WASHINGTON —

Inside the world’s worst Ebola outbreak

Rising concern over a possible global outbreak of Ebola, especially in the wake of the new cases in Spain and the U.S., is putting investors on edge and has begun affecting the global economy.

The disease will likely prove a long-term drag on the African economy. Ebola’s two-year financial impact could reach $32.6 billion by the end of 2015 in West Africa alone, World Bank President Jim Yong Kim said Thursday.

Expectations that global travel will slow sent airline stocks down in the U.S. market Monday. The government has begun screening travelers from West Africa at major airports.

“In my 30 years in public health, the only thing that has been like this is AIDS,” said Thomas Frieden, director of the U.S. Centers for Disease Control, at a World Bank conference.

News broke Sunday that a nurse at a Texas hospital contracted Ebola from a Liberian man who died there. She was the second patient to catch the disease outside West Africa, after a Spanish nurse who treated sick missionaries in Madrid.

A United Nations worker transported from Liberia to Leipzig in eastern Germany also died there Tuesday, according to German media.

World Health Organization Assistant Director-General Bruce Aylward told reporters Tuesday that 5,000 to 10,000 people could be catching the deadly disease every week by the start of December. Currently, about 1,000 new cases of Ebola emerge each week.

Aylward also revealed the latest numbers: an estimated 8,914 cases and a death toll of 4,447.

But the actual figures could be much higher. The CDC sees the total number of cases possibly swelling to as many as 1.4 million by January.

Although developed countries are sending more aid to help contain Ebola, many of the affected West African nations lack the capability to use it. Protective gear and other medical equipment sent from the U.S. apparently sat at a Sierra Leone port since August, according to The New York Times.

Some also warn that neighboring countries that have not officially reported any Ebola cases in fact already have patients. Nigeria, Africa’s most populous nation, has many direct flights to and from the U.S., Europe and Asia. There are concerns that the disease could slip under the radar in these countries and spread to the rest of the world.

So unfortunately this maybe the case but that should also make our government in America to take  harder and stricter actions in rules and regulations on people entering the U.S. being checked from countries with the risk or history of having diseases that could be carried in this country for if we had these already in place this Ebola wouldn’t be at the level is in America .  We are lucky in America with less than 5 cases in America of Ebola this past year and presently now just 2 RN’s  with a active Ebola diagnosis that we are aware of in America.  We need to help America contain this disease and prevent further spreads  of Eboli in the country.

What is your opinion your word counts; write it under comment.

Stated by an official on CNN today “I am not going to question the President” with hesitancy but yet states he has “concerns” he stated in wondering “why he has no science or medical background”.

Rep. Bill Johnson stated on CNN Friday 10/17/14.

