The threat of the Ebola virus hit close to home this month after an infected nurse in Dallas boarded a plane to Cleveland. So far, no one in Ohio has been infected with the disease, but local and state agencies are preparing themselves for the possibility.
Statewide, there are 164 people who came in contact with an infected person and are being monitored until Nov. 4, the last day of the 21-day period in which a person can come down with the virus after being exposed, said Dr. Mary DiOrio, the state epidemiologist with the Ohio Department of Health (ODH). At least three people are under quarantine.
DiOrio was part of a conference call with reporters Oct. 22 that gave a status report on Ohio’s Ebola response one week after the Ebola threat in the Cleveland/Akron area. Also on the call were Dr. Christopher Braden, the Ohio lead of the U.S. Centers for Disease Control and Prevention (CDC); Richard Hodges, director of the ODH; and Michael Abrams, president and CEO of Ohio Hospital Association (OHA).
“This is significant in Ohio because we’ve never had to deal with Ebola, but we do have experience. We just had a measles outbreak recently,” DiOrio said. “We have protocols. We began our Ebola preparations over the summer and were quickly able to implement a response with state and local agencies.”
Braden told reporters that the state’s reponse to Ebola is in good shape but not yet “out of the woods” a week after the threat.
“When we first came (to Ohio) it was obvious that the rapid and aggressive response was started and well under way,” Braden said. “When we reflect back on a week of very hard work as an assessment, we are in a very good place. We have some time before we are out of the woods [but] we are at a place in the reponse where we can take a deep breath and reflect on the week to go forward.”
Federal authorities said Oct. 22 that everyone traveling into the U.S. from Ebola-stricken nations will be monitored for symptoms for 21 days. That includes returning American aid workers, federal health employees and journalists, as well as West African travelers.
Dallas nurse Amber Vinson was part of a team that treated Liberian Thomas Eric Duncan, who contracted the disease in Liberia before coming to the United States. Duncan died Oct. 8, eight days after diagnosis. Nurse Nina Pham contracted Ebola while caring for Duncan after he was admitted but before he was diagnosed. Vinson, the second nurse to be infected, boarded a plane from Dallas to Cleveland on Oct. 10. She had been monitoring herself for symptoms, but was not restricted from traveling because she was not a risk according to CDC guidelines. The condition of both nurses has improved, and Vinson recently tested negative for the virus.
Toledo response
In Toledo, the Lucas County Health Department has taken the lead on the area’s response to a potential Ebola outbreak and has been holding meetings and discussions with first responders, local hospitals and others, including the Lucas County Emergency Management Agency, the Lucas County Sheriff’s Office, the Toledo Express Airport, the Ohio Air National Guard and the mayor’s office.
“The situation that happened in the Cleveland/Akron area got us thinking it could be something we could be faced with. It’s always better to be prepared,” said Samantha Eitniear, Lucas County community response coordinator.
Stephen Arnold, Toledo Express Airport manager, said his agency is following the lead of the county and the Transportation Security Administration. The likelihood of Ebola arriving in Toledo from Africa by plane is small, because most international travelers are checked at O’Hare International Airport in Chicago before arriving in Toledo, he said. But if someone were to be suspected of infection, the 180th Fighter Wing of the Ohio Air National Guard would be the first responders. A guardsman would don protective gear and board the plane to question the person further.
“Everyone is standing back and taking a good look at this thing. We’re in the right position to handle this,” Arnold said. “We feel confident around here because there’s been so much discussion (of procedure) so we’re probably in better shape than Cleveland or Dallas. People here are taking notice of what could happen.”
ProMedica was “ahead of the game” and began Ebola preparations this past summer, said Brian Biggie, a nurse and ProMedica’s system coordinator for disaster preparedness.
“Aug. 2, our system brought together a small functioning team to work on our Ebola response plan before it had hit the United States,” Biggie said. “We take these things very seriously.”
However, when Duncan became the first Ebola patient diagnosed in the United States and Vinson flew to Cleveland, the “landscape” changed dramatically in Ohio, he said.
To be prepared here, the ProMedica team has conducted drills, established routes of communication and practiced patient management.
The ODH and the OHA have both required hospitals to hold drills and the CDC has released new guidelines on how to “don and duff” personal protective equipment (PPE). ProMedica has adopted those requirements.
“We have confidence in our PPE stance,” Biggie said. “We’re reacting as quickly as we can to every changing disease process. It’s a moving target.”
The ODH requested emergency funding from the state, which allocated $800,000 for protective gear to send to any area of the state that may have an outbreak, said Bill Teets, spokesman for Ohio’s Emergency Operations Center.
“Most health care providers have some supply of PPEs on hand because they’re used in a variety of situations,” Teets said. “But because of a large number of PPE required for an Ebola patient, we would go through supplies pretty quickly. So we have them ready and available.”
The Ebola virus, which is found in several African countries, was first identified in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. The 2014 Ebola outbreak is the largest Ebola outbreak in history, according to the CDC’s website.
Ebola spreads from direct contact with body fluids of an infected person. Symptoms appear within 21 days of exposure. People exposed are not contagious unless they have symptoms of the virus, which include fever, severe headache, muscle pain, vomiting, diarrhea, stomach pains or unexplained bleeding or bruising. Ebola does not spread through water or food, except for infected bushmeat.
For more information, go to www.odh.ohio.gov, www.cdc.gov or call the CDC at (800) 232-4636.
