Play Live Radio
Next Up:
Available On Air Stations
Watch Live

KPBS Midday Edition

Lessons Learned From Ebola Epidemic Discussed At San Diego Conference

Lessons Learned From Ebola Epidemic Discussed At San Diego Conference
Lessons Learned From Ebola Epidemic Discussed At San Diego Conference
GUESTS:Amesh Adalja, member, Infectious Disease Society of America Mark Sawyer, pediatric infectious disease specialist, UC San Diego and Rady Children's Hospital

Out of story on midday edition. This time last year the Ebola virus dominated news headline. It claimed a victim in the US and to people who treated him in Texas were infected. A growing panic was underway. Luckily that Ebola outbreak which claimed the lives of 11,000 people in west Africa has now been controlled. It's devastation made us all aware that the threat of infectious diseases is alive and well. The biggest meeting of the year for infectious disease clinicians and researchers is underway. In San Diego. Panels at ID 2015 will cover everything from Ebola to childhood vaccinations. Joining me are Dr. MS a Delta, he is a member of the infectious disease Society of America is in town for the conference, and Dr. a Delta welcome to the program. Thank you for having me. Dr. Mark Sawyer also joins us, a pediatric infectious disease specialist at UC San Diego and Julie's hospital. Dr. Sawyer welcome. It's great to be here, Maureen. I think when the Ebola cases emerged in the US, it changed the way a lot of people think about infectious disease outbreaks on other continents. These viruses are truly a global threat today? We always say infectious disease, the world is in small place and an infection on one side of the globe can be on the other side in one day. We saw this with Ebola but before that even with the stars outbreak in 2003. Which basically circled the globe and ground many economies to a halt because of. Contagion. So even in remote parts of the world, everybody should be worried about these diseases because they could be anywhere. What else did this Ebola outbreak change our view of, the way this disease spreads car or how it should be treated? I did learn a tremendous amount with this Ebola outbreak. You have to number that all of the Ebola breaks in the past have been very small and in a different part of Africa. This was the largest Ebola outbreak of the call with over 22,000 cases. And because of that large number we saw a lot of where the stations of Ebola, we found that it can live in semen longer than we thought before, we have seen it in a person's eyeball, we have learned that simple supportive care, IV fluids can really make a huge difference in treating Ebola patience. We saw vaccines and experiment therapies really get pushed to the front. To try to battle this outbreak, and we also learned that the public health messaging that we had used in prior outbreaks did not necessarily translate so well in west Africa. So you really have to tailor the message to the local population and that is one of the biggest lessons from the Ebola outbreak in West Africa. One of the keynote speakers at the convention will be Dr. Ian Crozier who became an actor -- infected with Ebola last year and deaths of course site. During the outbreak in America we heard a lot about new treatments and as you mentioned vaccines against Ebola. Do we have effective treatments now? I do think that we do, although there is going to be a lot of study to prove the worth of these measures. The biggest one that I want to emphasize is plain supportive care. IV fluids can really drop what we thought was a 90% mortality to a 24 the worth of these measures. The biggest one that I want to emphasize is plain supportive care. IV fluids can really drop what we thought was a 90% mortality to a 2480% mortality. -- 20% or 30% mortality. Ebola cases in the past were happening in remote villages where there wasn't access to simple character and. Finding that these patients with Ebola have massive dehydration, a lot of electrolyte imbalances that are very easy to correct and once you correct them if makes all the difference. And on top of that we have experimental medications that were tried, there are current chemical trials ongoing, and have a whole menu of options for treating Ebola which will change the face of the next Ebola outbreak with a face. And of course the search for the Ebola vaccine is to do with how crafty the virus is. HIV is another virus that is difficult to find a coupon. How successful are the medications that are being used now to control the disease? HIV has really been revolutionized by the use of what we call and try retro viral drugs and these are drugs that people have to take on life in return HIV doesn't really have a major decrement on their lifespan. They can live a normal life with these medications. They are not a cure but they do allow people to treat HIV at the chronic disease, and taking one pill, once a day, which is a big change from the massive regimens people talk in the early years pics and what about the search for the vaccine? That is an ongoing question, we are closer but not necessarily something we are going to see in the next couple of years. There are vaccine candidates one is a tie vaccine in Thailand, where they showed a 31% decrease in infection, but it is not like our hundred percent that we get in our measles vaccine. But these are baby steps in a vaccine for HIV of Dr. Mark Sawyer on the one hand the public is a eager for researchers to find vaccines, but in recent years there has been a backlash against getting children vaccines for deadly diseases that we can prevent. How do you clean up? Back well There is a lot of information that circulate on the Internet and most of it is not based on science. So parents have become concerned about possible side effects or safety concerns from vaccines. But that has been taken very seriously by the centers for disease control, American Academy of pediatrics, and thoroughly done research studies have been done to look into safe D issues. And can say with confidence now that the axioms we recommend routinely are safe. And the spread of infection around the world, we were reminded earlier this year about how contagious simple diseases like measles are, with the outbreak that occurred at the land and affected people right here in San Diego. And that is one of the things we are starting to see more of the cause of this reluctance to gets -- get vaccinations. People are making a direct election from that outbreak at Disneyland to a new law here in California that requires virtually every child to be vaccinated before they go to school. Do you see that, Dr. swear, turning the trend away from the anti-vaccine movement? I think the tide did change with the measles outbreak, people came to realize how contagious these infections are, the fact that you could simply be having a fun day at Disneyland and be exposed to and contract the measles which can be a deadly disease. So when the public realized that if the change opinion overall, and allowed the passage of this new law in