Ebola: Cause for Concern, But Not for Panic

Dino Rumoro, DO

The worst recorded outbreak of the virulent Ebola virus has killed more than 700 people in West Africa, including more than 60 health care workers, and is believed to have infected 1,300 more people since it began in March.

So far, the outbreak has been confined to Guinea, Liberia and Sierra Leone. The U.S. Centers for Disease Control has issued a Level 3 travel warning advising people to avoid nonessential travel to those countries.

Dr. Dino Rumoro, head of the Rush Department of Emergency Medicine, sees little danger to the U.S. from Ebola. He explained why in the following interview.

Q: Are you worried about it Ebola coming here?

Rumoro: There are a lot of diseases that cause us a lot of concern. In the ‘80s, when we saw the emergence of HIV and AIDS, that made us very nervous as well, and we learned how to deal with it. Our experience dealing with other infectious diseases makes us prepared for this disease. This is a disease that we know about in the scientific community, but it’s not native to the United States.

Q: How is Ebola spread?

Rumoro: The key thing to remember with Ebola is that it’s not an airborne virus, so we’re not worried about it being transmitted through the air. We’re worried about contact with bodily fluids like blood, vomit and diarrhea. If those fluids enter another person’s eyes, nose, or mouth, an infection could occur.

Q: Who’s at risk for Ebola?

Rumoro: Anyone who comes in direct contact with body fluids of an infected person is at risk. Health care workers are at higher risk, just because they’re getting in close contact with body fluids. A close family member who may be caring for a patient is at even higher risk than a health care worker, because they don’t have the personal protection we use. Family members, if they’re cleaning up the diarrhea or the blood, they think, ‘it’s part of my job,’ and may ignore the need to protect themselves.

While Ebola is a highly dangerous and infectious disease, we can control it by using blood and body fluid precautions. We want to protect ourselves from any types of secretion. All we really need to do it is wear a face mask with an eye shield, wear gloves, gowns, and boot covers, and we need to wash our hands frequently.

There’s reason to exercise caution, but with the proper equipment, if you follow the rules you’ll be safe. The problem they have in the third world countries is they don’t have the personal protective equipment we have.

Q: Could someone from Africa bring the virus to the U.S.?

Rumoro: Because of global travel, someone could come here and not have symptoms, and two weeks later they could develop symptoms. Because we’re an international community, we have to be aware of it, but it’s not something that should cause panic.

Q: Why not?

Rumoro: With a disease like Ebola, there’s less concern here because of the type of equipment we have and because we have advance notice that it’s out there. Public health is tracking who’s coming here.

If we saw a case pop up in the United States, it would be similar to how we were made aware of the MERS (Middle East Respiratory Syndrome) case that was identified in Indiana, and we were able to control that. We have a very good public health infrastructure. They were able to identify that, isolate it, treat it, I think the same thing would happen.

Q: Ebola is fatal between 60 and 90 percent of the time. What can be done to treat it?

Rumoro: The standard of care is support. Meaning, you’re going to treat the symptoms. One of the end stages is cardiovascular collapse. The blood pressure drops, the patient starts going into cardiac arrest.

Ultimately though, the source of that collapse is the virus, there is no treatment for the virus. So it would be supportive care at this point. We would try to ease the discomfort, try to keep the blood pressure maintained. It appears that the people who die of Ebola virus don’t mount the same immunologic response as the ones who live through it. If you get them through some of those rough points, maybe you give them enough time for a reactive response and they can fight the virus off.

New, Comprehensive, State-of-the-Art Center for Women and Infants to Open at Rush

The New Rush Family Birth Center to Be the City’s Most Advanced Facility for Women’s and Children’s Services

Ivy's Story

Ivy’s Story

The opening of the new Rush Family Birth Center will offer every service related to delivery and caring for a baby on the same floor.

“As part of the Rush Transformation plans that led to our new Tower building, the new Rush Family Birth Center was designed with the mindset of meeting families’ needs and providing patient safety and optimal outcomes,” said Dr. Larry J. Goodman, CEO at Rush.  “We have always provided advanced, quality care that is evidence based.  Now, we have a new facility that matches the type of care we provide mothers and their newborns.”

The new Rush Family Birth Center is located on a single floor at Rush and scheduled to open on March 9.

The space was designed with four key care concepts, which were to provide adjacency, privacy, family space and mother baby bonding. The new center has large, individual rooms to keep moms, babies and families together throughout their journey.

No other hospital in Illinois has located its Neonatal Intensive Care Unit immediately adjacent to labor and delivery to afford newborn infants in distress specialty care in the first minutes of life. Patient safety as well as convenience inspired the design.

“The first 10 minutes of life are critical to newborns who come into the world in distress,” said Dr. Robert Kimura, neonatologist at Rush.  “Because of the way we designed these new facilities, babies that need special care can be put in the hands of neonatal medicine intensive care specialists within seconds after delivery.

“At Rush, the birthing suites and operating rooms are right next to the NICU resuscitation room, so that a team of specialists can immediately and optimally care for babies in crisis,” said Kimura.

The antepartum rooms also are near labor and delivery, so in urgent situations women and their babies can promptly get the care they need.

Keeping services close and right next door to each other limits how far and how often babies need to move, which helps limit their risk of infection and reduces exposure to light and sound to help with the baby’s development.

For more information about the new Rush Family Birth Center, visit Rush Transformation.

 Read the Discover Rush story.

 Read the entire news release.

 

Preparing for Potential Surge of Lolla Drug Cases

With festival goers gearing up for Lollapalooza, emergency physicians at the Center for Advanced Emergency Response at Rush University Medical Center are preparing for potential cases being brought to the ER.

