Ohio agencies tighten protocols amid Ebola concerns
Since the diagnosis of a health care professional who contracted Ebola after caring for a man who traveled to the United States and died from the disease, health agencies across Ohio are putting protocols in place to screen patients more thoroughly.
Dr. Richard Hausrod, chairman of emergency medication at University Hospitals Elyria Medical Center, said that the hospital has an Ebola virus screening. If someone comes in with symptoms such as fever, headache, joint and muscle aches, fatigue and has traveled to West Africa in the last 21 days, this would trigger a screening.
If there is concern for Ebola in a patient, there are steps the hospital would take.
“Basically the patient would be moved to a private room,” Hausrod said. “We would contact the CDC (Centers for Disease Control and Prevention) as recommended in order to follow protocols.”
Hausrod said Ebola is difficult to diagnose early on because symptoms become more apparent after 21 days and there is no specific treatment.
“We’re well aware of this (outbreak),” he said. “We’re prepared and we’ve also educated the EMS folks so they’re aware when they show up at somebody’s house with those symptoms.
“You never know. That’s why we are being cautious,” he said.
Mercy Regional Medical Center in Lorain works very closely with the public health department, Ohio Department of Health, and CDC to be aware of and prepared for any health concerns including Ebola, said Jennifer Cakir, marketing and communications director of the Lorain hospital.
“Mercy has protocols in place to identify, treat and prevent for Ebola, including screening criteria in the ER and isolation plans if needed,” Cakir said.
Krystyna Strozewski, director of quality for Lake Health, said signs have been posted at the emergency rooms at both Lake Health West Medical Center in Willoughby and TriPoint Medical Center in Concord Township warning about Ebola symptoms.
“The hospitals will be screening for patients who have traveled to an Ebola area,” she added. “If the patient has a high fever, that’s the first sign.”
Other symptoms include headache, muscle weakness and abdominal pain.
If Ebola is suspected, hospital staff would take the patient to a private room and isolate. The local health department would be contacted, then specimens would be collected so the CDC could confirm the diagnosis, Strozewski said.
“Caregivers would wear appropriate attire — gloves, gowns and face shields — they would cover their eyes and mucus membranes,” she said. “We would try to limit the number of visitors and people caring for the patient. We’d also keep a log of the patient’s visitors.”
Ebola plans continue to evolve daily as more information becomes available.
Joyce Taylor, a registered nurse and vice president of quality at Lake Health, said the health system has always had an outbreak policy, depending on what the latest potential threat is.
“Wash your hands and make sure you get your flu vaccine.”
Cleveland Clinic Dr. Steven Gordon said that hospital has extensive experience with emergency preparedness.
“Our teams frequently practice scenarios with our city and county partners, such as plane crashes, natural disasters, explosions, outbreaks and containment,” Gordon said. “The Ebola situation is evolving and is the focus of our training at this time. We’re following the Center for Disease Control guidelines to detect potential cases, protect our employees and respond appropriately. In addition, we’re ensuring that our emergency rooms and other points of patient entry are stocked with the appropriate protective equipment.”
University Hospitals Case Medical Center in Cleveland is also well prepared for the threat, said Dr. Amy Ray, an infectious disease specialist and chairwoman of the UH System Infection Control Committee.
“We will continue to remain vigilant to identify patients at risk, at or before the point of care, and provide our health care personnel with the optimal personal protective equipment,” Ray said in a news release.
UH’s Ebola task force and preparedness plans were in place even before the situation at Texas Health Presbyterian Hospital in Dallas.
In addition, the infection control committee has urged employees who provide direct patient care to pose ‘what if?’ scenarios, she added.
“We also routinely include recommendations from the CDC as an important reference,” Ray said. “We will continue to update our frontline personnel, including pre-hospital providers, as the epidemiology of Ebola viral infection evolves.”
NE Ohio hospitals report nursing staffs are Ebola prepared and protected
Cleveland area hospitals report they have continually briefed and prepare their nursing staff members on Ebola safety and protocol, as concerns over Ebola here in the U.S continue to develop.
Metro Health Medical Center, University Hospitals, and the Cleveland Clinic have all told NewsChannel5 they have provided their nursing team members with the latest Ebola information and protective equipment for months.