California and some of the stator also looking at similar legislation. It is important because this concept that we are all in this together, and if we let our immunization rates drop to a certain level we are going to start to see increasing outbreaks of disease, and have started to see that with measles, it is one of the main reasons why this new law is enacted? Did this anti-vaccine movement as it gained momentum, did it send a shockwave through the infectious disease community? Are the researchers worked so hard to come up with some way to stop these things. Definitely, what it really represents is a return to the primitive. We have worked so hard to bring humankind out from under these infectious diseases that really limited lifespan, things from the smallpox axing to our brand-new vaccines against human papilloma virus, all of these have helped us bring civilization to the world through vaccines, and when you see people turning away from these vaccines which have added decades of lifespan it is ogling. Why is a meeting like ID week important for infectious disease doctors? Their important because they provide an opportunity to share the latest research, and the latest guidelines that have been released, to understand what is going on with outbreaks around the world, networking, exchanging ideas, it is really basically the combination of the infectious disease Society's collective efforts to put together a meeting where everybody can gain from the experience of others. Are they going to be any controversies and out during this weeklong meeting? There or is controversies in medicine and science. None at the top of my head that will happen at this meeting, however there will be new research windings that may send ripples through the crowd took with some unexpected results which is kind of the fun of science. Dr. Sawyer, one of the featured topics at ID week will be infectious disease from a child's perspective. A topic experts say is often overlooked. Children are the most valuable -- vulnerable members of society. That is why we recommend the vaccines we do and when we do. I know some parents have explored using alternative vaccine scheduled by spreading them out, but all that does is delay the protection that we can achieve starting right away at birth. So the schedule that is recommended by the CDC and American Academy of pediatrics is designed to immunize and protect children as soon as we possibly can. Because they are very honorable to the negative effects of these various infections. What areas of research will be covered at this meeting? A whole host of infectious disease topics, everything from HIV to influenza to Ebola to an RSA to see death everything including infections in adults and children. A hospital epidemiology, how do you keep bugs from spreading in a hospital? Everything you can think, under the sun. And it's not just researchers right? Now there are also rank and file clinical doctors who see patients every day, ethical students, infectious disease doctors in train -- training, public health officials, all the allied professions that work in the infectious disease profession are here. 7000 in all. Yes. Let's talk for a moment about the biggest infectious disease threats acing the public. What about antibiotic resistant infections? How big a threat to see that as being? To me antibiotic resistance is the biggest threat we face from infectious diseases. We have gotten very comfortable using antibiotics and people living through infections that would have killed people. However, the way we use antibiotics and because of what they are, we have increasingly seen bugs become much more resistant and now we are in situations where we have really bad bugs and no drugs to use against them. There are cases where you have nothing left to give the patient. And it is not just treating these infectious -- infections, we also give them prophylactic antibiotics, and if we lose them and bacteria really gain a foothold, we will seek modern medicine grind to a halt because we can't really do anything. This was all protected by Alexander turning discovered penicillin, he talked about the fact that we would lose antibiotics if we didn't use them judiciously and that is why they are -- we are in this particular. Is the answer to find new ones? That is part of the answer, find -- binding alternatives likes vaccines, viruses that can attack bacteria, but it is also about educating people to not use antibiotics when they have a viral infection, antibiotics have no bearing on them. And we have to get our veterinarians involved, our dentists involved, everybody who prescribes antibiotics need to do it appropriately. Dr. Sawyer what is the infectious disease threat you are most concerned about? Of Debated by Ebola last year but if you look at what is really causing problems here in the United States we are having a continuing battle with whooping cough which affects people of all ages, adults, seniors, healthy adolescents, but most importantly very young babies. And I say that because they are at risk for very severe disease, we even see deaths from pertussis. And have learned over the last few years that we can help protect baby by getting their mothers immunize while they are pregnant pics of the biggest challenge we have right now in pediatric medicine is to get vaccines not only into children but into their mothers for the babies are even born. That works for pertussis and it also works for influenza, and about to get into influenza season which is another big infection that we all face every year. Has there been some resistance to that? Four years we told pregnant women not to take any medicine, don't drink alcohol, don't put anything in your body when you are pregnant. And we have learned that although that is good conservative care for advice, it actually was not warranted in the case of vaccines. We now have good evidence that vaccines are safe in pregnancy, and also have evidence that they work to prevent -- illness in both the mother and the baby. And finally, there has been some controversy about the effectiveness of the flu vaccine. Do we know if this is the vaccine or next year's flu vaccine might be better? Early indications are that this year's flu vaccine will be better than last year. What happened last year was a fluke. There was a mismatched -- mismatch between the strain in the vaccine and the dominant strain of the season. We picked the strains several months before the vaccine is captured, it is a long manufacturing process and we get it wrong it doesn't decrease the effectiveness of the vaccine. That said, it is the only means to prevent influenza infections and it is a huge burden on society and individuals who do get a bad case of flu so I encourage everyone to get the vaccine this year. I have been speaking with Dr. idolater, a member of the infectious diseases Society and Dr. Mark Sawyer pediatric infectious disease specialist at UC San Diego, the ID week conference will continue through Sunday at the San Diego convention Center. Gentlemen, I give very much.

