“West Africa is in the midst of the worst Ebola outbreak in history. The Centers for Disease Control and Prevention estimates that some 9,000 people have contracted the disease so far. Heath officials put the death toll at around 4,500, meaning that one in two people who get Ebola in this outbreak die.”
CNN World http://www.cnn.com/2014/10/19/world/africa/west-africa-ebola-outbreak/index.html?hpt=hp_t1
WASHINGTON —
Rising concern over a possible global outbreak of Ebola, especially in the wake of the new cases in Spain and the U.S., is putting investors on edge and has begun affecting the global economy.
The disease will likely prove a long-term drag on the African economy. Ebola’s two-year financial impact could reach $32.6 billion by the end of 2015 in West Africa alone, World Bank President Jim Yong Kim said Thursday.
Expectations that global travel will slow sent airline stocks down in the U.S. market Monday. The government has begun screening travelers from West Africa at major airports.
“In my 30 years in public health, the only thing that has been like this is AIDS,” said Thomas Frieden, director of the U.S. Centers for Disease Control, at a World Bank conference.
News broke Sunday that a nurse at a Texas hospital contracted Ebola from a Liberian man who died there. She was the second patient to catch the disease outside West Africa, after a Spanish nurse who treated sick missionaries in Madrid.
A United Nations worker transported from Liberia to Leipzig in eastern Germany also died there Tuesday, according to German media.
World Health Organization Assistant Director-General Bruce Aylward told reporters Tuesday that 5,000 to 10,000 people could be catching the deadly disease every week by the start of December. Currently, about 1,000 new cases of Ebola emerge each week.
Aylward also revealed the latest numbers: an estimated 8,914 cases and a death toll of 4,447.
But the actual figures could be much higher. The CDC sees the total number of cases possibly swelling to as many as 1.4 million by January.
Although developed countries are sending more aid to help contain Ebola, many of the affected West African nations lack the capability to use it. Protective gear and other medical equipment sent from the U.S. apparently sat at a Sierra Leone port since August, according to The New York Times.
Some also warn that neighboring countries that have not officially reported any Ebola cases in fact already have patients. Nigeria, Africa’s most populous nation, has many direct flights to and from the U.S., Europe and Asia. There are concerns that the disease could slip under the radar in these countries and spread to the rest of the world.
So unfortunately this maybe the case but that should also make our government in America to take harder and stricter actions in rules and regulations on people entering the U.S. being checked from countries with the risk or history of having diseases that could be carried in this country for if we had these already in place this Ebola wouldn’t be at the level is in America . We are lucky in America with less than 5 cases in America of Ebola this past year and presently now just 2 RN’s with a active Ebola diagnosis that we are aware of in America. We need to help America contain this disease and prevent further spreads of Eboli in the country.
What is your opinion your word counts; write it under comment.
Stated by an official on CNN today “I am not going to question the President” with hesitancy but yet states he has “concerns” he stated in wondering “why he has no science or medical background”.
Rep. Bill Johnson stated on CNN Friday 10/17/14.
