Sunday, December 17, 2017

OCMA Blog

Updated Ebola Guidance from the OC Health Care Agency

The Ebola epidemic of West Africa has led to 13268 cases as of November 7, with 8168 confirmed cases and 4960 deaths. The epidemic seems likely to continue for at least the next several months. There still have been no suspect Ebola cases in Orange County.

To date, there have been no confirmed Ebola cases in California.
 The Orange County Health Care Agency will be monitoring persons returning from countries with widespread Ebola virus transmission (currently Liberia, Guinea, and Sierra Leone) or who have had contact with a confirmed Ebola case within the previous 21 days.  The risk of Ebola in the U.S. remains low, and the risk of a symptomatic (infectious) patient that we are not following presenting unannounced for health care is even lower, but something we all continue to prepare for.  The following recently released documents may be of assistance to you in your preparations:

1)      Algorithm for Ambulatory Care Evaluation of Patients with Possible Ebola Virus Disease – CDC document, modified by OCHCA with Orange County contact information (attached)

2)      Algorithm for Emergency Department Evaluation and Management of Patients with Possible Ebola Virus Disease:  http://www.cdc.gov/vhf/ebola/pdf/ed-algorithm-management-patients-possible-ebola.pdf 

3)      Web-based training- Guidance for Donning and Doffing PPE during Management of Patients with Ebola in US Hospitals:  http://www.cdc.gov/vhf/ebola/hcp/ppe-training/index.html 

Traveler Assessment
Travelers coming from a country experiencing widespread Ebola disease will be assessed upon arrival to one of five airports in the United States. Information about the traveler will be passed on to local public health departments. The Orange County Health Care Agency will monitor any such travelers in our county daily to assess for symptoms. A hospital will be pre-designated for each of these travelers, based on factors such as a patient’s insurance type and proximity to a facility. That facility will be contacted ahead of time, to assure that the patient receives prompt care if needed. However, it is not certain that this system will identify all travelers from the affected areas, so area hospitals need to be prepared in the event that a suspect case arrives at their facility without prior warning.

Healthcare providers should assess all patients for a history of travel to countries experiencing widespread Ebola disease, which includes Guinea, Sierra Leone, and Liberia at this point. Providers should report any suspect Ebola cases to the Orange County Health Care Agency immediately at 714-834-8180 during regular hours, or 714-628-7008 after hours.

All Orange County hospitals need to prepare to isolate and evaluate a potential Ebola patient.

There is no designated Ebola hospital in Orange County. University of California-Irvine Medical Center has indicated that it will accept one confirmed Ebola case. However, suspect cases identified at a different hospital will need to be cared for at that facility until the case is confirmed, which may take from 24-72 hours. For suspect cases that present to an outpatient clinical setting not associated with a hospital, Orange County Public Health will facilitate transfer of the patient to the closest appropriate facility.

Orange County Health Care Agency can assist with testing a patient for possible Ebola disease.

The test of choice for Ebola is serum PCR. Tests can be falsely negative if performed in the first three days of illness. Patients who test serum PCR negative but have a clinical and exposure history consistent with Ebola may need repeat testing performed. This test is currently performed at selected public health laboratories.

For more information, see http://ochealthinfo.com/phs/about/dcepi/epi/disease/ebola . For healthcare worker recommendations, see www.cdc.gov/vhf/ebola/hcp/index.html. A hospital checklist for Ebola preparedness can be found at www.cdc.gov/vhf/ebola/pdf/hospital-checklist-ebola-preparedness.pdf.

Please let us know if you have any questions.

If you have any comments or questions or would like to be added to the distribution list, please email us at epi@ochca.com 

HCA/Epidemiology & Assessment
1719 W. 17th St., Bldg. C/79
Santa Ana, CA 92706
(P) 714-834-8180
(F) 714-834-8196


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