Lessons learned from the 2014 Ebola outbreak will be a topic of conversation this week in San Diego when an Ebola survivor — who is a doctor — shares his experience before an infectious disease conference.

Last year's Ebola outbreak was the largest in history resulting in more than 11,000 deaths.

Ian Crozier became infected with Ebola after treating patients in Kenema, Sierra Leon, in August 2014.


Crozier was evacuated to Emory University Hospital in Atlanta and became critically ill. He survived after being given an experimental drug.

Amesh Adalja, a member of the Infectious Disease Society of America and senior associate with the University of Pittsburgh Medical Center, said a lot has been learned about Ebola from the outbreak.

“We’ve learned more about how Ebola spreads and also what kind of personal care equipment health care workers need to reduce the risk of transmission,” Adalja said.

Adalja said doctors learned that Ebola can live in semen longer than previously thought and that it can be found in an eyeball. They also learned about public outreach.

"The public health messaging we used in prior outbreaks did not necessarily transfer well to West Africa," Adalja told KPBS Midday Edition on Wednesday.


Adalja said Ebola can be cured by "plain supportive care." For example, he said, many patients were suffering from massive dehydration and electrolyte imbalances, and that is easy to correct.

"We have a whole menu of options now to treat Ebola," he said.

The IDWeek conference — which is a joint meeting among four medical associations — runs Wednesday through Sunday at the San Diego Convention Center. The four participating groups are the Infectious Diseases Society of America, Society for Healthcare Epidemiology of America, HIV Medicine Association and the Pediatric Infectious Diseases Society.