Weird Medicine Healthcare for the Rest of Us

March 5, 2015

Abscopal Effect and Malignant Melanoma

Filed under: Non-pseudoscience Cancer Cures,Steve's Blog — dr steve @ 8:08 am

[This one is a rare effect, but if they can just figure out how to trigger it consistently (research is ongoing) this would be a kickass weapon in the war against malignant melanoma and some other cancers.   A more general article on the abscopal effect can be found on Wikipedia, but here’s a quickie from Oncology Nurse Advisor.   –dr steve]

A recent melanoma case featuring the abscopal effect, in which local radiotherapy delivered to a single tumor results in the regression of metastatic cancer at a distance from the irradiated site, may lay the groundwork for a promising approach to melanoma treatment.

Although the abscopal effect is extremely rare, it has been described in several cases of melanoma, lymphoma, and kidney cancer, according to a statement from Memorial Sloan-Kettering Cancer Center (MSKCC) in New York, New York. MSKCC medical oncologist Jedd Wolchok, MD, PhD, was senior author of the report describing the recent case (N Engl J Med. 2012;366-925931).

“We are excited about these results, and what we have seen in this one patient proves the principle that adding radiation therapy to immunotherapy may be a promising combination approach to treatment for advanced cancer,” commented Wolchok.

Wolchok’s team used ipilimumab, an immunotherapy, to treat a patient with advanced melanoma. Approved by the FDA in March 2011, ipilimumab is the first drug to demonstrate improved overall survival in persons with advanced melanoma. This monoclonal antibody works by inhibiting an immunologic checkpoint on T cells known as cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4).

Over time, Wolchok’s patient’s melanoma had metastasized to the spleen, lymph nodes, and near the spine. When localized radiation was administered to the tumor near the spine to provide pain relief, the targeted tumor shrank significantly—and, unexpectedly, so did the tumors in the spleen and the lymph nodes, even though those sites were not directly targeted by the radiation therapy. The use of radiation therapy also resulted in other changes that allowed the patient’s immune system to recognize and control the cancerous cells more effectively.

The researchers followed the patient from her initial diagnosis of melanoma in 2004 through a series of treatments and eventual disease regression in April 2011 after a combination treatment of radiation and immunotherapy.

Measles and Multiple Myeloma

Filed under: Non-pseudoscience Cancer Cures,Steve's Blog — dr steve @ 7:52 am

[Another interesting idea…if you know someone with refractory multiple myeloma, they may qualify for a clinical trial in vaccine therapy (take THAT, anti-vaxxers!)  –dr steve]

from cnn.com

A woman with an incurable cancer is now in remission, thanks, doctors say, to a highly concentrated dose of the measles virus.

For 10 years, Stacy Erholtz, 49, battled multiple myeloma, a deadly cancer of the blood. Doctors at the Mayo Clinic say she had received every type of chemotherapy drug available for her cancer and had undergone two stem cell transplants, only to relapse time and again.

Then researchers gave her and five other multiple myeloma patients a dose of a highly concentrated, lab-engineered measles virus similar to the measles vaccine. In fact, the dose Erholtz received contained enough of the virus to vaccinate approximately 10 million people.

“The idea here is that a virus can be trained to specifically damage a cancer and to leave other tissues in the body unharmed,” said the lead study author, Dr. Stephen Russell.

It’s a concept known as virotherapy, and it’s been done before. Mayo Clinic scientists say thousands of cancer patients have been treated with viruses, but this is the first case of a patient with a cancer that had spread throughout the body going into remission.

Virus put woman's cancer in remission

Erholtz was cancer-free for nine months.

“I think we succeeded because we pushed the dose higher than others have pushed it,” Russell said. “And I think that is critical. The amount of virus that’s in the bloodstream really is the driver of how much gets into the tumors.”

In simple terms, the measles virus makes cancer cells join together and explode, Mayo Clinic researcher Dr. Angela Dispenzieri explains. There’s also some evidence to suggest, she says, that the virus is stimulating the patient’s immune system, helping it recognize any recurring cancer cells and “mop that up.”