Responding to growing calls to appoint an “Ebola Czar” to lead America’s battle against the deadly virus, sources confirm to Fox News that President Obama plans to name Ron Klain, a longtime political hand with no apparent medical or health care background. “Appointed by our President Barack Obama is former White House official Ron Klain to coordinate the U.S. government’s response to the Ebola outbreak, an administration official said on Friday.  He is an attorney, comes to the job with strong management credentials, extensive federal government experience overseeing complex operations and good working relationships with leading members of Congress, as well as senior Obama administration officials, including the president,” the official said to fox news.com. What is a czar?  This word by definition, is any person exercising great authority or power in a particular field.  This man has no medical background, not even a license as an M.D. just working as even a general practitioner in a clinic, who does understand all diseases in general.  Wouldn’t you want someone with some type of medical background in charge since he carries the role in giving primary guidance on health issues to our President, which helps him in making the final direction we should take in America regarding health issues withespecially those that can become an epidemic.  If this czar makes the wrong presumption and our President agrees this could be a problem for our country’s future health.   This decision he makes is for all people who are citizens in America and even visitors in the country regarding what is best for them in protecting their health the best way possible.?  I would be concerned with this man only due to his lack of any medical background since the job entails decision making on health issues that regards our safety and future. Isn’t this bizarre to you or at least don’t you question why this man is not a MD or biologist or scientist or something in science research? I could understand if our President gave this role to Mr. Ron Klain with a science major as a doctor, biologist, scientist or someone with a lot of disease research knowledge experience working with him but so far no one in media or the President himself has not mentioned that this is the case.  You already have officials mentioning this concern with the media with no one else defending or favoring the czar decision by our President.  We don’t even have a Surgeon General in place.  The President of the United States chooses who the Surgeon General will be and our President has still not made a decision who takes on this role at this present time. The Surgeon General is the operational head of the U.S. Public Health Service Commissioned in the federal government and thus the leading spokesperson on matter of public heath in the federal government of the U.S. for 4 years, when hired.  This person reports to the Assistant Secretary of Health, who may be a 4 star general in the United States Public Health Service, Commissioned Corps. and who serves as the PRINCIPLE advisor to the secretary of heath and scientific issues but we don’t have one chosen yet by our President.  Such a vital position for our country to be safe regarding American citizens health on a daily basis.   Is this decision by our President logical for protecting and keeping health in the U.S. safe?  Is this logical? Rep. Bill Johnson stated on CNN today “I am not going to question the President” with hesitancy but yet states he has “concerns” he stated in wondering “why he has no science or medical background”. Do you not have confidence in the CDC? he was asked by CNN today this morning and he even responded  “Absolutely not, and the CDC found this out in March but we have no resolution yet.  They don’t know how this spread went to 2 coworkers in the same hospital.” Do you feel safe?  I am concerned. Do you find this scary living in the U.S.?  I have my concerns not that I am moving out of the country or locking myself  up in my house, like a paranoia case but this situation means we need to CONTAIN this situation with proper PREVENTION of this disease before ever becoming an epidemic. Go under comment and give your opinion; your thoughts matter especially if  America is your home and even if you visit the U.S.  We have 2 RN’s already in hospitals with this and one person deceased in America that did visit Africa coming home to the U.S. with this terrible virus.  Remember the hospital follows CDC in rules and regulations they make which goes national.  Is our government doing enough.  The CDC website in http://www.cdc.gov/.

Today Saturday10/18/14 on CNN.com interviewed was Maria Cordona, asked what do you think about this situation?  She responded “This is just a way to pick on the President and it’s a good idea to have someone who knows how to run a campaign.”  What intelligence to you see in that reply that deals with the “Ebola Czar”, a possible health epidemic.

Now Amy Holmes  interviewed also on CNN.com asked about her opinion; she responded “This is not the best choice, you have a man with no health background and he is involved in the health of others.”  She also stated “There were other choicex for the President that were more suitable for this job.”  So the gist of it was she felt that a experienced medical professional would be the most intelligent choice.

What is your opinion?

“The current outbreak in West Africa, (first cases notified in March 2014), is the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976. There have been more cases and deaths in this outbreak than all others combined.”

CDC (Center for disease control and prevention)

Responding to growing calls to appoint an “Ebola czar” to lead America’s battle against the deadly virus, sources confirm to Fox News that President Obama plans to name Ron Klain, a longtime political hand with no apparent medical or health care background.

“Appointed by our President Barack Obama is former White House official Ron Klain to coordinate the U.S. government’s response to the Ebola outbreak, an administration official said on Friday.  He is an attorney, comes to the job with strong management credentials, extensive federal government experience overseeing complex operations and good working relationships with leading members of Congress, as well as senior Obama administration officials, including the president,” the official said to fox news.com.

What is a czar?  This word by definition, is any person exercising great authority or power in a particular field.  This man has no medical background, not even a license as M.D.  working as even a general practitioner who understands all diseases in general.  Wouldn’t you want someone with medical background who decides for our US guiding our President in what to do with  medical diseases, and who makes the decision in what is best to  protect our country by giving the President what proper direction to go towards?  I would.

Isn’t this bizarre to you or at least don’t you question why this man is not a biology major, or a scientist, or a M.D. or something in science research?

I could understand if our President gave this role to Mr. Ron Klain with a science major as a doctor, biologist, scientist or someone with a lot of disease research knowledge experience working with him but so far no one in media or the President himself has not mentioned that this is the case.  You already have officials mentioning this concern with the media with no one defending it that favors the czar decision by our President.  We don’t even have a general surgeon in place, our President has still has not made a decision who takes on this role at this present time.

