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Sunday, October 12, 2014

5 Ways U.S. Hospitals Need to Get Ready For Ebola

5 Ways U.S. Hospitals Need to Get Ready For Ebola


5 Ways U.S. Hospitals Need to Get Ready For Ebola

Posted: 12 Oct 2014 11:13 AM PDT

A health care worker who had “extensive” contact with Dallas Ebola patient Thomas Eric Duncan has been infected with Ebola.

“We don’t know what occurred, but at some point there was a breach in protocol,” Centers for Disease Control and Prevention (CDC) director Dr. Tom Frieden said in a meeting with the press Sunday. The Dallas hospital worker is the second health care worker in the Western world to be infected with the disease, which begs the question: Are all hospitals really capable of caring for a patient with Ebola, as Americans have been repeatedly told?

The CDC is still insisting yes, but hospitals need to start listening very carefully to their guidance. The CDC has long been advising hospitals on how to take care of a potential patient, but the agency is kicking it up a notch this week given the new patient and Texas Health Presbyterian Hospital’s blunders, including not admitting Duncan the first time he arrived at the hospital with a 103-degree fever.

The CDC is sending in a team of six to eight disease specialists to Dallas to help with infection control, a CDC spokesperson told TIME. A couple of those members just returned from Dallas on Friday, but given the new infection, they’re hopping back on the plane to help the hospital. “As that team continues to investigate what happened [at Texas Health Presbyterian Hospital], it will be used as a lesson learned experience,” says CDC. President Obama also directed the CDC on Oct. 12 to investigate.

Every hospital in the U.S. has the equipment and isolation areas needed to treat someone with Ebola, but there’s no denying that the physicians at Emory University hospital, for example, have more experience and training. TIME visited the infectious disease team at Emory in August, and the team had been training for a situation like Ebola for 12 years, undergoing drills at least twice a year. That’s not the case at most medical facilities.

“You’re going to see us really making even more clear what hospitals need to be doing,” says the CDC spokesperson. “We are really trying to help health care workers understand the principles [they] need to follow and why, and how to do them.” The CDC received a 10-fold increase in calls from hospitals after a nurse in Spain was infected with Ebola.

1. Have a lead manager. Frieden said the CDC is recommending that hospitals have someone’s whose role it is to monitor the protocols that physicians and nurses are taking for protection. Taking on and off the protective equipment is one of the most high-risk scenarios and has to be done meticulously. “[Treating Ebola] can be done safely, but it’s hard to do safely,” Dr. Frieden said in the press conference, adding that even a single slip can result in contamination.

2. Learn from the country’s best. On Oct. 14, doctors at Emory and Nebraska—both best-in-class facilities when it comes to treating something like Ebola—will host a conference call for health care workers. On Oct. 21, the CDC and the Partnership for Quality Care will be hosting a live educational meeting in New York to show health care workers how to prepare their facilities and themselves. The CDC says the goal is to get 5,000 front-line health care workers there in person, and to also live stream it for those who cannot attend in person. The CDC has long been running a Health Alert Network that hospitals and individuals can subscribe to for notifications and advice on caring for diseases.

3. Get a patient’s travel history. The CDC says health workers should consider the possibility of Ebola if a patient exhibits fever, severe headache, abdominal pain, vomiting, diarrhea, or unexplained bleeding or bruising. If a patient has been to Ebola-affect countries, “immediate action should be taken.”

4. Isolate immediately. If a patient might have Ebola, they should be “isolated in a single room (with a private bathroom), and healthcare personnel should follow standard, contact, and droplet precautions, including the use of appropriate personal protective equipment (PPE).”

5. Be protected. PPE should consist of gloves, gown, eye protection (goggles or face shield), and a face mask. In situations where there may be copious amounts of bodily fluids like blood, vomit and feces, health workers should consider double gloving, wearing disposable shoe covers and leg coverings. Some hospitals may choose hazmat suits, since those suits are made up of fewer pieces—which means it’s less for doctors to take on and off.

You can read more of the CDC’s recommendations here.

Stem-Cell Researchers Make Breakthrough in Type 1 Diabetes Treatment

Posted: 12 Oct 2014 10:13 AM PDT

Researchers have made a major breakthrough in finding a treatment for type 1 diabetes, Harvard University announced Thursday.

For the first time, scientists were able to create insulin-producing beta cells using human embryonic stem cells, at a volume required for cell transplantation and pharmaceutical use. Type 1 is the variety of the metabolic disease that one is born with–an autoimmune condition in which the body destroys the beta cells that produce insulin, a hormone that regulates glucose and helps the body process sugar.