This treatment is still in the early testing stages, though. Doctors recently used radiation therapy to treat a small, localized tumor in Erholtz’s body.

And the other patients in the trial did not go into remission. Tests showed the virus helped shrink one woman’s tumors, but they started growing again soon after. The other patients’ cancers did not respond to the treatment.

Researchers also don’t know whether this virotherapy will help other patients or whether it can be applied to other types of cancer. The measles virus worked with these multiple myeloma patients because they are already immune-deficient, meaning their bodies can’t fight off the virus before it has a chance to attack the cancer cells.

More of the highly concentrated measles virus is being created now to be used in a larger clinical trial, Mayo Clinic researchers say. They’ve developed a manufacturing process that can produce large amounts of the virus, Russell says.

“We recently have begun to think about the idea of a single shot cure for cancer — and that’s our goal with this therapy,” he said.

Striking Results With T-Cell Immunotherapy in Cervical Cancer

Filed under: Non-pseudoscience Cancer Cures,Steve's Blog — dr steve @ 7:41 am

[I used to say we were 100 years away from a more generalized approach to cancer therapy.  In the end, barring some unforeseen breakthrough, cancer “cures” will come from the realm of immunology.  The immune system is perfectly appointed to eradicate cancer cell by cell, molecule by molecule, but it only works if it actually recognizes the cancer as abnormal.  Turning on the immune system to recognize cancer cells as foreign is the purpose of a lot of research right now and this is the outcome of a small pilot study.  This makes me think the time horizon is much less than 100 years. Stay tuned for more; I’ll post new articles as I find them.  –Dr Steve]

 

by Roxanne Nelson

June 02, 2014CHICAGO ? The data are preliminary, but the results are striking, demonstrating that an immunotherapy approach using adoptive T-cell therapy may have a role in the treatment of advanced cervical cancer.

A single infusion of the T-cell therapy induced a complete and durable remission in 2 patients with advanced metastatic cervical cancer. In addition, a third patient achieved a partial response of 3 months’ duration, with a 39% reduction in tumor volume.

“This study shows that complete and durable tumor regression can occur following a single infusion of HPV [human papillomavirus]–targeted tumor-infiltrating T cells,” said lead study author Christian Hinrichs, MD, an assistant clinical investigator at the National Cancer Institute.
Dr. Christian Hinrichs

As of last week, he noted, the 2 patients remain in complete remission and are now at 15 and 22 months after treatment.

Speaking at a press briefing during the 2014 Annual Meeting of the American Society of Clinical Oncology, Dr. Hinrichs explained that new therapies are needed for metastatic cervical cancer, because chemotherapy is not curative and rarely provides durable palliation.

“Cervical cancer harbors attractive targets for immunotherapy for the HPV E6 and E7 oncoproteins, but clinical trials in immunotherapy for this disease have been disappointing at this time,” he said.

Adoptive T-cell therapy is an emerging and promising immunotherapy platform, Dr. Hinrichs explained, but its study in epithelial cancers has really been limited, and it has not been studied in cervical therapy.

Objective and Durable Responses

Dr. Hinrichs and colleagues evaluated the use of adoptive T-cell therapy in carcinoma of the uterine cervix, a virally induced malignancy that constitutively expresses the HPV E6 and E7 oncoproteins. They conducted a small trial that included 9 patients with metastatic HPV-positive cancers, and treated them with tumor-infiltrating lymphocytes (TIL) selected for HPV-E6 and -E7 reactivity (HPV-TIL).

All patients received a median of 81 x 109 T cells (range, 33 to 159 x 109) as a single infusion, and the infused cells possessed reactivity against high-risk HPV E6 and/or E7 in 6 of 8 patients. There were 2 patients with no HPV reactivity, and they did not respond to treatment.

Treatment with HPV-TIL infusion was preceded by nonmyeloablative conditioning and was followed by high-dose bolus aldesleukin (Proleukin, Chiron Corporation), an interleukin-2-like product.

Of the 6 patients with HPV reactivity, 3 experienced objective tumor responses by RECIST, 1 partial response and 2 complete responses.

