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New Hampshire officials, hospitals prepare for Ebola

Last modified: 10/7/2014 12:22:24 AM
The only confirmed case of Ebola to be diagnosed in the United States is thousands of miles away in Dallas. But the possibility – however slim – that the disease that has devastated parts of West Africa, killing thousands and straining its health care system in the process, could make it to New Hampshire has nonetheless prompted precautions at the state and local levels.

“It’s very low,” Concord Hospital Infection Prevention Officer Lynda Caine said of the potential for an Ebola infection to present locally. “However, the impact it would have on our hospitals, our community and our state would be huge. We would be fools to be the ostriches and not prepare for it. That’s not the way we roll here in the ’Shire.”

At the same time, the state’s chief of infectious disease surveillance, Beth Daley, said it’s imperative to put things into perspective. There’s an “incredible resource disparity” between West African countries – where the disease claimed 3,091 lives between March and September, according to the Centers for Disease Control and Prevention – and the United States, she said.

“We have a strong health care system and at many levels are working hard to ensure there is not the transmission of Ebola within the U.S.,” she said. “I believe it’s absolutely possible, perhaps likely, that we will have another case of Ebola in the United States, but I do not believe there will be a sustained outbreak.”

New Hampshire has no active investigation for a possible Ebola case, and no medical professionals from New Hampshire have yet been sent to assist with the international response to Ebola, Daley said, but she is attending a CDC training session next week for health care workers responding to the disease.

At Concord Hospital, Caine said preparation has expanded significantly in recent weeks. Meetings that started about a month ago initially were limited to senior leaders, safety and prevention personnel, but now include staff who work in information technology, security, environmental services, materials and other areas.

The hospital is also trying to learn from issues reported in Texas, Caine said. Texas Health Presbyterian Hospital officials initially released the man who would eventually be diagnosed with Ebola and have since given several different explanations for why that occurred, according to the Dallas Morning News.

Hospital officials said, then retracted, that a “flaw” in the hospital’s electronic medical records system contributed to a communication breakdown between the medical staff and, as a result, the doctor who initially released the man was unaware that he had recently traveled from Liberia, the newspaper reported.

Concord Hospital has since altered its own electronic medical records to ask patients whether they have been to West Africa within the past 21 days. If the answer is yes, Caine said the system is programmed to send an alert to nursing supervisors and infection control staff. If that person is also experiencing Ebola-like symptoms, he or she would be isolated and evaluated for the disease, she said.

Daley said the case in Texas has underscored “how very important it is for patients to present their travel history, and (for) doctors to elicit the travel history of patients,” not just to watch out for Ebola but also other diseases. The CDC, on its website, maintains a list of travel advisories to warn about medical outbreaks that have emerged in other countries.

As with other institutions around the state, the hospital is communicating frequently with the Department of Health and Human Services – which, in turn, is keeping tabs on relevant updates from the CDC, Daley said. The public health division has also provided instructions to “travel hubs” – airports and bus ports, for example – advising them to screen travelers who are coming in and out of the state.

Concord Hospital has also helped produce a video on safe procedures for staff members who might find themselves treating an Ebola patient, Caine said.

Additionally, Caine and Daley said the CDC worked with the Department of Transportation to modify an existing regulation that would have barred the transport of waste from Ebola patients. Now, Caine said, the department is operating under interim guidance on how to handle such waste.

Caine said Concord Hospital’s medical waste vendor, Stericycle, yesterday announced changes to its plans to accommodate materials from Ebola patients. Previously, Caine said the company had indicated it would not take Ebola-related waste.

Overall, the pair said the preparedness steps taken in this case illustrate the importance of thinking through a potential outbreak from all sides – and of making sure everyone is communicating with one another along the way.

“There’s always going to be a new outbreak, a new virus, a new bacteria,” Caine said. “We have to be prepared and work together as a team.”

(Casey McDermott can be reached at 369-3306 or cmcdermott@cmonitor.com.)


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