How U.S. hospitals are preparing for Ebola

Another ED goes into lockdown over an Ebola scare

As the Ebola outbreak grows in West Africa and a second infected patient arrives in the United States for treatment, hospitals across the country are preparing for possible cases of the deadly, incurable virus.

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Background on Ebola

The Ebola outbreak—now considered the deadliest in history—was first detected in Guinea in March. The incurable disease kills about two-thirds of the people it infects by causing untreatable bleeding that can claim victims' lives in a matter of days or weeks. To date, the Ebola outbreak has infected more than 1,200 people in Guinea, Sierra Leone, and Liberia, killing more than 700 of its victims.

Health officials last week announced that a U.S. volunteer physician from Doctors Without Borders and a medical missionary with Samaritan's Purse had contracted the disease. The physician arrived at Emory University Hospital in Atlanta, Georgia, on Saturday for treatment, and the missionary worker will arrive on Tuesday, officials say.

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Emory University Hospital will treat the two volunteers because it possesses a Level 1 infectious diseases containment unit, built in conjunction with CDC, according to Emory's Bruce Ribner, who oversees the unit.

Each patient will be cared for by two specialists and two specially trained nurses wearing masks, hoods, gloves, and a specially developed "outer shell" to prevent them from being infected via bodily fluids, Ribner says.

The patients will be given intravenous fluids and put on respirators and dialysis machines. "We just have to keep the body alive long enough for the body to survive this infection," says Ribner, adding, "If they can arrive in a reasonably good state, we have a reasonable chance of restoring them."

Hospital prepare for possible cases

CDC Director Tom Frieden says the virus "poses little risk" to the nation. Nonetheless, the agency on Friday released guidelines on how hospitals should manage patients with Ebola. CDC recommends that clinicians entering a room with an Ebola-stricken patient wear:

  • Gloves;
  • Eye protection;
  • Fluid-resistant gowns;
  • Face masks; and
  • Shoe or leg covers.

Not every hospital is equipped with a special wing for Ebola patients like Emory is, but Vanderbilt University infectious disease specialist William Schaffner says almost every U.S. hospital can take care of an Ebola patient without creating a danger for staffers or the public.

U.S. hospitals should be on alert for patients with Ebola symptoms—such as fever, diarrhea, and red eyes—and a history of travel. "It's extremely rare for a case of Ebola virus to occur in the Heartland or even the U.S. But the deadly virus is only an airplane ride away," says University of Kansas Hospital CMO Lee Norman.

Last week, a North Carolina ED closed briefly amidst an Ebola scare. And on Sunday, a California hospital went into lockdown after physicians expressed concern about a patient who had recently traveled abroad.

St. Luke's Cornwall Hospital in Orange County was on lockdown while police and hazmat teams responded to the announcement that a patient with strange symptoms had recently returned from an overseas trip. As in the North Carolina case, the patient was eventually deemed not a threat and the hospital reopened.

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The New York City Health Department is not taking any risks and has ordered providers to immediately report any suspected cases of Ebola.

"We are monitoring the situation and are prepared to protect the health of New Yorkers against any infectious diseases imported into the city," the health department said, adding that it has stationed quarantine officers at the John F. Kennedy International Airport. "If you're a passenger on a plane and you say you're sick, you will be met when you land by the CDC," says spokesperson David Daigle.

CDC has issued guidelines for how airline personnel can handle travelers who may have the Ebola virus. Such passengers should be separated from other travelers and be handled only while wearing disposable gloves, CDC says. Moreover, airline captains are required by law to report to CDC any passengers suspected of carrying Ebola.

Is your airport a hub for infectious disease?

"People who have been exposed to Ebola virus disease should not travel on commercial airplanes until there is a period of monitoring for symptoms of illness lasting 21 days after exposure. Sick travelers should delay travel until cleared to travel by a doctor or public health authority," the agency says (Stobbe/Henry, AP/Sacramento Bee, 8/3; Fischer, New York Business Journal, 8/1; Pfannenstiel, Kansas City Business Journal, 8/1; Burnett, TIME, 8/4; Bernstein, "To Your Health," Washington Post, 8/1; News 12 Hudson Valley , 8/4; Shute, "Shots," NPR, 8/1).

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