The Ebola Threat Grows
Claudewell S. Thomas, MD, MPH, DLFAPA, is an established psychiatrist who is currently retired ,, He received his medical degree in 1956 at SUNY Downstate College of Medicine and specializes in social psychiatry, public health psychiatry, and forensic psychiatry. Dr. Thomas was board certified by the American Board of Psychiatry... more
Ebola is a viral hemorrhagic fever which means it causes severe bleeding in tissues like the gut, lung, brain, kidney, liver, etc. It is a painful and agonizing illness which results in the virtual explosion of cells and a quick death. It is characterized by extreme temperature elevation and sweating. The blood, sweat, tears, saliva, and excreta of the sick are extremely infectious, with contagion or contact spread being the most common pathway.
The Discovery of Ebola
The Ebola virus was discovered in the Democratic Republic of the Congo (DRC) and carries the name of the nearby Ebola river. Of the 5 strains of virus, only one (Reston) is non-African in origin. It is of Philippine origin and comes from a primatology trade where primates are bred and sold to buyers worldwide. This illegal strain is apparently capable of respiratory person to person spread, but so far seems relatively benign.
On July 17th of this year, the World Health Organization declared the outbreak in the DRC and Nigeria a world emergency. The problem has gone beyond the acquisition and consumption of bush meat, having spread to large cities, some of which have airports and populations of millions.
The Spread of Ebola
These sized cities have airports and international travel (Gomo) and the crude screening of temperature and respiration control. However, this cannot stop the transport through airports of sick and carrying Ebola passengers. The CDC's Health Alert Network indicates that Ebola should be considered in patients who present with fever, myalgia (muscle aches), severe headache, vomiting, diarrhea or unexplained or severe bruising. For anyone presenting as above, inquiry must be made as to their recent travel history. Anyone who came in contact with an Ebola affected person needs to be in isolation with a private bathroom, with standard precautions.
Local, county, and state officials need to be notified. Clearly coordinated efforts at all levels must begin quickly while bats may be reservoir of 4 of the 5 strains of African origin. Bats can bite and infect any and virtually all other animals. The fact that most primates become or appear ill doesn't mean that all will; and dogs or cats may become infected without being ill.We need to enable a national system that can swing into action quickly and which can access information from the military about radiation illness survival, etc.
Treatment for Ebola
The widespread use of hyperbaric chambers and elaborate isolation chambers cannot be expected to take place unless planned for. It will be expensive and requires a prior re-identification of the purpose of government to include protection of a vulnerable population. It will also require the cooperation of all levels of government, first nationally and then the cooperation of governments across the world.
While there has been some success with goat 'horse' vaccines, many of those vaccinated have died anyway. We do not know enough about the treatment of this world threat. To expect your local medical department or local emergency room to be able to treat this illness without a massive preparatory effort is unrealistic.