Responding to growing calls to appoint an “Ebola Czar” to lead America’s battle against the deadly virus, sources confirm to Fox News that President Obama plans to name Ron Klain, a longtime political hand with no apparent medical or health care background. “Appointed by our President Barack Obama is former White House official Ron Klain to coordinate the U.S. government’s response to the Ebola outbreak, an administration official said on Friday. He is an attorney, comes to the job with strong management credentials, extensive federal government experience overseeing complex operations and good working relationships with leading members of Congress, as well as senior Obama administration officials, including the president,” the official said to fox news.com. What is a czar? This word by definition, is any person exercising great authority or power in a particular field. This man has no medical background, not even a license as an M.D. just working as even a general practitioner in a clinic, who does understand all diseases in general. Wouldn’t you want someone with some type of medical background in charge since he carries the role in giving primary guidance on health issues to our President, which helps him in making the final direction we should take in America regarding health issues withespecially those that can become an epidemic. If this czar makes the wrong presumption and our President agrees this could be a problem for our country’s future health. This decision he makes is for all people who are citizens in America and even visitors in the country regarding what is best for them in protecting their health the best way possible.? I would be concerned with this man only due to his lack of any medical background since the job entails decision making on health issues that regards our safety and future. Isn’t this bizarre to you or at least don’t you question why this man is not a MD or biologist or scientist or something in science research? I could understand if our President gave this role to Mr. Ron Klain with a science major as a doctor, biologist, scientist or someone with a lot of disease research knowledge experience working with him but so far no one in media or the President himself has not mentioned that this is the case. You already have officials mentioning this concern with the media with no one else defending or favoring the czar decision by our President. We don’t even have a Surgeon General in place. The President of the United States chooses who the Surgeon General will be and our President has still not made a decision who takes on this role at this present time. The Surgeon General is the operational head of the U.S. Public Health Service Commissioned in the federal government and thus the leading spokesperson on matter of public heath in the federal government of the U.S. for 4 years, when hired. This person reports to the Assistant Secretary of Health, who may be a 4 star general in the United States Public Health Service, Commissioned Corps. and who serves as the PRINCIPLE advisor to the secretary of heath and scientific issues but we don’t have one chosen yet by our President. Such a vital position for our country to be safe regarding American citizens health on a daily basis. Is this decision by our President logical for protecting and keeping health in the U.S. safe? Is this logical? Rep. Bill Johnson stated on CNN today “I am not going to question the President” with hesitancy but yet states he has “concerns” he stated in wondering “why he has no science or medical background”. Do you not have confidence in the CDC? he was asked by CNN today this morning and he even responded “Absolutely not, and the CDC found this out in March but we have no resolution yet. They don’t know how this spread went to 2 coworkers in the same hospital.” Do you feel safe? I am concerned. Do you find this scary living in the U.S.? I have my concerns not that I am moving out of the country or locking myself up in my house, like a paranoia case but this situation means we need to CONTAIN this situation with proper PREVENTION of this disease before ever becoming an epidemic. Go under comment and give your opinion; your thoughts matter especially if America is your home and even if you visit the U.S. We have 2 RN’s already in hospitals with this and one person deceased in America that did visit Africa coming home to the U.S. with this terrible virus. Remember the hospital follows CDC in rules and regulations they make which goes national. Is our government doing enough. The CDC website in http://www.cdc.gov/.
Today Saturday10/18/14 on CNN.com interviewed was Maria Cordona, asked what do you think about this situation? She responded “This is just a way to pick on the President and it’s a good idea to have someone who knows how to run a campaign.” What intelligence to you see in that reply that deals with the “Ebola Czar”, a possible health epidemic.
Now Amy Holmes interviewed also on CNN.com asked about her opinion; she responded “This is not the best choice, you have a man with no health background and he is involved in the health of others.” She also stated “There were other choicex for the President that were more suitable for this job.” So the gist of it was she felt that a experienced medical professional would be the most intelligent choice.
What is your opinion?
“The current outbreak in West Africa, (first cases notified in March 2014), is the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976. There have been more cases and deaths in this outbreak than all others combined.”
CDC (Center for disease control and prevention)
Responding to growing calls to appoint an “Ebola czar” to lead America’s battle against the deadly virus, sources confirm to Fox News that President Obama plans to name Ron Klain, a longtime political hand with no apparent medical or health care background.
“Appointed by our President Barack Obama is former White House official Ron Klain to coordinate the U.S. government’s response to the Ebola outbreak, an administration official said on Friday. He is an attorney, comes to the job with strong management credentials, extensive federal government experience overseeing complex operations and good working relationships with leading members of Congress, as well as senior Obama administration officials, including the president,” the official said to fox news.com.
What is a czar? This word by definition, is any person exercising great authority or power in a particular field. This man has no medical background, not even a license as M.D. working as even a general practitioner who understands all diseases in general. Wouldn’t you want someone with medical background who decides for our US guiding our President in what to do with medical diseases, and who makes the decision in what is best to protect our country by giving the President what proper direction to go towards? I would.
Isn’t this bizarre to you or at least don’t you question why this man is not a biology major, or a scientist, or a M.D. or something in science research?
