Ebola and MRSA

Question 1

Ebola

Answer 1

Rare and deadly disease generally in Africa believed to be spread by bats.
Spread by direct contact with infected bodily fluids.
Virus may remain in some body fluids even after the patient has recovered (Semen).
Virus can survive on dry surfaces for several hours and in body fluids for days at room temperature.

Not contagious until they have symptoms.

Recovery is dependent on good supportive care and patients immune response. Survivors have antibodies which can be detected up to 10 years after recovery.

Question 2

Ebola symptoms, diagnosis and treatment

Answer 2

Symptoms appear on average 2-21 days after contact with the virus. Average is 8-10 days.

Symptoms include severe, severe headache, muscle pain, weakness, fatigue, diarrhea, vomiting, abdominal pain, unexplained hemorrhage.

Diagnosis- immediate isolation if suspected, confirm with lab testing. May take up to three days after symptom onset to test positive.

Treatment- primarily supportive, investigational studies ongoing.

Patients may have long term complications- joint and/or vision problems.

Question 3

MRSA

Answer 3

Type of staph infection which is resistant to antibiotics.
Carried on skin or nasal linng in up to 30% of healthy patients. Usually no symptoms.

When skin is damaged, bacteria can enter causing infection.

Initially most cases were in institutionalized patients, now more than half are living in the community.

Question 4

MRSA Hospital Acquired Risk Factors

Answer 4

Surgical wound
IV line
Prolonged stay
Weakened immune system
Recent abx use
Close proximity to other patients, family members or health care providers colonized with MRSA

Question 5

Community Acquired Risk Factors

Answer 5

Skin trauma
Athletes
Shaving or waxing to remove body hair (axilla, groin)
Tattoos, body piercings
Physical contact with a person with draining sores or a carrier or MRSA
Sharing personal items that are not clean between uses, Towels, protective sports equipment.

Question 6

MRSA Presentation

Answer 6

Usually presents as as skin infection. A pimple which turns into a large furuncle or carbuncle. Almost always though to be a spider bite. Can enter the blood stream causing bacteremia.
May lead to infection on heart valves, joints, prosthetic devices, lungs, pacemakers.
Prevention is key.

Question 7

MRSA Infection Diagnostics/Treatment

Answer 7

Obtain culture to determine appropriate abx.
I&D usually more important than antibiotics.
Oral abx are effective if not bactermia.

Keflex for simple infections

Bactrim, doxycycline, clindamycin if high suspicion for MRSA.

Treat 5-14 days and keep antibiotic courses as short as possible.

Question 8

IV Therapy for MRSA

Answer 8

Extensive soft tissue involvement
Signs of systemic toxicity
Rapid progression of clinical manifestations
Persistence of symptoms after 48-72 hours of oral therapy
Proximity of soft tissue infection to indwelling device (prosthetic join, vascular graft)
Bacteremia