From BBC Ebola crisis: Spanish nurse tests negative for virus
The Spanish nurse who became the first person to contract Ebola outside West Africa has now tested negative for the virus, the Spanish government says,
It had been reported in the past few days that Ms. Romero Ramos seemed to be improving, but testing negative for Ebola is the gold standard for survival. She will be weak and need rest and care for some time, but a full recovery is in sight. She has said that she willing to care for Ebola patients in the future. Survivors appear to have an immunity to the virus.
This is an important clinical case because the time when she could have been infected is shorter (three days) than other well-documented cases AND it’s precisely known when her first symptoms appeared. The five or six day delay in getting her tested, isolated, and under care was unacceptable. It may have needlessly prolonged her illness and increased her suffering. But her battle may have a positive data outcome if her contacts during her symptomatic phase continue to test negative for Ebola until the end of their quarantine/monitoring period.
Good wishes for Ms. Romero Ramos as she continues her recovery and return to good health.
Early tomorrow, the 21 day quarantine will end for all those who came in contact with Thomas Duncan before Sept. 29th. All have been monitored for one of the first EVD symptoms, low-grade fever, and not one has exhibited any symptoms during this period. This adds important data that has been difficult, nearly impossible, to collect in the Ebola epidemic countries. Duncan was symptomatic from by 9/24 (the low-grade fever could have set in a day earlier) and at least one of those in quarantine had close contact on the 28th when he was highly symptomatic but was a few hours to day before the more intense symptoms began.
Not only has the 21 day deadline passed without additional cases, we are also seeing that in first world countries with adequate medical resources ebola is drastically less fatal. That should also be encouraging. Just IV fluids seems to make a big difference.
Hydration appears to be vital — as much orally as a patient can consume and IV to get the volume up to necessary amounts. It also appears that the hydration must begin close to when the symptoms first appear. While some patients in Nigeria, Liberia, Sierra Leone, and Guinea have survived with hydration alone, all of those treated in US and European hospitals have received more than hydration during their treatment. For example,
While Ramos’ treatments didn’t begin until at least six days after the appearance of her first symptom, it was before the vomiting and diarrhea stage.
Nina Pham’s condition upgraded to good. Eleven days of treatment from the first symptom of Ebola. Consistent with the UK nurse that began treatment within 56 hours of his first symptoms. Although that delay may have caused him to experience more severe symptoms while EVD ran its course.
Ashoka Mukpo, admitted to Nebraska hospital on 10/6 (first symptoms? guessing four days or less prior), released on 10/21 after three days testing negative for Ebola. He has stated they he did get quite ill while in the hospital.
10/23 — will add this here as a bookmark —
HuffPo Dr. Craig Spencer
The careful wording of that third paragraph suggests something that I’ve been thinking about and nobody has publicly talked about, intimate contact.
NBC news is reporting that Nurse Nina Pham is Ebola virus free.
First symptom, low-grade fever, on 10/10. Immediately tested and isolated. Ebola confirmed on 10/12.
Good WaPo article: Government Considering Changing Protocols for Aid Workers Responding to Ebola Outbreak.
Current protocols are probably scientifically good enough, but are failing on the PR front in the era of national mass-market crazed news reporting. DeBlasio said what all new reports should convey:
Would have been better if he’d said, “a symptomatic infected person’s” …
The article touched on but didn’t explore why we want Ebola aid workers to return to the US when they are asymptomatic. Most will not even have been infected, and those that have, are some days away from being contagious (with the possible exception of physically intimate contact — IOW — avoid the Mile High Club).
The public doesn’t seem to get that a low-grade fever is the one consistent, early symptom of EVD and precedes a contagious stage of EVD by at least a day if not several days. For some it appears to be the earliest. For others, it may be a sore-throat, fatigue, or body ache, but the elevated temperature follows quickly enough. Except for those that experienced such symptoms but didn’t have EVD — many of whom have appeared in news headlines.
For PR purposes, should the protocol for those under monitoring, like Nurse Vinson and Dr. Spencer, trigger closer monitoring and self-isolation for a day or so? It doesn’t help that the CDC cleared Vinson to travel back to Dallas from Ohio when her temperature was elevated and then responded to Dr. Spencer’s elevated temperature with an ambulance and personnel wearing HazMat garb. Looks to me as if the latter was an overabundance of caution, and in Vinson’s case was closer to being about right. Except, if her temperature remained elevated when she arrived in Dallas and for her protection and not the public’s, she should have been advised to go to the hospital instead of going home.