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Preston and Health Department Discuss Ebola Preparedness

Binghamton, NY – Broome County Executive Debbie Preston joined Director of the Broome County Health Department Claudia Edwards and other community health care organizations to outline plans in the event that Ebola Virus disease (EVD) is found in Broome County.

There are currently no confirmed or suspected cases, nor is anyone being currently monitored for Ebola in Broome County. It is important for the residents of Broome County to know about the virus, and what Broome County agencies and community partners are doing to ensure the proper preparedness measures are in place to protect the health of all Broome County residents.

In New York State, the Department of Health (NYSDOH) reports there is one confirmed Ebola case. The patient remains in isolation at Bellevue Hospital in New York City.  There are three contacts in quarantine for 21 days. 

Ebola is a rare and deadly disease caused by infection with one of the Ebola viruses. Ebola first appeared in 1976 in two outbreaks in Africa.

Currently in three countries of West Africa; Liberia, Guinea, and Sierra Leone there are over 10,000 cases with a mortality rate of 58%. 

According to the Centers for Disease Control and Prevention (CDC), Ebola spreads in three different ways:  1) Direct contact with bodily fluids of a person is sick or has died from Ebola.  These fluids include: blood, urine, sweat, feces, vomit, saliva, semen, breast milk and mucus; 2) Objects contaminated with the virus, including needles and medical equipment; 3) Infected animals, by contact with blood or fluids or infected meat.  Ebola is not transmitted through air. The CDC, US Department of Agriculture, and the American Veterinary Medical Association do not believe that pets are at significant risk for Ebola in the United States.

The CDC states that Ebola only spreads when people are sick with symptoms. Symptoms can appear from 2 to 21days after exposure. These symptoms include: fever, headache, diarrhea, vomiting, stomach pain, unexplained bleeding or bruising and muscle pain. Ebola is diagnosed with a blood test, which takes up to 72 hours to provide a definitive result and there are no approved vaccines available for Ebola at this time.  

The CDC has recently issued these new risk levels based on degree of exposure for public health officials to use along with assessing symptoms, in order to decide how best to monitor for symptoms and determine what other restrictions may be necessary.  High risk is direct contact with infected body fluids though needle stick or splashes to eyes, nose, or mouth, getting body fluids directly on skin, handling body fluids, such as in a laboratory, without wearing personal protective equipment ( PPE)  or following recommended safety precautions, touching a dead body without correctly wearing PPE in a country with widespread Ebola transmission. Some risk includes close contact with a person showing symptoms of Ebola such as in a household, healthcare facility or the community (no PPE worn). Close contact means being within 3 feet of the person with Ebola for a long time without wearing PPE. And in countries with widespread Ebola transmission: direct contact with a person showing symptoms of Ebola while wearing PPE.  Low risk (but not zero) includes having been in a country with widespread Ebola transmission within the previous 21 days and having no known exposure, being the same room for a brief period of time without direct contact with a person showing symptoms of Ebola, having brief skin contact with a person showing symptoms of Ebola when the person was believed to be not very contagious, in countries without widespread Ebola transmission: direct contact with a person showing symptoms of Ebola while wearing PPE, and travel on an airplane with a person showing symptoms of Ebola. No risk  includes contact with a person who is NOT showing symptoms AFTER that person was in contact with a person with Ebola,  having traveled to a country with Ebola outbreak MORE than 21 days ago, having been in a country where there is no widespread Ebola transmission( e.g., United States) and having no other exposures to Ebola.      

The Broome County Health Department has already begun taking the necessary precautions to ensure we are prepared to respond to Ebola, should there be a need.  On October 22nd the Commissioner’s order requires all hospitals, clinics (diagnostic and treatment centers) and ambulances in New York State to follow protocols for identification, isolation and medical evaluation of patients requiring care. The order mandates that all staff receive in-person training in putting on and removing PPE. The protocols ensure that New York's hospitals can safely treat patients with Ebola, as well as, proper management of people with potential exposure to Ebola.

“Although the remote chance of Ebola being present in Broome County is low, our people should be reassured that we have engaged highly skilled staff and community partners, mobilized preparedness and response activities and are actively participating in continuous guidance opportunities provided by the New York State Department of Health and the CDC.” States Broome County Executive, Debbie Preston. 

“It is important that everyone has the correct facts about Ebola in order to keep our people safe,” adds Preston.           

