How serious is the threat?
Though there are no suspected or confirmed cases of the virus in St. Charles Parish, St. Charles Parish Hospital is well prepared should an Ebola case arise, according to chief of nursing Jean Hill.
The hospital has received equipment capable of protecting nurses from infection and new procedures are designed to help minimize the risk of misdiagnosing a patient with the virus.
“We have policies and protocols in place at our facility for the screening and isolation of any patient suspected of having the disease,” Hill said.
Current Centers for Disease Control and Prevention (CDC) procedures that recently saw success in Nigeria and Senegal, both in Africa, include isolating patients that meet certain Ebola screening criterion, such as those who have traveled to high-risk countries and have a fever. Even before the virus was confirmed, friends and family members who came into contact with any African victims were closely monitored by emergency personnel.
In order to make sure anyone with the infection is identified quickly in the St. Charles Parish, the government has distributed Ebola-screening questionnaires to its 911 operators and other emergency workers. In line with CDC recommendations, parish spokeswoman Renee Simpson said the questions are designed to determine whether residents suffering from flu-like symptoms are at risk for Ebola by asking them about their travel history.
If certain conditions are met, Simpson said that police, firemen and EMS are then instructed to “[secure] the patient’s place of residence” and begin interviews with family members. The affected patients, their cars and homes are then decontaminated.
Ron Perry, Louisiana’s point of contact for Ebola-related issues in St. Charles Parish, said the parish will hold a meeting with emergency response personnel on Monday. The state has requested that all parishes conduct such meetings.
While it’s important for governments and health care providers across the country to prepare to fight an Ebola outbreak, Dr. Frank Welch, the medical director of community preparedness at the Louisiana Public Health Office, said media coverage of the two Dallas nurses who contracted the virus may have caused an unnecessary overreaction by the public.
Welch said containment procedures are fairly simple.
“All you have to say is, ‘this person goes in that room, alone, preferably with their own bathroom,’” Welch said.
Stopping Ebola, he said, comes down to making sure no infected patient’s “wet” gets on a another person, which includes sweat, saliva, blood or feces.
Much of the anxiety over the transmission of the disease has come from the seemingly lax initial response of the CDC in containing the U.S.’s first Ebola-infected patient. Since that time, the CDC has regularly updated guidelines that are distributed to hospitals in Louisiana through the state’s Health Alert Network. This alert system distributes information to, among others, every hospital and every parish office of the Department of Homeland Security.
Welch said that 19 such updates have been issued regarding the current Ebola outbreak. He said these have ranged from general updates about Ebola to very specific “algorithms” on diagnosis and treatment.
“Because this is a rapidly changing public health situation, we adjust our protocols quickly and effectively so that we are always in compliance with new CDC guidelines,” said Sandra Kemmerly, infectious disease specialist and medical director of Clinical Practice Improvement for the Ochsner Health System, which manages St. Charles Parish Hospital.
In addition to the Ebola protocol, St. Charles Parish Hospital recently completed a drill that tested, among other things, the hospital’s ability to handle an influx of patients.
“It’s extremely important that our staff knows how to respond in real emergency situations and during a crisis or disaster that could affect the safety and well-being of our patients, employees and community,” Hill said.
How serious is the threat?
The World Health Organization recently celebrated the eradication of all Ebola cases in Senegal and Nigeria. For Nigeria, the threat was particularly harrowing as the first case was reported in Lagos, a city of 21 million.
The WHO credited good leadership and sufficient funding for outbreak control measures in bringing the disease under control quickly within the African nation.
This comes on the heels of news from Dallas that all 49 of the people quarantined after having contact with Thomas Eric Duncan, the man who fell ill with Ebola after flying from Liberia and later died, have been cleared from a 21-day health watch and have not shown any symptoms. Those quarantined include the late Duncan’s fiancée.
“To the ordinary person there is virtually no risk at all,” said Dr. Frank Welch, the medical director of community preparedness at the Louisiana Public Health Office.
Welch emphasizes that while the risk is minimal for the general public, healthcare workers on the front lines face more dire consequence. Roughly 70 health care workers who cared for Duncan remain under close watch, but none are exhibiting symptoms.
“As someone gets sicker and sicker, they become very, very contagious,” Welch said. “That’s why you see in Dallas the people who did get [Ebola] were intensive care nurses.”
The CDC considers 24 hours to be a “cautious upper limit” for how long the virus can survive outside of a body.
Welch, who visited the bio-containment facility at Emory University where the two infected Dallas nurses were being treated, also defended the transporting of U.S.-born victims in western Africa back into the United States. The blood serum of one of those survivors, he said, is currently being used to treat one of the nurses.
According to a CDC bulletin distributed to health care workers, any disinfectant rated for “non-enveloped” viruses, such as rotavirus, is sufficient in disinfecting hard surfaces in the vicinity of an Ebola-positive patient. The CDC said that this recommendation is made “as a precaution,” as the non-enveloped viruses are more resistant to disinfectants.
Ebola is an enveloped virus and is easier to disinfect.Welch said the loss of thousands of lives throughout countries in western Africa is a tragedy, but there is a silver lining to this easily contained infection. He said that drills and disease prevention and decontamination procedures will prepare healthcare workers for another virus that kills as many as tens of thousands throughout the world each year: influenza.
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