By Keving Jensen MD and Bethann Kane RN
Director of Emergency Medicine and Emergency Control Officer
The William Bee Ririe Hospital and Clinic (WBRCAH/Clinic) is working with state health authorities and the U.S. Centers for Disease Control and Prevention to address the possible implications of the Ebola Virus outbreak in West Africa on the state of Nevada.
WBRCAH/Clinic and its partners have been preparing for the unlikely incident and management of an infected individual being diagnosed in the state.
There have been NO confirmed cases of the Ebola Virus in Nevada.
The United States and the State of Nevada has a robust healthcare system with capabilities to detect, respond, and stop Ebola should a confirmed case come to the state.
So what do we know about Ebola? The Ebola virus is not new. Most of the following information comes from the article from the US Center for Disease Control, (CDC) in the article, Ebola Fact Sheet, which can be found online at the website, http://www.cdc.gov/vhf/ebola/pdf/ebola-factsheet.pdf. To quote the article “(The Ebola Virus) was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Since then, outbreaks have appeared sporadically in Africa.” The virus seems to be cold intolerant as outbreaks have occurred only in warm, moist tropical areas, usually around the equator in Africa, (hence the first diagnosis in the US occurred in Texas, and as yet, there have been no cases in colder, dry climates such as White Pine County). We don’t know much about the transmission of the virus, but it seems to be found in monkey populations and may be primarily transmitted from animal populations to humans via bats, and secondarily by human contact with raw animal products, especially feces. When the first human in an outbreak becomes infected, it is almost always by contact with an infected animal. Transmission from human to human is by way of direct contact with infected body fluids such as blood, feces, saliva, urine, vomit and semen. The virus in the blood and body fluids can enter another person’s body through broken skin or unprotected mucous membranes in, for example, the eyes, nose, or mouth. There has been no documented transmission by respiratory droplets, such as coughing or sneezing.
The diagnosis of Ebola Virus Disease is difficult at first, as it appears like many other common diseases. Symptoms may include: Fever greater than 101.5°F, severe headache, muscle pain, vomiting, diarrhea, stomach pain, unexplained bleeding or bruising. A person infected with Ebola is not contagious until symptoms appear. The diagnosis should be suspected in persons presenting with those symptoms who have had recent travel (within 21 days) to Africa or contact with the body fluids of a person known to be infected with Ebola.
In short, our cold, dry climate is protective of transmission of the Ebola virus, and I am not aware of any African monkeys in the area. Though we have bats in the area, most are locals, though some migrate from Mexico, occasionally carrying rabies. We, like most of the US, have a greater chance of being killed by accidents, including motor vehicle accidents, and smoking related diseases, including heart attack, stroke, and cancer. So, we expect the common diseases and prepare for the worst. In the meantime, wear your seatbelts, don’t text and drive, try to cut back or quit smoking, and don’t share needles with, or kiss any African monkeys.
“We do not track individual travelers. We think the most effective way to address this is, first, to work on control in the three countries.” Tom Frieden
07/31/14 http://www.cdc.gov/media/releases/2014/t0731-ebola.html
FROM JULY 31, 2104 JOEL ACHENBACH: Okay. But how do you communicate this to people? Have you sent direct e-mails to different organizations? Are you tracking people who have traveled from these three countries to the U.S.? TOM FRIEDEN: We have something called the health alert network. It goes out to a very wide range of physicians, other clinicians, health care organizations. We work with and through state and local health care organizations. We sent a health alert message Monday of this week. We’ll continue to provide updated information. We do not track individual travelers. We think the most effective way to address this is, first, to work on control in the three countries. Second, to strengthen these three countries’ ability to reduce the likelihood that exposed people will leave the country. And, third, by strengthening the overall systems by which health organizations in this country would think of the possibility in this case of someone coming from the region, do the appropriate isolation, testing and follow up. Next Question.
*Any questions at all? Anyone? Anyone?