One patient with a complete response was a 36-year-old woman with chemotherapy-refractory HPV-16+ squamous cell carcinoma. “She had been treated with 3 different cytotoxic chemotherapy regimens and had multiple tumor sites, and had a complete response and no evidence of disease at 18 months, and her scans at 22 months look the same,” said Dr. Hinrichs.

The other patient who achieved a complete response was also 36 years old and had chemoradiation-refractory HPV-18+ adenocarcinoma. “Her primary tumor was very aggressive, and at the time of surgery, it was found to have spread to the pelvis and distant sites,” he explained. “She had a complete regression, for 15 months now.”

Both patients also demonstrated prolonged repopulation with HPV-reactive T cells following their treatment, and increased frequencies of HPV-specific T cells were detectable after 13 months in 1 patient and 6 months in the other. Conversely, 2 patients with HPV-reactive TIL that did not respond to treatment did not display repopulation with HPV-reactive T cells.

The most common adverse events were hematologic, and the other most common toxicity was related to infection, Dr. Hinrichs pointed out, with about half of patients experiencing febrile neutropenia. None of the patients had infusion reactions, and all of the hematologic events were completely reversible.

“This study offers proof of principle that immunotherapy can induce regression of cervical cancer and that adoptive T-cell therapy can mediate regression of epithelial cancer,” Dr. Hinrichs concluded. “Continued investigation of HPV-TIL for metastatic cervical cancer is warranted.”

He added that they plan to expand the trial to 35 patients and that there is a separate cohort for noncervical HPV-related cancers.

Exciting Despite Small Numbers

Two experts have expressed enthusiasm over these results.

“This is a very hard group to treat, and if the disease recurs, they essentially have zero survival,” commented David O’Malley, MD, gynecologic oncologist and assistant professor, Ohio State University Comprehensive Cancer Center, the Arthur G. James Cancer Hospital, and the Richard J. Solove Research Institute, Columbus. “So anything that offers the possibility of a complete response is very exciting.”

However, these results have to be taken in the context of a very small trial as well as a fairly toxic regimen that is very expensive to initiate, he told Medscape Medical News. “But if these responses are found to be durable, then this is an exciting new avenue to pursue for these women with little to no choices.”

Michael Birrer, MD, PhD, director of medical gynecologic oncology, Gynecologic Oncology Research Program, Massachusetts General Hospital in Boston, agreed that these results were exciting, despite the limited number of patients.

“For metastatic cervical cancer, the prognosis is amazingly dim, with what used to be about a 3.7-month survival now has been extended to about 6 months with bevacizumab [Avastin, Genentech, Inc],” he said. “But it is uniformly fatal. Still, we don’t see complete remissions, and we certainly don’t see prolonged remissions. So despite the small numbers, this is quite provocative and quite interesting.

“On top of that, this is an immune therapy intervention which has been around a long time, but there is a renewed interest in it because of the PD-1 drugs,” Dr. Birrer continued. “But because this is a viral propagated disease with HPV as the target, it all makes sense. Even though the numbers are small, I think a lot of us are quite excited about it.”

This study was supported by the National Cancer Institute, National Institutes of Health. The authors have disclosed no relevant financial relationships.

2014 Annual Meeting of the American Society of Clinical Oncology: Abstract LBA3008. Presented June 3, 2014.

February 8, 2015

Eat Fiber and Die – 1987

Filed under: Steve's Blog — dr steve @ 4:28 pm

Ok, I recorded this in my little bedroom studio in 1987 with a Korg DSS-1 sampling synthesizer.  I was an idiot.  There was overwhelming response to this being played on my show (none of it positive, mind you) so I thought I’d post it here for your non-enjoyment.  Drive your significant other crazy with it, pretending to like it.

It’s titled “Eat Fiber and DIE” for no other reason than hipsters were (correctly) extolling the virtues of fiber at the time and I was an ass.  If you can’t understand it, the refrain is “Someone roll me a GREAT BIG ‘SPLEEF’, in return I’ll give you MANUAL RELIEF!”