The surgeon general is the operational head of the U.S. Public Health Service Commissioned in the federal government and thus the leading spokesperson on matter of public heath in the federal government of the U.S. for 4 years, when hired.  This person reports to the Assistant Secretary of Health, who may be a 4 star general in the United States Public Health Service, Commissioned Corps. and who serves as the PRINCIPLE advisor to the secretary of heath and scientific issues but we don’t have one chosen yet by our President.  Such a vital position for our country to be safe regarding American citizens health on a daily basis.   Is this decision by our President logical for protecting and keeping health in the U.S. safe?  Is this logical?

Rep. Bill Johnson stated on CNN today “I am not going to question the President” with hesitancy but yet states he has “concerns” he stated in wondering “why he has no science or medical background”.  I personally heard it on CNN straight from his mouth not someone else’s.

Do you not have confidence in the CDC? he was asked by CNN today this morning and he even responded  “Absolutely not, and the CDC found this out in March but we have no resolution yet.  They don’t know how this spread went to 2 coworkers in the same hospital.”

Do you feel safe?  I am concerned.

Do you find this scary living in the U.S.?  I have my concerns not that I am moving out of the country or locking myself  up in my house, like a paranoia case but this situation means we need to CONTAIN this situation with proper PREVENTION of this disease before ever becoming an epidemic.

Go under comment and give your opinion; your thoughts matter especially if  America is your home and even if you visit the U.S.

According to the Center for Disease Control (CDC )the 2014 Ebola epidemic is the largest in history, affecting in West Africa. One imported case from Liberia and associated locally acquired cases in healthcare workers have been documented. CDC and partners are taking precautions to prevent the further spread of Ebola within the United States. We should have taken action with making limitations a long time ago but again our government seems to worry about other countries more than our own or else we would not have this potential epidemic. Look at what is finally being doing in airports at least in New York regarding visitors coming from Africa, they are being checked for disease in someway, that should have started years ago with the increase or population into our country from people unfortunately in other countries with more disease due to less protection or action due to their economy and what they can afford. Yet, in the end our government needs to protect us the US citizens and have a regulation much more tighter than it was if US citizens for whatever the reason is leaving this country to other countries for business (EX. News Report Employees.) or vacation is allowed; which it has been going on for ages. The key factor like to almost any disease or infection in or out of hospitals is: Prevention!

One major way in prevention is MSF (Médecins Sans Frontières) health staff in protective clothing constructing perimeter for isolation ward.

***Background of the disease Ebola

***The Ebola virus causes an acute, serious illness which is often fatal if untreated. Ebola virus disease (EVD) first appeared in 1976 in 2 simultaneous outbreaks, one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name.

The current outbreak in West Africa, (first cases notified in March 2014), is the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976. There have been more cases and deaths in this outbreak than all others combined. It has also spread between countries starting in Guinea then spreading across land borders to Sierra Leone and Liberia, by air (1 traveller only) to Nigeria, and by land (1 traveller) to Senegal. God willing we do something fast enough with all the medical technology we have in America and fine a way to control it in our own country; we came through in controlling the flu and so many other epidemics.

The most severely affected countries, Guinea, Sierra Leone and Liberia have very weak health systems, lacking human and infrastructural resources, having only recently emerged from long periods of conflict and instability. On August 8, the WHO Director-General declared this outbreak a Public Health Emergency of International Concern. Well the US better do something fast to prevent both me and many others in this home land to keep us safe. By the way I am RN 26 years and this topic Ebola concerns me terribly.

PRESENTLY NOW according to the CDC this is the case with Ebola since this past Monday, “there are about 8,900 cases of Ebola infection worldwide with almost 4,500 deaths as of this week. And, the World Health Organization announced on Monday that we may see 10,000 new cases per week by December. Yes, that headline-making virus has now also made its way to the U.S. But, no, you will still probably not get it. Here’s what we know, and what you need to know about today’s Ebola situation.”  There is no treatment reinforced by Dr. Anthony Fauci  asked today on CNN live at 1045 this morning; one of the MD’s treating Nina Pham the RN infected by Ebola in Dallas who was transferred to another hospital for treatment.  He also stated that Ebola “is an unpredictable situation, he will follow the direction of the US President, there is no information to support that this is airborne contaminating, but for safety the staff is also using face masks with regular contact isolation equipment with remaining still on contact isolation”.  The government pays 4.2 million dollars a year to run this hospital hopefully this will save the patient with this money.  He also stated, “It would be unusual for a patient with Ebola not to worry about Ebola.”  just like us in America hearing all this information.  CNN states “the reason this hospital is so special for the patient Nina Pham is they have bio-containment rooms to prevent spreading the disease.”

