I want to inform you about what the Commonwealth of Virginia is doing to protect citizens against the Ebola virus and to provide information on the virus itself. In response to the Ebola outbreak in the United States, the Virginia Department of Health is taking a number of steps to address the issue here in the Commonwealth.
On Monday, the Department of Health implemented a program to monitor those most at-risk for contracting Ebola. Local health departments will begin monitoring all travelers arriving from West African nations suffering from the outbreak. Health officials will stay in contact with these travelers every day throughout a 21-day period and develop individually tailored monitoring plans.
The Department of Health has indicated that they are prepared to take additional steps as needed. This includes isolating or quarantining individuals if necessary.
Virginians are understandably alarmed and gravely concerned about the plans to deal with Ebola. While we will no doubt be at the forefront in helping contain this health threat, I believe that it is time to place a ban on travel from those West African nations battling Ebola.
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What is Ebola?
Ebola is one of numerous viral hemorrhagic fevers. It is a severe, often fatal, disease. Sporadic cases and outbreaks of Ebola have been reported throughout Africa. The Centers for Disease Control and Prevention confirmed on September 30, 2014, through laboratory tests, the first case of Ebola to be diagnosed in the United States in a person who had traveled to Dallas, Texas from West Africa.
What are the symptoms of Ebola?
- Fever (greater than 100.4°F)
- Severe headache
- Muscle pain
- Abdominal (stomach) pain
- Unexplained hemorrhage (bleeding or bruising)
- Fever is usually the first symptom that appears.
How soon after exposure do symptoms usually occur?
Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days.
How is Ebola spread?
Almost always, Ebola is spread from person to person through direct contact (through broken skin or mucous membranes) with blood or body fluids (like urine, feces, saliva, vomit, sweat, breast milk, or semen) of a person who is sick with Ebola or has died from Ebola.
Ebola may also be spread through indirect contact with surfaces or objects (like needles) that have been contaminated with the blood or body fluids of a person sick with Ebola or has died from Ebola.
Ebola is not spread through the air, water, or food. However, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats.
Ebola cannot be spread through casual contact in public places with people who do not appear to be sick.
What happens if an Ebola outbreak occurs in Virginia?
Upon receiving a report of a probable "high risk" and/or laboratory confirmation of an Ebola case 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).
Guidelines for if an Outbreak Occurs:
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 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 the Department 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 Ebola. 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 Ebola, 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 Ebola are at risk of infection.
- Infection prevention measures used every day in U.S. health care are sufficient to prevent the spread of Ebola.
- 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 Ebola. At a minimum, the local health district response would operate under incident command with support of the Department's Emergency Coordination Center and Central Office resources.
As always, if I can ever be of assistance, please don't hesitate to call me at 703-772-7168 or email me firstname.lastname@example.org.