As health officials in Dallas took steps to isolate as many as 100 people known to have had contact with the only Ebola patient diagnosed in the United States, officials at Maine’s largest medical facilities said Thursday that they have instituted emergency plans to address the deadly virus if it turns up in Maine.
How U.S. hospitals are preparing to deal with Ebola has come into sharp focus since a Texas hospital failed to isolate Thomas Eric Duncan on Sept. 26, even though he was showing symptoms and had told health workers there that he had just returned from Liberia. The current Ebola outbreak has stricken Liberia and two other West African countries, infecting more than 7,100 people and killing at least 3,300, according to the World Health Organization.
Managers at Maine’s hospitals are stepping up training for staff members, including asking specific questions of patients who show symptoms of the infection, to make sure no one misses any signs of the virus.
“We want to make sure we are documenting the questions we ask and the answers we get to those questions,” said Kathy Knight, director of the Northeastern Maine Regional Resource Center based at Eastern Maine Medical Center in Bangor.
Knight, who oversees emergency preparedness at the Bangor hospital and several smaller affiliated facilities, said Bangor in particular had to be prepared weeks ago, when a plane carrying an American aid worker who contracted Ebola while treating patients in Africa touched down Aug. 5 at Bangor International Airport. The plane landed in Maine to refuel on its way to the Centers for Disease Control and Prevention headquarters in Atlanta.
“We wanted to make sure we were prepared,” Knight said. “We’re always concerned when we see a highly lethal virus begin to circulate in the United States.”
POOR COMMUNICATION AT HOSPITAL
Duncan began showing symptoms about four or five days after arriving, Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, told The Washington Post. He visited Texas Health Presbyterian Hospital in Dallas shortly thereafter for medical treatment because he had a fever and some abdominal pain. He told a nurse that he had traveled from Liberia, but that information was not relayed to other health care workers and he was released.
“This is a very sophisticated hospital,” David Lakey, commissioner of the Texas Department of State Health Services, said during a conference call with reporters. “They’ve done a lot of education related to preparedness for Ebola. . . . Unfortunately, connections weren’t made related to travel history and symptoms.”
As a result, Duncan left the hospital during the period when health officials say he was symptomatic, which is the only time Ebola becomes contagious, the Post reported. A little more than two days later, he returned to the same hospital in an ambulance and was placed in isolation after being recognized as a potential Ebola patient.
DETAILED PROCEDURES
Joshua Frances, the director of emergency management at Maine Medical Center in Portland, said the state’s largest hospital and other Maine medical facilities have adopted policies and procedures recommended by the CDC and the World Health Organization in August.
“We’re absolutely concerned about this, but it’s something we’ve known about for enough time to get our ducks in a row,” Frances said.
If someone were to come into the hospital with possible symptoms of Ebola, such as fever, vomiting or unexplained bleeding, Maine Med staff would immediately isolate that patient in a safe area, he said.
Medical workers would then don full body suits, including double gloves, double boots, a gown, full head covering and a shield for their eyes, and take the patient into a specialized treatment area.
“They’d be brought to an isolation room, which is a negative air pressure room, to keep germs from spreading,” Frances said. “We do it all the time for things like tuberculosis.”
A patient diagnosed with Ebola would continue to be treated at Maine Med unless his or her condition deteriorated, Frances, said. But the hospital is capable of treating the infection, he said.
STATE, FEDERAL OFFICIALS CONSULTING
Knight and Frances both said Ebola infections are less likely to turn up in Maine than in more populated parts of the country.
Knight said Maine’s growing population of refugees and immigrants, many of them from African nations, should also not be viewed as a potential threat, even if they have traveled internationally.
“We obviously do have a large refugee population, which is largely east African. But Africa is a huge continent, and the outbreak is strictly in West Africa,” Frances said.
State officials also have been working with the federal CDC and hospitals to ensure the state is prepared for the virus.
“The federal CDC has been working closely with all of us, asking us to set up precautions and testing, and they have been dictating to us what they feel the best practices are to contain the virus should it be here,” said Dr. Sheila Pinette, acting director of the Maine Center for Disease Control and Prevention.
Anyone who is hospitalized or has a fever should be asked whether they have been to West Africa in the previous 21 days, Pinette said. If so, they should be immediately isolated – anyone having contact with them should wear protective clothing, including a mask, so there is no exposure to bodily fluids, she said.
A sample of the person’s blood would be sent to the state laboratory and then to the federal CDC for testing, she said.
“We do know the major medical centers in the state do have plans in place and are notifying their emergency rooms and we’re giving them guidance, working with our preparedness people,” Pinette said. Each of the state’s eight public health districts has a regional resource center and a public health preparedness team.
Smaller state hospitals that lack adequate isolation facilities or equipment would transport an Ebola patient to one of the major medical centers, she said.
There is no antidote or cure for Ebola, other than to treat the symptoms of the illness, such as dehydration, and hope the person recovers. The mortality rate is about 50 percent.
Staff Writer David Hench contributed to this report.
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