Ebola haemorrhagic fever (EHF) Preparedness

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The information below is straight from the Centers For Disease Controls and Prevention. I’ll be posting more about Ebola in the following days but this is a good place to get started.

WHO recommended guidelines for epidemic preparednessand response : Ebola haemorrhagic fever (EHF) also has a lot of good information.

 

About Ebola Hemorrhagic Fever

Ebola hemorrhagic fever (Ebola HF) is one of numerous Viral Hemorrhagic Fevers. It is a severe, often fatal disease in humans and nonhuman primates (such as monkeys, gorillas, and chimpanzees).
Ebola HF is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. When infection occurs, symptoms usually begin abruptly. The first Ebolavirus species was discovered in 1976 in what is now the Democratic Republic of the Congo near the Ebola River. Since then, outbreaks have appeared sporadically.
There are five identified subspecies of Ebolavirus. Four of the five have caused disease in humans: Ebola virus (Zaire ebolavirus); Sudan virus (Sudan ebolavirus); Taï Forest virus (Taï Forest ebolavirus, formerly Côte d’Ivoire ebolavirus); and Bundibugyo virus (Bundibugyo ebolavirus). The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates, but not in humans.
The natural reservoir host of ebolaviruses remains unknown. However, on the basis of available evidence and the nature of similar viruses, researchers believe that the virus is zoonotic (animal-borne) with bats being the most likely reservoir. Four of the five subtypes occur in an animal host native to Africa.
A host of similar species is probably associated with Reston virus, which was isolated from infected cynomolgous monkeys imported to the United States and Italy from the Philippines. Several workers in the Philippines and in US holding facility outbreaks became infected with the virus, but did not become ill.

Transmission

Because the natural reservoir of ebolaviruses has not yet been proven, the manner in which the virus first appears in a human at the start of an outbreak is unknown. However, researchers have hypothesized that the first patient becomes infected through contact with an infected animal.
When an infection does occur in humans, there are several ways in which the virus can be transmitted to others. These include:

  • direct contact with the blood or secretions of an infected person
  • exposure to objects (such as needles) that have been contaminated with infected secretions

The viruses that cause Ebola HF are often spread through families and friends because they come in close contact with infectious secretions when caring for ill persons.
During outbreaks of Ebola HF, the disease can spread quickly within health care settings (such as a clinic or hospital). Exposure to ebolaviruses can occur in health care settings where hospital staff are not wearing appropriate protective equipment, such as masks, gowns, and gloves.
Proper cleaning and disposal of instruments, such as needles and syringes, is also important. If instruments are not disposable, they must be sterilized before being used again. Without adequate sterilization of the instruments, virus transmission can continue and amplify an outbreak.

Signs and Symptoms

Symptoms of Ebola HF typically include:

  • Fever
  • Headache
  • Joint and muscle aches
  • Weakness
  • Diarrhea
  • Vomiting
  • Stomach pain
  • Lack of appetite

Some patients may experience:

  • A Rash
  • Red Eyes
  • Hiccups
  • Cough
  • Sore throat
  • Chest pain
  • Difficulty breathing
  • Difficulty swallowing
  • Bleeding inside and outside of the body

Symptoms may appear anywhere from 2 to 21 days after exposure to ebolavirus though 8-10 days is most common.
Some who become sick with Ebola HF are able to recover, while others do not. The reasons behind this are not yet fully understood. However, it is known that patients who die usually have not developed a significant immune response to the virus at the time of death.

Risk of Exposure

In Africa, confirmed cases of Ebola HF have been reported in:

  • Guinea
  • Liberia
  • Sierra Leone
  • Nigeria
  • Democratic Republic of the Congo (DRC)
  • Gabon
  • South Sudan
  • Ivory Coast
  • Uganda
  • Republic of the Congo (ROC)
  • South Africa (imported)

The natural reservoir host of ebolaviruses, and the manner in which transmission of the virus to humans occurs, remain unknown. This makes risk assessment in endemic areas difficult. With the exception of several laboratory contamination cases (one in England and two in Russia), all cases of human illness or death have occurred in Africa; no case has been reported in the United States.
During outbreaks of Ebola HF, those at highest risk include health care workers and the family and friends of an infected individual. Health care workers in Africa should consult the Infection Control for Viral Hemorrhagic Fevers In the African Health Care Setting to learn how to prevent and control infections in these setting. Medical professionals in the United States should consult the Interim Guidance for Managing Patients with Suspected Viral Hemorrhagic Fever in U.S. Hospitals  [PDF - 60KB].

Diagnosis

Diagnosing Ebola HF in an individual who has been infected for only a few days is difficult, because the early symptoms, such as red eyes and a skin rash, are nonspecific to ebolavirus infection and are seen often in patients with more commonly occurring diseases.
However, if a person has the early symptoms of Ebola HF and there is reason to believe that Ebola HF should be considered, the patient should be isolated and public health professionals notified. Samples from the patient can then be collected and tested to confirm infection.