At the time, there were “massage parlors” all over my area that advertised “Manual Relief” in signs outside their little trailers that they stacked up all up and down the highway just into the county.  Once the county made handjobs illegal, the parlors went away, but the euphemism never left me.

yr obt svt,

 

Dr Steve

 

PS: Here are the lyrics:

There’s a lot of things that I would like to say
I’d like to talk to you, talk to you today
There’s a lot of scary things happening in this world
It’s a scary scary scary kind of world

Someone roll me a great big spliff
In return I’ll give you manual relief
Someone roll me a great big spliff

Madman options
French fried dough
You don’t read the papers,
So what do you know?
You think kickin’ ass be cool…
…shove a bomb up your ass, cut off your tool.

There’s a lot of things, I’d like to say to you
But you won’t listen, won’t listen, won’t listen, will you?
You bitch about the world’s a piece of shit
But you won’t do nothing about it, go suck your mama’s tit.

Someone roll me a great big spliff…

As long as you’re just pissin’
Ain’t no one gonna listen.
Do something about it.
Get up, get up, get off your brush head ass
Go fucking run for mayor or something, I dunno.

There’s a lot of things that I would like to say
I’d like to talk to you today
There’s a lot of scary things happening in this world
It’s a kind of scary kind of world

Someone roll me a great big spliff…

 

February 1, 2015

Recipe: Cheesy No Grain Breadsticks

Filed under: NSNG,Steve's Blog — dr steve @ 7:53 pm

I’m going to create a new category of NSNG recipes as I find and test them.   I tried this one SuperBowl Sunday and even my kids thought it was pretty good.  It ends up with a soft, bread-y interior, with a crisp outside crust (made of cheese).  Dip it in marinara or eat it with NSNG chili, as we did.  I’ll be using this basic recipe for pizza crust in the future.

1 large head of cauliflower
4 eggs
1 1/2 cups mozzarella, shredded, divided into 2 parts
1 cups cheddar cheese, shredded
1-2 tsp dried oregano
1 tsp minced garlic
1/2 tsp salt

You can use more or less cheese, just experiment with the proportions.

Preheat oven to 425 degrees Fahrenheit, 400 if a convection oven.  Cut up the cauliflower into medium sized florets and place in a pot with 1″ water in the bottom.  Turn on high and steam the cauliflower for 10 minutes, covered, after the water starts to boil.  Turn out the cauliflower into a colander and drain for a few minutes.  Transfer the cauliflower into a bowl and smash it with a potato masher until it is the size and consistency of rice.

Add the eggs, half the mozzarella, the cheddar, oregano, garlic and salt. Mix thoroughly and turn out onto a large cookie sheet lined with parchment paper.  The “dough” will be liquidy but shapeable.

Bake for 25 minutes, or until the dough is uniformly golden-brown.  Top with remaining mozzarella and bake again until golden-brown, usually 5-7 minutes.

Remove and cut into pieces and let cool for a couple of minutes before serving plain or with marinara dip.

Yours will look something like this, though this is a stock photo 🙂

Let me know if you like it!  Cauliflower sounds horrendous but it’s amazing how little taste it has and how easy it is to fool your palate into actually enjoying it.

yr obt svt,

 

Steve

[editor’s note: Dr Steve is not pushing one “diet” or another…choose a dietary lifestyle based on your own needs and tastes.  If you’re interested in NSNG lifestyle, check out Vinnie Tortorich’s website.]

Nutritional Information

January 11, 2015

Female Ejaculation vs Coital Incontinence

Filed under: Steve's Blog — Tags: , , , , , , , , , , — dr steve @ 9:25 am

Much has been made of a study on female ejaculation in the media and on Twitter and Reddit lately.  The media and the blogosphere have been rife with headlines like: “Scientists Say Female ‘Squirting’ is Just Peeing!”

Unfortunately, once again the bloggers and medical media got it wrong.

