounter has Ebola as a starting point, as well as the flu, hepatitis, HIV, anthrax, chicken pox, smallpox, etc. So I wear proper protective gear, use proper protective protocols, and decontaminate everything.
I'm not worried about Ebola.
Well, I'm happy for you bae. But the majority of people who come in contact with ebola, are unaware that they are around someone with the disease and aren't in a hazmat suit. We see already on our first "go round" with it, that nobody was even thinking about it. (the E.R.).
I'm not sure how that hospital is supposed to be a good one. I certainly would have been more on the ball than that. But.....In my trek through life, I'm discovering that the people who are on the ball are in the minority.
I'm not at all concerned with Ebola--or with dengue fever, for that matter :~). I think bae's attitude is a good one--take the usual precautions unless you're in an exposure situation--then up your game.
I think we've already learned a lot about Ebola from our limited exposure, which is a Good Thing. We'll likely be exposed to more contagious diseases in the future, so it's best to be prepared. As that Texas hospital so obviously wasn't.
Meanwhile a new strain of enterovirus (EV D-68) has been spreading; it's now been reported in 42 states. There is no vaccine, and some patients have died from it. If you're determined to be worried, it's likely more of a threat than exotic strains from Africa.
We see already on our first "go round" with it, that nobody was even thinking about it. (the E.R.).
"When you hear hoofbeats, think of horses not zebras."
http://en.wikipedia.org/wiki/Zebra_(medicine)
I totally disagree with you bae. Someone comes into your E.R. and just came over from Liberia and has the symptoms of Ebola........that ain't no horse. And treating it as a horse is not doing your job.
I totally disagree with you bae. Someone comes into your E.R. and just came over from Liberia and has the symptoms of Ebola........that ain't no horse. And treating it as a horse is not doing your job.
Your original post says that he told only the nurse, and she told nobody.
Yet you are blaming the doctor and the hospital. Do you have more detailed information about who to throw under the bus, and why?
Do *you* ask everyone you encounter who has flulike symptoms "have you just come back from Liberia?"...
If I still worked in the E.R., I would make sure someone asked them that. It's like when you go see an Infectious Disease doc........they always ask you if you've traveled abroad within the last 6-12 months. It's being a responsible doctor/nurse.
Here's an article someone showed me. Interesting that the patient had had contact with someone who obviously had Ebola, but he didn't tell the E.R. people that. I still would have asked him though. But that doesn't mean they would give up accurate information.
I was thinking.......I wonder if some people from there, who can afford it and knew that they had come in contact with Ebola, and had family over here, if they would come here, just for the treatment?
http://www.breitbart.com/Breitbart-Texas/2014/10/1/Liberian-Government-Identifies-Dallas-Ebola-Patient
Here's an article someone showed me. Interesting that the patient had had contact with someone who obviously had Ebola, but he didn't tell the E.R. people that. I still would have asked him though. But that doesn't mean they would give up accurate information.
I was thinking.......I wonder if some people from there, who can afford it and knew that they had come in contact with Ebola, and had family over here, if they would come here, just for the treatment?
http://www.breitbart.com/Breitbart-Texas/2014/10/1/Liberian-Government-Identifies-Dallas-Ebola-Patient
Don't know if you've heard yet, but the US Feds are thinking of charging and prosecuting him for lying about his contact with someone who had Ebola. Apparently before you get on a plane to come here you are not only checked for fever/flu-like symptoms, but required to state if you had any contact within a certain period of time with someone known to have Ebola. He wrote "no" but he clearly had lied about that (or maybe didn't even know) on the application. Not really much can be done to stop infectious diseases from entering any country - flight attendants alone deal with multiple people on multiple planes from hither and yon all the time. So even with screening - and even if people don't lie (and they do or don't know) - there is no way to stop it without sealing off the borders to anyone who is or has been anywhere else on the planet - or in contact with anyone who has been somewhere else on the planet, or in contact with someone who has been in contact with someone who has been anywhere else on the planet. 6 degrees of separation (from Kevin Bacon!) or much less for infectious diseases.
Thanks Spartana........DH told me this tonight. What a mess. Here's hoping he didn't infect any of the people he's been around.
I wonder if some people from there, who can afford it and knew that they had come in contact with Ebola, and had family over here, if they would come here, just for the treatment?
Wouldn't you?
ApatheticNoMore
10-2-14, 11:48pm
But of course we don't actually have treatment. We have one semi-effective treatment that maybe has 50% effectiveness and who knows if it will even be used, though yes of course if I had ebola it would be better than nothing.