The Chicago Department of Public Health reported nearly 250 ambulance runs from Lollapalooza last year, a majority of which were drug-related. Rush emergency physicians are warning of a growing trend involving the use of hallucinogenic amphetamines such as Ecstasy or Molly at summer concerts and festivals.

Use of these drugs may result in hallucinations, increased heart rate, increased blood pressure, nausea, vomiting, agitation and seizures. In severe cases, users may experience an elevated body temperature, kidney or liver failure, uncontrolled bleeding, coma or possibly death.

“Taking these drugs in the heat can increase the possibility of dehydration and can contribute to very high body temperatures which can be life-threatening,” said Dr. Edward Ward, medical director of emergency services at Rush.

Sudden Decline in Testosterone May Cause Parkinson’s Disease Symptoms in Men

The results of a new study by neurological researchers at Rush University Medical Center show that a sudden decrease of testosterone, the male sex hormone, may cause Parkinson’s like symptoms in male mice.  The findings were recently published in the Journal of Biological Chemistry.

One of the major roadblocks for discovering drugs against Parkinson’s disease is the unavailability of a reliable animal model for this disease.

“While scientists use different toxins and a number of complex genetic approaches to model Parkinson’s disease in mice, we have found that the sudden drop in the levels of testosterone following castration is sufficient to cause persistent Parkinson’s like pathology and symptoms in male mice,” said Dr. Kalipada Pahan, lead author of the study and the Floyd A. Davis endowed professor of neurology at Rush. “We found that the supplementation of testosterone in the form of 5-alpha dihydrotestosterone (DHT) pellets reverses Parkinson’s pathology in male mice.”“In men, testosterone levels are intimately coupled to many disease processes,” said Pahan.  Typically, in healthy males, testosterone level is the maximum in the mid-30s, which then drop about one percent each year. However, testosterone levels may dip drastically due to stress or sudden turn of other life events, which may make somebody more vulnerable to Parkinson’s disease.

“Therefore, preservation of testosterone in males may be an important step to become resistant to Parkinson’s disease,” said Pahan.

Read the entire news release.

Does Being a Bookworm Boost Your Brainpower in Old Age?

Neurological researchers at Rush Alzheimer’s Disease Center at Rush University Medical Center have found that brain-stimulating activities such as reading books and writing at any age may preserve memory.

The study recently was published in a recent online issue of Neurology, a publication of the American Academy of Neurology.

“Our study suggests that exercising your brain by taking part in these activities is important across a person’s lifetime, from infancy through old age,” said Robert S. Wilson, PhD, the lead author of the study and neuropsychologist at the Rush Alzheimer’s Disease Center.

For the study, 294 people were given tests that measured memory and thinking every year for about six years before their deaths at an average age of 89. They also answered a questionnaire about whether they read books, wrote and participated in other mentally stimulating activities during childhood, adolescence, middle age and at their current age.

After they died, their brains were examined at autopsy for evidence of the physical signs of dementia, such as lesions, brain plaques and tangles.

The research found that people who participated in mentally stimulating activities both early and late in life had a slower rate of decline in memory compared to those who did not participate in such activities across their lifetime, after adjusting for differing levels of plaques and tangles in the brain. Mental activity accounted for nearly 15 percent of the difference in decline beyond what is explained by plaques and tangles in the brain.

Read the entire news release.

MRSA Study Slashes Deadly Infections in Sickest Hospital Patients

Dr. Mary K. HaydenUsing germ-killing soap and ointment on all intensive care unit patients can reduce bloodstream infections by up to 44 percent and significantly reduce the presence of methicillin-resistant Staphylococcus aureus (MRSA) in ICUs, according study results published in today’s New England Journal of Medicine.

The REDUCE MRSA trial, funded by the Department of Health and Human Services, was conducted in two stages from 2009-2011. It tested three MRSA prevention strategies and found that using germ-killing soap and ointment on all ICU patients was more effective than other strategies.

“The strategy that proved to be most effective was perhaps the most straightforward: All patients were bathed daily with chlorhexidine antiseptic soap for the duration of their ICU stay and all received mupirocin antibiotic ointment applied in the nose for five days,” said Dr. Mary K. Hayden, associate professor of infectious diseases and pathology at Rush University Medical Center, and one of the co-authors of the study.

Read the entire news release.

Neurologists at Rush Working to Discover New Biomarkers for Parkinson’s Disease

Jennifer_GoldmanRush University Medical Center has been named one of only five clinical sites in the U.S. to lead a landmark, two-year, multi-site study exclusively focused on discovering new biomarkers for Parkinson’s disease.     

“The discovery of a biomarker is critical to the development of new and improved treatments for Parkinson’s disease, particularly treatments that could slow or stop the progression of the disease, which is something currently not available,” said Dr. Jennifer G. Goldman, neurologist in the Parkinson’s Disease and Movement Disorders Center at Rush.  Goldman is also an associate professor in the Department of Neurological Sciences at Rush.

This study, called BioFIND, aims to identify new biomarker candidates, which are substances or characteristics found in people’s bodies that are associated with the presence of disease or changes over time in a way that can be linked back to the progression of disease.

The BioFIND study will complement the Parkinson’s Progression Markers Initiative (PPMI), another observational clinical study to comprehensively evaluate a cohort of recently diagnosed PD patients and healthy subjects using advanced imaging, biologic sampling and clinical and behavioral assessments to identify biomarkers of Parkinson’s disease progression.

“The data we collect from the BioFIND study along with the data from PPMI will produce the most comprehensive and long-ranging dataset available for biomarker discovery work throughout the Parkinson’s disease community,” said Goldman.

Read the entire news release.