Read the original study:

http://www.ncbi.nlm.nih.gov/pubmed/25545022

This study suffers from a severe case of selection bias. Finding that the fluid emission was urine was the only possible outcome of the study given its structure, because they selected only women who already had coital incontinence:

“Seven women, without gynecologic abnormalities and who reported recurrent and massive fluid emission during sexual stimulation, underwent provoked sexual arousal.”

The problem is that women with “massive” fluid emission certainly suffer from coital incontinence, rather than enjoying female ejaculation (though they may do both).  Coital incontinence is the involuntary release of urine from the bladder, sometimes during penetration but often with orgasm and contraction of the pelvic floor muscles.   Female ejaculation is emission of a semen-like fluid from the “female prostate”, or Skeens Glands.

There is female ejaculation and there is coital incontinence. They are two separate things. In case you were wondering, female ejaculation is a fact undisputed by rational researchers:

“Female ejaculation orgasm manifests as either a female ejaculation (FE) of a smaller quantity of whitish secretions from the female prostate or a squirting of a larger amount of diluted and changed urine (Coital Incontinence (CI)). Both phenomena may occur simultaneously. The prevalence of FE is 10-54%. CI is divided into penetration and orgasmic forms. The prevalence of CI is 0.2-66%.”

http://www.ncbi.nlm.nih.gov/pubmed/23634659

Some women ejaculate. Some women have coital incontinence. Some women have both. This current study was structured only to find people with coital incontinence. It’s interesting that five of the seven also ejaculated:

“[Prostatic Specific Antigen] was present in S and ASU in five out of seven participants.”

This is buried in most of the stories, and is not mentioned at all in some of them.

There is one interesting finding in this study that bears further investigation. These women had a rapid increase in the volume of their bladders during sexual stimulation:

“After a variable time of sexual excitation, US2 (just before squirting) showed noticeable bladder filling, and US3 (just after squirting) demonstrated that the bladder had been emptied again.”

To my knowledge this is a previously unknown phenomenon. So this study does have something to say about coital incontinence but says absolutely nothing, or very little, about what we’re really interested in, which is female ejaculation.

Our upcoming show on January 20th on Riotcast is basically dedicated to this topic, so stay tuned!

Your pal,

Dr Steve

December 31, 2014

Recipe: NSNG Smoothies

Filed under: NSNG,Steve's Blog — Tags: , , , , , — dr steve @ 8:27 pm

People have emailed me, asking me for my smoothie “recipes” from the last podcast. I really don’t have any; I mostly improvise like a jazz musician using the following “chord chart” (yecch):

First Principles:

1) Spinach is basically tasteless raw (Kale is vile to me, but some people like it)
2) Almond milk is better than soy milk which is better than cow’s milk (especially if you’re lactose intolerant). Do I have evidence to back that up? Nope! Just my opinion.
3) The taste of fresh carrots is pretty good and can be masked with a single serving of fruit

so:

if you’re grain-free, you start with a handful of spinach and a handful of carrots, dump them in your nutribullet (get one or something similar…it’s worth it), then add whatever you like to make up some stuff…

Ideas:

  • Almond milk + banana (simple, tasty, and 2 veggies and 1 fruit).\
  • Yogurt (greek, or not)+banana+V8 Fusion+frozen black cherries (lots of sugar, unfortunately, but kids will dig it, never knowing they’re eating spinach and carrots (Not “No Sugar,” but better than a lot of stuff kids eat today).
  • Apple slices + banana + almond milk.
  • all of the above with or without a scoop of vegetable protein or whey protein (if you want more protein).

You can go more veggie by adding cucumber, squash, and using water+protein powder (OR WHATEVER, you getting the idea?)

if you’re not grain free, you can add some chia seeds or flax seeds or oatmeal. Remember, I always start with spinach and carrots as a “base”. You don’t have to. Do whatever you want, who am I, your smoothie guru? Find your own path, you’ll enjoy it more. If you made something and it tastes like shit, throw it out and make something else…it’s not like you’re smelting gold bars.

