San Diego County Prepared for Ebola Virus: Experts

All acute care centers in the region are prepared to handle an Ebola virus patient, according to one infectious disease expert

Health care officials in San Diego County say the region is adequately prepared to handle a diagnosis of an Ebola patient.

The disease has killed at least 3,800 people in West Africa with no signs of subsiding.

After the death of Thomas Eric Duncan, the first person in the U.S. to be diagnosed with Ebola, NBC 7 asked health care officials in San Diego about screening and treatment if a case of the deadly virus were to surface here.

San Diego Fire Rescue and City Emergency Medical Services met with Centers for Disease Control and Prevention representatives Thursday to talk about how to handle such a situation.

EMTs and firefighters are equipped with the proper gloves, masks, gowns and medical equipment to handle any patient exhibiting symptoms, should crews be called to take him or her to the hospital, the City Emergency Medical Services says.

“Every acute care hospital is prepared to deal with contagious, infectious pathogens,“ said Dr. Michael Butera, Infectious Disease Physician and chairman of the Infection Control Department at Alvarado Hospital.

Alvarado Hospital has negative pressurized rooms and other isolation rooms used for droplet and contact precaution, Butera said.

He added that all hospitals in San Diego County – particularly acute care centers – are very well prepared to care for someone exhibiting symptoms of the Ebola virus.

Currently, Alvarado Hospital staff is using a standard list of questions posed to all patients that asks about recent travel and exposure to people who may have recently been in West Africa.

He believes that screening and training is key to preventing an outbreak similar to the one currently in West Africa here in the U.S.

“Having robust policies in our hospitals and with first responders to be able to recognize and anticipate that it could happen anywhere is really important for the protection of everyone else in both the medical community and our public,” Butera said.

Physicians, nurses and other hospital staffers are outfitted with standard layers of protective gear including impermeable gowns, gloves, mask, face shield or goggles, as well as eye protection to prevent splatters from body fluid and special shoes.

That type of gear is used for other transmissible diseases currently in San Diego County including seasonal and pandemic influenza, West Nile Virus and tuberculosis.

“The epidemiology of all the [Ebola] outbreaks to date… suggest that this is a contact-spread virus that does not behave like influenza, SARS,” Butera said.

“We are well prepared, well poised to handle a first diagnosis of Ebola in San Diego,” said Dr. Wilma Wooten, Public Health Officer County of San Diego.

The health department should be notified if someone arrives at a hospital or doctor’s office with symptoms of Ebola and has either traveled to the three countries in the West African Ebola outbreak or have had contact with someone carrying the Ebola virus, Wooten said.

Once a potential Ebola patient has been identified, then that person needs to be isolated and the health care official should call the health department, Wooten said.

At that point, her agency’s laboratory will package the specimen and then call a courier to ship the specimen to Los Angeles to run tests.

Then, contact tracing begins – something Wooten called, “the bread and butter activities of the public health department” and points to San Diego County’s Measles outbreak in 2008 as the agency’s most recent experience with the process on a large scale.

Butera said it’s important for San Diegans to remember that the incubation for the Ebola virus is two to 21 days. Most patients who are going to become ill will get sick on days 6 through 10 after exposure.

“The key to understand is that if you’re not symptomatic, you’re not infectious,” he said.

During the time a person has no symptoms, the patient cannot spread the virus and those symptoms, he repeats, include fever, headache, body ache, back pain, nausea and vomiting.

The mainstay of treatment for the Ebola Virus is support of care – maintaining hydration, stable blood pressure and organ function, he said. 

However, the San Diego Border Patrol is not as optimistic about its ability to handle a patient with Ebola, according to National Border Patrol Union Representative Gabe Pacheco.

He said while agents have masks, gowns and gloves, those supplies are few, and they do not have the full mock suits needed.

The Department of Homeland Security has only sent mass internal emails about the disease's indicators, Pacheco said, but agents have not recevied clear guidelines about how to handle a case at the border.

"I think we're all waiting for the direction, and I think that's what's lacking is their direction and leadership that we're saying, 'Hey this is what we're going to do, this is where we're gonna go," said Pacheco.

The CDC says Border Patrol and TSA agents are at low risk for coming across the disease.

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