Infectious Disease

Infectious disease physicians and clinicians writing on KevinMD about outbreaks, antimicrobial resistance, vaccines, and the ongoing challenge of preventing and treating infection. Contributors include the physicians who treat infectious disease and the public health physicians who track it. For a maintained record of what physicians have said about vaccines and vaccine refusal since 2004, see Vaccines: what physicians say, in their own words. For what clinicians wrote during the COVID-19 pandemic as it happened, see COVID-19: what physicians wrote as it happened.

The people treating Ebola patients should be volunteers

Chris Porter, MD

Conditions and Diseases

November 7, 2014

I was recently injecting anesthetic into a boil for incision and drainage. The abscess swelled and returned an arcing spray of lidocaine laden with blood and pus, soaking the thigh of my cotton scrub pants. A cheap plastic gown would have protected me — I usually wear one. But I couldn’t find one and had other tasks waiting. My mind went to Ebola and exposed nurse necks.

What if this were …

Would you treat a patient with Ebola?

Denitza Blagev, MD

Conditions and Diseases

November 4, 2014

“If I get a call about smallpox from the ER I’m not coming in,” an infectious disease doctor said to a colleague in the hospital where I was working. It was the early days of 9/11 and anything seemed possible.

“Are you all OK with providing care for Ebola patients?” our section chief asked. Our ICU is the designated unit to care for all adult patients suspected of having Ebola in our system. We …

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Would you treat a patient with Ebola?

Why EMRs won’t prevent the spread of Ebola

Matt Patterson, MD

Health Technology

November 4, 2014

According to IBM, there are 2.5 exabytes of data created every day, and most of it is unstructured. Imagine receiving all the words ever spoken by human beings on your doorstep each and every day. Now, imagine consuming that, making sense of it and trying to keep up with the ever-accelerating pace of data creation each day.

As a physician, I experienced firsthand the angst that comes with trying to keep up …

Immunoglobulin deficiencies and its association with infectious disease

Andrew Pugliese, MD

Conditions and Diseases

November 4, 2014

The largest challenge facing the infectious disease community in the 21st century is the increasing number of resistant organisms found in various disease processes. The reason is much more complex than the over prescribing of oral antibiotics for sore throats. This is not to say that good antibiotic stewardship is an important concept because it is but it must be recognized that the medical challenges of the human population today is …

Ebola in Dallas: Failure to connect data and story

Kirsten Ostherr, PhD, MPH

Conditions and Diseases

November 3, 2014

The tragic case of Thomas Eric Duncan represents a failure of communication with consequences that extend well beyond the current Ebola crisis. When Mr. Duncan first presented at Texas Health Presbyterian Hospital in Dallas, his recent travel history from Liberia was reportedly ascertained and entered into the hospital’s electronic health record (EHR) system. Somehow, this critical piece of information never registered with the physician who diagnosed Mr. Duncan, and …

Ebola: A cause that can unite us

Edwin Leap, MD

Physician

November 2, 2014

Whatever our individual belief systems, here is a cause that can unite us. Whatever our party affiliations, this can cause us to “reach across the aisle.” Whether or not we are religious, or believe in this life only or the next, this is a cause we can agree on, here and now. Conservative or liberal, right or left, theist or atheist, libertarian or green, male, female, gay, straight, we must …

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Ebola: A cause that can unite us

How to talk to your kids about Ebola

Courtney Schmidt, PharmD

Conditions and Diseases

November 2, 2014

Ebola is a scary topic; there’s no doubt about that. With the onslaught of media coverage that has no end in sight, it’s likely that older children have already heard of the Ebola outbreak or will hear about it in the near future. The question is, what can we do to help our kids work through the confusing and frightening messages they see on television?

Here are some suggestions to help …

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How to talk to your kids about Ebola

What’s the right way to think about Ebola?

Alex Lickerman, MD

Physician

November 1, 2014

shutterstock_177163439

Ebola has riveted our attention: It’s a deadly disease with no known cure, and as is true of most infectious diseases, it’s easy to imagine how it could become a global pandemic and threaten us directly. For what it’s worth, though, here is what the federal Centers for Disease Control and Prevention tells us about Ebola:

1. The Ebola virus is not spread through:

casual …
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What’s the right way to think about Ebola?

Ebola: If Nigeria can do it, so can we

Roy Benaroch, MD

Conditions and Diseases

October 31, 2014

In June, a man became very ill during a flight into Lagos, Nigeria. On the plane, he developed vomiting and diarrhea, and he collapsed in the very busy airport. Contacts on the plane and on the ground had no idea that he had Ebola — initially, he was treated for malaria — and many health care workers and bystanders on the plane and in the airport were exposed to his …

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Ebola: If Nigeria can do it, so can we

Ebola! But don’t forget about the flu.

