Morning Rounds; The Ebola Virus Is Scary But That Doesn't Mean We Should Be Fearful
Thursday, November 20, 2014 5:37 AM
The Ebola virus scares me. How could it not? It is not highly contagious, but it is highly infectious, and it is fatal 25 to 90 percent of the time.
Like everyone else, I read articles about Ebola in our local papers as well as newspapers like the New York Times and the Wall Street Journal. Unlike most other people, I also spend a great deal of time reading information from the U.S. Centers for Disease Control and Prevention (CDC) and from experts on infectious disease and health service delivery. We are all scrambling to be as prepared as possible for any patient who might arrive on our doorstep with a condition that would put our caregivers at risk of dying.
This type of calling is not unique to health care. Soldiers, firemen and police officers all commit to their vocation with the full understanding that they will be called upon to put their lives at risk in order to help save another person.
Commercial fishermen, steelworkers and farmers all go about their day-to-day work understanding that their livelihood puts them at risk of dying.
I clearly recall my first experiences being frightened caring for a patient with a lethal infectious disease. In the mid-1980s, there was a new, poorly understood illness that began to affect homosexual men and people who abused intravenous drugs. The virus causing the illness was identified in 1983 and was first called HTLV III. We soon came to understand the infection, which at that time was uniformly fatal, could be transmitted by injections with contaminated needles. Suddenly, drawing blood or performing procedures on an infected patient put the health care provider at risk of contracting the fatal illness if they unluckily stuck themselves with a contaminated needle or scalpel. That fear came to encompass caring for all patients who were known to be in "high risk" groups, especially if they appeared to be chronically ill.
My closest friend inadvertently stuck himself with the needle he used to perform a lumbar puncture (spinal tap) on a patient with meningitis who was dying of AIDS. He and his family nervously waited through months of testing before he was finally assured he had not contracted the virus and its death sentence.
Like most of my colleagues, I have anxiously awaited blood tests after I have been stuck by a contaminated needle or scalpel. Those can be long waits with sleepless nights. Thankfully, none have come back positive for me.
When the Ebola virus again raised its head in West Africa, most people expected the outbreak to be a limited experience, as has occurred on numerous occasions since the virus was first recognized in 1976. Due to the poverty and lack of adequate public health services in these countries, the outbreak has developed into a frightening epidemic. Let's face it, dying from the Ebola virus looks like a miserable way to go. Who wants to go out of this world with vomiting and diarrhea, profound weakness and bleeding; all while putting everyone around you at risk of dying?All of this has contributed to the panic around the possible spread of this disease to North America.
But, are our fears about Ebola really warranted?
If you are lucky enough to live in the United States, the answer is probably not.
To bring this question into better perspective, we don't have to look very far. While AIDS is no longer a death sentence and treatment improves each year, it is still a very dangerous infection that can be incredibly isolating for those who are HIV positive. Approximately 1.1 million people in the U.S. are HIV positive, and new infections occur every day.
While health care workers were mostly scared about getting AIDS in the '80s, we intellectually knew we were at much greater risk of contracting and dying from hepatitis B. Today, there continue to be 730,000 cases of hepatitis B each year in the U.S., and the illness is still dangerous and all too common. Fortunately, there is now an effective vaccine for hepatitis B, and since I have had my hep B shots, that's one less thing I have to worry about.
Influenza is a virus that spreads easily and causes a high number of deaths on a regular basis. Every year between 3,000 and 49,000 people die from this illness in the United States alone! And yet, many people don't feel inclined to get a flu shot that not only can save their life, but can help prevent the spread of infection to others as well. Worldwide, we expect 250,000 to 500,000 people to die this year from influenza, compared to 5,000 deaths from Ebola virus disease thus far.
Scientists are feverishly working to refine new vaccines for Ebola in order to protect health care workers and the people of West Africa. It will be a great day when vaccines can stamp out that frightening illness. Until then, the Ebola epidemic reminds us of the importance of paying attention to the prevention of all infections. We can do our part as individuals and as a community to stem the tide by staying informed, washing our hands and making sure that we are all up to date on our vaccinations.
Mark Fourre, MD, is an emergency physician and Chief Medical Officer of Lincoln County Healthcare, the parent company of Miles Memorial Hospital and St. Andrews Hospital. He also serves on Lincoln County Healthcare's Board of Trustees. Prior to joining Lincoln County Healthcare, Dr. Fourre was attending faculty at Maine Medical Center, where he developed the Emergency Medicine Residency Program and served as Residency Director.