I could understand if our President gave this role to Mr. Ron Klain with a science major as a doctor, biologist, scientist or someone with a lot of disease research knowledge experience working with him but so far no one in media or the President himself has not mentioned that this is the case. You already have officials mentioning this concern with the media with no one defending it that favors the czar decision by our President. We don’t even have a general surgeon in place, our President has still has not made a decision who takes on this role at this present time.
The surgeon general is the operational head of the U.S. Public Health Service Commissioned in the federal government and thus the leading spokesperson on matter of public heath in the federal government of the U.S. for 4 years, when hired. This person reports to the Assistant Secretary of Health, who may be a 4 star general in the United States Public Health Service, Commissioned Corps. and who serves as the PRINCIPLE advisor to the secretary of heath and scientific issues but we don’t have one chosen yet by our President. Such a vital position for our country to be safe regarding American citizens health on a daily basis. Is this decision by our President logical for protecting and keeping health in the U.S. safe? Is this logical?
Rep. Bill Johnson stated on CNN today “I am not going to question the President” with hesitancy but yet states he has “concerns” he stated in wondering “why he has no science or medical background”. I personally heard it on CNN straight from his mouth not someone else’s.
Do you not have confidence in the CDC? he was asked by CNN today this morning and he even responded “Absolutely not, and the CDC found this out in March but we have no resolution yet. They don’t know how this spread went to 2 coworkers in the same hospital.”
Do you feel safe? I am concerned.
Do you find this scary living in the U.S.? I have my concerns not that I am moving out of the country or locking myself up in my house, like a paranoia case but this situation means we need to CONTAIN this situation with proper PREVENTION of this disease before ever becoming an epidemic.
Go under comment and give your opinion; your thoughts matter especially if America is your home and even if you visit the U.S.
According to the Center for Disease Control (CDC )the 2014 Ebola epidemic is the largest in history, affecting in West Africa. One imported case from Liberia and associated locally acquired cases in healthcare workers have been documented. CDC and partners are taking precautions to prevent the further spread of Ebola within the United States. We should have taken action with making limitations a long time ago but again our government seems to worry about other countries more than our own or else we would not have this potential epidemic. Look at what is finally being doing in airports at least in New York regarding visitors coming from Africa, they are being checked for disease in someway, that should have started years ago with the increase or population into our country from people unfortunately in other countries with more disease due to less protection or action due to their economy and what they can afford. Yet, in the end our government needs to protect us the US citizens and have a regulation much more tighter than it was if US citizens for whatever the reason is leaving this country to other countries for business (EX. News Report Employees.) or vacation is allowed; which it has been going on for ages. The key factor like to almost any disease or infection in or out of hospitals is: Prevention!
One major way in prevention is MSF (Médecins Sans Frontières) health staff in protective clothing constructing perimeter for isolation ward.
***The Ebola virus causes an acute, serious illness which is often fatal if untreated. Ebola virus disease (EVD) first appeared in 1976 in 2 simultaneous outbreaks, one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name.
The current outbreak in West Africa, (first cases notified in March 2014), is the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976. There have been more cases and deaths in this outbreak than all others combined. It has also spread between countries starting in Guinea then spreading across land borders to Sierra Leone and Liberia, by air (1 traveller only) to Nigeria, and by land (1 traveller) to Senegal. God willing we do something fast enough with all the medical technology we have in America and fine a way to control it in our own country; we came through in controlling the flu and so many other epidemics.
The most severely affected countries, Guinea, Sierra Leone and Liberia have very weak health systems, lacking human and infrastructural resources, having only recently emerged from long periods of conflict and instability. On August 8, the WHO Director-General declared this outbreak a Public Health Emergency of International Concern. Well the US better do something fast to prevent both me and many others in this home land to keep us safe. By the way I am RN 26 years and this topic Ebola concerns me terribly.
