A first case of Ebola infection arising in a person on U.S. soil was diagnosed on Tuesday, September 29, in Dallas, Texas, in a visitor who had travelled from Liberia only 8 days earlier. Liberia is one of the three primary countries involved in the current outbreak of the Ebola virus in west Africa. Public Health experts from the Centers for Disease Control have responded as a team to help investigate and limit any secondary cases that might occur in close contacts to the infected traveller.
Hospitals throughout California have reviewed and are continuing to refine their capacity to respond to any potential cases of the Ebola illness that might present to their doors. The case definition used to screen patients who develop a viral illness with a fever includes one of two situations – either travel in the past 21 days to one of the three countries in west Africa that continue to be affected by this outbreak or close contact with an individual who has traveled to one of these countries in the last 21 days. These countries include Sierra Leone, Liberia and Guinea. While infected patients have been identified in Nigeria and Senegal, these outbreaks have been contained at this date. The majority of cases have occurred in people who have provided care to others who have been ill with the virus. Again, it is important to recognize that the case definition at the present time requires a history of travel or contact with a traveler to one of these three countries.
Measures have been taken by the Dallas hospital to isolate the infected individual. Similar isolation methods would be used in the event of a case occurring closer to Tuolumne County. Through the process of building a local Public Health Emergency Response plan in partnership with a coalition of local health care facilities, the Tuolumne County Health Department has contingencies in place to address emerging infectious diseases like Ebola. Preparations for the possibility of a potential Ebola case presenting to the local hospital or to a local clinic is referred to as “preparedness planning” and includes such steps as making masks, gowns and gloves available and clear instructions for screening potentially infected patients. This information is regularly distributed to local health care providers and hospital staff.
While travel restrictions are currently in place to carefully screen travellers to the areas affected by this outbreak, these measures are under constant review to determine whether additional steps are necessary in order to minimize risk to U.S. residents while still
providing assistance to the foreign governments and populations grappling with this tragic infectious disease.
The Ebola virus has been studied since it was first recognized in 1976. Symptoms of the illness in people who have been exposed by travel to the affected region include fever and muscle aches followed by diarrhea and vomiting beginning about 4 days after contracting the virus. This is followed by high fevers and organ injury over the next several days with a fatal outcome in about half of all infected patients. People do not transmit the disease to others until they have symptoms of illness, so careful distancing of ill individuals in the affected countries is helpful.
Previous clusters of illness due to Ebola have responded to practical measures such as the institution of proper barrier nursing practices (use of gloves, gowns and masks while working with patients), sterilization of medical equipment, improved waste management and modification of cultural burial and funeral practices in the endemic countries. The availability of such resources in the U.S. make significant outbreaks of Ebola extremely unlikely to occur in this country, but constant vigilance is ongoing.
For reliable updated information, the public can access the CDC website at www.cdc.gov or the Tuolumne County Public Health website at www.tuolumnecounty.ca.gov/publichealth.