Basically, make stuff up. It’s fun and I HATE books with a blue-million “Smoothie Recipes” with all kinds of made-up benefits (I just saved you 10 bucks on one of those self-published pieces of crap). The main benefit is getting in more fresh fruit and veggies than you’re normally going to get with a Crappy American Diet (CAD). So make something you like that doesn’t have too much sugar in it and you’ll do fine.

Good luck and let me know if you come up with something! Experiment, you really can’t go wrong (my wife makes a “smoothie” with coffee and grass-fed butter, but that’s a whole ‘nother topic).

yr obt svt,

Steve

PS: Frozen Black Cherries > > Frozen mango >Frozen Strawberries > Frozen Blueberries > Frozen Peaches when it comes to flavor…some frozen fruit doesn’t add anything, but I’ve found the frozen black cherries you can at least taste.

If you’re not using anything frozen, you can add a couple of ice cubes to chill it. Banana always gives a nice smooth texture.

PPS: if you’re an author who wrote a book of smoothie recipes and are offended by what I said above, I wasn’t talking about you. Every OTHER book except yours is a piece of crap. Thank you.

December 8, 2014

Help Some People at the Holidays

Filed under: Steve's Blog — dr steve @ 8:11 am

Well, it’s that time of year and we have a couple of people we can help if you have an extra $1, $5, $10, or more!

First:

Our pal RexDart has been taking chemotherapy, but his fixed income makes traveling to MD Anderson AND keeping the lights on at home difficult. He also pays child support out of his Social Security check which is less than $1000/month in the first place.

If you’d like to help him out, click the button below. Any amount will help!  This will basically go toward keeping propane in the tank and the lights on.




Second:

Ok, ok, we get it, Lady Di is a mess. Sending her money directly would simply be enabling her and would fatten the coffers of the Natty Ice distributor. I do have her landlord’s name and address, though, and we could send him a few bucks to offset her rent payment for the holidays (around $770/month). However annoying she is, I know Weird Medicine listeners wouldn’t want her homeless again, tooting on unclean junk to keep beans on her plate.

To donate to Lady Di’s rent (100% will go to her landlord; Di has foodstamps and welfare to count on for food and heat), click the link below:

SUCCESSFULLY FULFILLED…FURTHER DONATIONS SUSPENDED PENDING DI MAKING SOME SERIOUS STEPS TO IMPROVING HER LIFE.

 

Third:

If you’d like to help Kevin, the Ron and Fez fan with the pineal gland cyst, click here to go to his YouCaring.Com fundraiser! The problem with having health insurance is that it DOESN’T PAY THE MORTGAGE or make sure your KIDS ARE OK AT THE HOLIDAYS…Kevin and his family could use some real help while he is recuperating.

 

FOURTH:

Mad Scientist Party Hour (partners of ours on the RiotCast Network) has a friend with multiple brain aneurysms.  He had a huge medical bill and did something you can do too if you run up a huge bill:  he went to the hospital and negotiated his bill down to $5500!  Nicely done, but he needs help paying it off.   Give him some help by checking out his funding site at:  tinyurl.com/rolloutforsiike

Weird Medicine listeners are the best;  you all ALWAYS come through and you are most appreciated.

Thanks as always, and I’ll keep you up to date on the progress of these campaigns.

yr obt svt,

Steve

 

 

UPDATE:

Thanks to all of you, we have so far sent half her rent to Lady Di’s landlord and a few shekels to RexDart to make his holiday slightly less crappy.   Diana understands ANY FURTHER HELP FROM WEIRD MEDICINE LISTENERS IS PREDICATED ON HER TAKING CERTAIN STEPS, including seeing her local doctor for referral to an addictionologist and following up regarding her hip so she can get back to work and get off the couch.   This has been a consistent demand from donors;  help during the holidays is a gift without strings but that goodwill only goes so far.  Having said that a LOT of you said they’d be willing to help Di if she would simply show signs of helping herself.

Any further donations after our show airs on 12/13/14 will go to RexDart and his kids and dog unless you specifically request that it be held for Di once she shows some sign of interest in making her life better.

Thanks to everyone who helped and to everyone who didn’t donate but refrained from bashing me for helping Diana out at this time of year.

