Ebola: What You Need to Know

In recent weeks, we have seen many reports on the Ebola epidemic.  Mostly, this has been due to the fact that American aid workers were infected and brought back to the US for treatment. What seemed like something that only happened in a remote area was suddenly thrust into Atlanta’s own CDC/Emory Hospital.  This left many of us wondering whether or not we should be concerned for our own safety.
Here are a few things that are important to know. The first Ebola virus was discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Since then, outbreaks of Ebola among humans have appeared sporadically in Africa.  Ebola viruses are now found in several African countries.  Ebola is one of numerous Viral Hemorrhagic Fevers. It is a severe, often fatal disease in humans and nonhuman primates (such as monkeys, gorillas, and chimpanzees).

Symptoms

• Fever (greater than 101.5°F)
• Severe headache
• Muscle pain
• Diarrhea
• Vomiting
• Abdominal (stomach) pain

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola virus, although 8-10 days is most common.

Some who become sick with Ebola are able to recover. Others, who die, usually have not developed a significant immune response to the virus. We don’t yet know why this is.

Transmission

Although it is not certain, it is believed that the first patient becomes infected through contact with an infected animal.

Once in humans, the virus can be spread in several ways. This is through direct contact (through broken skin or mucous membranes) with: 

• a sick person's blood or body fluids (urine, saliva, feces, vomit, and semen)
• objects (such as needles) that have been contaminated with infected body fluids
• infected animals

Who is at risk?

• Healthcare workers
  This is when hospital staff are not wearing appropriate protective equipment, such as masks, gowns, and gloves. Instruments must be properly sterilized and stored.

• Family and friends in close contact with Ebola patients
  This is because they may come in contact with infected blood or body fluids.

• Romantic partners of an infected or otherwise high individual risk 

Demographics

• All cases of human illness or death have occurred in Africa (with the exception of several laboratory contamination cases: one in England and two in Russia)
• No cases have been reported in the United States
• In 2014, two U.S. healthcare workers who were infected with Ebola virus in Liberia were transported to a hospital in the United States.

Past Ebola Outbreaks

Past Ebola outbreaks have occurred in the following countries:

• Democratic Republic of the Congo (DRC)
• Gabon
• South Sudan
• Ivory Coast
• Uganda
• Republic of the Congo (ROC)
• South Africa

Current Ebola Outbreak in West Africa

The current (2014) Ebola outbreak is occurring in the following West African countries:

• Guinea
• Liberia
• Sierra Leone
• Nigeria

http://www.cdc.gov/vhf/ebola/about.html

Respiratory Illness Sending More Kids to the ER

At least 14 states are reporting a "marked increase" in the number of patients -- mostly children and teens -- admitted to the hospital with respiratory distress or needing intensive care for respiratory symptoms.

Having said this, in the scope of the big picture, there is no reason for a panic. The spread so far has been not very large, and in general as its coming from West to East, it seems to be dissipating.
The concern is both the increased number of patients affected and the severity of the illness. Many present with severe refractory wheezing, requiring continuous albuterol treatment and oxygen supplementation, and some patients need either noninvasive ventilation or full-scale mechanical ventilation.

The true extent of the outbreak is not clear. But, there’s also a lot of mild disease out there that goes unreported.

What is causing this illness?
Enterovirus D68, or EV-D68, can cause mild to severe respiratory illness. However, most people are only mildly symptomatic.

What are the symptoms?
Mild symptoms may include:

• fever
• runny nose 
• sneezing 
• cough 
• body and muscle aches 

This is what most otherwise healthy people might experience.
Children who were severely ill additionally had:

• difficulty breathing
• wheezing

*Many of these children had asthma or a history of wheezing.


How does the virus spread?

EV-D68 can be found in an infected person’s respiratory secretions, such as saliva, nasal mucus, or sputum.

EV-D68 likely spreads via coughs, sneezes, or touching a contaminated surface.


Who is at risk?
Generally, infants, children, and teenagers.  That’s because they do not yet have immunity from previous exposures to these viruses.

*People with a history of asthma and allergies are more at risk for more severe forms of the illness.


How is it treated?

Since it is a virus, there is no need to treat with antibiotics.

Treating symptoms, just as with a cold or flu, with over-the-counter remedies is adequate.


For more information go to:

http://www.cdc.gov/non-polio-enterovirus/about/ev-d68.html

http://www.medpagetoday.com/InfectiousDisease/URItheFlu/47638

http://www.usatoday.com/story/news/nation-now/2014/09/08/respiratory-virus-midwest-children/15269751/ 

Four Critical Steps to Recognize, Neutralize and Prevent Exertional Heat Stroke

Based on Official 2014 Guidelines

Many people spend their free time in the summer outside exercising and taking advantage of the warm weather. Just like adults, summer is the peak outdoor season for children and teens as they practice for sports and play in the neighborhood. While this is usually not a problem, sometimes the intensity of the sun can sneak up on people. It is always helpful to know what to do should an emergency such as heat stroke arise.

