Ebola and fish bone ingestion in Ghana

The Ebola epidemic was the topic of this week’s clinical conference. This virus is named after the Ebola river in what is now the Democratic Republic of Congo where the disease was first identified in 1976. It is transmitted by close contact with an infected person’s skin or body secretions. The Public Health Authorities here advise against bringing a suspected patient directly to the hospital where he could contaminate others, but prefer instead that a trained team go out to the suspected patient’s house to properly isolate and transport him to a unit which has the proper equipment and trained health care providers. There have been no proven cases in Ghana.

There are many cases of aspiration and ingestion of foreign bodies in northern Ghana. With modern telescopic equipment and magnified images, the foreign bodies can be successfully removed. However, the local hospitals and clinics lack both x-ray equipment and doctors and the patients present a year later with abscesses, perforations and bleeding. Two cases are typical. A nine year-old boy with a nail in his bronchus presented eighteen months after aspirating it. We were unable to get it out with our first try and while waiting a necessary interim before making another attempt, the patient’s family took him from the hospital and did not return.  We will now try to locate him in order to remove the object and hopefully  prevent his death or having some of his lung removed. In another case, a sixteen  year-old girl presented a week after a fish bone was caught in her throat;  there was  400 ml of exudate in her neck and her larynx and esopha gus were  edematous. The bone could not be located with all the edema.  In two days, after a ten-day course of antibiotics to reduce her infection and edema, a second attempt at removal will be made.