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GCH Fieldwork: Ebola












Ebola: A Brief
by Nicole Kraatz

Ebola virus disease has become a hot topic in recent health related news around the world. With the current reemergence of the disease in four West African countries, many are beginning to wonder what the disease is capable of and where it comes from. Ebola virus was first discovered in 1976 during two simultaneous outbreaks in Sudan and the Democratic Republic of Congo. Since then, outbreaks of Ebola have appeared sporadically throughout time, occurring mainly in African countries. Although researchers do not know the natural reservoir of the ebola virus, it has been predicted that the first human infection came from coming in contact with an infected animal.

There are a few ways in which a person can become infected with the ebola virus. The virus is spread by direct contact. This happens when the infected patient’s bodily fluids, such as urine, saliva, feces, vomit, semen, or blood, come in contact with broken skin or mucous membranes of healthy people. Because of this, health care workers dealing with those infected as well as the family and friends of a patient can be easily at risk of exposure to the disease. Infected blood or bodily fluids can also be spread through needles or coming in contact with infected animals.

Ebola virus can be difficult to diagnose because many of the initial signs and symptoms are non-specific. The typical incubation period from the time of infection to the onset of symptoms is 2-21 days. Because ebola virus is a severe acute viral illness, symptoms of infection include onset of high fever, fatigue, muscle pain or sore throat. As the disease progresses, symptoms range from vomiting and diarrhea to decreased kidney function and both internal and external bleeding. Since there is no vaccine or cure for Ebola, symptoms are treated as they appear in order to help the chances of survival. Some of the treatment methods include IV fluids, electrolyte balance and maintaing oxygen and blood pressure.

Because the method of human infection is still unclear to researchers, there are limited ways of preventing the spread of Ebola. However, health care workers and those in contact with infected persons can prevent the spread of disease by wearing the correct protective clothing. It is also important to isolate infected patients and to make sure that infection control measures are being utilized and properly monitored according to the guidelines set forth by the Centers for Disease Control and Prevention and World Health Organization.

Ebola: A Presentation
by Nicole Kraatz

(Click on the image for a Prezi short on Nicole Kraatz's presentation)


Ebola in West Africa
by Hamza Ijaz

Ebola Paper.pdf (PDF — 183 KB)

Ebola: A Global Health Crisis

by Nicole Kraatz


Ebola Term Paper.pdf (PDF — 151 KB)






Creating Health-Orientated Protocols for Ebola
By Jason Zheng

From September to December 2014, the American citizens suffered from an Ebola scare which came from Dallas, Texas. The primary patient was Thomas Eric Duncan who left Monrovia, Liberia for a trip to Dallas, Texas to visit his family members. Duncan was exposed to Ebola but he did not exhibit symptoms, which made him not contagious. It is still unclear whether or not he had knowledge that he was exposed.

When Duncan arrived in Dallas, Texas he became sick and admitted to the Texas Health Presbyterian Hospital Dallas on September 26, which he was sent back home with antibiotics. Two days later Duncan was transported to the hospital by ambulance and was confirmed that he came in contact with Ebola. Nurses Nina Pham and Amber Vinson treated Duncan’s illness and contacted Ebola. Duncan died during the treatment process, but nurses Pham and Vinson made a full recovery.

It can also be said that one of the reason why the United States did not have a set protocol of dealing with Ebola because guidelines for treating patients were “constantly changing”. However, union members from National Nurses United developed different claims to argue that regardless of the missing protocols for dealing with Ebola, it was carelessness that allowed the virus to spread.

The first claim is how the patient Duncan was not immediately isolated. The nurse union co-president Deborah Burger stated that “he [Duncan] was ‘left for several hours, not in isolation, in an area where other patients were present’”. About seven patients were present where Duncan was held. As well, a nursing supervisor faced resistance from the hospital authorities when the supervisor demanded Duncan to be move to an isolation unit. 

The second claim is how nurses found their necks to be exposed while wearing protective gears. A simple fix was to wrap their necks with medical tape with four to five pieces of the tape. Nurses did express discouragement because they were concerned on how difficult it would be peeling the tape away from their neck.

The third claim is where the hazardous materials piled up, which no one cared to solve this issue nor did they have access to proper supplies.
The fourth claim is how there was “no hands-on training’. There was no mandate that all nurses had to attend an Ebola seminar. Even though the nurses did receive an e-mail about the seminar, the hospital treated as a “voluntarily seminar” offered to staff.

The fifth claim is how authorities shifted blames to Nurses like Pham and Vinson for being contacted with Ebola for not following protocols. The problem was there was no protocols to follow in the first place.
All of these arguments and/or claims from the unions of Nurses successfully illustrate the hospital’s lack of attention for safety to their staff and patients. Nonetheless, the amount of denial the Texas Health Presbyterian Hospital is in, authorities blame their staff for their actions of not providing a safe operable medical environment. 

There are two known institutions in the United States that are capable of treating the Ebola virus.  The National Institutes of Health located in Bethesda, Maryland and Emory University Hospital in Atlanta, Georgia, treated Nurses Pham and Vinson respectively. Emory Healthcare has a drafted set of protocols to deal with Ebola, which will be generously analyzed in the following paragraph.

The Emory Healthcare Ebola Preparedness Protocols is an 84 pages manual that provides the necessary protocols and education that I believe all health institutions should follow. The manual is broken down into individual parts, then following with visuals. A sample table of content is provided by the Emory University to depict how an ideal set of medical protocols should be:

      I.          Overview
a.      Purpose
b.     Commitment
c.      Assumptions
d.     Risk Assessment
e.      Specimen Management & Laboratory Protocol for High-Risk Testing
f.      Education
g.     Occupational Health
 
   II.          Special Communicable Diseases Unit
a.      SCDU Background
b.     Staffing
c.      Operational Protocols
d.     Protocol for Activation of the Unit
e.      Protocol for Biosafety Transport Team
f.      Infection Control Policy

This manual is then followed by graphical illustrations that accompanies the prior treatment, laboratory testing, and post treatment of patients with Ebola. Overall a very well assembled report that should be read by people that are interested in Ebola.

Ebola should be properly treated just like any viral infection. Even though there were no known Ebola protocols in United States, this caused a nationwide scare because of the lack of knowledge. However now that we have sets of protocols to follow for treating Ebola thanks to Emory Healthcare, we should continue to work to improve treatments for Ebola.   
Another factor to consider is the readjustment of the protocols in medical institutions. Educative seminars should be made mandatory because the degree of an illness occurring is complete random.


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