Efforts made by northeast Ohio hospitals come to light after officials confirmed on Oct. 12 that Dallas nurse Nina Pham contracted the virus while assisting Thomas Eric Duncan, who died from the disease last week.
The case has sparked a Centers for Disease Control investigation about Ebola protection protocol, after it was confirmed Pham was wearing the recommended protective gear for handling Ebola patients.
It’s a case that has National Nurses United now calling for the “highest standards for protective equipment, including hazmat suits and training.”
NNU released its latest poll on Oct.12, showing 76 percent of some 2,000 RNs at more than 750 facilities in 46 states report their hospitals have not yet communicated to them any policy regarding potential admission of patients infected by Ebola.
NNU Co-President Deborah Burger told the media during a news conference that more protection and information for nurses is needed.
“We would like to make sure that there is optimal personal protection, and that every single nurse and healthcare provider that is providing care for an Ebola patient has a “buddy” that actually helps them take off their the personal protection that they’re using,” explained Burger.
Metro Health, Cleveland Clinic and University Hospitals responded to the poll, outlining their education and outreach to nursing staff members over the past several weeks.
Dr. Jennifer Hanrahan with Metro Health Medical Center told NewsChannel5 staff members have been receiving constant Ebola information since August.
Dr. Hanrahan is waiting for additional CDC protocol, and said her team is already set to use the “buddy system” when it comes to personal protection protocol.
“We would definitely utilize it, it makes sense to have someone watching you, so that you know if there’s been any breeches,” explained DR. Hanrahan. “Somebody else had also suggested video monitoring, so that you could look to see if there was any problem.”
“The CDC does not actually have specific instructions at this point in time on how to put on that equipment and them more importantly how to take it off. The outside of that suit is going to be completely contaminated, and taking it off without recontamination yourself, it can be somewhat difficult.”
University Hospitals responded to our story with the following statement:
If a person suspected of having Ebola were to seek care at a University Hospitals facility, UH is prepared. That’s the message from Amy Ray, MD, MPH, an infectious disease specialist and chair of the UH System Infection Control Committee.
UH has had an Ebola preparedness plan in place for several months, Dr. Ray says, long before the current situation at Texas Health Presbyterian Hospital in Dallas. It was developed by the UH System Infection Control Committee, which includes specialists in the prevention of infectious disease, hospital epidemiologists, corporate health employees and supply chain representatives. UH has also established an Ebola task force, led by Michael Anderson, MD, Chief Medical Officer, Ron Dziedzicki, Chief Operating Officer at UH Case Medical Center, and Dr. Ray.
The infection control committee has communicated its Ebola preparedness plan throughout the UH system and has urged individual units to pose “what if” scenarios with their employees who provide direct patient care. “Tabletop exercises have been conducted system-wide in the setting of disaster preparedness meetings,” Dr. Ray says. “We also routinely include recommendations from the CDC as an important reference.”
“We will continue to update our frontline personnel, including pre-hospital providers, as the epidemiology of Ebola viral infection evolves,” Dr. Ray says.
The Cleveland Clinic responded to our story with the following statement:
“Cleveland Clinic has extensive experience with emergency preparedness. Our teams frequently practice scenarios with our city and county partners such as plane crashes, natural disasters, explosions, outbreaks and containment. The Ebola situation is evolving and is the focus of our training at this time.
We’re following the Center for Disease Control (CDC) guidelines to detect potential cases, protect our employees and respond appropriately. In addition, we’re ensuring that our emergency rooms and other points of patient entry are stocked with the appropriate protective equipment.”
Early detection is important. Signs and symptoms of Ebola typically include:
• fever (greater than 38.6°C or 101.5°F),
• severe headache,
• muscle pain,
• stomach pain
• unexplained bleeding
Ebola in Northeast Ohio? Unlikely, area physicians say, but hospitals prepared just in case
How concerned should we be about an Ebola outbreak in Northeast Ohio? Not very, say area health experts.
Although an influx of Ebola cases is certainly possible, given the ease of travel around the world, it is highly unlikely.
But if someone here is suspected of being infected with the virus, area hospitals say they are well-equipped to be able to properly diagnose and treat the patient, without putting others in danger.
