Dr.Linda Girgis,MD, FAAFP


The following Medical Doctors articles found on our website are not written by us, we have asked qualified Doctors, and Scientists to send us articles and information they want us to include on our website.

These opinions are not the opinions of this website, we are just reporting Ebola news and information from doctors and qualified people that wish to have their articles appear on our website.

Ebola Containment : System Failures

by Dr. Linda Girgis,MD, FAAFP





The media was alive today with the news of a second nurse being tested positive for Ebola after providing medical care for the first ever patient diagnosed with this disease in the US. Rumors are swirling while we are being reassured we have nothing to fear and it is being contained. However, it is hard to remain at ease when we hear that this nurse had flown on a commercial flight with 132 other people after notifying the CDC.

So, why did this happen?

The main reason is our inexperience. In the US, we have never had to deal with Ebola. These healthcare workers were thrust into a position of treating something we are just learning about. There were no protocols in place at that time so these healthcare workers were not adequately protected. To be fair, we are facing a new threat that guidelines have had to be developed retrospectively. Casting blame is not going to help us reach a solution to this rising spread of a disease that many of us never expected would show up within our borders. We all need to come together and discuss the faults in the system and ensure this never happens again.
The nurse should have not been allowed to fly. Given her high risk exposure and the fact that she was under watch, she should have been informed not to travel, especially using public transportation. She did take steps to do the right thing by notifying the CDC when she began not feeling well. However, she was given the wrong advice. The ball was clearly dropped here and I doubt anyone would disagree. Now, the task is to find all those she may have exposed.
There also seems to be a lack of adequate communication. The CDC has set up guidelines but they are not reaching the health care workers. Many doctors have received no notifications about what we need to know if we were to find a suspected Ebola case. Also, the local health departments are not stepping up to the task of getting these guidelines to the people who need to know them. Many LHD also do not feel adequately prepared.
Many missteps have been taken in the current Ebola cases. Rather than finding who to blame, we all need to learn from these. Many people are scrambling to get a handle on this and how to contain it. The fact that nurses got infected in the call of duty is a true travesty of the American healthcare system. They are truly heroes for stepping up to the plate in such an uncertain situation and putting themselves at risk.
As Ebola flourishes in West Africa, we all need to have a heightened awareness. We need to ask travel history. And we need to act if we ever suspect a person is infected with Ebola. The most important task is exposing the least amount of people as possible and notifying the proper authorities immediately. While it is easy to fault the ones in charge, it is truly a systems failure. As we all learn in this process, we need to collaborate and fix the system failures.
My thoughts go out to the brave nurses being treated for Ebola.

© 2014, drlindag@gmail.com. All rights reserved.


What Is Ebola?

by  Dr. Linda Girgis,MD, FAAFP



The news is full of the Ebola outbreak in Western Africa. Over 700 hundred people have died from it so far and more than 1300 have been infected. It started in February of this year in Guinea. Healthcare workers from all over are traveling there to try to contain the epidemic and find a way to treat those afflicted. Many fear the spread of the disease. In the early stages, it can mimic other diseases that are common in that region, such as malaria and thus be missed

So, what is Ebola?

  1. It is a virus that infects humans and is transmitted by coming in contact with the bodily fluids of animals who are infected. Fruit bats are considered to be its natural host.
  2. It is also known as hemorrhagic fever and this is the most dangerous aspect of the disease. All patients who are infected with Ebola have some extent of coagulopathy. Bleeding can occur in many sites throughout the body but the most common site is the GI tract.
  3. Symptoms typically start 2 days to 3 weeks after exposure. This is one of the reasons it has been so difficult to contain. People who are infected do not show symptoms right away. Symptoms include fever, headache, muscle and joint pains, sore throat, nausea, vomiting, diarrhea, decreased functioning of the liver and kidneys and eventually bleeding.
  4. Once a human is infected, it can then be spread from person to person through exposure to bodily fluids or blood. Direct contact is required. Many have become infected while preparing a victim’s body for burial.
  5. As stated above, Ebola can mimic other more common diseases, such as malaria, cholera, meningitis and many others. It is important to make a distinction. However, with the current epidemic, Ebola needs to remain high on the differential diagnosis list. The mortality for Ebola can approach 90% for those afflicted. There are several test that can be run on a patient’s blood to confirm the diagnosis. The sample needs to be handled as an extreme biohazard and there have been some healthcare workers who have been infected.
  6. There is no vaccine available to prevent Ebola, although it is being tested.
  7. There is no specific treatment available. Patients require intensive supportive care and fluids to avoid dehydration. Also, careful blood pressure management needs to be maintained.
  8. The best way to prevent spread of this virus is by keeping those infected isolated and quarantined. This is not working in West Africa because people do not have trust in the hospitals and are keeping the sick at home. And the infrastructure of the hospitals there is not so able to keep up with this disease.

