Ebola and Flu Season

[daveyjwin]

At my hospital, we now have an "Ebola Screening Tool" flowsheet in triage, and it seems everyone is having mini freak outs about Ebola screening and testing, symptoms, etc, and there's literally been ONE PERSON infected in the US. Theoretically, over the next couple of months, several more people might get infected, maybe a couple dozen, maybe more, likely increasing the anxieties about Ebola. With the extreme cautions will undoubtedly be taken, what are we to expect when the dozens of people per day come through with a flu like syndrome?

Symptoms of Ebola: fatigue, fever, headaches, sore throat, joint, muscle, and abdominal pain
Symptoms of Influenza: fatigue, fever, headaches, sore throat, joint, muscle pain, + URI syndrome

How are the hospitals, and us, as health care providers, going to deal with this? What do you think the expectations are going to be when a person walks through the door, with a fever, cough, sore throat, and myalgias? What is they test negative for Flu?

It's right around the corner...

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[NinerNiner999]

As with any media frenzy and in a world of 3-second sound bites and video clips, our reality will likely not be the disease itself, but the paranoia of everyone who thinks they have the disease. The scary thing is that the sheer population density of our nation compared to the "outbreak" in Africa does make a national epidemic in the US a possibility. A major US city 1/20th the geographic size of an African nation will hold just as many people. That means more people in contact with those who are exposed (with any infection, including ebola) and more people likely to panic.

I agree - this is likely to be a very busy "flu" season and our challenge will be to diagnose those who likely have the flu, and MAY have ebola. I think the only way to sort through the walking discharges and the truly infectious will be to use the screening tools that local health departments and the CDC have given us. With our ED volumes, length of time for definitive testing for ebola, and the difficulty of containing transmission, the only standard of care we will have is that which is given to us by our national health experts. Sadly, no tool is perfect and there will continue to be misses here and there.

I suppose if things get super busy nationwide, outdoor screening tents and temporary screening facilities may be needed, but for now, these screening tools are all we have to work with. We certainly can't admit/observe everyone that "may" have ebola...

 

[Arcan57]

So far Ebola has only gained a foothold in places that have a complete breakdown of public health. It's popped up in other areas but through contact tracing and quarantine it's controlled. It's just that the Guinea, Sierra Leone, and Sierra Leone have essentially no ability to perform the public health services required to stop the outbreak. So I honestly don't see this getting into widespread panic mode absent some mutation that dramatically increases it's Rnaught.

 

[Rendar5]

It's actually quite easy and not worrisome. Ask if they've been out of the country in the last 3 weeks. When they say now or don't mention an Ebola region you're done.

 

[EctopicFetus]

But what if we see a small outbreak in the US?

I just gave a talk on Ebola and it is so hard to diagnose since the symptoms are all so vague until late in the process.

 

[daveyjwin]

But what if we see a small outbreak in the US?

I just gave a talk on Ebola and it is so hard to diagnose since the symptoms are all so vague until late in the process.

That's my concern. I don't mean when it's so easy to screen by asking if they've traveled. I'm talking, if someone nearby may have had it, say at a hospital 50 miles away or something. How are we going to be expected to differentiate this from the Flu? To pick out the Ebola from the Flu Haystack? We can't quarantine everyone with a fever until the CDC gets there.

Also, I just got a work email, apparently, fake Ebola patient's are coming around my state to test our preparedness...

If this get worse in the states, even a little bit, I don't think it's going to be as easy in real life to catch these cases.

 

[Birdstrike]

Show up to work like this:

http://aneeshchaganty.files.wordpress.com/2011/04/outbreak-poster.jpeg