Wednesday, October 8, 2014

EBOLA VIRUS - What You Need to Know by William C. Parsons, MD, MPH

Ebola virus has made the news, and has been somewhat sensationalized as the first case has been diagnosed in Dallas.  The patient was in Liberia at a family funeral.  He returned to the US, and four days after arriving at his Dallas home, he became sick.  He was hospitalized in isolation at a Dallas hospital and died this morning.  Preliminary reports have now surfaced that a second patient (a family contact) is in the process of being tested.  Ebola is now in America.  How concerned should you be?  You should be aware of the situation, but by no means should you be highly fearful.

Ebola is not spread like influenza or the common cold.  These diseases are spread by airborne droplets from a cough or sneeze.  Ebola requires direct contact with bodily fluids from a clinically sick patient.  The disease starts like a simple flu, but over 48 hours, it rapidly deteriorates to a painful, debilitating condition with bleeding from all body orifices.  In over 50% of cases, death occurs within 72 to 96 hours of this stage.  The dead body fluids are infectious and may be the source infection for the Dallas patient.

The infectious bodily fluids must come from a clinically sick patient.  A patient is not infectious during the incubation period.  This infected fluid must either enter a break in the skin or through a mucus membrane (mouth, eye, etc.) to infect a new host.  Prompt use of soap and water can remove the virus from intact skin.  The risk of infection is the highest for family members, intimate contacts, and healthcare workers.  It is very low for the local community population.

The incubation period is 2 to 21 days with the average being 6 to 9 days.  The initial symptom is a fever above 101.5 F (38.6 C).  All patient contacts are to be monitored for this sentinel fever for a full 21 days.  If a fever appears, that person is immediately quarantined and tested for the disease.  If there is no fever in the 3 weeks, the contact’s monitoring is stopped and that person is declared disease free.  These actions are currently in use for approximately 80 individuals in Dallas.

In conclusion, this is a serious, deadly disease that we should be regarding with awareness.  Risk of infection involves intimate contact with a clinically sick individual that has had some connection with a West African source.  The spread can be controlled using common Public Health measures that are available in most US hospitals and larger communities.  The risk for the general US population is minimal at this time. 

We are monitoring the spread of this disease and the levels of risk for the duration of this epidemic.  We are not only monitoring the US situation, but also the spread in Africa.   Should threat levels change, we will be providing updates as soon as information is available.

William (Bill) Parsons is the Chief Medical Officer of Phillips 66.  He directs the Company wide medical surveillance programs and internally consults to management, human resources, legal, and safety regarding matters that have a medical or health component.  He oversees the medical operations of 14 refinery medical clinics and 3 corporate medical clinics staffed by 20 registered nurses, 4 physician assistant/nurse practitioners along with 15 part time contracted physicians.

Dr. Parsons has been a physician for 30 years and is a Fellow in Occupational Medicine and is also board certified in Family Medicine.  He has an extensive medical background in the petrochemical industry having also held medical positions in CITGO Petroleum, Phillips Petroleum Company, and Sunoco.  In addition, he was an associate professor for 5 years with the University of Oklahoma Department of Family Medicine in Tulsa.  Academically, he holds a Doctor of Medicine from the University of Oklahoma, a Masters of Public Health from the Medical College of Wisconsin, and a Doctor of Veterinary Medicine from the University of Missouri.

Bill is married to Nancy Parsons, President of CDR Assessment Group, Inc.