The three Ebola Virus Disease (EVD) cases in Dallas, TX, one patient from Liberia and two nurses who treated that patient, has clearly awakened the country concerning Ebola preparedness. Several states have taken action on this topic.

Ebola Virus Disease
SEM revealed some of the ultrastructural morphologic features displayed by the Ebola virus/CDC

In Illinois, an an Ebola task force is being assembled made up of medical, health care, emergency response and state officials to further strengthen the state’s ability to respond to Ebola. In addition,  a designated hospital will have staff with Ebola-specific training.

The CDC recently designated Illinois as one of the few states able to perform Ebola testing. The Illinois Department of Public Health (IDPH) laboratory has received the reagents (testing supplies) and IDPH is in the process of validating the test and training staff to perform it.

Illinois health officials also recognize the importance of good communications. This has prompted the activation of an Ebola hotline to answer residents’ questions about Ebola 24 hours a day, seven days a week. The hotline number is 800-889-3931.

Managed by staff from the Illinois Poison Center, hotline operators are able to provide timely information on Ebola and the state’s response. Residents can call any time with questions such as how Ebola is spread, who is at risk of being infected, when should someone go to a doctor, what hospitals and local health departments are doing to identify and control possible Ebola infections and other frequently asked questions.

In South Carolina, The medical University of South Carolina (MUSC) and S.C. Department of Health and Environmental Control (DHEC) announced that MUSC has agreed to serve as the state’s hub for treatment of patients with an Ebola diagnosis, should a patient need transportation to the academic medical center.

“South Carolina has a world class trauma system that includes MUSC, Greenville Hospital and Palmetto Health. While every hospital in this state, rural or metropolitan, is ready to identify and isolate suspected cases, we are taking care of ourselves by identifying trauma level one hospitals that are ready, willing and able to treat people sick with Ebola,” Templeton said. “MUSC has a team of experts who have volunteered to be the boots on the ground for South Carolinians.”

The  Indiana State Department of Health has increased response efforts to include the following:

  • Continuing regular communication with the Centers for Disease Control and Prevention (CDC) and Indiana healthcare providers.
  • Establishing a healthcare provider hotline to answer questions about screening and diagnosis of Ebola.
  • Developing a training video for healthcare workers about how to put on and take off personal protective equipment.
  • Creating a questionnaire for healthcare workers to use when screening a patient for Ebola. Includes directions for worker protection and patient management based on answers provided.
  • Planning standing weekly calls with hospitals and local health departments.
  • Working with the Department of Education to provide information to school nurses.
  • Working with the local health departments and the Indiana Department of Environmental Management regarding hazardous waste management specific to Ebola.

Finally, in Ohio, where the 2nd Texas Health Presbyterian Hospital Dallas nurse to become infected in the US, Amber Vinson, traveled Oct. 10-13, state health officials have put numerous measures in place.

Last week, the Ohio Department of Health (ODH) activated a 24-hour-a-day call center to answer the public’s questions about Ebola and the recent events in Ohio in an effort to ensure Ohioans get accurate, timely information.

They also  issued new, stronger recommended quarantine protocols for local health departments responding to suspected or confirmed Ebola cases in Ohio. The guidelines include:

  • For individuals with any direct physical contact with the index case (including brief contact such as a handshake without personal protective equipment), ODH recommends quarantine for 21 days after the last contact in conjunction with public health officials.
  • For individuals without direct contact, but within a three foot radius of the index case (such as adjacent passengers in an airplane or car) for a prolonged period of time, ODH recommends twice-daily temperature-taking and symptom check (one observed by a public health official) for 21 days after the last contact with the index case.
  • For individuals without direct contact but in the vicinity of the index case as indicated by a public health official, notification and self-monitoring is recommended.
  • Ohioans required to have a public health official monitor their health condition daily would be prohibited from leaving their health department’s jurisdiction unless the health department jurisdiction to which they are travelling agrees to assume that daily monitoring responsibility. If that agreement is not reached, the individual cannot travel and must keep their daily monitoring appointments in their home health department jurisdiction.
  • Ohioans under self-monitoring and reporting requirements cannot leave the United States due to the inability to track them down in the event they fail to meet their daily reporting requirements.

Individuals in any of the above categories who have an oral temperature of 100.4 degrees or greater, or develop symptoms including muscle aches, weakness, vomiting, diarrhea or bruising/bleeding, should seek medical evaluation and testing.

In order to ensure Ohio hospitals are prepared to handle a potential Ebola patient, the Ohio Department of Health (ODH)  recommended that Ohio hospitals conduct a series of training and practice drills within the next two days. The drill should include instruction for frontline patient-contact staff on how to properly receive, isolate and implement proper infection control practices for a potential Ebola patient, as well as how to properly put on and remove personal protective equipment (PPE).

Concerning PPE, health officials are stockpiling the protective items. With a team of health care workers treating a single Ebola patient using as many as 240 sets of personal protective equipment per day, hospitals can quickly use up whatever stores they may have. ODH is adding to its already large stockpile in order to support whatever requests for support may come from local hospitals.