Ebola is Here: Now What?

October 2nd, 2014 by Trudy Henson

With the first case of Ebola confirmed in Dallas, Texas, the deadly virus has officially come to the United States. Although thought of as inevitable by some, the case raises a number of questions: Are traveling screening protocols sufficient? Did the hospital initially drop the ball by releasing the patient when he first presented? And of course, are we ready?

A number of sources have speculated on what an Ebola response would look like in the U.S., but with this first diagnosis we are now getting a clearer picture. The Texas Health Department has issued an order to the family of the Ebola patient, asking them to stay home and not have visitors to prevent the potential spread of disease. The order legally requires the family to comply until at least October 19, until the incubation period has passed. Additionally, the order requires the family to “be available to provide blood samples and agree to any testing required by public health officials.” Texas health officials are also attempting to trace other individuals who may have come into contact with the patient or his family—an estimated 80 people.

Although questions of isolation and quarantine are largely settled—legally, at least—the potential for an outbreak raises additional questions, many of them practical. The quickly growing number of people to be monitored (originally estimated at approximately 20) underscores the difficulty and resource-intensive nature of contact tracing a disease, and the importance of early identification and isolation. The relatively long incubation period—symptoms can take up to 21 days to appear—make isolation/quarantine a lengthy albeit necessary precaution. Additionally, although hospitals are well-rehearsed in isolation treatment protocols, many are wondering about the best way to properly transport and dispose of medical waste from Ebola patients. Incineration is typically recommended, but many hospitals do not have on-site incineration capabilities.

So far, there are few easy answers, but preparation, not panic, is key. The CDC has vowed to stop the virus in its tracks. Public health officials, from the CDC to the local health departments, reiterate that the U.S. health system is poised to handle a medical surge, including from a highly infectious virus like Ebola. Many hospitals (including the hospital in Dallas where the patient presented) have been drilling specifically for Ebola, and the CDC has been briefing hospitals for months on identification, protocols, and infection control measures. Here in Maryland, Department of Health and Mental Hygiene (DHMH) Secretary Joshua Sharfstein stated that “DHMH continually is monitoring communicable disease trends both within and outside Maryland,” and outlined other steps Maryland has taken during a press conference on Maryland’s public health readiness. Finally, Maryland government officials and hospitals have drilled their Ebola responses, should one become necessary.

Still, vigilance and knowledge are powerful allies. To read more about the Ebola virus, click here. For more information about response, protocols, and disease monitoring, including interim guidance and patient evaluation, click here.

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