Step 1: Identify the Signs of Heat Stroke
There are a combination of clear signs that can indicate the onset of heat stroke. Once familiar with the following symptoms, it is much easier to detect the condition.

Symptoms of exertional heat stroke include:

• Dehydration, dry mouth and/or  thirst
• Altered consciousness, seizures, confusion, emotional instability, irrational behavior, decreased mental acuity or combativeness
•  Seeming bored or disinterested
•  Headache dizziness or weakness
•  Nausea, vomiting or diarrhea
•  Cramps
•  Hot and wet or dry skin
•  Excessive fatigue such as not being able to run as fast or play as well
•  Increase in core body temperature, usually above 104 °F
•  Increased heart rate, decreased blood pressure or fast breathing

Steps 2 and 3: Cool Then Transport
Cool first, transport second, if there is appropriate medical staff or an athletic trainer on site.  The old way of thinking was to get to the hospital first without trying to cool the patient. But waiting for an ambulance could cause 40 minutes to elapse before the patient is finally aggressively cooled.

Please note, the goal for any exertional heat stroke victim is to lower core body temperature to less than 102.5 °F within 30 minutes of collapse.

Step 4: Prevent Heat Stroke
Exertional heat illnesses are largely preventable during sports practices when appropriate protocols are put into place. Water immersion cools the fastest. Therefore, sports teams or anywhere someone is at risk for heat stroke, should have a cooling tub on site to start the cooling process immediately.

Other preventative measures include:

     ●  Heat acclimatization

     ●  Body cooling

     ●  Hydration

     ●  Modifying exercise based on environmental conditions 

Urgent Care at Peachtree encourages everyone to exercise throughout the year.  Please be aware of the above heat stroke prevention guidelines during the Summer, and always exercise caution while exercising your body.

Sources: 
New Exertional Heat Stroke Guidelines: Cool First, Transport Second, By Megan Brooks, June 30, 2014

How to Recognize, Prevent & Treat Exertional Heat Illnesses, National Athletic Trainers' Association, NATA.org, 2014

Summer Sun and Skin Cancer

Skin Cancer is the #1 most diagnosed cancer, and it continues to increase in prevalence.  Every year, over 1 million cases of non-melanoma skin cancer are diagnosed.  Almost 60,000 each year are diagnosed with melanoma, which is a more serious skin cancer.  About 7,800 of the 10,600 skin cancer deaths are caused by melanoma.  The non-melanoma cases have been on the rise and are a cause for concern.  Most cases of skin cancer are due to long-term or intense sun exposure, tanning beds, increased exposure to UV light, ozone depletion, and increased detection.

What can you do?

• Yearly skin exams by your doctor, and monthly self- exams can help with early detection.
• You should check all areas of your body – even those not exposed to the sun such as scalp, palms of hands, soles of feet, underarms, etc.  Use a mirror for places that are hard to see.

Look for the “ABCDs” of moles and melanoma
A. Asymmetry
Most melanomas are asymmetric (a line drawn through the middle would not split it evenly in half).
B. Border
Melanomas have irregular borders, scalloped edges or notched edges. Normal moles have a smoother border.
C. Color
Melanomas have varied shades of brown, tan or black, and may later progress to red, white and blue. Normal moles are usually a single shade of brown.
D. Diameter
A melanoma may be larger than a regular mole, or at least the size of a pencil eraser. They may also be smaller.

Smart Sun Exposure

• Get some sun, but don’t stay out long enough to get burned
• Use a sunblock of SPF 20 or higher
• Use a hat, umbrella and sunglasses (UV-absorbing lenses) to block the sun
• Avoid tanning beds
• People with dark skin may need 6-10 times more sun exposure to get healthy levels of Vitamin D

Sources:
Health Realizations, Inc. / The Skin Cancer Foundation / The American Cancer Society

Summertime Skin Care Tips

Summer is upon us once again, and it’s time to remember to take extra daily precautions with your skin.  In order to maintain the health and integrity of your skin, please remember the following:

• Apply sunscreen with a sun protection factor (SPF) of 30 or greater at least 20 minutes before sun exposure, and then at least every 2 hours thereafter (use more frequently if you are sweating or swimming). Slather on at least a shot glass’ worth!
• Select cosmetic products and contact lenses that offer UV protection. The active ingredients in sunscreens can lose their potency, so check the expiration date.  It is better to start fresh each summer.
• Never rely solely on cosmetics for sunscreen protection.  There are many sunscreens available in non-greasy formulations specifically for the face.  These are easy to use under cosmetics.

·         Wear sunglasses with total UV protection (UVA and UVB)

• Wear wide-brimmed hats, long sleeved shirts, and pants when possible
• Avoid direct sun exposure as much as possible during peak UV radiation hours between 10 a.m. and 2 p.m.
• Perform skin self-exams regularly to become familiar with existing growths and to notice any changes or new growths
• Eighty percent of a person's lifetime sun exposure is acquired before age 18. As a parent, be a good role model and foster skin cancer prevention habits in your child!
• Avoid tanning beds
• People often forget to protect their scalp—and end up with a burn in their part. Mist your scalp and hairline with a spray sunscreen.
• Drink plenty of water.  All of your body, including your skin, needs it!

