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Dallas Ebola Patient Thomas Eric Duncan Dies

Wed October 08 2014 10:21 am  http://www.arlingtoncardinal.com/?p=71400
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Thomas Eric Duncan, the first patient to be diagnosed with Ebola has died Wednesday morning. Ebola patient Thomas Eric Duncan’s condition was downgraded to critical from serious on Saturday October 4, 2014.

His case is believed to be the first case diagnosed outside of Africa of this strain of Ebola.

Ebola patients were treated in the United States for the first time recently, and the victims contracted Ebola in West Africa. Ebola has killed 2,917 people and infected 3,346 others since the outbreak began in March 2014. This is the first time that Ebola

Thomas Eric Duncan arrived at Texas Health Presbyterian Hospital Dallas on Sunday with possible Ebola symptoms and a history of recent travel to West Africa. The patient was being kept in isolation until the CDC could confirm the diagnosis.

The patient arrived in the United States on Saturday, September 20, 2014 on a flight that departed Liberia on Friday, September 19, 2014. He was not known to be involved in the United States response to Ebola.

The patient began having symptoms on Wednesday, September 24, 2014.

On Friday, September 26, 2014 the patient sought care.

He was admitted on Sunday, September 28, 2014. The patient was reported to be critically ill and in Intensive Care Unit isolation.

Officials played down the potential for exposure on the aircraft that arrived on Saturday, September 20, 2014.

According to WHO (World Health Organization)
The incubation period for Ebola, that is, the time interval from infection with the virus to onset of symptoms is 2 to 21 days. Humans are not infectious until they develop symptoms. First symptoms are the sudden onset of fever fatigue, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g. oozing from the gums, blood in the stools). Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

Diagnosis

It can be difficult to distinguish Ebola Virus Disease (EVD) from other infectious diseases such as malaria, typhoid fever and meningitis. Confirmation that symptoms are caused by Ebola virus infection are made using the following investigations:

• antibody-capture enzyme-linked immunosorbent assay (ELISA)
• antigen-capture detection tests
• serum neutralization test
• reverse transcriptase polymerase chain reaction (RT-PCR) assay
electron microscopy
• virus isolation by cell culture.
• Samples from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions.

Treatment and vaccines

Supportive care-rehydration with oral or intravenous fluids- and treatment of specific symptoms, improves survival. There is as yet no proven treatment available for EVD. However, a range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated. No licensed vaccines are available yet, but 2 potential vaccines are undergoing human safety testing.

Prevention and control

Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation. Community engagement is key to successfully controlling outbreaks. Raising awareness of risk factors for Ebola infection and protective measures that individuals can take is an effective way to reduce human transmission. Risk reduction messaging should focus on several factors:

Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
Reducing the risk of human-to-human transmission from direct or close contact with people with Ebola symptoms, particularly with their bodily fluids. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home. Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.
Outbreak containment measures including prompt and safe burial of the dead, identifying people who may have been in contact with someone infected with Ebola, monitoring the health of contacts for 21 days, the importance of separating the healthy from the sick to prevent further spread, the importance of good hygiene and maintaining a clean environment.

See also …
WHO Ebola Virus Disease Fact Sheet


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