Tahoe-Truckee hospitals taking extra Ebola precautions
October 8, 2014
TRUCKEE, Calif. — As Ebola deaths mount in West Africa, and with cases confirmed now in the United States and Spain, regional health officials are preparing for the unlikely scenario of the deadly virus making its way to California and Nevada.
Within Tahoe Forest Health System and at the main hospital branches in Truckee and Incline Village, staff is taking extra steps to ensure infected patients, should any be admitted, are isolated and treated as quickly as possible.
"I think it's important for the public to know that there are no confirmed cases, or even suspicious cases, in California," Laurel D. Holmer, Infection Control Practitioner for TFHS, said Monday. "However, the potential exists, and we are prepared. As we all know, a disease is just an airplane flight away."
There hasn't been a single confirmed case of someone being infected with Ebola on U.S. soil — the one case involves a Liberian man, Thomas Duncan, who contracted the virus overseas and is being treated in Dallas. Duncan, who began receiving an experimental drug Monday, remained in critical condition as of Tuesday.
Further, officials at the U.S. Centers for Disease Control, while urging providers to be prepared, have repeatedly said that they don't believe the country is likely to see the type of outbreak that has killed more than 3,400 people and infected more than 4,000 others in Liberia, Sierra Leone and Guinea.
Still, with news Monday that a nurse in Spain became the first person known to catch Ebola outside the outbreak zone in West Africa, health care providers across the country are taking extra precautions.
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For example, some public hospitals in New York City have reportedly been secretly sending actors with mock symptoms into emergency rooms to test how well triage staffs identify and isolate possible cases.
READ MORE: US health providers are expanding their Ebola precautions in efforts to be better prepared.
While precautions aren't to that level at Truckee and North Lake Tahoe, TFHS has hung fliers in its hospitals, urging patients with fever-like symptoms and who may have traveled in the past three weeks to West Africa to immediately notify staff.
If a patient met the criteria as a potential Ebola patient, Tahoe Forest would "immediately notify the local health department," Holmer said — that could be Washoe (Nev.), Placer (Calif.) or Nevada (Calif.) county, depending on the residence of the patient.
"We contact the county health department because testing for Ebola is handled through our public health liaison," Holmer said when asked how Tahoe Forest would report a potential case. "The local public health agency, upon receiving a request for blood test, they would then notify the CDC — that's kind of the chain of command."
Dr. Ken Cutler, Nevada County's Public Health Officer, said Tuesday the possibility of an infected patient in our region is "very unlikely."
"Locally, we do not anticipate an outbreak of Ebola to occur; however, if a suspected case of Ebola should occur, the Nevada County Public Health Department has prepared to work with local hospitals to identify and diagnose any suspected Ebola case through public health laboratories, to assure isolation of the patient, and to work closely with those who have had contact with the patient in order to limit any spread," Cutler's office said in a statement Tuesday afternoon.
If TFHS did have an Ebola patient, staff would isolate him or her in a private room; nurses, practitioners and doctors would wear face masks, gowns, eye protection and other forms of "Personal Protective Equipment" during treatment to minimize the risk of the virus's spread.
As part of standard protocol for treatment of any virus or infection, Tahoe Forest has plenty of that kind of equipment at its Truckee and Incline Village campuses, Holmer said.
"We are very prepared to handle a potential Ebola patient — to not be prepared would mean we aren't practicing our standard protocols in the first place," she said.
Further, because Truckee-Tahoe is a location that features many visitors from across the country and world — as well as many locals who travel overseas — Tahoe Forest asks patients to list extended travel history as part of its normal entry procedures for patients.
READ MORE: In Washington, the White House has continued to rule out any blanket ban on travel from West Africa.
"That's just standard protocol for us. Now, when the consequences are extreme, like with Ebola and its mortality rate, that obviously puts heightened awareness to our standard protocols," Holmer said. "Even though that's just part of our standard operation procedure, is that more altered with Ebola on U.S. soil? Absolutely. We don't want to have our head in the sand, of course. So we are revising our protocol and stressing the importance every time with every patient about specific travel history."
According to the CDC, Ebola signs and symptoms include fever (greater than 38.6°C or 101.5°F), severe headache, muscle pain, weakness, diarrhea, vomiting, abdominal/stomach pain and unexplained hemorrhage (bleeding or bruising).
Symptoms may appear anywhere from two to 21 days after exposure to Ebola; the average is eight to 10 days. Recovery depends on good supportive clinical care and the patient's immune response, according to the CDC. People who recover from Ebola infection develop antibodies that last for at least 10 years.
Because the natural reservoir host of Ebola viruses has not been identified, the manner in which the virus first appears in a human at the start of an outbreak is unknown. However, researchers believe the first patient becomes infected through contact with an infected animal.
With humans, Ebola is spread through direct contact with blood or body fluids of a person who is sick with Ebola; through objects (like needles and syringes) that have been contaminated with the virus; or through infected animals.
Ebola is not spread through the air or by water, or in general, by food, according to the CDC. There is no evidence that mosquitos or other insects can transmit Ebola.