“We are now just one pre-clinical step away from the finish line,” said Doug Melton, who led the research and who has worked toward finding a cure for diabetes since his son was diagnosed as an infant 23 years ago.

That final step is finding a way to protect the 150 million beta cells needed to for transplant in the treatment of each patient from their immune systems, which automatically attack those cells. Melton is working with other researchers to develop a device for such protection. Tests of a device in mice have so far protected insulin-producing beta cells for several months.

Washington Man Killed by Bus at Idaho Corn Maze

Posted: 12 Oct 2014 09:44 AM PDT

HAUSER, Idaho — A bus carrying paintball players struck and killed a Washington state man inside a zombie attraction at a corn maze in northern Idaho, authorities said Saturday.

Jeremy T. McSpadden Jr., 18, of Spokane Valley, Washington, was a role player in the “Zombie Slayer Paintball Bus” attraction at the Incredible Corn Maze in Hauser on Friday night, the Kootenai County Sheriff’s Office said. Dressed as a zombie, he emerged from his hiding place and ran toward the modified school bus, but he tripped and fell in front of the rear passenger-side tires, witnesses reported.

He was run over and apparently killed instantly. Because of the uneven terrain of the corn maze, the bus frequently rocks, and the occupants did not immediately notice what had happened, investigators said.

“It was not until the bus had traveled away from the victim’s location and the role players began to reset for the next bus to come along that anyone realized something was wrong,” the sheriff’s office said in a news release.

The attraction is new this season, according to the corn maze’s website. For $15, customers ride the bus, which has paintball guns mounted outside the windows, and shoot at the zombies as the vehicle drives through the corn maze.

The bus was going forward, and neither speed nor alcohol was a factor, Sgt. Ward Crawford said.

“The focus of the attraction is the bus creeps forward so the customers have plenty of opportunity to blast away at the zombies,” Crawford said. “This looks like it was just a horrific confluence of events.”

A recording on the corn maze’s information line Saturday morning said, “We are sad to announce that all of the attractions, including the free drive-in movie, will be canceled for the remainder of the weekend.”

A message left seeking further comment was not immediately returned.

Hauser is near the Washington border east of Spokane.

Lena Dunham to Adapt YA Novel Catherine, Called Birdy

Posted: 12 Oct 2014 09:15 AM PDT

Corpus bones! Girls creator and author Lena Dunham is working on a film adaptation of Karen Cushman’s award-winning 1994 young-adult novel Catherine, Called Birdy.

Dunham, who just released her debut essay collection Not That Kind of Girl: A Young Woman Tells You What She’s “Learned”, announced the project on Friday at the New Yorker Festival, the Huffington Post reports.

“This is actually my first time talking about it publicly,” Dunham said at the event. “I’m very excited about it. I’m not sure when it’ll happen, but I’m in the process of [working on it].”

The book follows a thirteenth-century teenager who finds clever ways to scare off the unsuitable suitors her father tries to marry her off to.

[Huffington Post]

Thunder Star Kevin Durant Has Foot Fracture

Posted: 12 Oct 2014 08:39 AM PDT

OKLAHOMA CITY — Kevin Durant has a fractured foot and the Oklahoma City Thunder say they are not sure how long the NBA’s MVP will be sidelined.

General Manager Sam Presti said in a statement Sunday that Durant informed the team of “discomfort” in his right foot after practice a day earlier.

He underwent tests and the team says he was diagnosed with a “Jones” fracture. The team says traditional treatment requires surgery, and recent NBA cases have resulted in a return to play in six to eight weeks.

The team says it is “collaboratively evaluating the most appropriate next steps with Kevin, his representatives and Thunder medical personnel.” It adds, that until a course of action is set “we are unable to provide a timeline specific to Kevin’s case.”

 

Kerry Pledges $212M in U.S. Aid to Gaza

Posted: 12 Oct 2014 07:37 AM PDT

U.S. Secretary of State John Kerry has pledged $212 million in new aid to help rebuild Gaza after the region accumulated heavy damage during this summer’s 50-day war between Israel and Hamas.

Kerry made the announcement on Sunday as diplomats from more than 40 countries gathered in Cairo to pledge humanitarian aid, the New York Times reports. The U.S. previously provided $118 million in aid to Gaza earlier in 2014.

United Nations Secretary General Ban Ki-moon said that approximately one-third of Gaza’s population was displaced by the violence and that the parts of the region are still plagued by blackouts and lack of access to water.

Palestinian Authority head Mahmoud Abbas has said that Gaza will need $4 billion to rebuild, and Qatar has already promised $1 billion toward that goal. U.S. officials suggest concerns for the region’s stability may hinder aid commitments among donors.

