DALLAS (AP) – The death of the first Ebola patient diagnosed in the United States renewed questions about his medical care and whether Thomas Eric Duncan’s life could have been extended or saved if the Texas hospital where he first sought help had taken him in sooner.
Duncan died in Dallas on Wednesday, a little more than a week after his illness exposed gaps in the nation’s defenses against the disease and set off a scramble to track down anyone exposed to him.
The 42-year-old Liberian man had been kept in isolation since Sept. 28 at Texas Health Presbyterian Hospital, where a fevered Duncan first showed up days earlier and told the staff he had been in West Africa. Doctors initially sent him home. He returned after his condition worsened.
Dr. Phil Smith is the director of the biocontainment center at the Nebraska Medical Center, where an NBC News freelance cameraman is being treated for Ebola. He said getting early treatment is key to surviving Ebola.
When a patient reaches the point of needing dialysis and respiratory help, as Duncan did this week, there may be little doctors can do.
“At that point, any kind of intervention, whether it is an antiviral drug or convalescent plasma, is less likely to work,” said Smith, an infectious disease specialist.
Duncan carried the deadly virus with him from his home in Liberia, though he showed no symptoms when he left for the United States. He arrived in Dallas on Sept. 20 and fell ill several days later.
Of the six Ebola patients treated so far in the U.S., Duncan was the only one not cared for in one of the special hospital units set up to deal with highly dangerous germs. That’s because health officials knew the others had Ebola at the time they decided where the patients should go, whereas Duncan sought care at Texas Health Presbyterian hospital on his own.
Health officials also have said that any hospital with isolation capabilities can treat Ebola patients, but Duncan’s death is sure to renew attention on the hospital’s response.
There is no way to know whether any specific treatment or step might have saved Duncan’s life. At the time of his death, he was taking an experimental antiviral drug.
He died “despite maximal interventions,” said Dr. Tom Frieden, director of the Centers for Disease Control and Prevention. “The earlier someone is diagnosed, the more likely they will be to survive.”
Pastor George Mason of Wilshire Baptist Church in Dallas was present when county officials told Louise Troh, the woman Duncan had been staying with, of his death.
“She expressed all the what-ifs,” including whether the initial delay in admitting Duncan made a difference, Mason said.
Health officials have identified 10 people, including seven health workers, who had direct contact with Duncan while he was contagious. Another 38 people also may have come into contact with him. The four people living in the Dallas apartment where Duncan stayed were moved to another home and are in isolation.
Officials have said everyone who had potential contact with Duncan is being monitored for 21 days, the maximum incubation period for the disease, which can cause vomiting, diarrhea, bleeding and in later stages, damage to vital organs.
The hospital has changed its explanation several times about when Duncan arrived and what he said about his travel history. The hospital has said the staff did not initially suspect Ebola, even though Duncan told them on his first visit that that he came from West Africa.
His body was to be cremated and his remains returned to the family. The Centers for Disease Control recommends that bodies of Ebola victims not be embalmed and instead suggests they be cremated or promptly buried in a hermetically sealed casket.

 ATLANTA /Christian Newswire – The verdict is in with Total Fitness DVDs, the largest privately-owned online fitness DVD retailer, announcing that Shazzy Fitness claimed their number one spot on the dance fitness DVD sales charts.
Shazzy Fitness offers new and bold dance workout videos choreographed to Christian Hip-Hop music. Last month, Shazzy Fitness announced Total Fitness DVDs as its newest distributor and preferred distribution partner on Amazon.com. Shazzy Fitness DVDs are also outpacing all other titles in the Total Fitness DVD spirituality category.
Hailed by audiences and critics alike, Shazzy Fitness dance workouts are easy to follow and are led by esteemed choreographers – Leslie Alison, Vera Musgrove and Apollo Levine – as well as directed by award-winning production veterans at ECG Productions, all based in Atlanta, Georgia. In addition to the riveting choreography, the DVDs contain behind-the-scenes features including bonus routines, outtakes and instructor biographies.

With over 1500 health & exercise DVD titles, Total Fitness DVDs has become one of the most highly regarded home video distributors, due in part to their large array of fitness categories.

“In Shazzy Fitness we’ve found an organization that shares our passion for providing new and innovative fitness products as well as the highest quality workout videos.” says Mary Crowder Director of Sales at Total Fitness DVDs.

“We are very pleased and humbled that our exercise videos are successfully competing with the top secular dance workout DVDs.” says Shazzy Fitness CEO, Kristy McCarley. “Our videos’ current sales performance demonstrates the demand for a different kind of home workout experience. It’s a clear validation of our assertion that high-caliber faith-based videos can appeal to mainstream audiences reaching far beyond traditional spirituality segmentations.”

New layers of screening at airports that receive more than 94% of West African Travelers

The Centers for Disease Control and Prevention (CDC) and the Department of Homeland Security’s Customs & Border Protection (CBP) this week will begin new layers of entry screening at five U.S. airports that receive over 94 percent of travelers from the Ebola-affected nations of Guinea, Liberia, and Sierra Leone.
New York’s JFK International Airport will began the new screening on Saturday. In the 12 months ending July 2014, JFK received nearly half of travelers from the three West African nations. The enhanced entry screening at Washington-Dulles, Newark, Chicago-O’Hare, and Atlanta international airports will be implemented next week.
“We work to continuously increase the safety of Americans,” said CDC Director Tom Frieden, M.D., M.P.H. “We believe these new measures will further protect the health of Americans, understanding that nothing we can do will get us to absolute zero risk until we end the Ebola epidemic in West Africa.”
“CBP personnel will continue to observe all travelers entering the United States for general overt signs of illnesses at all U.S. ports of entry and these expanded screening measures will provide an additional layer of protection to help ensure the risk of Ebola in the United States is minimized,” said Secretary of Homeland Security Jeh Johnson. “CBP, working closely with CDC, will continue to assess the risk of the spread of Ebola into the United States, and take additional measures, as necessary, to protect the American people.”
CDC is sending additional staff to each of the five airports. After passport review:

·         Travelers from Guinea, Liberia, and Sierra Leone will be escorted by CBP to an area of the airport set aside for screening.
·         Trained CBP staff will observe them for signs of illness, ask them a series of health and exposure questions and provide health information for Ebola and reminders to monitor themselves for symptoms. Trained medical staff will take their temperature with a non-contact thermometer.
·         If the travelers have fever, symptoms or the health questionnaire reveals possible Ebola exposure, they will be evaluated by a CDC quarantine station public health officer. The public health officer will again take a temperature reading and make a public health assessment. Travelers, who after this assessment, are determined to require further evaluation or monitoring will be referred to the appropriate public health authority.
·         Travelers from these countries who have neither symptoms/fever nor a known history of exposure will receive health information for self-monitoring.
Entry screening is part of a layered process that includes exit screening and standard public health practices such as patient isolation and contact tracing in countries with Ebola outbreaks. Successful containment of the recent Ebola outbreak in Nigeria demonstrates the effectiveness of this approach.
These measures complement the exit screening protocols that have already been implemented in the affected West African countries, and CDC experts have worked closely with local authorities to implement these measures. Since the beginning of August, CDC has been working with airlines, airports, ministries of health, and other partners to provide technical assistance for the development of exit screening and travel restrictions in countries affected by Ebola. This includes:

·         Assessing the capacity to conduct exit screening at international airports;
·         Assisting countries with procuring supplies needed to conduct exit screening;
·         Supporting with development of exit screening protocols;
·         Developing tools such as posters, screening forms, and job-aids; and
·         Training staff on exit screening protocols and appropriate personal protective equipment (PPE)

Today, all outbound passengers are screened for Ebola symptoms in the affected countries. Such primary exit screening involves travelers responding to a travel health questionnaire, being visually assessed for potential illness, and having their body temperature measured.  In the last two months since exit screening began in the three countries, of 36,000 people screened, 77 people were denied boarding a flight because of the health screening process. None of the 77 passengers were diagnosed with Ebola and many were diagnosed as ill with malaria, a disease common in West Africa, transmitted by mosquitoes and not contagious from one person to another.
Exit screening at airports in countries affected by Ebola remains the principal means of keeping travelers from spreading Ebola to other nations. All three of these nations have asked for, and continue to receive, CDC assistance in strengthening exit screening.

For Breast Cancer Awareness Month, woman living 
with incurable cancer offers 4 suggestions
Shy about asking, “What’s the etiquette for supporting my loved one, friend or colleague in their battle against cancer?” many people simply avoid the question altogether – and offer nothing.
“It’s okay to wonder, and it’s okay to ask. Be direct!” says Jane Schwartzberg, who has been battling stage 4 metastatic cancer for several years. She’s the co-author with Marcy Tolkoff Levy of “Naked Jane Bares All,”www.nakedjanebaresall.com, which shares her story with candor and humor.
Jane was a 31-year-old newlywed when she was first diagnosed with breast cancer. She underwent treatment and eventually was declared cancer free. She moved on with her life, giving birth to two children and launching a technology company. Then, when she was 42, the cancer returned. She’s now 45.
“I’m a fighter, and the support I’ve received from my family and friends has given me an immeasurable amount of strength, without which I don’t know what I would do,” Schwartzberg says.
What are some suggestions for providing support? She offers these:
•  Do it without any expectations or requirements for a response. “I’m often asked, ‘What can I do to help?’ ” she says. “What I’ve suggested: Be in my life at my pace, let me take the lead; make your presence, availability and support known, but do it without any expectations or requirements for a response.”
•  Embrace their big dream, even if it doesn’t sound realistic. During a very low point, Schwartzberg was asked by a friend: If you could have anything, swinging for the fences, what would help you get out of this pit? Without skipping a beat, she answered, “I want to take [comedian] Larry David out to lunch.” As impossible as it seemed, her friend encouraged her to write to the co-creator of “Seinfeld” – and he accepted.
“As terrible as having terminal cancer is, there is that undeniable quality of embracing every moment, including asking your heroes out to lunch,” Schwartzberg says. “Cancer brings out the boldness in people, which may entail a dream vacation to Hawaii. Don’t be afraid to embrace their wishes.”
•  Don’t hesitate to say, “You look beautiful,” when health has returned. After her chemotherapy treatments ended, Jane slowly started looking like her old self – healthy Jane, not cancer Jane. Part of reengaging with life is caring about the superficial things, at least to some extent. On the unforgettable day she met Larry David, the maître d had beforehand told her that she looked beautiful, to which Jane responded, “You have no idea how much I appreciate that.”
•  Don’t sugarcoat it. “If you want to really infuriate me, you’ll tell me that this whole mess is beshert, Yiddish for ‘meant to be’ – that it’s all part of a plan from a higher power,” she says. “Maybe terminal cancer is part of some crazy plan, but I promise you that these are the last things I want to hear from anyone.”
Don’t sugarcoat or try to put a positive spin on what’s going on – in fact, it’s more of a comfort to Jane when others acknowledge that her situation stinks and that she is looking at a life that’s far different from, and likely to be shorter than, anything she’d imagine.