Not running around bowling.

Probably worse when we're older ...

103 is about the highest I can remember having myself.

I think different people have different tolerances.

It's also good to know we' re not all going to die today.

I hate dying right before a weekend.

and people, decimal points matter.

But it was 100.3

wasn't high enough to correlate with a positive test.

I wish the CDC would change its official guidelines to lower the temp requirement for a presumed diagnosis and further testing (along with possible exposure and other Ebola-like symptoms) to 100 degrees.

This has been on the CDC website unchanged since Sept 4. They should update it in light of new information. Both Duncan and Dr. Spencer arrived at the hospital with temps below the official diagnostic criterion.

http://www.cdc.gov/vhf/ebola/hcp/case-definition.html

Person Under Investigation (PUI)

A person who has both consistent symptoms and risk factors as follows:

Clinical criteria, which includes fever of greater than 38.6 degrees Celsius or 101.5 degrees Fahrenheit, and additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage; AND
epidemiologic risk factors within the past 21 days before the onset of symptoms, such as contact with blood or other body fluids or human remains of a patient known to have or suspected to have EVD; residence in—or travel to—an area where EVD transmission is active*; or direct handling of bats or non-human primates from disease-endemic areas.

Side note : flu season is starting, I pity ERs and clinics this year. I hope people look at other factors like were you a MSF doctor working with ebola in Guinea vs I went grocery shopping yesterday.

in someone with a fever of 100 together with other Ebola-like symptoms should get serious investigation, as it did with Dr. Spencer.

The earlier treatment begins, the fewer people are exposed, and the greater the odds that a victim will survive the disease.

I think the owners and employees of the bowling alley would disagree. They are going to lose money because their business is shut down for decontamination. Also, the two people who went bowling with Dr. Spencer are also quarantined.

"too high see a health care provider" temperature by over a degree when he got help.

Yes, he handled it well. The media however did not.

for decontamination or quarantine the other people with whom he was bowling.

removing shoes before going through security to fly.

made that number up?

Why not write a paper and get it published and I am sure the CDC will evaluate your suggestion.

that a person wouldn't test positive for Ebola unless their temp was at least 101.5.

Dr. Spencer proved that isn't true, and Mr. Duncan proved that a temp can quickly spike from 100 to 103.

In light of the experience in the US, the CDC should change its criteria so that patients have the best chance of being diagnosed and treated as early as possible, which would greatly improve their prognosis.

There isn't time for anyone to do a study on this. The criterion should be changed now. Dr. Spencer was correct to express concern over his temp of 100.3, and the NY hospital was correct to order the blood test for Ebola, even though his temp didn't reach the CDC guidelines. Every hospital should follow that hospital's example, and they're more likely to if the CDC changes its official recommendation.

reported his temp at 100.3. They didn't tell him to stay home and wait to see if it got worse. They sent an ambulance with medics in hazmat suits immediately, and quarantined his fiancé, and sent the police to cordon off the area.

I read somewhere that they tested him for Ebola right away, but that it would take several hours to get the results back. But no, I don't know what his temp was at that moment.

The point is that someone with a temp of 100 who has been exposed to Ebola and has Ebola-like symptoms should be treated like this hospital treated Dr. Spencer -- not wait for a temp of 100.5.

Two tenths of a degree isn't very much.

I don't know how fast the rate of deterioration is for Ebola. Don't know what you should expect for a rate of temperature increase.

You are right though, everyone should err on the side of caution and early detection.

and what the CDC says to treat as possible Ebola -- the difference between 100.3 and 101.5 is 1.2 degrees.

being used on the same person at the same time? A difference of 1 degree doesn't seem to be too much to expect. But if the time difference between when the person took his own temperature and when the hospital tested him was great enough it could account for the test being positive for Ebola.

My mentioning of two tenths of a degree come from post #27 if that is what you are referring to.

for the CDC to err on the conservative side. It would be much more likely for a thermometer to register below the true temp, because of not being in place long enough, than above it.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418963/

Conclusions:

Evidence suggests that, regardless of whether the assessment is recorded at rest or during periods of changing core temperature, oral temperature is an unsuitable diagnostic tool for determining body temperature because many measures demonstrated differences greater than the predetermined validity threshold of 0.27°C (0.5°F). In addition, the differences were greatest at the highest rectal temperatures. Oral temperature cannot accurately reflect core body temperature, probably because it is influenced by factors such as ambient air temperature, probe placement, and ingestion of fluids. Any reliance on oral temperature in an emergency, such as exertional heat stroke, might grossly underestimate temperature and delay proper diagnosis and treatment.

Because it sure makes no sense.

Using their temp guidelines, ebola hasn't spread to unsuspecting contacts. Even with Eric Duncan, who was living in close quarters with multiple people and much further along in his illness (with the associated increased viral load), none of his pre-hospitalization contacts got sick.

And to date, none of the contacts of Nina Pham and Amber Vinson have shown up with ebola either - not on Amber's plane or the wedding party or whatever. And given the timing of this doctor going to the hospital, it will quite likely be the same for him.

So what is it about the temp levels that seem so inappropriate to you? How do they make 'no sense'? And do you honestly think they just made it up? (wtf?)

From where I sit, despite my misgivings about our healthcare system overall, it seems things are working pretty well and any significant of outbreak has been avoided thus far. It has only spread to direct HCWs, and those protocols are being improved with every case.

I was really worried about his outcome with a fever that high so quickly! I think Duncan's was 103 when he finally got admitted and he couldn't be saved. So the good doctor has an excellent chance of a full recovery. That is a relief. We need him and he is a hero!

There's a whole lot of blame-the-victim gameplaying going on, even here, and getting the temperature right (and lower) means he wasn't contageous and cavalier about it.

on my way home from work.

But I kept thinking...ugh, I would super sick if I had a fever that high, so why did he wait so long to call?

Ah-ha! It was 100.3 and the media was dishing out the usual bad information.

103 is the number they were given by health officials.

I think many of us get low-grade fevers like that when we merely have a cold.

for Ebola even though he didn't meet the official CDC criterion of 101.5. This means he exposed fewer people and his own treatment could start earlier.

Good for the doctor and good for the hospital. It's time for the CDC to lower the temp of concern to 100 degrees for people with known exposure who are exhibiting other Ebola-like symptoms.

but misreporting the temperature is just more (maybe inadvertent) fear-mongering.

Most the population (especially the repiggies) have no idea what you're talking about.