“There is the third time in less than six years that we have seen war break out and Gaza left in rubble,” Kerry said. “As long as there is a possibility that Hamas can fire rockets on Israeli civilians at any time, the people of Gaza will remain at risk of future conflict.”

[NYT]

CDC: Protocol Breach in Treating Ebola Patient

Posted: 12 Oct 2014 07:11 AM PDT

WASHINGTON — A top federal health official says the Ebola diagnosis in a health care worker who treated Thomas Eric Duncan at a Texas hospital shows there was a clear breach of safety protocol.

Dr. Tom Frieden, head of the Centers for Disease Control and Prevention, says the worker had treated Duncan multiple times after the Liberian man was diagnosed.

Frieden tells CBS’ “Face the Nation” that all those who treated Duncan are now considered to be potentially exposed. Frieden couldn’t give an exact number.

Health care workers treating Duncan were to follow CDC protocol that included wearing protective gear.

Among the things CDC will investigate is how the workers took off that gear — because removing it incorrectly can lead to a contamination.

Duncan died of the disease last Wednesday.

Health Worker in Texas Tests Positive for Ebola

Posted: 12 Oct 2014 06:23 AM PDT

Updated 1:30 p.m. EST

A Texas health worker has tested positive for Ebola after caring for an Ebola patient who died this week, the Texas Department of State Health Services announced Sunday.

“We don’t know what occurred, but at some point there was a breach in protocol,” said Centers for Disease and Control and Prevention Director Tom Frieden at a Sunday press conference, noting that “there is a need to enhance the protocol to make sure that they are followed.”

The CDC will do further testing to confirm the preliminary diagnosis. If the CDC tests confirm the results, the patient will be the first known case of someone contracting the deadly Ebola virus in the U.S.

The patient reported a fever on Friday after following the CDC’s self-monitoring procedures, which include twice-daily temperature checks. The patient was admitted into isolation within 90 minutes of the temperature check.

“We knew a second case could be a reality, and we’ve been preparing for this possibility,” Dr. David Lakey, commissioner of the TDSHS, said in a statement. “We are broadening our team in Dallas and working with extreme diligence to prevent further spread.”

The worker, who is in stable condition and whose identity has not been made public, reportedly wore protective gear while caring for Thomas Eric Duncan at Texas Health Presbyterian Hospital, according to chief clinical officer Dr. Daniel Varga, the Associated Press reports. Duncan, the first individual in the U.S. to be diagnosed with Ebola, died on Wednesday.

Varga said the hospital is “very concerned” about the spread of the virus despite the worker’s safety precautions, which he said included “gown, glove, mask and shield.”

Frieden said that treatment of Ebola “can be done safely but it’s hard to do safely. Even a single inadvertent slip can result in contamination.”

The White House said in a statement Sunday afternoon that President Obama had been briefed on the new patient’s condition, and had directed that the CDC’s breach investigation move quickly and that “Federal authorities take immediate additional steps to ensure hospitals and healthcare providers nationwide are prepared to follow protocols should they encounter an Ebola patient.”

Due to staffing limitations, the emergency department at the hospital is currently on “diversion” and is not allowing ambulances to deliver patients to the emergency room, the hospital said in a statement. Texas Health Resources is also monitoring all staff who cared for Duncan and “triple-checking” its safety measures and compliance with CDC guidelines.

“Breaking the links in the chains of transmission is key is the key to preventing further spread,” Frieden said.

–with additional reporting by Zeke Miller.

The Salty Food That’s Shockingly Healthy

Posted: 12 Oct 2014 05:00 AM PDT

Pop quiz: What do pickles, vinegar, tempeh, chocolate and wine have in common? Yes, they’re all delicious—and they’re all fermented. And that means they all have major health perks.

Cultures around the world have enjoyed fermented foods for millennia; they devour kimchi in Korea, sauerkraut in Germany and cheese—everywhere. Now fermenting is appealing to consumers eager to return to naturally healthy ways of eating. Top chefs are embracing it too; Momofuku’s David Chang has a culinary lab dedicated to food science, including fermentation, which he calls the “machinery of flavor.” Fermentation is what happens “when rotten goes right,” Chang says. It may sound kind of gross, but fermentation involves “good” micro-organisms breaking down or partially digesting food, which makes nutrients easier for your body to absorb. Research suggests that fermented foods can also strengthen immunity.

HEALTH.COM: 12 Foods That Control Your Appetite

Fermentation helps extend shelf life (think how much longer a block of Cheddar lasts than a carton of milk) and can make food safer, since foodborne pathogens are less likely to survive in the acidic environment fermentation creates.

You’re probably already enjoying many of these foods. Here are some of my favorites.