PRESENTLY NOW according to the CDC this is the case with Ebola since this past Monday, “there are about 8,900 cases of Ebola infection worldwide with almost 4,500 deaths as of this week. And, the World Health Organization announced on Monday that we may see 10,000 new cases per week by December. Yes, that headline-making virus has now also made its way to the U.S. But, no, you will still probably not get it. Here’s what we know, and what you need to know about today’s Ebola situation.” There is no treatment reinforced by Dr. Anthony Fauci asked today on CNN live at 1045 this morning; one of the MD’s treating Nina Pham the RN infected by Ebola in Dallas who was transferred to another hospital for treatment. He also stated that Ebola “is an unpredictable situation, he will follow the direction of the US President, there is no information to support that this is airborne contaminating, but for safety the staff is also using face masks with regular contact isolation equipment with remaining still on contact isolation”. The government pays 4.2 million dollars a year to run this hospital hopefully this will save the patient with this money. He also stated, “It would be unusual for a patient with Ebola not to worry about Ebola.” just like us in America hearing all this information. CNN states “the reason this hospital is so special for the patient Nina Pham is they have bio-containment rooms to prevent spreading the disease.”
Transmissiono of Ebola:
It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest that picked up this virus.
Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.
Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced or taught to the medical workers through detailed and concise information with written instructions, proper demonstration, with most important follow up by health care worker superiors like managers to nursing education depts.
For further information on this go to my reference http://www.who.int/mediacentre/factsheets/fs103/en/The World Health Organization. *** There is no FDA-approved vaccine available for Ebola, unfortunately but like most after damage occurs in enough quantities (which is the case) in time most diseases come up with one regarding the many over the few diseases we haven’t seem to have invented yet. So the key for this disease right now is PREVENTION of it.
Keep in mind, through the CDC, we are in the U.S. working on a treatment. Let us take a look.
“Experimental vaccines and treatments for Ebola are under development, but they have not yet been fully tested for safety or effectiveness.
Recovery from Ebola depends on good supportive care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years, possibly longer. It isn’t known if people who recover are immune for life or if they can become infected with a different species of Ebola. Some people who have recovered from Ebola have developed long-term complications, such as joint and vision problems.”
Check out part 2 on EBOLA with more information you should know about this weekend and Monday!
“Vertigo is the conflict between the fear of falling and the desire to fall.“
“My father has positional vertigo, and if he flies he gets really dizzy, so he has to drive out to California, which he does a couple times a year. We talk, but we e-mail mostly.”
Causes of BPPV;
Timothy C. Hain MD of dizziness and balance.com states The most common cause of BPPV in people under age 50 is head injury . The head injury need not be that direct – -even whiplash injuries have a substantial incidence of BPPV (Dispenza et al, 2011). There is also a strong association with migraine (Ishiyama et al, 2000). BPPV becomes much more common with advancing age (Froeling et al, 1991) and in older people, the most common cause is degeneration of the vestibular system of the inner ear. Viruses affecting the ear such as those causing vestibular neuritis and Meniere’s disease are significant causes(Batatsouras et al, 2012).
Occasionally BPPV follows surgery, including dental work, where the cause is felt to be a combination of a prolonged period of supine positioning, or ear trauma when the surgery is to the inner ear (Atacan et al 2001). While gentamicin toxicity is rarely encountered, BPPV is common in persons who have been treated with ototoxic medications such as gentamicin (Black et al, 2004). In half of all cases, BPPV is called “idiopathic,” which means it occurs for no known reason. Other causes of positional symptoms are discussed here.
Web MD points out tiny calcium “stones” inside your inner ear canals help you keep your balance. Normally when you move a certain way, such as when you stand up or turn your head, these stones move around. But things like infection or inflammation can stop the stones from moving as they should. This unfortunately sends a false message to your brain and causes the vertigo. About half the time, doctors can’t find a specific cause for BPPV.
When a cause can be determined, BPPV is often associated with a minor to severe blow to your head. Less common causes of BPPV include disorders that damage your inner ear or, rarely, damage that occurs during ear surgery or during prolonged positioning on your back. BPPV also has been associated with migraines. In many cases the doctors can’t figure out the cause.
Inside your ear is a tiny organ called the vestibular labyrinth. It includes three loop-shaped structures (semicircular canals) that contain fluid and fine, hair-like sensors that monitor the rotation of your head.
