Ebola: Cause for Concern, But Not for Panic

Dino Rumoro, DO

The worst recorded outbreak of the virulent Ebola virus has killed more than 2000 people in West Africa and is believed to have infected about 4,000 people since it began in March.

So far, the outbreak has been confined to West Africa (primarily Guinea, Liberia and Sierra Leone) and two suspected cases in the U.S. (in Dallas and Washington, DC).

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 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: 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.

(This post was updated on Oct. 3, 2014)

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.