Thursday, October 30, 2014

Finding Truth and Taking the Appropriate Action

I received a call last week from a family member asking me, in the wake of the Ebola outbreak and media frenzy, if it was safe to fly on US commercial aviation. I told her that unless she was flying to West Africa and headed to one of the three Ebola-ridden countries, I did not see any reason why it would be unsafe.  This is a prime example of fear affecting people.  The fact that this family member called me was a good thing, but I am very concerned about well-intentioned people acting in ways that actually make a situation worse.

As we enter flu season, there is a great public health risk that people will take actions out of fear and ignorance and neglect actions that will actually protect them….like getting a flu shot. Because Ebola has a high mortality rate and the media has been talking about it for weeks now, we are all on heightened alert. But one must have direct contact with the body fluids of a patient with active Ebola to contract the disease. What has happened in Dallas should allay people’s fears about the communicability of Ebola.   The influenza virus is much more easily transmitted than Ebola. It is spread by respiratory droplet through coughing, sneezing, touching contaminated surfaces or shaking hands.

It is important to know the facts, to investigate the truth about something before making decisions, and this is particularly true about immunizations. I remember one day in 2005, when I was taking care of children on the inpatient unit at Boston Medical Center, a big inner-city trauma hospital, that we received a call from the Life Flight system.  We were getting a child from Nantucket. I immediately thought that the child must have been the victim of trauma, but I instead learned that the boy was suffering from invasive haemophilus influenza type B bacterial disease. The residents working with me had never seen a case of this disease.  This was because the Hib immunization came out in the mid 1980s, but when I was a resident in the early 1980’s, we had many cases and a significant number of children with serious complications and death.  Then the vaccine came out, and it was so effective that within a few years the disease became nearly eradicated in the States. Why, then, 20 years later, was this child being Life Flighted to Boston Medical Center from Nantucket, sick with a case of H-flu?  Because his parents did not believe in immunizations, and the child was on the verge of death from a preventable illness. The parents had never seen a child sick with the disease or heard about the devastation that it caused, so they minimized the risk. They also fell victim to misinformation and ignorance about the risks and benefits of the immunization. Luckily for them, the child survived the disease and did not have a significant complication.

We should be worried that people will drop their guard on influenza (the viral disease that we get annual immunizations to prevent) because they are scared about Ebola. Ebola has affected a mere handful of people in the United States, whereas influenza kills an average of 30,000 people per year.  If my family member had called me and said, “I’m going on a plane, what would you recommend?” I would have responded, “Get your influenza vaccine.”  Since influenza does not generally kill otherwise healthy people, many people ignore the evidence and don’t take the appropriate precautions.

Unless someone is less than 6 months of age, has a true chicken egg allergy or has had Guillain Barre syndrome after a previous immunization, there is no contraindication to the influenza immunization.  In our society, we have a tendency to fall into the trap of fads and pseudoscience, believing in ideas that are contrary to the actual facts.

GBMC must work hard to help people get the care that will cure them or keep them healthy. Let’s work to maximize the rate of influenza vaccine this season, and help get the facts out about Ebola to minimize fear and the nonsensical actions that fear can trigger.

4 comments:

  1. Michael SchwartzbergOctober 30, 2014 at 6:49 PM

    Excellent post, Dr Chessare. People need to focus on the Facts, not the Fear, of Ebola, and understand that influenza is a disease that is much more threatening and prevalent here in Maryland and across the United States.

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  2. I was a volunteer "shooter" on the day we administered flu vaccines to employees over in the Conference Center. One person said to me, "I'm doing this under protest" and I responded, "OK. Right arm or left?" What I wanted to say was, "As a health care worker, you are obligated to protect your patients by being healthy enough to take care of them, and not make them ill. You also let your team down when you call out sick." If you follow that person's logic, why not protest hand hygiene? Or wearing PPE? What if your surgeon decided he didn't feel like scrubbing before he operated on you because none of his patients had ever had a bad outcome? I have been happy to hear news reports that the general public's request for flu vaccines has increased dramatically this year, in the face of Ebola. Thank you for your blog on this important topic, Dr. Chessare.

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