Locally, the Broome County Health Department has activated its Broome County Public Health Emergency Preparedness and Response Plan which establishes the protocols and methods to be used to coordinate a public health response to a potential or confirmed case of Ebola. For the past several weeks, the Health Department has been working closely with a host of community partners including; local health care systems, emergency medical services, law enforcement, educational institutions, airport leadership, funeral directors, Supreme Court, and others, to ensure local preparedness efforts are underway and the recommended guidance issued by the NYSDOH and CDC are being adhered to and fully executed. These preparedness efforts include making sure our hospitals, first responders, and other response providers have adequate supplies, proper personal protective equipment (PPE), training, and protocols to safely identify and care for patients with Ebola. The protocols include:

  • Identify at least two Health Department lead points of contact for EVD preparedness and response activities, one of whom must be available 24 hours per day, seven days per week.

  • Provide all Covered Personnel with personal protective equipment (PPE).

  • Conduct in-person training for all Covered Personnel, on donning and removing PPE.

  • Maintain a log of all personnel coming into contact with a Patient, or a Patient’s area or equipment.

  • Implement a written protocol to safely contain, store and dispose of regulated medical waste.

  • Implement a written protocol to safely clean and disinfect any room.

  • Implement a written patient registration protocol for the immediate identification, isolation, and medical evaluation of any person presenting for care with: (1) a travel history within the last 21 days to Liberia, Guinea, or Sierra Leone, or any other country that CDC designates as having a widespread EVD outbreak.

  • Post signs prominently at all entrances, at reception, and at triage locations, in at least English, French, Spanish, Chinese, Russian, Italian, Korean and Haitian Creole.

  • Designate a room for isolation that is in, or in proximity to, the area in which Patients would reasonably be expected to present for care, for patients in need of medical evaluation of EVD.

  • Maintain a list of all persons who came into contact with a Patient before they were placed in isolation, including direct physical contact or coming within three feet of a Patient.

  • Immediately notify the local health department or the New York City Department of Health and Mental Hygiene (NYCDOHMH), as applicable, when a Person Under Investigation is placed in isolation for the medical evaluation of EVD.

“This is a real life example of how public health and community partners activate a response in the event of a public health emergency. We are continually training for situations such as this, in order to ensure we are meeting the mission of protecting and preserving the health of our residents.”  Claudia Edwards, Broome County Public Health Director reported.   

“We are communicating with NYSDOH and CDC on a daily basis, and have established the necessary policies and protocols in accordance with the most recent state and federal guidelines. Early identification of potential cases is an important step in stopping the spread of Ebola,” Edwards remarked.  

There are significant efforts underway to continue monitoring and identifying potential Ebola cases from both a national, state and local perspective. CDC and the Department of Homeland Security's Customs & Border Protection (CBP) have enhanced entry screening at five U.S. airports; JFK International Airport in New York and at Washington-Dulles, Newark, Chicago-O'Hare, and Atlanta international airports. Passport review includes:

•Identifying travelers from Guinea, Liberia, and Sierra Leone and escorting them to an area of the airport set aside for screening.

•Trained CBP staff observe travelers for signs of illness, ask them a series of health and exposure questions and provide health information for Ebola and reminders to monitor themselves for symptoms. Trained medical staff take their temperature with a non-contact thermometer.

•Travelers from these countries who have neither symptoms/fever nor a known history of exposure will receive health information for self-monitoring.

Entry screening is part of a layered process that includes exit screening and standard public health practices such as patient isolation and contact tracing in countries with Ebola outbreaks. Successful containment of the recent Ebola outbreak in Nigeria demonstrates the effectiveness of this approach.

New York is the first state to receive a list of travelers from the three affected countries. Working with the CDC, NYSDOH is receiving reports of travelers arriving at JFK International Airport daily whose destinations are somewhere in New York State. NYSDOH will work with local health departments to contact all incoming travelers to 1) ensure that they have no risk exposure to Ebola; 2) are taking their temperatures for 21 days; 3) have a plan if they get sick; and 4) have contact information at NYSDOH.

Locally, The Broome County Health Department continues to work closely with Greater Binghamton Airport officials.

For anyone who has concerns please call Broome County Health Department’s Communicable Disease Nurse at 778- 2804, or for information about Ebola see our website at http://www.gobroomecounty.com/hd.

For more information on the various topic areas of Ebola, please visit these sites:

  1. New York State Department of Health:

http://www.health.ny.gov/diseases/communicable/ebola/?utm_source=doh&utm_medium=hp-button&utm_campaign=ebola#public

  1. Centers for Disease Control and Prevention:

http://www.cdc.gov/vhf/ebola/

  1. Broome County Health Department:

www.gobroomecounty.com/hd

 

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11/03/2014 - 11:37am