Miso
This paste, made from fermented soybeans, is the essential ingredient in the Japanese soup of the same name. The darker the miso, the longer it has been fermented, and the saltier and stronger the flavor will be. I keep a container in my fridge and use it in marinades and glazes for chicken or fish. I also make salad dressing out of it: I mix 1 tablespoon of miso with a little chopped garlic and ginger, 1 tablespoon of rice vinegar and 1 or 2 teaspoons of honey. Then I whisk in 2 to 4 tablespoons of a neutral oil, like grapeseed.

HEALTH.COM: 11 Foods that Make You Hungrier

Sourdough bread
It’s lower on the glycemic index, so it’s less likely to wreak havoc on your blood sugar and leave you hungry and craving more carbs. Try it as French toast, croutons, bread crumbs and stuffing.

Pickles
Be sure the label says “fermented.” Commercially made pickles and capers aren’t always made using good bacteria; often they’re just soaked in brine.

Wine and beer
They’re both fermented (yay!). You don’t need me to tell you how to enjoy them.

HEALTH.COM: The 18 Best Snacks for Weight Loss

Other delicious ideas: Swap tempeh for tofu in a stir-fry, pile sauerkraut on a turkey sandwich or marinate chicken in buttermilk overnight. With so many great choices, you’ll be in a pickle in no time (but in a good way).

Snack On This: If you love sriracha, the super flavorful Southeast Asian hot sauce, like I do, grab a bag of Indiana Sriracha Popcorn ($4 for a 6-oz. bag; at Whole Foods Market). Seasoned with red chili pepper, it brings the heat. And studies suggest that chiles boost metabolism.

Gotta Have It: When I see something I don’t recognize on a food label, I turn to the Chemical Cuisine app (free; iTunes and Google Play) from the Center for Science in the Public Interest. Search the alphabetical list of 130-plus food additives; color-coded icons indicate whether the ingredient you’re curious about is safe, OK for some people or to be avoided completely.

HEALTH.COM: 16 Ways to Lose Weight Fast

This article originally appeared on Health.com.

Texas Healthcare Worker Tests Positive for Ebola

Posted: 12 Oct 2014 04:55 AM PDT

DALLAS — A Texas health care worker who provided hospital care for an Ebola patient who later died has tested positive for the virus, health officials said Sunday in a statement. If the preliminary diagnosis is confirmed, it would be the first known case of the disease being contracted or transmitted in the U.S.

A statement posted on the Texas Department of State Health Service’s website said “confirmatory testing will be conducted by the Centers for Disease Control and Prevention in Atlanta.”

Officials said the health care worker reported a low grade fever Friday night and was isolated and referred for testing. Preliminary test results were received late Saturday.

Hospital and state health officials did not identify the health care worker or provide their job description.

“We knew a second case could be a reality, and we’ve been preparing for this possibility,” said Dr. David Lakey, commissioner of the Texas Department of State Health Services. “We are broadening our team in Dallas and working with extreme diligence to prevent further spread.”

Health officials have interviewed the patient and are identifying any contacts or potential exposures. They said people who had contact with the health care worker after symptoms emerged will be monitored based on the nature of their interactions and the potential they were exposed to the virus.

Ebola spreads through close contact with a symptomatic person’s bodily fluids, such as blood, sweat, vomit, feces, urine, saliva or semen. Those fluids must have an entry point, like a cut or scrape or someone touching the nose, mouth or eyes with contaminated hands, or being splashed. The World Health Organization says blood, feces and vomit are the most infectious fluids, while the virus is found in saliva mostly once patients are severely ill and the whole live virus has never been culled from sweat.

Thomas Eric Duncan, the first person diagnosed with Ebola in the U.S., died Wednesday in Dallas. Duncan, 42, grew up next to a leper colony in Liberia and fled years of war before later returning to his country to find it ravaged by the disease that ultimately took his life.

Duncan arrived in Dallas in late September, realizing a long-held ambition to join relatives. He came to attend the high-school graduation of his son, who was born in a refugee camp in Ivory Coast and was brought to the U.S. as a toddler when the boy’s mother successfully applied for resettlement.

The trip was the culmination of decades of effort, friends and family members said. But when Duncan arrived in Dallas, though he showed no symptoms, he had already been exposed to Ebola. His neighbors in Liberia believe Duncan become infected when he helped a pregnant neighbor who later died from it. It was unclear if he knew about her diagnosis before traveling.

Duncan had arrived at a friend’s Dallas apartment on Sept. 20 — less than a week after helping his sick neighbor. For the nine days before he was taken to a hospital in an ambulance, Duncan shared the apartment with several people.

 

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