I am board-certified in family medicine and preventive medicine, and have a master’s degree in preventive medicine from the University of California at Berkeley with a special focus on environmental medicine and epidemiology. I have been in medicine since 1957 when I first entered the University of Michigan Medical School. I have served in multiple medical positions during my 25-year career in the Army and in civilian practice, and just semi-retired a few weeks ago.
I HAVE PRACTICED family medicine in the Army, at the Medical College of Georgia and in underserved areas in Mexico, Vietnam and Malaysia, not to mention four under-doctored counties surrounding the CSRA. I have served as a preventive medicine officer at several large military installations during my career, and have been involved with various epidemics during that time.
I’ve had it with our federal government’s obfuscation over the Ebola threat. The index case never should have been allowed in this country.
Quarantine has worked for centuries. I can remember as a kid in the late 1930s and early ’40s the yellow quarantine signs on houses in neighborhoods. The endemic countries should be immediately quarantined, and people from these countries should be prevented from coming to America. The current screening procedures are a joke, as so clearly debunked recently on Fox News by Bill O’Reilly.
FIRST, ACCORDING TO the online-posted résumé of Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, he is a democratic internationalist who appears to be more concerned with global issues of Ebola rather than protecting Americans – hence his stand on quarantine of endemic areas. He generally has been on the public payroll since completing his medical training, and his claim to fame is working on the spread of tuberculosis in India.
Second, the Ebola virus is found in multiple body fluids such as blood, urine, feces, sweat, tears and nasal/pharyngeal secretions, but the government doesn’t mention that it also is found in semen (from the CDC website). If it is found in semen, it most likely also would be found in vaginal secretions and menstrual bleeding. So it probably is a sexually transmitted disease, which has never been mentioned by our government’s puppet at the CDC.
THIS WILL BE BAD news for the 4,000 American troops in Liberia and other endemic countries. After 24 years of experience with soldiers in the Army, I can tell you that it is highly probable that there will be cases in this group unless there is a strict anti-fraternization policy, if you get my meaning.
Third, Dr. Frieden glibly states that one is not contagious until 21 days after exposure. Based upon infectious disease models, the potential for transmission and secondary infection from the index case follows a spectrum depending upon the initial infecting dose of the virus and the recipients our health and immune system.
PROOF: NINA PHAM first came into contact with Ebola patient Thomas Eric Duncan on Sept. 29 and developed a fever Oct. 10 – an incubation period of only 12 days. I think you can speculate that she was shedding virus a few days before Oct. 10, and probably was contagious as early as Oct. 7 or 8, depending upon the potential route of contamination to a tertiary patient. I do not know if she was married, but if so her husband and family become potential cases.
It is disgraceful to blame this young girl for causing herself to contract the disease. It is more likely that the protocol for isolation had a flaw, such as decontamination of the gowned and protected provider upon exit from the room. There also is fear that the virus may have the ability to permeate protective barriers.
IT IS HARD TO understand the incompetence and negligence of the emergency room staff at Texas Presbyterian Hospital on Sept. 26. It is sad that Mr. Duncan died, but the real tragedy is that the medical staff at the ER allowed a highly infectious Ebola patient to return to the community and possibly serve as the index case for a potential epidemic in the Dallas area.
(The writer is an emeritus associate professor of family medicine at Georgia Regents University.)