Bae and Jane............your attitude is fine for you. Just because I'm concerned about an obvious potential problem doesn't mean I have the "wrong" attitude about it. You said a similar thing when I mentioned my concern about the guy making it into the Whitehouse.........yet most of the various officials agreed with my take on it.
And bae.......look at your arsenal of weapons. Perhaps my concern about a pandemic or two pales in comparison to what you do with some of your fears.
Pinkytoe........Yes, I might do that..........and maybe I would even lie when asked if I had been exposed. (Hopefully I would first think about how many others I might put in harm's way by doing that.) I'm just talking about what ramifications that has for our "family".......the U.S.
Re the White House intruder: I never said it wasn't a concern, I just pointed out that most of our terrorists are home-grown. It's clear the Secret Service needs an immediate overhaul.
The first thing I thought when I read this story is here is another place taking someone presenting viral issues and sending them home with antibiotics (which have no effect on viruses).
The nurse was clueless as well as whoever saw him - aside from the whole issue of releasing him, they should have been concerned about their own health at that point. Funny I haven't seen anything about them being isolated.
That's a good point creaker. I wonder how long this guy waited in the waiting room there.......and maybe used the bathroom. I think bathrooms (anywhere....and on planes, etc.) are at a greater risk for harboring the virus. I wonder how long it lives on fomites?
And yes....if I'd had anything to do with him in the E.R., I'd be concerned. Funny they haven't mentioned that.
Here's a creepy thing that happened long ago when I was working in the ER (l980's). The ambulance brought in a guy. I think he was having chest pain. Anyhow....when they moved him to one of our beds, there was blood all over the sheet he was on. They couldn't figure out what was happening. Turns out, the previous patient the ambulance had transported had a miscarriage and it soaked through the entire cot.
I know the guy who went to the E.R. in Texas probably (?) wasn't bleeding or vomiting or having diarrhea.....but still........microorganisms are....well.....micro.
And bae.......look at your arsenal of weapons. Perhaps my concern about a pandemic or two pales in comparison to what you do with some of your fears.
Cathy - I think you are projecting your own fears with that statement. I do not own my "arsenal" because of fear.
I teach firearms use - so I have representative examples of every type of firearm available for instruction.
I study firearms technology, so I have representative examples of most historically important developments, and a few that are just plain silly. (I mean, do you *really* think I have a Gyrojet Rocket Pistol sitting here because I am afraid Martians will attack?)
I do research in terminal ballistics, so I have suitable firearms for carrying out those projects.
I am particularly interested in the inventions of one specific designer, so I have at least one example of each major breakthrough he accomplished. As he was perhaps the most prolific firearms designer in history, and invented most of the technologies since the black powder days, this is a large portion of my "arsenal", yet most of these weapons are ill-suited to use these days to deal with whatever fears haunt you, Cathy.
I also am interested in a very short period of history, and have an example of every firearm used during that period.
I hunt, so I have firearms for hunting everything from small birds to T-Rex. I do not live in fear of elephants trampling my fields however.
I also have a few firearms that I use as tools in my daily life, out of prudence or necessity.
When you add all those up, it is a lot of tools and examples, but it's not an "arsenal". If it were an "arsenal", I'd have 2-3 different varieties, and lots of each type lined up in neat little rows, and stacks of ammunition to the ceiling geared towards repelling Ebola Zombies or something.
I could have sworn you told us you eat breakfast with your gun on your table. Yeah, whatever.
Miss Cellane
10-3-14, 3:17pm
But of course we don't actually have treatment. We have one semi-effective treatment that maybe has 50% effectiveness and who knows if it will even be used, though yes of course if I had ebola it would be better than nothing.
Well, we don't have a *cure*. Which is, I think, why people are so frightened of Ebola. Just as they were about AIDS. We still don't have a cure for AIDS/HIV, but we do have treatments that work to some extent. The panic about Ebola reminds me of the panic in the early days of AIDS--lots of fear, lots of misinformation.
There is treatment for Ebola--supportive care that works to treat the symptoms, in the hope that the patient can then fight off the disease.
It's just that people hear of a fatal disease with no cure, and that's scary.
I'm not personally afraid of getting ebola. I'm afraid of poor judgement by some people in charge of certain things and also our inability to screen the massive amounts of people that go in and out of this country. We'll see. Let's come back in a year and see where we are. Just because I'm talking about it doesn't mean I'm pacing the floor, screaming out "Oh my God!! What are we going to do? We're all going to die!!" I'm just discussing it.
Just because I'm talking about it doesn't mean I'm pacing the floor, screaming out "Oh my God!! What are we going to do? We're all going to die!!"
I just got my hair cut earlier today and the stylist was almost to that point - it really surprised me - I suppose the media has really fanned a lot of people into over-reacting.
