Penn. Health Officials Prepare for Possibility of Ebola Outbreak, Urge Residents to Remain Calm

Oct. 08--Nathan Harig, an assistant chief at Cumberland Goodwill EMS, believes the spread of the Ebola virus in the United States is likely at some point, but health professionals emphasized the virus is not currently an issue in Pennsylvania.

"We expect there to be more cases in America, just with the nature of transport and travel," Harig said.

An outbreak of the infectious virus that generates flu-like symptoms has killed nearly 3,400 people in western Africa. Alarm bells began sounding in the United States Sept. 30 after Texas Health Presbyterian Hospital acknowledged it had released a patient who was later confirmed to be infected with Ebola.

Still, Harig and other Cumberland County health officials said Ebola is not an active problem in the Midstate. If it ever does spread to Cumberland County, officials said they are prepared for the spread of Ebola with better medical techniques than those used in western Africa. They urged residents to not be more alarmed than they would be about the flu or other viruses.

No active concerns

Health professionals emphasized that the Ebola virus is not an active problem in the Midstate. In fact, south-central Pennsylvania residents are far more likely to contract measles or enterovirus strain 68 than Ebola, Harig said.

"Unless you start seeing that there are cases in central Pennsylvania, it's extremely unlikely that someone in our area is even going to come in contact with the virus," said infectious disease specialist John Goldman of PinnacleHealth. The virus spreads through mucus membranes and blood, not through casual contact, Goldman added.

"It's not airborne, so you won't just get it sitting next to someone on a plane or a bus," he said.

There have not been any cases of Ebola in the United States outside of Texas, where officials have taken steps to contain the virus and monitor anyone who had been in contact with the infected patient, according to The Associated Press.

Educational institutions not concerned about spread

Local colleges with international students also indicated there are not reasons their programs pose a risk.

"We have no cause for concern, any more than anywhere in this area. We all have wariness," said Carol Kerr, spokesperson for the U.S. Army War College, which has fellows from around the world.

The war college monitors state department health alerts and has direct contact with embassies oversees to ensure proper precautions would be taken in the event a student travelled to an affected country, she said.

Both Kerr and Dickinson College spokeswoman Christine Dugan said the schools' international students have been on campus for longer than the 21-day maximum incubation period for the virus.

Dickinson College sent a message to students from affected countries asking them to complete a health exam, and the school continues to monitor and follow the advice of the Centers for Disease Control and Prevention and the World Health Organization, Dugan said.

Prepared hospitals

Even if the virus did begin to spread, officials said it is unlikely that it would create the same level of crisis that has occurred in western Africa.

Harig said the American medical system is better prepared to contain the virus than systems in western Africa. For example, most medical supplies in the United States are disposable rather than reused, limiting chances of contamination, he said.

To put the threat in perspective, Goldman said the Ebola virus has only killed 10,000 people throughout human history, while the flu virus kills 20,000 to 40,000 American each year.

"If they really want to protect themselves realistically for something happening this winter, they should get their flu shots," he said.

Even if the threat of an Ebola outbreak is remote, health officials say they are prepared.

The CDC issued guidelines for hospitals, first responders andemergency dispatch personnel after confirming the Texas Ebola case. The procedures discuss proper use of protective equipment, cleanliness guidelines and reporting requirements between emergency personnel, hospitals and the federal government.

Goldman said PinnacleHealth, which operates three acute care hospitals including West Shore Hospital, is following the CDC guidelines. They have signs and maps at the hospital instructing patients to tell a health care professional if they have been to countries known to have cases of Ebola, ask patients where they have been outside of the United States, and have procedures that would trigger a contact with an infectious disease specialist if a patient was in an area with Ebola, he said.

"We're doing a combination of surveillance -- making sure if a case shows up here we won't miss it -- and preparation so that we would recognize a case if it showed up here, so that we would be prepared to take care of it properly to ensure that it wouldn't spread to anywhere in the community, to any other patients, or to any health care providers," he said.

John Strazzullo, associate director of quality assurance at Patient First urgent care center, said Patient First is also preparing for a case of Ebola.

"We have put a plan into place that focuses on getting patients who may have Ebola to the most appropriate care as safely and as quickly as possible, while continuing to safely provide care to our other patients," he said.

Signs at the center tell patients who have been to western Africa to put on a face mask, bypass the electronic sign-in and immediately notify a receptionist, he said. A nurse would then direct a patient to the nearest hospital able to evaluate patients for the virus or arrange for EMS transport if the patient showed signs of a rapidly deteriorating condition. Patient First would notify the EMS workers or the hospital of the possibility the patient could have contracted the Ebola virus.

The Carlisle Regional Medical Center released a statement saying they plan to follow the CDC's infection control protocols. If a patient exhibits symptoms of Ebola, the patient would be isolated, medical personnel would have to wear gowns, masks, face shields and gloves before entering the room, and nonessential staff and visitors would be prohibited from entering. The case would also be reported to local and state health departments and the CDC, the hospital said.

EMS and public safety

Harig said Cumberland Goodwill EMS personnel have received training based on the CDC recommendations. They were instructed to avoid contamination much the same way they avoid bloodborne pathogens, and are prepared to recognize possible signs of Ebola and pass that information along to health care facilities, he said.

"The infrastructure's in place, with a robust public health system, that if a case took place here, I'm pretty confident we could all address it in a way it should be addressed," he said.

Cumberland County Department of Public Safety spokeswoman Megan Silverstrim said various aspects of the department have taken proactive measures to prepare for the possible spread of the Ebola virus.

"At this point we will treat this like we would if there was a flu virus that popped up," she said. "We're doing the same thing that we would do with any public health concern."

Dispatch center staff has been informed of and will be following the CDC recommendations for dispatchers and pass along any information that could indicate signs of the Ebola virus to appropriate medical responders, she said. Other elements of the public safety department have prepared strategies for handling a possible outbreak, she said.

"We're keeping an eye on the situation, so that should it become a concern, we can respond in the best way possible," she said.

Seeking treatment

Local health care organizations say Midstate residents are unlikely to contract Ebola in the near future, but if they do, they should seek medical attention.

Silverstrim recommends people react to the Ebola virus the same way they would respond to other viruses and seek medical attention if symptoms are sufficiently severe.

"If you are extremely ill and having trouble breathing, can't stand up, or become incapacitated, than that's a 911 emergency," she said.

In additional to normal flu symptoms, the textbook case of Ebola will include a fever with blood in either the stool or vomit, Harig said. People with that symptom should seek emergency medical help whether it stems from Ebola or not, he said.

If you only have mild symptoms but have reason to believe you may have Ebola, he recommends contacting your local doctor first.

"If you have questions, we certainly encourage you to go to your doctor before this mass rush to the emergency room from people having the flu," he said.

However, Strazzullo said someone truly exhibiting symptoms of Ebola and who had been to or been in contact with someone in western Africa should contact an emergency room, because emergency rooms have private rooms that are best equipped for treating a possible Ebola patient. The patient should first call the emergency room to notify them that they will be arriving, Strazzullo said.

Harig recommended people get a flu shot to help limit the spread of the flu this year, which he said could increase both Ebola hysteria and the overall burden on the local health care system.

Copyright 2014 - The Sentinel, Carlisle, Pa.