With news of the first imported case of Ebola in Dallas, the Virginia Department of Health (VDH) has plans in place if there is a case of imported Ebola identified in Virginia. Below are some key points related to four areas (Protecting Healthcare Workers, Identifying and Monitoring Personal Contacts of the Ill Individual, Communication, and Coordinating the Response).
Virginia Department of Health (VDH) Actions Upon Receiving a Report of a Probable “High Risk” Case and/or Laboratory Confirmation of a Case of Ebola in Virginia
The following actions would occur concurrently and in coordination with the treating clinician(s) and hospital, the local health district, the Division of Consolidated Laboratory Services (DCLS), and the Centers for Disease Control and Prevention (CDC) in response to a patient who is a probable “high risk” case and/or who has laboratory confirmation of Ebola virus disease (EVD).
Protecting Healthcare Workers
- Ensure the medical care facility is aware of the diagnosis and that all healthcare workers are following recommended precautions, including use of personal protective equipment for standard, droplet, and contact precautions.
- Recommend, per CDC guidance, that specimen collection be kept to a minimum for the patient a and that laboratory workers and others handling specimens are aware of the potential diagnosis and are following all recommended precautions to prevent work-related exposures to the virus.
Identifying and Monitoring Personal Contacts of the Ill Individual
- Collect as much information about the ill person as possible by asking healthcare workers already in contact with the patient to conduct comprehensive interviews (travel and exposure history, description and history of illness, and dates and types of interactions the person had with anyone since the earlier signs of illness)
- Locate and speak with every person who had the type of contact with the ill person that could potentially lead to blood or body fluid exposures since the onset of the earliest symptom, such as when the fever presented. These contacts may include, but are not limited to, household or other close contacts, emergency medical services providers, health care workers providing care to the patient, and laboratorians.
- Direct contacts to monitor his/her temperature twice each day and record it in a written log and coordinate daily monitoring of contacts by VDH for out-of-hospital contacts and by hospital for healthcare workplace contacts.
- Advise contacts including health care workers, per CDC guidance, that they may perform usual daily activities unless any symptoms of illness develop. An exception is that the contacts will be asked to refrain from taking long trips on public conveyances. (If specific conditions warrant, the Commissioner has the authority to issue an order of quarantine per existing law and regulations.)
- If contact develops symptoms, direct person to stay home and away from others to watch to see if symptoms worsen. Person will be evaluated to determine if symptoms are compatible with EVD. If symptoms are such that medical care is required, health care providers would be notified in advance of any care-seeking so that precautions can be put into place to prevent any further exposures.
- Coordinate information for senior leadership, interagency, and federal and state partners.
- Coordinate public messaging with hospital, local health district, DCLS, CDC, and other agencies (e.g., VDEM). If there is laboratory confirmation of EVD, there will be an initial press conference with, at a minimum, State Health Commissioner, local health director and hospital leadership.
- Provide key risk communication messages to the public:
- Ebola virus is not communicable to others until a person exhibits signs of illness.
- Only persons who have had direct contact with the blood and body fluids of someone ill with EVD are at risk of infection.
- Infection prevention measures used every day in U.S. health care are sufficient to prevent the spread of EVD.
- There is a coordinated public health and health care response that will contain the spread of Ebola in Virginia.
Coordinating the Response
- Activate incident command if there is laboratory confirmation of EVD. At a minimum, the local health district response would operate under incident command with support of VDH’s Emergency Coordination Center and VDH Central Office resources.
The VDH feels confident in its ability and the ability of the entire health care community to respond to this and other public health threats.
The following are links to additional information concerning Ebola:
- Ebola Information for Virginia Healthcare Providers and Facilities
- Ebola Information for the Public