Janice Boughton, MD

Physician

October 31, 2014

Ebola virus has grabbed headlines since the epidemic started in West Africa nearly a year ago. The death toll is estimated at 4,500 people, and the epidemic continues to spread. One person infected in Liberia returned to Texas with the disease and died, infecting maybe 2 health care workers.

Ebola is a nasty virus, surely, with a case fatality rate of 80 percent. Overall health and nutrition as well as living …

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Ebola! But don’t forget about the flu.

The lessons hospitals and physicians can learn from Ebola

David Klein, MD

Physician

October 30, 2014

Among reams of coverage on the Ebola outbreak, Politico just published a characteristic story with the headline, “In the world of Ebola, no room for error.” The only problem is that is as soon as you introduce a human element to any system, there will be error.

That’s the reality that health care leaders across the United States are grappling with now in a simultaneous effort both to tighten the health …

The Ebola quarantine: Is 21 days enough?

Manoj Jain, MD, MPH

Conditions and Diseases

October 29, 2014

A few weeks ago an emergency room doctor called our infectious disease physician group concerning a patient who had returned from Liberia and was having nausea and vomiting. Several of the patient’s family members had died of Ebola.

As panic struck us, our decisive question was: When did he return from Liberia?

The Centers for Disease Control and Prevention guidelines for screening and isolating patients for possible Ebola infection are …

Instead of being hysterical about Ebola, respect it

Dr. Saurabh Jha

Conditions and Diseases

October 29, 2014

shutterstock_210544051

Some years ago I was in Australia’s Northern Territory. The intrepid explorer that I was, I was croc-spotting from the comfortable heights of a bridge over the East Alligator River. The river derives its name because it is east of something. And because it’s croc-infested.

I was reading a story about a German tourist (it’s usually a German) who was attacked by …

Ebola: We suffer from unrealistic expectations

Richard Reece, MD

Physician

October 28, 2014

Oft expectation fails, and most oft there.
Where most it promises.
– Shakespeare, All’s Well That Ends Well

It may seem a strange thing to say, but I believe the U.S. suffers from unrealistic expectations. We expect government, health, and hospital officials to get things right the first time around. This is unrealistic. People, and believe it or not, including politicians, are never perfectly competent in things they are never experienced before. Disease …

Ebola and the psychology of contagious disease

Myles Riner, MD

Physician

October 27, 2014

A month ago I published a post predicting that paramedics, emergency nurses, and emergency physicians would be exposed to patients with Ebola and have difficulty picking out these patients from the many other patients who present to the ED with similar symptoms. In light of the events in Dallas, Texas, this seems prophetic, but it is really not so difficult to explain (despite the finger-pointing from a horde of outraged reporters …

Ebola in the United States: Don’t forget the lessons we learned

Maja Feldman

Conditions and Diseases

October 27, 2014

Although I never disclosed this in my medical school interviews for fear of being just another cliche (“Hollywood sparks interest in medicine story”), I decided to become a doctor in 1997 at the age of 11 when I first saw the movie, Outbreak. For years and years, this was my favorite movie. The scene where they showed the electron micrograph image of the Ebola virus had me captivated. I was staring at …

Ebola in the digital age: How doctors can confront it

Chiduzie Madubata, MD

Social Media in Medicine

October 27, 2014

With the recent attention given to the Ebola outbreak in West Africa and the cases diagnosed in the United States, one of the main ways in which the public is being informed is through social media. Every single day on Facebook, I see at least one story posted about the Ebola epidemic and its potential impact on the U.S. public and …

Ebola causes a crisis of commitment in physicians

Pamela Davis, MD

Physician

October 27, 2014

What happens when your faith, commitment and professional integrity collide with great personal risk? This is what I imagine is happening across the country to physicians, nurses and other health care workers as we all face the Ebola tragedy.

Sure, people dying in far away Africa bring an ache to our hearts. Admiration for those working with aide groups brings the passing thought so easily conjured from the safety of our …

Ebola forces us to rethink how we document in the EMR

John Halamka, MD

Health Technology

October 26, 2014

Over the past several years I’ve written about the inadequate state of clinical documentation, which is largely unchanged since the days of Osler, (except for a bit more structure introduced by Larry Weed in the 1970s) and was created for billing/legal purposes not for care coordination.

One of the most frequent complaints in my email box these days is a sense that the current record is filled with data, but little knowledge and …

Ebola presents a new paradigm from the ER

Joshua Elder, MD, MPH

Physician

October 26, 2014

Ebola is frightening but not for the reason you may imagine.

A little over a year ago Asiana Flight 214 crashed while landing at San Francisco International Airport resulting in 181 injuries and 3 deaths. As an emergency medicine resident, this fast-forwarded my training as I took care of many of the patients arriving in our emergency department. I left that day inspired that I had the education and training to …

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