For several weeks, once an outbreak in West Africa had been confirmed, hospitals have been working on their emergency response plans.
Even before the first two American aid workers arrived in Atlanta from Liberia for treatment at Emory University, officials at University Hospitals began putting an Ebola preparedness plan in place, said Dr. Amy Ray, an infectious disease specialist who is also chairperson of the UH System Infection Control Committee.
The Cleveland Clinic and MetroHealth Medical Center also are taking similar precautions.
“Cleveland Clinic has the capacity to treat any type of illness,” Dr. Steven Gordon, the Clinic’s chairman of the Department of Infectious Disease, said Wednesday in an email to The Plain Dealer. “For any patient with suspected or proven viral hemorrhagic fever (such as Ebola) we would follow the CDC’s recommendations for infection control and isolate the patient in a private room, safely managing and treating their condition.”
Dr. Al Connors, MetroHealth’s chief medical officer, said he understands that people are concerned about their personal risk of contracting the virus.
“There’s more danger here to our health care workers because this is where people go when they are sick,” he said. “It’s important for workers who might come in contact [with someone] to handle them appropriately to keep that risk low.”
A previous post provided some answers to common questions about Ebola. Here is additional information:
What are the hospitals’ plans in the event of a suspected case of Ebola?
Plans include the following components:
• Ensuring that all health care workers are educated about Ebola symptoms and proper precautions to take.
• Assessing a person’s symptoms.
“Symptoms can be non-specific,” said Ray, assistant professor of the Division of Infectious Diseases and HIV Medicine at Case Western Reserve University School of Medicine. If a patient has been identified to be at potential risk of exposure, and they have a fever or other symptoms, she said, “We’ve instructed our healthcare workforce to immediately isolate them.”
• Identifying which patients might be at risk for Ebola, because of their travel history or history of close contact with someone who has recently been in an affected region. That includes consulting with the Centers for Disease Control and Infection for updated information.
• Conducting diagnostic tests and exams, including drawing blood samples for analysis by the CDC.
• Placing the patient in isolation.
Can Ebola be transmitted from an infected person coughing?
No. Unlike the flu, Ebola is not an airborne virus and cannot be transmitted through droplets or particles that are floating in the air. Ebola usually does not cause respiratory problems; coughing is not one of the symptoms of Ebola.
Can Ebola be transmitted through mosquitoes in the same way as West Nile virus or Malaria?
No. The regions of West Africa where Ebola outbreaks have been recorded have their share of mosquitoes, but there have been no reported cases of Ebola being transmitted through mosquitoes.
Can the virus be killed with disinfectants?
Yes. The cleaning agents that hospitals routinely use to disinfect patient rooms and other areas are effective in killing the Ebola virus.
Should I be worried about getting the Ebola virus from a contaminated surface such as a doorknob?
No, because direct contact is necessary for transmission, but practicing good hygiene — and washing hands — wouldn’t hurt, MetroHealth’s Connors said.
H1N1: Separating Myth From Fact
With swine flu, there are certain groups with worse outcomes, including pregnant women, who may think they’re healthy but are being negatively impacted,” said Dr. Amy Ray, an infectious disease and public health specialist with University Hospitals Case Medical Center in Cleveland, Ohio. “People with underlying heart and lung disease, even mild asthmatics, appear to be prone to more negative outcomes.”
Should You Be Afraid To Take A Cruise?
A second cruise ship was recently forced to cut its journey short, as Princess Cruises’ Caribbean Princess ship returned to Houston after nearly 200 passengers and crew members fell ill. Earlier, Royal Caribbean’s Explorer of the Seas vessel was also forced to return to port after nearly 700 developed gastrointestinal illnesses—leading some to wonder whether it might be wise to stay on-land for their next vacation.
Though the Centers for Disease Control and Prevention (CDC) is investigating the outbreaks—which occurred on Royal Caribbean International and Princess Cruises—they said it would be premature to issue an advisory against cruise travel.
“Just because we’ve had two cruise ships with gastrointestinal illness… doesn’t mean there’s a problem with all cruise ships,” CDC press officer Bernadette Burden tells FoxNews.com. “It’s not uncommon or unique to us, it’s just that this particular vessel garnered a lot of media attention but that wouldn’t cause us to say there’s something wrong with all cruise ships. Each ship is different, each cruise is different.”
