Local health officials: We are prepared for Ebola

Rochester and Olmsted County health officials say they're prepared to defend against the deadly Ebola virus should a case show up here.

Preparations include quizzing emergency room patients about Ebola symptoms, tracking ill passengers on incoming flights and having protective suits ready for medical personnel.

"We've been working on this since July," said Mayo Clinic infectious diseases expert Dr.Pritish Tosh . "So, we are four months into our preparations for exactly this."

However, he said it's unlikely the United States or Rochester will see Ebola spread. That's because medical facilities in this country are able to quickly identify and isolate an individual with possible Ebola symptoms, get that person the supportive care needed and locate people who may have been exposed.

Ebola is only infectious when the affected person is very sick, Tosh said.

At Mayo, "we have many protocols in place to make sure that any blood or body fluids are taken care of in appropriate fashion to reduce the risk of transmission," he said.

Pete Giesen, Olmsted County Public Health director, said Public Health is collaborating with Mayo Clinic, medical transportation providers, Olmsted Medical Center and the Rochester International Airport.

"There's a plan in place around isolation and quarantine," Giesen said. "That includes a joint plan around ourselves, the Rochester airport, the CDC Quarantine Office and Minneapolis and the Minnesota Department of Health."

Airlines will communicate if someone is ill on a plane that is coming in to Rochester, for example.

"That's something that we've exercised a couple different times, and ever since severe acute respiratory syndrome reared itself in the early 2000s, that plan was put into place, and we've exercised that," Giesen said.

What happens if Ebola found in Rochester

If an Ebola case is found in Rochester, Public Health will be involved in helping to identify all individuals who might have been exposed to determine who is at risk.

OMC spokesman Jeremy Salucka said OMC ramped up staff education even before public concern about Ebola rose.

It's now standard protocol in the emergency room, Salucka said, to ask patients about Ebola symptoms, such as fever, headache, joint and muscle aches, diarrhea, vomiting and general weakness.

Patients also are asked if, within the past 21 days, they have been to a country where Ebola has been confirmed.

If it's determined a patient has symptoms that fit possible Ebola, employees don personal protective suits, using gloves, gowns, masks and protective eyewear, Salucka said. Thepatient will be given a private room, and the hospital will notify the Minnesota Department of Health, the CDC, Olmsted County Public Health and possibly other local public health units.

"Odds are very, very high that we would not treat Ebola," Salucka said, adding that once a patient is put into isolation, OMC would work with other health professionals to determine where the patient should be sent for treatment.

Mayo Clinic is able and prepared to treat Ebola patients, Tosh said.

"We are able to take care of these patients from the time that they are seen in the emergency room to the time that they would be discharged," he said, noting that local, regional and national public health authorities would be involved.

There also are plans underway in Rochester to screen patients at outpatient clinic locations, Salucka said, such as OMC convenience clinics and its main outpatient clinic locations.

Giesen said Olmsted County Public Health will work closely with the Minnesota Department of Health and the CDC "monitoring the contacts of cases."

What happens if someone returns with Ebola

That means if a person with Ebola symptoms returns to Rochester after spending time in areas of West Africa where the current outbreak is happening, that person, once the individual is recognized as potentially infected with Ebola, would be interviewed by public health staff, such as epidemiologists and nurses. Staff are familiar with this kind of work from tracking outbreaks of various infectious ailments, Giesen said.

"Depending on the infectious disease, those who may have been exposed to that infectious disease are monitored," Giesen said. Public-health staff call each contact, who stays isolated at home, two or three times daily. They monitor whether symptoms arise in the person who spent time around the already diagnosed individual.

Public health staff also work with volunteer organizations, such as the Red Cross, to help anyone who is quarantined at home "to make sure that they have what they need when they're quarantined," he said. For example, if a person is quarantined at home and has limited groceries on hand, arrangements will be made to get food to the person.

"Ideally, and state law requires, that quarantine be done in as least restrictive way as possible," Giesen said. "So it's basically, somebody's in their home, or in a hotel room, asking them to stay put and provide them with anything essential that they need, so they get fed and all of those things — that they're not left kind of stranded there."

Olmsted County Public Health would log into a state program that tracks both the health status of those who are staying in isolation at home or elsewhere and "that their needs are being met during the time that they are quarantined," Giesen said.

Tosh said planning at Mayo has been "very multidisciplinary" and includes "people from our emergency room, our ICU, nursing, transportation — really anyone you think might be involved has been involved.

"We know very well how this virus is transmitted, and that is through direct contact with blood or body fluids from an infected person who is symptomatic, meaning that they are acutely ill from the infection," Tosh said. "The CDC has made recommendations for personal protective equipment to be worn by health-care workers when taking care of a patient with suspected or proven Ebola virus disease."

What is the likelihood that someone with Ebola will come to Rochester?

"That is very real," Tosh said. "It has already happened, in Dallas. Lest we are able to stop the outbreak in West Africa, that risk will continue. For that reason, hospitals across the country need to be prepared to quickly identify, isolate and treat patients who have suspected Ebola virus disease."

But is there a risk of a widespread community outbreak of Ebola in a place like Rochester?

"That answer is, really, no," Tosh said. For Ebola to spread within a community would require people to be in direct contact with the blood or body fluids of an infected person. Such a person would be too sick to travel or move around, Tosh said. Also, the United States has a better public health infrastructure, sanitation and healthcare access, he added

"If we were to see a case, there may be secondary cases in those close family members who had direct contact with them in their home," he said. "But, because we would be able to quickly do contact-tracing and quarantine of any contacts, we would not see an uncontrolled outbreak of Ebola in the United States."

Facts about Ebola