Transmissiono of Ebola:

It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest that picked up this virus.

Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.

Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced or taught to the medical workers through detailed and concise information with written instructions, proper demonstration, with most important follow up by health care worker superiors like managers to nursing education depts.

For further information on this go to my reference http://www.who.int/mediacentre/factsheets/fs103/en/The World Health Organization. *** There is no FDA-approved vaccine available for Ebola, unfortunately but like most after damage occurs in enough quantities (which is the case) in time most diseases come up with one regarding the many over the few diseases we haven’t seem to have invented yet. So the key for this disease right now is PREVENTION of it.

Keep in mind, through the CDC, we are in the U.S. working on a treatment. Let us take a look.

“Experimental vaccines and treatments for Ebola are under development, but they have not yet been fully tested for safety or effectiveness.

Recovery from Ebola depends on good supportive care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years, possibly longer. It isn’t known if people who recover are immune for life or if they can become infected with a different species of Ebola. Some people who have recovered from Ebola have developed long-term complications, such as joint and vision problems.”

Check out part 2 on EBOLA with more information you should know about this weekend and Monday!

“Vertigo is the conflict between the fear of falling and the desire to fall.“

“My father has positional vertigo, and if he flies he gets really dizzy, so he has to drive out to California, which he does a couple times a year. We talk, but we e-mail mostly.”

Ben Affleck

“Know what to do if you feel faint or dizzy, especially if you might fall and hit your head.”

If one day you start the day going to work than come home feeling like a sinus infection that appears to be spreading to the ears and after going to bed several hours upon awakening you sit up finding yourself pulling to one side that you think the cause is an ear infection but in it could be something else; or if when you get up and feel dizzy, than have a meal but due to the dizziness you vomit causing dizziness to increase terribly (like if sea sick or even like too much alcohol followed with vomiting and now everything’s spinning to the point you can’t get up from the ground) this might just be something else. What might this be?

This could be an ear infection with BPPV or just BPPV itself; this abbreviation stands for BPPV-Benign Paroxsymal Posterior Vertigo (highly probable if its feeling clogged, no draining from the ear canal, no wax build up after checked with an otoscope by an ENT or Neurologist and the symptoms listed above present that I mentioned= Vertigo, Nausea; Possibly vision disturbance with lethargy) including a nystagmus (described below). This is how you feel after a concussion (with or without a nystagmus) in varying intensities depending on the impact after a blow to the head. How do these symptoms arise with no infection in the ear?

This involves the inner ear causing the brain to pick up miscommunication signals in detecting or reading what is happening going on giving the ending result of vertigo =dizziness, causing your balance to be off, which again I reenforce is due to the condition that is going on in the middle ear. It is the sensitivity detection by ear sensitivity hairs picking up what shouldn’t be there, which in turn is causing the symptoms. This can be due to inner ear particles clumped together in the ear or particles in the inner ear floating freely depending where the are located in the inner ear. We will discuss this more in detail shortly, just know these particles are called “rocks”.

If your having these symptoms this should be checked for BPPV and (I do recommend you go to MD to be evaluated first):

Benign paroxysmal positional vertigo (BPPV) is probably the most common cause of vertigo in the United States. It has been estimated that at least 20% of patients who present to the physician with vertigo have BPPV. However, because BPPV is frequently misdiagnosed, this figure may not be completely accurate and is probably an underestimation. Since BPPV can occur concomitantly with other inner ear diseases (for example, one patient may have both Ménière disease and BPPV at once), statistical analysis may be skewed toward lower numbers.

BPPV was first described by Barany in 1921. The characteristic nystagmus and vertigo associated with positioning changes were attributed at that time to the otolithic organs. In 1952, Dix and Hallpike performed the provocative positional testing named in their honor, shown below. They further defined classic nystagmus and went on to localize the pathology to the proper ear during provocation. *

It deals with the inner ear.

The patient is placed in a sitting position with the head turned 45° towards the affected side and then reclined past the supine position.

