BY CHERYL SLAVIN
Ever since the outbreak of the Ebola virus reached epidemic proportions in Africa this summer, the Rockland County Department of Health has been preparing for the possibility of handling an Ebola patient here in the lower Hudson Valley region.
“It’s not a matter of if, but of when a case will show up in our area,” says Scott Salotto, public information officer for the Office of the County Executive. “But, we will be ready.”
Ebola virus is a highly contagious and often fatal disease that had originated in West Africa, but has recently made landfall in the United States and Europe. Its symptoms include fever, headache, diarrhea, vomiting and uncontrolled bleeding and has resulted in the death of over two thirds of the people in whom it has been diagnosed.
Since symptoms can appear between two and 21 days after exposure, it is very likely that asymptomatic but infected persons can unknowingly carry the disease through unimpeded travel. This likelihood had prompted increasing expressions of concern both from the medical community and the public at large, even as most governmental authorities strive to assure that protocols are in place to prevent widespread contagion.
The Centers for Disease Control, for example, has recently upped its travel notices for three of the most heavily affected African nations—Liberia, Sierra Leone and Guinea—to level three, recommending that U.S. citizens avoid all non-essential travel to those countries. The CDC has also issued a series of prevention and protection advisories and protocols to guide health care workers both here and abroad as well as provide basic information to the public. It is those procedures that the County DOH has most heavily relied upon, along with New York State DOH guidelines, to prepare for the possibility of an infection in Rockland.
“Prevention is the biggest key in fighting this disease,” says Salotto. “Being able to recognize the symptoms, understanding how the disease is transmitted, and knowing how to contain it by using protective measures are the most important factors in responding to the disease.”
He states that the County DOH has been working heavily with hospitals, doctors, first responders, ambulance corps and emergency medical services to instruct and coordinate the safest and most effective response. Being able to recognize when an ill person is exhibiting signs of the disease, whether showing up in an emergency room, a doctor’s office or an ambulance call, is the first crucial step.
Once a possible Ebola patient has been identified, protocols such as isolation, the use of protective gear, and the proper handling of contaminated objects would then be implemented. Proper handwashing, using soap and running water as well as alcohol based disinfectants, continues to be the first and most important protection of them all.
Post-exposure sterilization is also extremely important, especially of ambulances, doctor’s offices and the home or workplace of a patient. Salotto notes that the Rockland DOH has received many inquiries from medical cleaning companies about how to proceed if a case of Ebola is confirmed. The DOH advises them to follow CDC guidelines as to protection and proper disposal of contaminated objects.
The CDC, WHO and the U.S. Department of Health and Human Services all assert that the disease is not air or water borne, and that it is only communicable through direct contact with the bodily fluids of a person already exhibiting symptoms. This assessment, however, has come under attack by other health related organizations, most recently the Association of American Physicians and Surgeons.
In an October 3 article, Director Jane Orient questions the accuracy of the CDC assurances, stating instead that much about the disease is still unknown and emerging. She also notes that the “sophisticated health system” that is supposed to protect the American public through port of entry screenings and proper inquiries at ground level, has already been breached though human error.
“The system is only as strong as its weakest link,” the AAPS site says, “and violation of basic precautions has already necessitated the monitoring of 100 contacts of one patient in Dallas who entered by air from Liberia.”
The U.S. government has also come under criticism as not moving quickly enough or doing enough to contain the threat. There have been calls for intensely increased port of entry scrutiny, as well as some calling for a complete ban on admitting flights and travelers from the most severely affected countries. Several European airlines and nations have already done just that.
Yet, the World Health Organization still insists on its website that travel to affected African countries is “low risk,” and the Obama administration appears reluctant to implement more drastic measures.
Salotto remains confident, however, that when the time comes, the Rockland health care and medical community will be able to handle the challenge.
“We have been training for this, and staying on top of all of the latest developments,” he asserts. “We will remain vigilant to protect the residents of our county.”