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Beating Ebola Hinges on Sipping a Gallon of Liquid a Day
By Jason Gale - Nov 17, 2014
The best medical advice for surviving Ebola right now might fit in one word: drink.
With targeted drugs and vaccines at least months away, doctors and public health experts are learning from Ebola survivors what simple steps helped them beat the infection. Turns out drinking 4 liters (1 gallon) or more of rehydration solution a day -- a challenge for anyone and especially those wracked by relentless bouts of vomiting -- is crucial.
...
Aggressive fluid replacement was deemed critical in saving two American health-care workers with Ebola at the Emory University Hospital in Atlanta, according to a study published in the New England Journal of Medicine last week. Interviews Mardel and WHO colleagues conducted with six of the dozen patients who survived Ebola in Nigeria, where the fatality ratio was much lower, also point to the importance of drinking. Ada Igonoh, a doctor who caught Ebola in late July while working at the First Consultants Hospital in Lagos, said she took oral rehydration salts, or ORS, mixed in water as soon her gastrointestinal symptoms started -- even before her Ebola diagnosis. Once hospitalized, she trawled the Internet on her iPad for insights from survivors.
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The Ebola Scourge
Patients in Liberia lost 5 liters of fluid a day from diarrhea alone, doctors treating cases there wrote in a Nov. 5 paper in the New England Journal of Medicine.
....
Mortality could be reduced by delivering a simple message about the importance of taking fluids and picking the right painkillers, he said. Paracetamol, the active ingredient in Panadol, is the preferred medication for pain and fever, and picking others such as aspirin and ibuprofen can worsen bleeding, he said.
?We will halve the mortality by firstly just stopping anti-inflammatories and giving hydration, and really pushing it,? Mardel said. ?I want every man and woman in Sierra Leone to know this. I want sports personalities to be talking about it. I want everybody to be talking about it.?
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?Over eight to 10 days of illness, you will need possibly 40 liters of fluid,? Mardel said. ?Day after day, if you?re not getting that, we can?t suddenly give you 20 liters to catch up.?
A fluid deficit and ?profound electrolyte derangement” appears to increase the risk of death, the WHO said in a Nov. 6 statement. In that document, the Geneva-based agency recommended intravenous rehydration. Not everyone agrees that that delivery route is the best way to go. Oral rehydration, which is taken up in the gut, seems to help patients maintain a better balance of electrolytes, according to Mardel.
Don?t Gulp
Most intravenous rehydration fluids also don?t have much potassium, calcium, or magnesium, doctors at Emory University Hospital wrote in their journal article last week. They recommend supplementing oral rehydration with all three, especially in patients with large-volume diarrhea.
Still, drinking has its challenges. Patients must overcome recurring nausea, as well as debilitating joint pain that can make gripping and movement difficult.
...
http://www.bloomberg.com/news/print/...uid-a-day.html
By Jason Gale - Nov 17, 2014
The best medical advice for surviving Ebola right now might fit in one word: drink.
With targeted drugs and vaccines at least months away, doctors and public health experts are learning from Ebola survivors what simple steps helped them beat the infection. Turns out drinking 4 liters (1 gallon) or more of rehydration solution a day -- a challenge for anyone and especially those wracked by relentless bouts of vomiting -- is crucial.
...
Aggressive fluid replacement was deemed critical in saving two American health-care workers with Ebola at the Emory University Hospital in Atlanta, according to a study published in the New England Journal of Medicine last week. Interviews Mardel and WHO colleagues conducted with six of the dozen patients who survived Ebola in Nigeria, where the fatality ratio was much lower, also point to the importance of drinking. Ada Igonoh, a doctor who caught Ebola in late July while working at the First Consultants Hospital in Lagos, said she took oral rehydration salts, or ORS, mixed in water as soon her gastrointestinal symptoms started -- even before her Ebola diagnosis. Once hospitalized, she trawled the Internet on her iPad for insights from survivors.
....
The Ebola Scourge
Patients in Liberia lost 5 liters of fluid a day from diarrhea alone, doctors treating cases there wrote in a Nov. 5 paper in the New England Journal of Medicine.
....
Mortality could be reduced by delivering a simple message about the importance of taking fluids and picking the right painkillers, he said. Paracetamol, the active ingredient in Panadol, is the preferred medication for pain and fever, and picking others such as aspirin and ibuprofen can worsen bleeding, he said.
?We will halve the mortality by firstly just stopping anti-inflammatories and giving hydration, and really pushing it,? Mardel said. ?I want every man and woman in Sierra Leone to know this. I want sports personalities to be talking about it. I want everybody to be talking about it.?
...
?Over eight to 10 days of illness, you will need possibly 40 liters of fluid,? Mardel said. ?Day after day, if you?re not getting that, we can?t suddenly give you 20 liters to catch up.?
A fluid deficit and ?profound electrolyte derangement” appears to increase the risk of death, the WHO said in a Nov. 6 statement. In that document, the Geneva-based agency recommended intravenous rehydration. Not everyone agrees that that delivery route is the best way to go. Oral rehydration, which is taken up in the gut, seems to help patients maintain a better balance of electrolytes, according to Mardel.
Don?t Gulp
Most intravenous rehydration fluids also don?t have much potassium, calcium, or magnesium, doctors at Emory University Hospital wrote in their journal article last week. They recommend supplementing oral rehydration with all three, especially in patients with large-volume diarrhea.
Still, drinking has its challenges. Patients must overcome recurring nausea, as well as debilitating joint pain that can make gripping and movement difficult.
...
http://www.bloomberg.com/news/print/...uid-a-day.html