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Ebola Facts, Risks, and Air Travel

by James Hubbard, MD, MPH

Ebola is highly contagious and kills nine out of 10 people infected. So, why do I think headlines like USA Today’s “Ebola only a plane ride away from USA.” paint the wrong picture? Now that I think of it, why does my first sentence do the same? It’s all about perspective.

First, a little background.

The current Ebola outbreak in Africa has been going on for several months. It hit the American news cycle big time on Monday because an American doctor contracted it while in Africa. And someone on a plane there was found to have the disease. The media is asking, “Could it come here?”

This is not the first outbreak in Africa, but past ones have been localized to small villages. The usual outbreak runs its course and eventually just goes away. But this one has been spreading—to multiple regions, including large cities.

This is serious business. For those in Africa, it’s a nightmare. Horrible. Devastating. But here are some more facts to put it in perspective for the rest of us:

  • Ebola has never been shown to spread [... continue reading]
  • Author: James Hubbard, M.D., M.P.H.
    Posted: July 29, 2014, 9:55 am


    by James Hubbard, MD, MPH

    Unless you’re of a certain age, you may have never seen some of the diseases in the chart on the next page. Join the crowd; many younger doctors haven’t either. Measles and rubella, which used to be so common, have been close to wiped out in the U.S. Chickenpox cases have come down to an estimated 80 percent of what they were in the 1990s. (Scarlet fever cases have remained about the same, but they’re still pretty rare compared with fifth disease and roseola.)

    So why should you care about them? The words “close to” are key. Measles and rubella are still very prevalent in many countries and crop up in outbreaks in children and adults here in the United States and other developed countries every year. (In fact, my daughter Beth Hubbard, a flight paramedic and owner of the Alaska wilderness medical survival school Solace of Safety, suggested I put together this chart. She plans to utilize it at work.) And you need to recognize scarlet fever since it’s the only one treated with antibiotics.

    For disaster [... continue reading]

    Author: LAwordsmith
    Posted: July 28, 2014, 10:00 am

    Nectarines and peaches are in latest listeria recall.

    by James Hubbard, MD, MPH

    Listeria symptoms can sometimes take weeks to develop. Here are some tips on protecting yourself and your family—plus what to do if you get sick and can’t get expert help.

    Every so often, listeria gets in the news because of an outbreak found in commercial produce. The latest one  is in peaches and nectarines at certain grocery stores, including Kroger, Walmart, and Whole Foods.

    Recalls happen periodically, and you should take them seriously. The one in cantaloupes in 2011 killed 33 and caused one miscarriage, and that was with a very quick, very publicized recall.

    One of the problems is the listeria symptoms can be pretty generalized in most people, and sometimes it can take as long as 70 days from infection to symptoms. Meantime, a lot of people could have eaten the contaminated food.

    Other than depending on recalls, there are precautions you can take, whether you buy your produce or are living off the land. And of course I’ll tell you what to do if you get the symptoms and can’t get expert help.


    Listeriosis [... continue reading]

    Author: James Hubbard, M.D., M.P.H.
    Posted: July 25, 2014, 9:49 am

    Notice how tiny the tick that causes Lyme disease can be.

    by James Hubbard, MD, MPH

    When someone comes in my office for a tick bite, their main concern is usually, what’s their risk for Lyme disease.

    And I can’t blame them. Lyme disease from tick bite warnings are all over the media (one reason probably is New York is a high-risk state), and since the disease has only been recognized in the U.S. since 1975 (first suspected by a physician in Lyme, Connecticut, who was seeing kids with unusual symptoms) we’re still learning about it. This, and its rather general initial symptoms, make it rife for myth and speculation.

    One thing’s for certain, Lyme disease is serious business. And it’s at full force in the summer because that’s when the ticks that spread it are most prevalent. So, in this post, I’ll try to answer some of the most common questions I’m asked.

    How is Lyme disease spread?

    Ticks. Ever had one on you? Yeah, it’s pretty creepy.

    Ticks are one of nature’s true vampires. The tiny specks sit silently on leaves of bushes and trees, patiently waiting for whatever warm-blooded creature (they’re attracted to [... continue reading]

    Author: James Hubbard, M.D., M.P.H.
    Posted: July 20, 2014, 2:56 pm

    A chest X-ray from a person with tuberculosis (in right upper part of the photo).

    by James Hubbard, MD, MPH

    Lately I’ve had several interviewers ask me a question I haven’t been asked before: How contagious is tuberculosis? I’m guessing the reason is either the highly reported outbreak in a California classroom, a couple of publicized cases of multiple-drug resistant tuberculosis found in foreigners traveling here in the United States, or the news of camps of children—some reportedly with TB—at the U.S.-Mexican border.

    But then, I should never be surprised that people would like to know about the risk of one of the oldest, deadliest, and still most worldwide prevalent diseases around. And since this could well be a deadly concern in disaster situations, I thought it a good subject to address.

    Tuberculosis Truths
  • In the early part of the 20th century, tuberculosis killed about one in seven Americans.
  • In 2012, the latest year data is available, the CDC reports there were around 10,000 documented cases in the U.S.
  • Over 500 people died of TB in 2012.
  • If treated properly with the right antibiotics, tuberculosis is curable in most cases.
  • The earlier [... continue reading]
  • Author: James Hubbard, M.D., M.P.H.
    Posted: July 14, 2014, 9:51 am

    Girls are especially prone to knee injuries.

