Archive for October, 2014


Update: A second U.S. case has been confirmed, the first of a citizen contracting Ebola within United States. The patient is a nurse who tended the original patient. Although this is concerning, it is not alarming because I feel that the health profession is putting in place comprehensive treatment protocols to prevent further spread of this disease.

There has been one confirmed case of Ebola virus infection in the United States where a man traveled from Liberia in Africa, to Dallas, Tex. to visit relatives.

His symptoms developed only after being in the U.S. for a few days. The very word “Ebola” brings a shudder to many people — as well it should, since the mortality rate is so high amongst its victims.

Ebola infection is caused by a virus. As I’ve stated many times previously, viruses cannot be treated with antibiotics, therefore there is no successful treatment of Ebola.

Those infected with Ebola need top-notch critical care for any chance of survival.

The current Ebola outbreak began in West Africa. As of this writing, it has infected approximately 7,500 people, of which 3,500 have died. This is a very high mortality rate and is what makes this disease so scary.

Various international health organizations are converging on the affected African nations to do everything possible to prevent the spread and to keep the epidemic localized.

There is a tremendous need for trained health care workers with adequate equipment to help contain the virus in those underdeveloped countries.

The good news is that Ebola is not as contagious as other virus-caused diseases, such as the common cold or influenza.

At this time, it is not believed to be spread by respiratory droplets — such as from coughing or sneezing.

It is spread by contact with an infected person’s skin or body fluids — especially vomit, diarrhea, and blood.

It is also spread, perhaps to a lesser degree, with contact of infected saliva, sweat, tears, and open wounds. It is not thought to be passed from air, water, or food.

You can’t get Ebola from an infected person until they are showing obvious symptoms.

Ebola infection manifests after at least one week from the time of exposure, and one may become critically ill within just a few days thereafter. 

Symptoms of Ebola include:

– Sudden fever as high as 105 degrees Fahrenheit.

– Intense headache, weakness, sore throat, as well as terrible joint and muscle aches.

– Profuse vomiting and diarrhea.

When death occurs, it is usually due to internal bleeding and generalized organ (kidney, heart, and lungs) failure.

At this time, only supportive care is available utilizing intravenous fluids and blood transfusions. A human vaccine is being developed as quickly as possible.

All hospitals and large clinics such as mine, the Palo Alto Medical Foundation, have put into place strict protocols for the screening, isolation, and treatment of Ebola patients, as well as for protecting other patients and medical staff.

I have never seen this level of preparedness for a disease in my entire 41 years of medical practice.

This level of preparedness is a good thing, not only for the very rare possibility of an Ebola epidemic, but also in case of epidemics from other virus-borne deadly diseases — such the influenza epidemic seen in 1918.

In conclusion, I want to reiterate that the current Ebola infection is very unlikely to spread throughout the United States and that the isolated cases that will continue to show up will be well-controlled by our increasing level of health care preparedness.

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It’s time for me to make my annual plea for everyone to get their flu shot. In today’s column, I’d like to answer common questions I hear about influenza and the flu shot.

– Can’t I get the flu from the flu shot?

This is a very common myth and proven to be wrong. You cannot catch the flu from the flu vaccine. The flu vaccines that are given by needle are made with viruses that are killed (inactivated), and cannot cause an influenza infection.

– I’ve had the flu shot previously and I got the flu anyhow.

This is possible, but not likely, in that no vaccine is 100 percent effective.

– I’ve never had a flu shot and have never had the flu.

Consider yourself lucky, and as in most cases, one’s luck will usually wear out. Don’t take a chance, this could be the year.

– The flu is no big deal.

Tell that to those who have not survived a bout of influenza, or to the worker who misses a week or more of work, as well as the student missing time from school. Besides, having the flu can make you feel very miserable.

– I worry that it could be harmful to my baby/child to have yet another vaccination.Babies have a higher incidence of death due to influenza. There is no proof that the flu vaccine worsens or changes the effects of the other routine childhood vaccinations. The recommendation is that everyone from six months of age and older should receive the flu vaccine.

– I have already gave a chronic disease and I take lots of medications. Do I really need a flu shot too?

All the more reason to receive a flu shot since the flu is the most deadly for those with chronic medical conditions.

– I have a tremendous fear of getting a shot.

The flu vaccine is available as a nasal spray and is approved for those between the ages of 2 to 49 years of age. It has been proven to be more effective than the shot in children 2 to 8 years of age. The viruses used to develop the nasal spray flu vaccine are alive but weakened (attenuated).

– I’m pregnant, won’t a flu shot harm my baby?

Not only has the flu vaccine injection been proven to be safe during pregnancy, but is highly recommended for pregnant women in any trimester of pregnancy. Only the injection form of flu vaccine and not the nasal spray should be used in pregnancy.

– I’m 35 years old and healthy, do I really need a flu shot?

In 2009-10, the swine flu (H1N1 virus) took a particularly heavy toll on the age group 18 to 64 years of age. Better safe than sorry.

– Any reason I absolutely shouldn’t get a flu shot?

There are a few reasons, the most common being a prior allergic reaction to a flu shot or a severe allergy to eggs. The vaccine should be delayed if you have an illness with a fever.

– When should I get the shot?

The flu season typically begins as early as October and can last until late spring. Flu shots are currently available and I advise getting it sooner rather than later. It takes about two weeks after receiving the shot for it to become effective.

– Where can I get a flu shot?

Most major pharmacies such as Rite Aid, Walgreens and CVS, provide flu shots on a drop- in basis, as well as through most primary care doctor’s offices. Larger medical groups such as mine, the Palo Alto Medical Foundation, will have special drop in flu clinic days. For children, call your child’s primary care provider to find out how they are to receive a flu vaccination.

– How much will a flu shot cost me?

For most people it is free, either because they have a government insurance plan such as MediCare or MediCruz, or they have private insurance. For those who have no such coverage, the out-of-pocket cost of flu vaccine is between $30 to $50 depending on which vaccine is given.

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