 

yr obt svt,

 

 

steve

December 1, 2014

RIOTCAST Holiday Gift Drive: Please Help!

Filed under: Steve's Blog — dr steve @ 7:47 pm

giftDrive

October 26, 2014

Commentary: First US-Contracted Ebola Patient Declared Disease-Free

Filed under: Ebola — Tags: , , — dr steve @ 10:18 am

To the panicky-Petes out there…Mr Thomas Eric Duncan was SYMPTOMATIC and in the community for approximately 4 days after he was sent home from the Emergency Room the first time with fever and gastroenteritis (and given antibiotics, which is another subject altogether).   Despite this, only Nurses Nina Pham and Amber Vinson are known to have contracted the illness from him.   The 3 week deadline from his ultimate isolation on Sept 28 is over.  There has been no great outbreak of Ebola in Dallas, and one is not expected in NYC from Dr Craig Allen Spencer’s “Big Day Out” as he was not symptomatic at any time and isolated himself within hours of becoming febrile.

I don’t agree with Quarantine, at least not the way it is being done to Kaci Hickox…but the lack of self-isolation by people like Nancy Snyderman and Dr Spencer create significant issues with contact tracing and increase societal anxiety.   We should not relieve people of their personal liberties just because people don’t understand the science behind Ebola transmission, but on the other hand we must do what we can as medical professionals to allay these fears.   If Dr Spencer had self-isolated and then became symptomatic, I’m quite convinced none of this mandatory quarantine business would have happened…until the next case, of course.

The CDC  has specific recommendations for asymptomatic people who have come into contact with Ebola virus:

  • Conditional release and controlled movement until 21 days after last known potential exposure
    • By “conditional release” they mean “people are monitored by a public health authority for 21 days after the last known potential Ebola virus exposure to ensure that immediate actions are taken if they develop symptoms consistent with EVD during this period. People conditionally released should self-monitor for fever twice daily and notify the public health authority if they develop fever or other symptoms.”
  • Controlled Movement “requires people to notify the public health authority about their intended travel for 21 days after their last known potential Ebola virus exposure. These individuals should not travel by commercial conveyances (e.g. airplane, ship, long-distance bus, or train). Local use of public transportation (e.g. taxi, bus) by asymptomatic individuals should be discussed with the public health authority. If travel is approved, the exposed person must have timely access to appropriate medical care if symptoms develop during travel. Approved long-distance travel should be by chartered flight or private vehicle; if local public transportation is used, the individual must be able to exit quickly.”

So the CDC so far does not recommend quarantine, even if a person has:

  • Direct skin contact with, or exposure to blood or body fluids of, an EVD patient without appropriate personal protective equipment (PPE)
  • AND is asymptomatic

If governments are going to quarantine people who return from close contact with the Ebola virus despite the CDC’s recommendations, and despite what we know about Ebola transmission, how about an ankle bracelet and home monitoring?   At least then they could binge-watch “Breaking Bad” or “Sons of Anarchy” (or “The Strain”!  Horrors!)  And if we’re going to mandate a 21 day quarantine, compensation for lost time at work needs to be part of the equation.  The government has the right to require quarantine;  it doesn’t appear to be necessary to prevent the spread of disease, but some politicians feel it’s necessary to prevent the spread of panic. If they’re going to do this, it should be done as humanely and as comfortably as possible.  These health care workers are heroes and need to be treated as such.

Some have proposed quarantine before people LEAVE the area;  this would certainly work, but it needs it be in at least 4 star surroundings, with access to food, electricity, clean water, and communications.  We need health care providers to travel to Ebola-stricken areas to stop this at the source;  giving them a well-earned 3 week vacation at the end of their tour sounds better than “quarantine”, doesn’t it?

More on this story as it evolves.  See the CNN article below. 

yr obt svt,

Dr Steve

============================================

 

CNN — Nina Pham was the first person to catch Ebola on U.S. soil, and now, 13 days after testing positive, she has been declared free of the deadly disease.

Her first order of business will be to hug her dog, Bentley, she said Friday.

