Tags: Ebola Outbreak | Travel | Liberia | Ebola | Texas

Disease Experts: Patient Travel History Should Be Standard Practice

By    |   Wednesday, 01 Oct 2014 02:15 PM

A Dallas man infected with Ebola might have been detected sooner if the doctor who evaluated him — and then sent him home with antibiotics — had asked what should be a mandatory question of any patient reporting fever and flu symptoms: Where have you traveled recently?

So said two professors with backgrounds in disease tracking and biological safety who spoke to "MidPoint" host Ed Berliner on Newsmax TV Wednesday.

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With the disease that is ravaging western Africa now in the United States, through a Dallas patient who had just visited Liberia, "There's still education to be done here," said Stephen Morse, professor of epidemiology at Columbia University.

"We always used to say that it all begins with an observation by an astute clinician," said Morse, "and then this case, obviously, was a very hurried clinician who wasn't thinking about Ebola as a possibility — which surprises me considering how much attention we've been giving to this possibility."

The Dallas patient sought help a second time when his symptoms persisted, and he is now in an isolation unit — and in critical condition — in a Texas hospital, according to reports. The worry is how many people he came in contact with in the two-day interim.

"Ultimately he came back and the right thing was done," said Morse. "But it reminds us that everybody really has to be asking these questions when they see a patient, even if it just looks like the flu: Where have you been lately?"

David Sanders, a Purdue University associate professor of biology, said that a patient's travel history "is a very useful tool to physicians and it should be included as part of a checkup — as part of a contact with a patient."

Asking about it "would widen the scope of the possible diseases that could be associated with the symptoms," said Sanders.

Neither Sanders or Morse attributed the miss in Dallas to doctor laziness or inattention.

"Physicians see lots of patients and [Ebola] isn't necessarily at the forefront of their consciousness," said Sanders. "This case will bring it forward, and these things are a process of learning. We have learned about this, and that's going to help in the future."

Asked whether the U.S. medical community has the capacity to contain and treat Ebola, and prevent it from spreading, Sanders said that larger hospitals are better equipped to respond and adapt to a potential disease threat.

But he added that "we're going to have to consider the fact that not every single hospital in this country is necessarily prepared."

He said the key is connecting those facilities "to those larger hospitals that will have sufficient containment facilities."

Morse said that the Dallas Ebola case points back to the slowness of the initial response, and the absence of an early warning system, when the disease surfaced earlier this year overseas and was "a little late in getting reported."

"That's a very big lesson here," said Morse, "and these are governments [in western Africa] that in general are not very strong, not very well trusted by the people, and have just gone through all sorts of civil wars and other problems."

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A Dallas man infected with Ebola might have been detected sooner if the doctor who evaluated him - and then sent him home with antibiotics - had asked what should be a mandatory question of any patient reporting fever and flu symptoms: Where have you traveled recently?
Travel, Liberia, Ebola, Texas
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2014-15-01
Wednesday, 01 Oct 2014 02:15 PM
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