Bracing for Ebola

With all the headlines about Ebola, including the first death on U.S. soil and questions from nurses about readiness to handle the disease, it’s understandable if people start picturing doomsday scenarios.

We’ve seen plenty depicted in movies and on television. One that Dr. Mark Lundberg, Butte County’s public health officer, thinks may have particular resonance is Outbreak—a film starring Dustin Hoffman about an Ebola-like epidemic. Difference is, that movie’s contagion (not to be confused with the movie Contagion) spread through the air, whereas Ebola spreads through contact with bodily fluids.

Ebola, then, is not as readily contractible as a respiratory illness, and since the current plague has been centralized in five countries in Africa, odds of exposure in the North State are remote.

“I think the public needs to be careful not to let this paralyze them with any kind of fear,” Lundberg told the CN&R in a phone interview. “It’s not justified for the public to lose sleep over this. It’s unreasonable; it’s too unlikely.

“For me as a public health official, though, this is my job,” he continued. “We need to get ready for Ebola or whatever the next thing might be. We’ve been preparing for bioterrorism agents, and even though they’re incredibly unlikely, we have to be ready. We had an anthrax scare in our country years ago, and in Butte County people were calling us about anthrax concerns. So those kinds of fears can grip people.”

The Public Health Department recently received a call from a local physician who wanted to rule out Ebola in a patient and—after reviewing the symptoms, travel history and the disease’s “case definition”—was able to do so.

Hospital emergency rooms “are likely the front line of an Ebola case,” Lundberg said. Enloe Medical Center has the biggest ER in the North State and draws patients from multiple counties, so it’s more likely than other local hospitals to face a hypothetical first case, but each has received alerts and protocols.

“Our hospitals in Butte County take this incredibly seriously,” Lundberg said. “The local infection control practitioners have been on the [conference] calls with the state. When we [at Public Health] get information that’s pertinent to them, we move it to them. I am confident they all have considered it and all have a plan.”

What is Ebola? According to the Centers for Disease Control and Prevention (CDC), it’s a viral disease found in Africa that’s rare but deadly. Symptoms include fever, severe headache, muscle pain, weakness, diarrhea, vomiting, abdominal pain and unexplained bleeding or bruising; these can appear anywhere from two to 21 days after exposure to the virus.

The California Department of Public Health stresses that “at present, the risk of Ebola infection in California is very low.” We cannot contract it from air, food or water; we only can get it by touching bodily fluids or contaminated objects (such as syringes) from an Ebola patient. People who do not have symptoms are not contagious.

State Public Health officials and the Emergency Medical Services Authority “continue to prepare for the unlikely event” of an infected traveler coming to California from one of the affected nations in West Africa: Guinea, Liberia, Nigeria, Senegal and Sierra Leone.

“Early identification of cases is crucial,” CDPH says. “Effective isolation of patients and appropriate infection control measures applied to any suspect Ebola patient would contain any potential spread.”

That’s where hospitals come in. Enloe, for instance, has rooms in its newly opened Emergency Department designed for quarantines, though for this disease any private room with its own bathroom can suffice, provided the care providers wear appropriate protective gear.

But there’s more to treating Ebola and preventing an outbreak than isolation. The CDC and Public Health specify steps health care professionals should follow, and the fatal case in Dallas, Texas, has made an impact.

“The discussions are more serious at the state level,” said Lundberg, who attended a statewide health conference two weeks ago where Ebola was a topic.

Enloe has created a training program for ER and Prompt Care employees who make contact with the public, including questions to ask patients with symptoms that match Ebola. The hospital also posted a FAQ for staff on its internal website, placed signs throughout its clinics and the ER, and scheduled a scenario exercise.

While Ebola has provided an opportunity for medical centers and public health departments to hone responses to epidemics and emergencies, Lundberg doesn’t think the general public should have the same alert level.

“There are so many other things to worry about, so many positive steps to take,” Lundberg said. “If you’re driving in a car, wear your seatbelt. If you’re smoking, stop smoking. If you’re not eating well, eat healthy today.

“We’re going to be entering flu season soon; every year flu or pneumonia is one of the top 10 causes of death in Butte County. Have you gotten your flu shot yet? Heart disease is the No. 1 killer. Are you going out for a walk?

“There are things that are guaranteed to be a risk to your health and your loved ones’ health. Ebola would be so far down the list …

“If fear grips people, that is unhealthy.”