BPPV is defined as an abnormal sensation of motion that is elicited by certain critical provocative positions. The provocative positions usually trigger specific eye movements (ie, nystagmus). The character and direction of the nystagmus are specific to the part of the inner ear affected and the pathophysiology.

BPPV is a complex disorder to define; because an evolution has occurred in the understanding of its pathophysiology, an evolution has also occurred in its definition. As more interest is focused on BPPV, new variations of positional vertigo have been discovered. What was previously grouped as BPPV is now subclassified by the offending semicircular canal (SCC; ie, posterior superior SCC vs lateral SCC) and, although controversial, further divided into canalithiasis and cupulolithiasis (depending on its pathophysiology).

Although some controversy exists regarding the 2 pathophysiologic mechanisms, canalithiasis and cupulolithiasis, agreement is growing that the entities actually coexist and account for different subspecies of BPPV. Canalithiasis (literally, “canal rocks”) is defined as the condition of particles residing in the canal portion of the SCCs (in contradistinction to the ampullary portion). These densities are considered to be free floating and mobile, causing vertigo by exerting a force. Conversely, cupulolithiasis (literally, “cupula rocks”) refers to densities adhered to the cupula of the crista ampullaris. Cupulolith particles reside in the ampulla of the SCCs and are not free floating.

Classic BPPV is the most common variety of BPPV. It involves the posterior SCC and is characterized by the following:

• Geotropic nystagmus with the problem ear down
• Predominantly rotatory fast phase toward undermost ear
• Latency (a few seconds)
• Limited duration (< 20 s)
• Reversal upon return to upright position
• Response decline upon repetitive provocation. The purpose for this appears to be the brain acquires a response in getting used to this vertigo as normal by picking up wrong messages from that affected ear due to improper messaging by the pick up of how the rocks in the inner ear canal are situated (free floating or residing in a canal portion with how the ear hairs are picking up by sensitivity their presence giving wrong messages to the brain causing vertigo, nystagmus, with or without vomiting.

• Because the type of BPPV is defined by the distinguishing type of nystagmus, defining and explaining the characterizing nystagmus are also important.
• Nystagmus is defined as involuntary eye movements usually triggered by inner ear stimulation. It usually begins as a slow pursuit movement followed by a fast, rapid resetting phase. Nystagmus is named by the direction of the fast phase. Thus, nystagmus may be termed right beating, left beating, up-beating (collectively horizontal), down-beating (vertical), or direction changing.
• If the movements are not purely horizontal or vertical, the nystagmus may be deemed rotational. In rotational nystagmus, the terminology becomes a bit more loose or unconventional. Terms such as clockwise and counterclockwise seem useful until discrepancies regarding point of view arise: clockwise to the patient is counterclockwise to the observer. Right versus left terminology is poorly descriptive because as the top half of the eye rotates right, the bottom half moves left.
• Rotational nystagmus also can be described as geotropic and ageotropic. Geotropic means “toward earth” and refers to the upper half of the eye. Ageotropic refers to the opposite movement. If the head is turned to the right, and the eye rotation is clockwise from the patient’s point of view (top half turns to the right and toward the ground), then the nystagmus is geotropic. If the head is turned toward the left, then geotropic nystagmus is a counterclockwise rotation. This term is particularly useful in describing BPPV nystagmus because the word geotropic remains appropriate whether the right or the left side is involved.
• These 2 terms are useful only when the head is turned. If the patient is supine and looking straight up, these terms cannot be used. Fortunately, the nystagmus associated with BPPV usually is provoked with the head turned to one side. The most accurate way to define nystagmus is by terming it clockwise or counterclockwise from the patient’s point of view.
• If you see the diagram below, click on it, where it is circled that is the tympanic membrane where no doctor can open that and to go further in your seme-circular canal in a doctor’s office or clinic near home that does general medicine and to resolve the problem with surgery you have to see a surgeon in ENT or Neurology specialty.  Surgery will not be your first option anyway.  Treatment I will go into tomorrow but click on the diagram below to understand this condition better by see where it takes place and how the brain picks up messages from rocks being stationed or free floating in a wrong area of the inner ear (the semicircular canal which is made up of 3).  Check it out.

Ear diagram gi…