Treatment

Standard treatment for Ebola HF is still limited to supportive therapy. This consists of:

  • balancing the patient’s fluids and electrolytes
  • maintaining their oxygen status and blood pressure
  • treating them for any complicating infections

Timely treatment of Ebola HF is important but challenging since the disease is difficult to diagnose clinically in the early stages of infection. Because early symptoms such as headache and fever are nonspecific to ebolaviruses, cases of Ebola HF may be initially misdiagnosed.
However, if a person has the early symptoms of Ebola HF and there is reason to believe that Ebola HF should be considered, the patient should be isolated and public health professionals notified. Supportive therapy can continue with proper protective clothing until samples from the patient are tested to confirm infection.
Experimental treatments have been tested in animals but have not yet been tested in humans for safety or effectiveness.

Prevention

The prevention of Ebola HF presents many challenges. Because it is still unknown how exactly people are infected with Ebola HF, there are few established primary prevention measures.
When cases of the disease do appear, there is increased risk of transmission within health care settings. Therefore, health care workers must be able to recognize a case of Ebola HF and be ready to employ practical viral hemorrhagic fever isolation precautions or barrier nursing techniques. They should also have the capability to request diagnostic tests or prepare samples for shipping and testing elsewhere.

 

MSF (Médecins Sans Frontières) health staff in protective clothing constructing perimeter for isolation ward.

Barrier nursing techniques include:

  • wearing of protective clothing (such as masks, gloves, gowns, and goggles)
  • the use of infection-control measures (such as complete equipment sterilization and routine use of disinfectant)
  • isolation of Ebola HF patients from contact with unprotected persons.

The aim of all of these techniques is to avoid contact with the blood or secretions of an infected patient. If a patient with Ebola HF dies, it is equally important that direct contact with the body of the deceased patient be prevented.
CDC, in conjunction with the World Health Organization, has developed a set of guidelines to help prevent and control the spread of Ebola HF. Entitled Infection Control for Viral Hemorrhagic Fevers In the African Health Care Setting, the manual describes how to:

  • recognize cases of viral hemorrhagic fever (such as Ebola HF)
  • prevent further transmission in health care setting by using locally available materials and minimal financial resources.

Source: Centers For Disease Controls and Prevention


Reply to: “Solar Storm: How to Get Ready” & Diabetes

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Hello Fernando,

I ran across your blog a couple of years ago and have enjoyed it very much.

In reading your latest post “Solar Storm: How to Get Ready” it reminded me of the book “One Second After” which talks about life after an EMP event.

What struck home to me was the main character had a daughter that was 12 and was a type I diabetic (insulin dependent). When I read it my 11 year old son had only been diagnosed with Type I Diabetes for a year. That and I have family an hour and a half from where the book’s story is located in North Carolina.

I thought I would share some of the things I have done that might be helpful for other Type I diabetics or parents. In addition please feel free to offer any other suggestions.

Feel free to use any of this information or images in any way that will help others.
Thank you for your blog and books.
-MIke

Building up Diabetic supplies…

Inline image 2

Building up Diabetic supplies…

Here is what we do. Basically it is like the “pantry” system for food. We order just a little extra with each order. Not much, just a little more than we need. In about a year and a half you’ll have a good amount on hand. Just make sure and keep it rotated out!! What those dates! (You’ll notice numbers on the strip cartons, they are months. Also that picture is really old. We don’t have any 2012 stuff! hahaha!!)

Build a good relationship with your doctor…

Things got a little worrisome at my job and it looked like their might be a layoff, so we told our doctor our concern and he increased our prescription for insulin so we could store a little extra just in case. not sure if all doctors are this way but when we got started I mentioned I liked having extra insulin on hand in case of an emergency. So we worked it out where we would get a little extra insulin with a 3 month order and that helped to get us ahead.

Build a network…

No man is an island… get networked with other diabetics in your community. Work together. You’ll be surprised how many people keep extra supplies on hand. Plus sometimes people will change meters and have a few boxes of test strips or switch gauge needles, etc…  they might give you some or sell to you cheaper than you could buy them.

We have ran out of Ketonestrips once (key word ONCE! Hahaha!!) and had a sick child and it was late at night. One phone call and we had a bottle in less than 15 minutes.

We have a list of Diabetic Parents we keep, and the group is quick to reach out to newly diabetic parents to help them cope.

Keeping your cool…

Insulin must be kept cool until opened. Test strips should not get too cold or overly hot. (About 43 to 100 degrees.) In case of power outages (which we have had in the winter) I have a few systems set up.
1. Generator
2. 1 Liter Frozen Ice bottles and small cooler just for insulin & strips)
3. 12 Volt Car cooler (in case we need to leave or use it to keep insulin cool and we are out of ice.)
Diabetic Emergency Supplies…

We keep an emergency Diabetic Supplies kit in all our vehicles.
These are basically for the “Oops” times when my son runs out of something while we are out.

Yeah, it has happened. (They are all stored in a Gluclose tablet bottles, they are rotated our during the time change.)