Other structures (otolith organs) in your ear monitor movements of your head — up and down, right and left, back and forth — and your head’s position related to gravity. These otolith organs — the utricle and saccule — contain crystals that make you sensitive to gravity.
For a variety of reasons, these crystals can become dislodged. When they become dislodged, they can move into one of the semicircular canals — especially while you’re lying down. This causes the semicircular canal to become sensitive to head position changes it would normally not respond to. As a result, you feel dizzy. Depending what section of the semicircular canal the problem is in will be a factor with the actual result on the crystals or rocks flowing freely or become stuck together causing a blockage in one of the canals. The other factor that determines this is the etiology for it occuring (ex. Dehydration or blow to the head).
Complications of BPPV:
Benign paroxysmal positional vertigo occurs most often in people age 60 and older, but can occur at any age. Aside from aging, there are no definite factors that may increase your risk of benign paroxysmal positional vertigo. However, a head injury or any other disorder of the balance organs of your ear may make you more susceptible to BPPV.
Although benign paroxysmal positional vertigo (BPPV) is uncomfortable, it rarely causes complications. In rare cases, if severe, persistent BPPV causes you to vomit frequently, you may be at risk of dehydration. The dizziness of BPPV can put you at greater risk of falling. It is more of a headache in going through the time to resolve the vertigo possibly affecting people in doing their regular activities of living for a week to several weeks. For some it never comes back but for many it does after several months depending on what the cause is.
TREATMENT
In all cases the doctor first has the patient (pt.) in their office and either through them or through physical therapy ordered by the M.D. after evaluating the pt with diagnosing the pt. with BPPV in treating the pt. using exercises which help in high percentages resolving the vertigo but continuing them when the vertigo is gone will do very little help unfortunately including it commonly comes back several weeks to months later and the exercises help more than. These exercises used are:
There are two treatments of BPPV that are usually performed in the doctor’s office. Both treatments are very effective, with roughly an 80% cure rate, ( Herdman et al, 1993; Helminski et al, 2010). If your doctor is unfamiliar with these treatments, you can find a list of clinicians who have indicated that they are familiar with the maneuver from the Vestibular Disorders Association (VEDA) .
The maneuvers, named after their inventors, are both intended to move debris or “ear rocks” out of the sensitive part of the ear (posterior canal) to a less sensitive location. Each maneuver takes about 15 minutes to complete. The Semont maneuver (also called the “liberatory” maneuver) involves a procedure whereby the patient is rapidly moved from lying on one side to lying on the other (Levrat et al, 2003). It is a brisk maneuver that is not currently favored in the United States, but it is 90% effective after 4 treatment sessions. In our opinion, it is equivalent to the Epley maneuver as the head orientation with respect to gravity is very similar, omitting only ‘C’ from the figure to the right.
The Epley maneuver is also called the particle repositioning or canalith repositioning procedure. It was invented by Dr. John Epley, and is illustrated in figure 2. Click here for a low bandwidth animation. It involves sequential movement of the head into four positions, staying in each position for roughly 30 seconds. The recurrence rate for BPPV after these maneuvers is about 30 percent at one year, and in some instances a second treatment may be necessary.
When performing the Epley maneuver, caution is advised should neurological symptoms (for example, weakness, numbness, visual changes other than vertigo) occur. Occasionally such symptoms are caused by compression of the vertebral arteries (Sakaguchi et al, 2003), and if one persists for a long time, a stroke could occur. If the exercises are being performed without medical supervision, we advise stopping the exercises and consulting a physician. If the exercises are being supervised, given that the diagnosis of BPPV is well established, in most cases we modify the maneuver so that the positions are attained with body movements rather than head movements.
After either of these maneuvers, you should be prepared to follow the instructions of your doctor or physical therapist who should give you written instructions on them to take home with you, which are aimed at reducing the chance that debris might fall back into the sensitive back part of the ear. Not always the case.
A doctor who sees you for symptoms common to BPPV may ask a number of questions, such as:
Stayed tune for Part 3 on Surgery as a last resort treatment and types of hospitals in NY that are rated high for this diagnosis in getting treated tomorrow Wednesday. Don’t stop reading the articles to this blog!