Many fear the virus will spread to the U.S. However, this is very unlikely. While theoretically someone infected could travel here, that is very unlikely. Additionally, the CDC has put doctors and hospitals on alert and any patients traveling from that area exhibiting any symptoms will be isolated. Hospitals here are better quipped to handle critical patients.
Will this current outbreak of Ebola has claimed many victims, many heroes have also rose up. Two American healthcare workers who have been infected are being flown home on a private plane to receive treatment in the U.S. They will be placed in isolation so there is very little risk of the virus to be spread. With the aid of these true heroes who are putting their lives at risk, hopefully this current epidemic can be contained and research started on a cure and possibly a vaccine.

© 2014, drlindag@gmail.com. All rights reserved.

The Infectivity of Ebola

by Dr.Linda Girgis,MD, FAAFP



Many people are alarmed with the news of Ebola reaching the US. The media is full of stories of possible other cases and the dangers of this infectious disease. People are scared but this fear is truly displaced. The vast majority of people will never be in the target zone of the infectivity of Ebola. Watching the news seems to tell a different story.
There are many rumors swirling around that there is a possibility that Ebola can be air-borne and thus spread by respiratory droplets, much like the common cold. If this were the case, there would be many more victims in the affected countries that what we have been seeing. Airborne spread of Ebola has not been seen and is simply not true at this point. You are not going to get Ebola just by sitting on a plane with someone who is infected.
Ebola has been shown to be spread only by direct contact with the victim’s bodily fluids. It may seem, thus, that it should be easy to avoid if precautions are taken. However, Ebola patients tend to lose large amounts of bodily fluids through vomiting, blood loss, etc. And it doesn’t take a large amount of viral particles to infect someone. Just a small amount can cause infection. While precautions are now being taken, victims in the countries of origin don’t have the equipment necessary to protect themselves. Even healthcare workers have been infected after minimal exposures. Recently, an American journalist became infected after helping to clean out a car that carried an Ebola victim. A person doesn’t necessarily need to come in contact with the person carrying Ebola, just their bodily fluids.
Patients do not become contagious until they start having symptoms. So, the gentleman who arrived in Dallas and then became ill was not infective to anyone on the same plane that he traveled on to come to the US. He only became ill after being here a few days and that is why all the people he came into contact after showing symptoms are now quarantined. People can carry the Ebola virus for 21 days and that is why the quarantine is for this period of time. If after 21 days from the possible exposure the person doesn’t have any symptoms, it is safe to assume there is no Ebola infection.
Many people in West Africa became infected while taking care of the dead victims. The virus can linger on afterwards. Also, many workers and volunteers contracted the virus from cleaning up afterwards. Precautions need to be taken around anywhere an Ebola victim may have excreted any bodily fluids.
While the media hype continues, few people truly have to fear coming into contact with the Ebola virus. The CDC and other world health agencies are on heightened alert. A recent flight landed in Newark, NJ and held until a sick passenger was cleared of an Ebola diagnosis. Researchers are working in erst to find a cure and/or vaccine. Volunteers are flocking to West Africa to halt the spread and even military units were sent to help in this battle. While most of us can rest assured that we will never be in danger of Ebola, let’s hope those suffering will find relief and the it will be halted in its tracks.

© 2014, drlindag@gmail.com. All rights reserved.

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