Though tests are still confirming the cause of each outbreak, it’s suspected that norovirus—a highly contagious form of acute gastroenteritis—may be to blame.
“The predominant features [of norovirus] are nausea, vomiting and diarrhea, and about half will have fevers associated with a norovirus infection,” Dr. Amy Ray, infectious disease expert at University Hospitals Case Medical Center in Cleveland told FoxNews.com.
Norovirus, which can last from 24 hours to three days, is the most common cause of acute gastroenteritis in the United States and occurs more frequently in the winter months, according to Dr. Ray. The infection, which can cause severe dehydration, kills up to approximately 800 people each year in the United States and sickens a suspected 19 to 21 million.
The confined space of a cruise ships can be a ripe breeding ground for infections like norovirus, which can easily be transmitted through contaminated food or drink, or contact with infected persons.
“Risk factors would be eating commonly prepared food, by a certain staff of people who may unfortunately be infected and transmitting norovirus into the food if their hands are not clean or gloves are not worn,” Dr. Ray says. “Another risk factor is sharing public restrooms; restrooms on a cruise ship would have to be cleaned frequently and thoroughly with bleach.”
Despite the two incidences this week, the official trade organization of the cruise industry of North America—the Cruise Lines International Association (CLIA)—said historic rates of gastrointestinal illnesses on cruise ships are low.
“In 2013, there were seven norovirus outbreaks on cruise ships reported to the CDC, involving a total of 1,238 passengers. To put that into perspective, approximately 21.3 million passengers sailed on CLIA member cruise ships in 2013 so this figure represents approximately six one thousandths of one percent (.006%) of global passengers,” David Peikin, director of public affairs for CLIA, says in an email to FoxNews.com.
Furthermore, the CLIA said all of its members—which include both Royal Caribbean International and Princess Cruises—take steps to prevent passengers with illnesses like norovirus from boarding a ship and have protocols in place to prevent the spread of disease should an outbreak occur.
For passengers worried about upcoming cruise travel, the CDC advised people to visit their website to research the health risks associated with cruises and educate themselves about how to avoid getting sick—and how individual cruise lines have performed in past inspections.
“If you are curious how well a particular ship has done in the past in terms of unannounced inspections, you can go into our website type in the cruise line and ship and it will bring this information up about the most recent inspections,” Burden says. “If you have knowledge that there was a recent outbreak of illness on a ship, you can search by year and find outbreaks that rise above the threshold where they must report illness to the CDC and you can learn more about what took place on that individual voyage.”
In the first six months of her new post as system medical director at University Hospitals of Cleveland, Amy Ray, M.D., had to use tactics worthy of a CSI agent – without the crime component – in order to track down an outbreak of the dreaded Acinetobacter baumannii (Ab). The outbreak impacted more than a dozen long-term acute care patients on ventilators, and took two lives. Dr. Ray, board certified in both adult infectious disease and internal medicine, was confronted with the Ab outbreak immediately at the January 1, 2008 start of her new position with University Hospitals, where she serves as chair of the System Infection Control Committee. She began with the hospital two years earlier in the Division of Infectious Diseases.
Case Western Reserve University infectious disease expert discusses swine flu outbreak
Deadly ‘superbugs’ on the rise: What you need to know
Concern has been raised once again over the threat of deadly ‘superbugs,’ after a seventh individual at the National Institutes of Health Clinical Center in Bethesda, Md., died Friday after contracting an antibiotic-resistant strain of bacteria.
According to the Washington Post, the boy from Minnesota contracted the bug while being treated at the hospital for complications from a bone marrow transplant. So far, he is the 19th patient at the NIH center to have contracted the bacteria – Klebsiella pneumoniae carbapenemase (KPC). The bug’s outbreak was traced back to a single patient who was carrying the bacteria when he was admitted to the hospital in the summer of 2011.
While the NIH declined to be interviewed on the matter, the agency released a statement about the incident.
“We are deeply saddened by the deaths at the NIH Clinical Center related to [KPC],” the NIH said in a statement. “The health and welfare of patients is NIH’s top priority, and NIH has – and will continue to – take every measure possible to protect patients at the Clinical Center and quell transmission.”