    James Hubbard, MD, MPH

    Question. What do adolescent girl athletes and the rest of us have in common? Answer. Knee injuries, of course :).

    In fact, anyone who gets in a little too much of a hurry or doesn’t watch what they’re doing is susceptible. Add jumping or a quick pivot for whatever reason and your risk increased greatly.

    A while back, I jumped off a porch with such a jar I thought I’d shaken my teeth out. The reason was I landed without bending my knees and it’s a wonder I didn’t injure one of them.

    You can be in tiptop shape (unlike me), and have the strongest of legs and still get hurt—just because you land or pivot wrong.

    Fortunately, there’s been a lot of recent research in knee injury prevention triggered by the growing amount of injuries in girls’ sports. It seems they are particularly prone to ACL tears. The keys are not only strength but balance, and training our brain to make our legs land in the correct position. A little preparation can go a long way to prevent a debilitating injury.

    Why Girls? [... continue reading]
    Author: James Hubbard, M.D., M.P.H.
    Posted: July 7, 2014, 10:05 am


    Part 3 in my series on drowning. See all my posts about rescuing drowning victims here.

    by James Hubbard, MD, MPH

    Ever heard of parking lot drowning? That’s what lifeguards anyway. Others may call it secondary drowning.

    It can happen minutes to hours after a near-drowning victim is revived. It can even happen to someone who didn’t nearly drown—who just sucked a little too much water down their lungs, coughed and choked, and then appeared perfectly fine.

    Later on (maybe, say, sitting in a parking lot), the victim can suddenly become unable to get enough oxygen. If not treated they can, in essence, drown.


    If even an ounce or so of water gets all the way down into the deep part of the lungs, it can damage the alveoli (air sacs where oxygen is exchanged for carbon dioxide). This impedes the lungs’ ability to get oxygen into your body and can become life-threatening.


    Who’s at risk: Anyone who’s been in the water within the past 24 hours and sucked in enough to cause a pretty bad initial choking and coughing spell is at risk for [... continue reading]

    Author: James Hubbard, M.D., M.P.H.
    Posted: June 30, 2014, 10:00 am

    by James Hubbard, MD, MPH

    This is part 2 of my drowning series. See part 1, about essential swimming skills and rescuing drowning victims, here

    Once you pull someone drowning to safety, what next? If they’re unresponsive and not breathing, three things should be done at once if there are enough people around to do them: Call 911, start CPR, look for an AED machine.

    In a survival situation, if you can’t call 911 and there’s no AED machine, do CPR until you’re exhausted. But know that CPR alone rarely revives a person. (It pumps blood to the brain to prevent damage until expert help arrives but rarely restarts the heart. An AED—automatic external defibrillator—can restart the heart. More and more public swimming areas are stocking one.)

    If you’re alone, make a judgment call about which of the three steps to do first. I’d take no more than 30 seconds to look for an AED machine. CPR needs to be started as soon as possible.

    >> Special circumstances: Click here for special instructions for resuscitating someone who was drowning in cold water.

    Those [... continue reading]

    Author: James Hubbard, M.D., M.P.H.
    Posted: June 23, 2014, 10:00 am

    James Hubbard, MD, MPH

    Every year even good swimmers drown. Some are in an accident or become unconscious due to a seizure, alcohol, or another reason. Some drown trying to help others. And some just don’t know how to swim as well as they thought.

    According to a survey done by the American Red Cross, 80 percent of Americans say they can swim, but only 56 percent can complete all five critical water safety skills that make up what’s known as “water competency.”

    Could you? The skills are:

  • Step or jump into the water over your head.
  • Return to the surface and float or tread water for one minute.
  • Turn around in a full circle and find an exit.
  • Swim 25 yards to the exit and exit from the water.
  • If in a pool: Exit without using the ladder.
  • If you’re not absolutely sure you can perform these skills, consider taking lessons.

    And those guidelines are just for keeping yourself alive. What if you were the only one around who could save another person from drowning?

    Just the other day I was asked what to do if you [... continue reading]

    Author: James Hubbard, M.D., M.P.H.
    Posted: June 16, 2014, 10:00 am

    James Hubbard, MD, MPH

    Father’s Day is close at hand. How about getting the old man something a little different this year? Something he can use—that might even help him avoid or treat an injury.

    Here are seven Father’s Day gifts that I think any man would relish. Since Father’s Day is close at hand, I made sure you could buy them all through Amazon Prime because if you sign up for a free trial, you can get many of them within a couple of days. The last on the list, if you wish, you can get directly from me.


    I can’t count the number of times I’ve treated someone who’s had their day ruined by being in their yard, or with machinery, and getting a speck in their eye that they can’t get out. Everyone needs a good pair of goggles. This is a pretty cool-looking pair.

    SAM Splint

    I love these things. They’re light, and you can store or pack them virtually anywhere. Cut to size, and your father can make about any type of splint he needs.


    Everyone needs a radio in [... continue reading]

    Author: James Hubbard, M.D., M.P.H.
    Posted: June 9, 2014, 9:44 am

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