Category: International EM
Keywords: Ebola, hemorrhagic fever, international (PubMed Search)
Posted: 7/30/2014 by Jon Mark Hirshon, PhD, MPH, MD
(Updated: 11/3/2024)
Click here to contact Jon Mark Hirshon, PhD, MPH, MD
General Information:
Ebola is a deadly hemorrhagic fever of the virus family Filoviridae.
Clinical Information:
Treatment and Public Health
Bottom Line:
While the likelihood of general dissemination to the general U.S. population is very low, U.S. healthcare workers need to be aware and alert for the signs and symptoms of Ebola for patients recently returned from West Africa.
References: http://www.cdc.gov/ebola
Current CDC advisory: http://emergency.cdc.gov/han/han00363.asp
Category: International EM
Keywords: Smallpox, public health, infectious diseases (PubMed Search)
Posted: 7/19/2014 by Jon Mark Hirshon, PhD, MPH, MD
Click here to contact Jon Mark Hirshon, PhD, MPH, MD
· Smallpox (Variola):
o Only eradicated human infectious disease.
o Prior to the advent of vaccination, it killed an estimated 400,000 Europeans annually and was a major cause of blindness.
· Major potential as a bioterrorism agent:
o Now only supposed to exist in two laboratories in the world (at the CDC in Atlanta, Georgia and in the Vector Institute in Koltsovo, Russia).
· Recently, previously unknown vials of active virus from the 1950s were found in a NIH laboratory in Maryland.
· Clinical Presentation:
o Incubation is usually 10-12 days (range 7-17 days)
o Signs and symptoms include:
§ Febrile (38.8-40.0C) prodome lasting 1-4 days, headache, myalgia (esp. back/spinal pain), pharyngitis, chills, abdominal pain
§ Rash: classically round and well circumscribed. May be confluent or umbilicated. The rash evolves slowly: macules to papules to pustules to scabs.
· It is important to differentiate smallpox from chicken pox (Varicella):
o Smallpox: Significant prodrome. Centrifugal rash (trunk to extremities). Can involve soles and palms. Lesions are in the same stage of development on any one part of the body.
o Chickenpox: Minimal prodrome. Centripetal rash (extremities to trunk). Seldom on soles and palms. Asynchronus evolution of rash.
Bottom Line:
Smallpox is a global public health emergency and requires immediate reporting. If the clinical presentation is unclear, discuss with local infectious disease experts or public health officials.
Category: International EM
Keywords: Geriatric, Global, Emergency Care (PubMed Search)
Posted: 7/3/2014 by Jon Mark Hirshon, PhD, MPH, MD
(Updated: 11/3/2024)
Click here to contact Jon Mark Hirshon, PhD, MPH, MD
Background:
Relevance to the EM Physician:
Bottom Line:
University of Maryland Section of Global Emergency Health Author: Terrence Mulligan DO, MPH
Samaras N, Chevalley T, Samaras D, et al. “Older Patients in the Emergency Department: A Review” Annals of EM Vol 56:3, Sept 2010, p 261-269.
WHO Global Burden of Disease. 2010. www.who.int/healthinfo/global_burden_disease/GBD_report_2010update_full.pdf
United Nations. “World Population Ageing 1950-2050” 2011. www.esa.un.org/wpp/