In the unlikely event you’re ever a patient in a U.S. hospital that’s treating someone with Ebola, you’d probably be concerned about contagion. Infection prevention experts say most facilities — using isolation precautions, proper sanitation and trained health care providers with access to protective gear — are equipped to prevent the spread of the lethal virus.
On Tuesday, the Centers for Disease Control and Prevention confirmed that the first patient to be diagnosed with the Ebola virus while in the U.S. is being treated in a Dallas hospital. But unlike the two U.S. hospitals — Emory University Hospital and Nebraska Medical Center — which have already admitted four Ebola patients who became ill while working with infected people in West Africa, Texas Health Presbyterian Hospital doesn’t have a specialized isolation unit. That scenario could happen elsewhere — and hospitals across the country are putting plans into place. (On Thursday, it was reported that a hospital in Hawaii has put a patient in isolation for symptoms that could be consistent with Ebola, although no diagnosis had been made.)
[Read: First U.S. Ebola Case Diagnosed in the U.S. Hits Texas Hospital .]
When a Patient Has Ebola
Rathel “Skip” Nolan, director of infectious diseases at the University of Mississippi School of Medicine and medical director of infection prevention at the University of Mississippi Medical Center, says it’s unlikely “but certainly not impossible” that his hospital would see Ebola patients. But if a patient were suspected of being infected, he says, staff would be ready.
“The patient would be put into gown, glove and mask isolation, and we would have designated volunteers to care for the person. We’d be using face shields, impervious gowns and double-gloving with examination gloves,” Nolan says, adding that it’s expected the CDC would “very quickly” provide additional help. “Everybody’s been trained in isolation protocols — that’s part of being a doctor or being a nurse.” But with Ebola, he says, the infection prevention department would seek volunteers to manage the patient “and there will be somebody there at the door to make sure that people are doing things appropriately.”
[Read: Stressed About Ebola? How and Why to Calm Down .]
Infection Concerns
The biggest concern is a needle stick or exposure to blood or body fluids, Nolan says. Ebola patients often “have problems with blood clotting, so in later stages of the disease they can have a lot of bleeding and a lot of oozing of fluid, and it’s exposures to those fluids that are worrisome as well as needle-stick exposures.”
What if you were placed with a hospital roommate who was afterward found to be Ebola-positive? “As a patient, it could be concerning if you had been a roommate. I don’t see how you wouldn’t be [concerned],” Nolan says. “It would also depend on how much direct contact you had with that individual. We don’t have double rooms, and many hospitals have gone over to single patient rooms. [Infection control is] one of the reasons.”
Ebola patients should be in a single room with a private bathroom, and with the door kept closed. While it’s not believed to be an airborne virus, certain procedures should ideally be performed in special negative-air pressure rooms, according to the CDC. Most hospitals already have those in place, Nolan says, for care of tuberculosis patients.
As a patient, if you have any questions or concerns about infection control measures, don’t hesitate to bring those up with hospital staff members.
[Read: 4 Things You Need to Know About Ebola .]
Before Isolation Starts: Gray Area
The window between a patient walking into a clinic or emergency room with flu-like symptoms and the point where Ebola is first suspected could be worrisome for health care providers. “I think that’s the biggest thing we’re concerned about in dealing with Ebola patients,” Nolan says “It does put health care providers at risk.” He says that at least in large cities, emergency rooms “are now asking everyone who comes in if they have a potential exposure to Ebola. That would be in travels from West Africa or being around someone who has returned from West Africa.” Awareness is heightened, he adds, with more screening going on.
There shouldn’t be much danger to people sharing a waiting room with patients later diagnosed with Ebola, Nolan says: “You have to have direct contact with bodily fluids — it would be unlikely that a patient would have contact with the bodily fluids of another patient.”
Dallas health officials who are now monitoring a range of people potentially connected to the new Ebola case. “They’re doing that because it’s good public health practice,” Nolan says.”They want to cast as wide a net as is necessary.” Even if they’re being overly cautious, he says that’s better than not being cautious enough.
Public Health Response
Infection control expert Timothy Landers, an assistant professor at the College of Nursing at The Ohio State University, says most people “think you need a big, fancy hazmat suit” to take care of Ebola patients, “but the [World Health Organization] is really just recommending contact and droplet precautions.”
Public health preparation for endemic, new and emerging conditions — including Ebola — is multipronged, Landers says. “It’s educational; there’s definitely some infrastructure, there’s some training, purchasing of supplies. The federal government has a huge stockpile of gowns and masks in the event that there’s some new avian influenza or some virus that mutates,” he adds. “The goal from the public health perspective is that we would have these interventions that are ready to go — that we could drop on top of a particular outbreak.”
[Read: When You’re Put in Hospital Isolation .]
Resources in Place
Nolan says he expects most U.S. Ebola cases will likely occur in major metropolitan areas with larger expatriate populations and more people traveling back and forth to West Africa. And if cases occur, his expectation is that there won’t be much spread of the disease. “Spread is due to lack of resources and lack of public health infrastructure,” Nolan says, “and we have the resources and the public health infrastructure to stop its spread.” In this country, he says, “If we do see transmission of cases, it’s going to be few and far between.”
While early symptoms of Ebola are “nonspecific,” it starts off as a flu-like illness, with nausea and vomiting. Nolan says people who have these symptoms and have recently visited affected areas of West Africa — including Guinea, Liberia, Sierra Leone and Nigeria — or had contact with someone who’s recently returned should be on the alert and seek treatment.
Nolan wants people to keep disease risk in perspective. “We’ve seen one case in the U.S. and we will probably see more,” he says. “Automobile accidents, gun violence — all those things kill dozens of people every day, and to date we have seen zero deaths from Ebola in the U.S.”
[Read: How to Survive Your Hospital Stay .]
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Ebola, Hospital Isolation and You originally appeared on usnews.com