 In case you are wondering what will happen if you forget these tips too often, or have had prolonged unprotected exposure to the sun, the following are effects of sun exposure:

·         Pre-cancerous (actinic keratosis) and cancerous (basal cell carcinoma, squamous cell carcinoma, and melanoma) skin lesions (these can look like moles or changes in moles, so please see your doctor if you have concerns)

·         Benign tumors

·         Fine and coarse wrinkles

·         Freckles

·         Discolored areas of the skin, called mottled pigmentation or melasma

·         A yellow discoloration of the skin

·         The dilation of small blood vessels under the skin that appear like small spider veins or broken capillaries

We hope this information helps as you venture outdoors.  Have a happy, safe and healthy Summer! 

Atlanta Soccerfest 2014

Urgent Care at Peachtree is proud to be one of the Gold Sponsors for Atlanta Soccerfest 2014. A unique, all day event for soccer fans of all ages. Mark your calendar for June 22ND, in Brookhaven Park. Then get ready for an ALL day World Cup Viewing Party, on a giant 11 ft. x 17 ft. LED screen. The event also includes a 5K race, 1 mile fun run, and soccer activities for kids and adults.

Plan to attend soccer clinics conducted by the Atlanta Silverbacks. Enjoy food from Atlanta's best food trucks and street vendors. And, for the adults, Sweetwater beer will be serving up ice cold beverages.

This year, Atlanta Soccerfest will be introducing the first, ever, Soccer Arcade. Kids who participate can win tickets to be redeemed at the Arcade Store. The more they play, the more they win.

There will be a Juggling Area, an Obstacle Course, Target Shooting, Soccer Tennis, and 3 v 3 open courts. All of this ... and MORE ... without any admission fees!

For details about parking, scheduled activities, and rules for the day, visit the Atlanta Soccerfest website.
http://www.atlantasoccerfest.org/

Urgent Care at Peachtree is Keeping the Atlanta Silverbacks on the Ball

(Atlanta, GA) March 31, 2014 – Urgent Care at Peachtree, Atlanta’s only After Hours Urgent Care solidifies its partnership with Atlanta’s Professional Soccer team by providing medical staff on the field and Urgent Care off the field.

Dr. Anthony Ferrara, one of the ER doctor owners of Urgent Care at Peachtree, is proud to announce their partnership with the Atlanta Silverbacks to provide comprehensive medical care to the players both on and off the field. Dr. Ferrara, an avid soccer player and fan, will serve as team physician for the Silverbacks. Dr. Ferrara has served as team physician for the last four years, helping the team with all of its medical needs. “I grew up with soccer. It is totally in my blood, so I am always very excited to be on the field with the Silverbacks and watching the action up close,” said Dr. Ferrara. “I know all too well the kinds of injuries that result from the fast play in soccer, and with Urgent Care at Peachtree being open from 6pm to 11pm every night, we can easily diagnose and treat those injuries and get the players back in the game fast.” Urgent Care at Peachtree is the Metro Atlanta area’s only Urgent Care that is open after hours when other urgent care centers are closed.

In addition, Urgent Care at Peachtree is one of the few Urgent Care centers that is owned and operated by local ER Doctors. So, patients with urgent medical needs can see an ER Doctor without the expense and time usually endured by going to the ER. Dr. Ferrara commented, “We have x-ray and lab facilities onsite to diagnose and treat all types of injuries and illnesses. We also have close affiliations with physicians who specialize in sports injuries so we can get a patient to see a specialist quicker and on the road to recovery sooner.”

Atlanta Silverbacks Technical Director, Eric Wynalda, expressed his appreciation for the partnership, “Many teams only have their medical staff there on game days, but we frequently have Urgent Care at Peachtree staff on hand at our practices during the week. Keeping our players healthy is something Dr. Ferrara and his staff take very seriously.” Silverbacks President & General Manager, Andy Smith, echoed Wynalda by saying, “Dr. Ferrara has been taking care of our medical needs for several years now, and no matter what the issue has been, he has always been on call 24/7 to help us,” Smith said. “He truly cares about the health of our players and it shows in his work. The support that he and his staff provide us is paramount to our success on the field.”

Silverbacks owner, Boris Jerkunica, met Dr. Ferrara when they both attended Emory University and played on the Emory Soccer team together. “I know firsthand of Anthony’s long-time commitment to soccer and medicine. I think partnering with him and his medical staff at Urgent Care at Peachtree is a win-win for the Atlanta Silverbacks,” says Jerkunica.

Michele Melamed, a medical student, has been assisting Dr. Ferrara with the Atlanta Silverbacks for the last three years. “Working with the Silverbacks has given me a unique opportunity to exercise my love for medicine and sports in one arena,” says Melamed.

Dr. Ferrara has also traveled with the US Women’s National Soccer team as their team physician and is the team physician for Georgia State University Athletics. A graduate of University of Colorado School of Medicine, Dr. Ferrara is also a board examiner for the American College of Emergency Physicians.