She invoked God and science in expressing gratitude for her ongoing recovery from a disease that has no established cure.

“I feel fortunate and blessed to be standing here today,” she said. “Throughout this ordeal, I have put my faith in God and my medical team.”

Nurse cured of Ebola: I’m so fortunate

Where is the Ebola dog Bentley?

After being greeted by her father, Peter, Nina Pham is presented with scrubs signed with well wishes by her colleagues at Texas Health Presbyterian Hospital Dallas.
After being greeted by her father, Peter, Nina Pham is presented with scrubs signed with well wishes by her colleagues at Texas Health Presbyterian Hospital Dallas.

Later Friday, President Barack Obama met Pham in the Oval Office and gave her a big hug.

Prayer sustained her, and she thanked people around the world who prayed for her, Pham told reporters Friday at a National Institutes of Health hospital in Bethesda, Maryland.

The nation saw a cheerful and composed Pham, dressed in a bright turquoise top and matching necklace, when she strode to a bank of microphones moments after Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said she was free of the virus.

Complete coverage of Ebola

She thanked Dr. Kent Brantly, the American physician who also survived Ebola, for donating his plasma to her while she was sick.

But she’s not entirely out of the woods, she said.

“Although I no longer have Ebola, I know that it may be awhile before I have my strength back,” Pham said. “So with gratitude and respect for everyone’s concern, I ask for my privacy and for my family’s privacy to be respected as I return to Texas and try to get back to a normal life and reunite with my dog, Bentley.”

Bentley, a Cavalier King Charles spaniel, remains in quarantine until the end of the month in Texas, but Pham “will be able to visit, hold and play with him tomorrow,” Dallas County Judge Clay Jenkins said Friday.

“I know that will be good for both of them,” said Jenkins, who oversees the Ebola response in Dallas.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, hugs Nina Pham outside the National Institutes of Health in Bethesda, Maryland.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, hugs Nina Pham outside the National Institutes of Health in Bethesda, Maryland.

A ‘stressful and challenging’ time

Pham, 26, who grew up in a Vietnamese family in Fort Worth, Texas, graduated with a nursing degree in 2010 and just months ago received a certification in critical care nursing, which deals with life-threatening problems.

The Ebola experience, she said, was a “very stressful and challenging” time for her.

Without direct reference to the continent, she alluded to how Ebola has ravaged West Africa in an unprecedented outbreak that the World Health Organization says has caused almost 10,000 confirmed or probable cases of infection and 4,877 deaths as of this week.

“I am on my way back to recovery even as I reflect on how many others have not been so fortunate,” she said.

White House press secretary Josh Earnest called Pham’s case “a pretty apt reminder that we do have the best medical infrastructure in the world.”

“The track record of treating Ebola patients in this country is very strong, particularly for those who are quickly diagnosed,” Earnest said. “The fact that she has been treated and released I think is terrific news.”

The first to catch virus on U.S. soil

Can pets get or spread Ebola?

Pham was among the doctors and nurses in Dallas who treated Thomas Eric Duncan, the first person to be diagnosed with Ebola in the United States. His diagnosis came after he returned from a trip to West Africa, and he died on October 8.

Three days later, Pham tested positive for the Ebola virus, becoming the first person in the United States to contract Ebola on American soil. That sent waves of anxiety through the network of health care workers — and beyond.

Latest Ebola developments

Those anxieties deepened on October 15 when a second nurse in Dallas, Amber Vinson, tested positive for Ebola. Vinson had flown from Dallas to Cleveland and back, prompting an airline to warn passengers on both legs of her trip as well as passengers who took subsequent flights on an aircraft she used. Some schools closed. Health departments monitored dozens of people.

None of them has tested positive for Ebola.

Pham said Friday that her thoughts are with Vinson, who is getting treatment for Ebola at Atlanta’s Emory University Hospital.

Vinson is steadily regaining her strength, and her spirits are high, her family has said. Doctors can no longer detect the virus in her body, but they have not yet determined when she will be discharged, the hospital in Atlanta said Friday.

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