ApatheticNoMore
10-3-14, 4:40pm
Well, we don't have a *cure*. Which is, I think, why people are so frightened of Ebola. Just as they were about AIDS. We still don't have a cure for AIDS/HIV, but we do have treatments that work to some extent. The panic about Ebola reminds me of the panic in the early days of AIDS--lots of fear, lots of misinformation.
Only it appears to be more easily spread than AIDS, if it's any bodily fluid including mucus etc.. There's not that many ways AIDS can be spread. Granted AIDs was a deadly epidemic among certain communities (mostly before the current treatments when it was a quick death sentence, however it still may be, I saw an ad 1 in 3 gay black men have AIDS).
There is treatment for Ebola--supportive care that works to treat the symptoms, in the hope that the patient can then fight off the disease.
Well there is also ZMapp which was given to the two Ebola patients who were transported over here initially, but it's not a cure either, it seems to increase the odds of survival:
https://en.wikipedia.org/wiki/ZMapp
I have not heard of it being given to this guy.
I'm not personally afraid of getting ebola. I'm afraid of poor judgement by some people in charge of certain things and also our inability to screen the massive amounts of people that go in and out of this country. We'll see. Let's come back in a year and see where we are. Just because I'm talking about it doesn't mean I'm pacing the floor, screaming out "Oh my God!! What are we going to do? We're all going to die!!" I'm just discussing it.
A lot of it I think is many people freak out when something comes up they are not used to. Some strains of e coli sound almost as bad as Ebola - but people are still out there buying burgers. And every time a few more people die from it we just shrug it off and move on.
I suppose the media has really fanned a lot of people into over-reacting.
Bingo.
I think I'd rather take my chances with Ebola than bacterial meningitis or any one of many other diseases. Ebola either kills you or it doesn't; you don't linger and suffer and die piece by piece.
It's good that we are establishing protocols for dealing with this and other threats before we're knee deep in something even scarier. (And yes, I have read Laurie Garrett...:confused:)
We'll see how it all plays out.
I was thinking.......I wonder if some people from there, who can afford it and knew that they had come in contact with Ebola, and had family over here, if they would come here, just for the treatment?
I really think this is not a concern. The people most likely to be exposed to Ebola are the poorest of the poor. The average income for a West African is $309/year. Cost of a passport: $205 (let's bear processing time in mind! it could take many weeks from completion of application form to getting the passport in one's hand!). Cost of a plane ticket:as of today: over $5,000.
Average income West Africa: http://web.worldbank.org/WBSITE/EXTERNAL/NEWS/0,,contentMDK:20179737~pagePK:34370~piPK:42768~the SitePK:4607,00.html
Cost of Liberian passport: http://www.liberiapassports.com/
Cost of round-trip ticket from Monrovia to New York: http://www.kayak.com/flights/NYC-ROB/2014-10-06/2014-10-31
Wealthy people in Liberia are unlikely to come into contact with Ebola; if they do get scared, they'd be more likely to head for France, Italy, or Germany. These countries are much closer than the USA, and have good doctors and hospitals.
That's probably true Suzanne.
a few thoughts...the hospital has been transparent about their actions, and tried to identify and correct problems, saying they would like to use their mistakes as teaching tools for other hospitals, and I appreciate this attitude. I can imagine no ER dr anywhere will neglect to ask about foreign travel now, even in what looks like routine stomach flu. Of course, it's more difficult if the patient flat-out lies, as this one apparently did at least to airport officials. Most recent news indicates that the patient's family is being quarantined at government expense, under guard, after they refused to stay in their home as advised. Between 21 days of government paying for quarantine, and patient's medical care, this is one expensive proposition.
Miss Cellane
10-6-14, 7:58am
Bingo.
I live in New England. I have a co-worker who is now offering hand sanitizer to everyone who stops by her cube, expressly for the purpose of not catching Ebola. "A spritz today keeps Ebola away!" she chirps.
I suspect she is a germaphobe anyway, and is just using this as an excuse for getting everyone to use the hand sanitizer, but still . . . it seems a bit of an over-reaction to me.
I saw something on the news this morning that was a little disconcerting. And you have to remember that, having been an R.N., I'm very aware of germs on fomites. anyhow....I don't know if he was the mayor of the town where that family of the guy from Liberia was living, but in order to show how NOT scared he was, he went to visit them while they were in the process of moving without any protection at all. To me, that's just irresponsible. What kind of message is that sending to everyone else?
Powered by vBulletin® Version 4.2.5 Copyright © 2026 vBulletin Solutions Inc. All rights reserved.