Inline image 1
Contents from picture… (From top to right):
10 – Pen Cap Needles (For Insulin Pen)
6 – 30 Unit Syringes (We are using the rest of the up and moving to the 50 unit ones.)
16 – Lancets
4 – 50 Unit Syringes
20 – Alcohol Prep Pads

“There is nothing nobler or more admirable than when two people who see eye to eye keep house as man and wife, confounding their enemies and delighting their friends.” – Homer
Thanks for sharing your experience MIke!
I read “One Second After” and liked it a lot, recommended reading.
Regarding keeping the medicine cool, I think a portable compressor Freezer/Refrigerator like this one the Dometic (CDF-11) would be a good idea.

Dometic (CDF-11) Portable Freezer/Refrigerator

Its portable and can be run using any vehicle as a power source rather than needing a generator. Of course there’s not much space, but it should do ok for medicine.

Another thing to keep in mind as a last resort is the Zeer pot, or Pot-in-pot refrigerator, which can be easily made for little money using two clay pots, one smaller than the other. Sand is placed in between the pots and its kept wet. Food is placed inside the smaller pot and covered with a wet cloth. Evaporation does the rest, removing some of the heat.
Don’t expect a lot, but it is surprisingly cool and it sure would help to drop the temperature some.
Thanks for your email and good luck!
FerFAL

Not kidding: Live 20% longer, get sick less AND save Money

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Sounds like one of those cheesy infomercials but all of the above is true.

The benefits of a calorie restricted diet aren’t new. Rats being fed a calorie restricted diet lived twice as long, were more active and overall healthier.

The recent findings published about studies done in monkeys may be even more relevant. Long story short a 30% reduction in calories while maintaining good nutrition roughly extends your life by 20%, reduces the rate by which you age and allows you to live much healthier while alive.

Here’s the link to the report, pretty interesting stuff:

http://www.nature.com/ncomms/2014/140401/ncomms4557/full/ncomms4557.html

This is all of course strongly linked to survival and preparedness for obvious reasons. Living 1% longer sounds pretty good, but if we’re capable of stretching it to 10% or 20% and not only that but also be healthier while doing so then the benefits start piling up. Eating less also means spending less money on food, which directly puts money in our wallet for supplies, gear and of course savings.

It’s not hard to combine the different benefits with our modern survival plans: We want to live longer, be fit and healthy, save money and stockpile the necessary supplies. Bulking up our supply of wholegrain rice, lentils and canned vegetables means we are buying some of the most affordable food in stores, food that also happens to be high on nutrition but low on calories AND happens to store well, ideal for long term food supply for emergencies.

Eating little of it at a time means we’re abiding by another important survival rule: Store what you eat, eat what you store.

So by now you’re probably thinking: “This all sounds great and I’m on board but I have two important questions, how much calories do I need so as to deduct 30% from that and how do I know how much calories I’m eating?”

Regarding the first question there are several ways of estimating your caloric need but this link would be a good way to start.

http://www.webmd.com/diet/features/estimated-calorie-requirement

Regarding how many calories you’re eating I suggest downloading a calorie counter app for your phone. They are simple enough to use. After some time you get the hang of it and have a pretty good idea of what you are eating. Having a mostly plant based diet will make things easier since they have good nutrition value but are usually low on calories. I would suggest minimizing the amount of meat consumed as well and sticking to lean meat such as chicken or turkey breast or meat with good fat like salmon and tuna.

If you want to give it a try using some of that rice and lentils you should have stocked up by now, check some out one of my favorite recipes, lentil stew.

FerFAL


Reply: AEDs

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Ferfal,

Thanks for your post on the privately owned AED. I do have an AED for the very reasons you mentioned. In fact, I have the very model you posted the link for from Amazon.

I bought mine about three years ago for $1300 so the price has come down a bit.

You might like to know that some states here in the U.S. require a “prescription” from a medical doctor in order to buy an AED. The great state of Texas does not so I did not need one. I cannot imagine a doctor denying such a request but it is another hoop to jump through. The American Red Cross offers a combined CPR/AED course which is well worth attending. You do not want to try to learn how to use the AED when someone is having a heart attack! Also, the wife and I take ours when we are away from the house for overnight road trips.

Best regards from Texas

K-

Hello K,
That’s very interesting, I didn’t know that. Texas is a great State.

It just makes a lot of sense to have a machine that can save your life when facing the #1 cause of death, yet very few people have it and the cost is high but not really that high compared to a high-end gun or a couple regular ones.

At a certain age or specific health conditions it makes a lot of sense to have one.

 

Philips HeartStart HomeDefibrillator (AED)

Philips HeartStart Home Defibrillator (AED)

 

It makes a lot of sense to take the CPR/AED course so as to know how to use it during an emergency.

FerFAL


Eating Healthy & Staying in Shape

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An update on what’ve I’ve been eating and doing fitness wise and how it has been working for me so far. Not only is your body your most imporant tool, but also your health directly impacts both your chances of survival and quality of life. Remember that!
FerFAL


What Happens When you get Shot Part 3

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Given the positive feedback I got, I did a final video wrapping it up and including a few final concepts.

 

FerFAL


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