Q&A: Pierce County is prepared, should Ebola arrive

With the number of patients in the United States receiving care for Ebola grows, the local health department has a plan in place if the deadly virus reaches Pierce County.

Nigel Turner heads the Communicable Disease Control and Emergency Preparedness Division of the Tacoma-Pierce County Health Department.

He explained how the county prepares for diseases such as Ebola, and what the chances are of the virus spreading locally.

Question: What is Ebola, and how is it spread?

Answer: It’s a virus that has been seen in Africa. We haven’t see it outside of Africa, typically. It’s associated with a high mortality rate. It’s spread person to person through body fluids, such as blood, vomit, possibly sweat. It is not an airborne virus.

It’s a very serious disease. We don’t have a specific treatment for it. There are things in the pipeline, but nothing specific at this time.

Q: What are the symptoms?

A: It starts with a headache, vomit and diarrhea, but oftentimes it develops into more severe forms of the disease. Blood clotting and multi-organ failures. Shock, and ultimately death.

Q: What are the chances that Ebola would spread to Pierce County?

A: Very slight. There’s a difference between it reaching here and it becoming an epidemic here.

As we’ve seen in Texas, we can get occasional cases. Our challenge is to make sure those isolated cases don’t then become an epidemic. The infection control we have in place makes it very, very unlikely that we’d see ongoing transmission in our county.

Q: Seeing isolated cases is more of a possibility?

A: I don’t think we can rule it out. The incubation period is 21 days, and people can travel during an epidemic. The number of people potentially exposed in West Africa keeps growing. We live in a global society.

Q: What systems are in place locally to prevent Ebola from spreading, if it arrives?

A: Ebola is a much higher-stakes organism, but the same principals apply for diseases such as pertussis and measles: Identifying cases, knowing what to look for and then medical providers contacting the health department so that we can arrange for testing.

We communicate to all medical providers in the county what to look for, not just for Ebola, but for other diseases as well. Especially for something like Ebola, we want them to contact us. We have a 24-hour, 365-days-a-year pager to make sure we can always be available to a clinician.

In August, we sent out a health alert to all providers in Pierce County, telling them what to look for with Ebola, how they should do infection control if they get a case and how to contact the health department to arrange for testing.

Q: There were reports that a hospital in Texas released an Ebola patient before the person was diagnosed because the patient’s travel history wasn’t properly communicated. Is evaluating travel history part of the local protocol for the disease?

A: One of the things in the advisory we sent out is for people to be talking about travel history to patients presenting with symptoms such as fever.

Q: Should the health department get a report of Ebola, what steps would be taken?

A: We’ll need to continue working with the hospital to make sure the person remains under isolation. If we get information from federal partners, we’d be coordinating to make sure the person treating the patient has the best advice.

We’d be talking with the patient, if they can talk, or talking with family members to identify all the places they might have been while they’ve been infectious and symptomatic. Seeing what those folks’ risk is and advising them to at least monitor their health for the incubation period.

Q: Would relatives with possible exposure be isolated?

A: Not typically. It depends. If somebody has had a large amount of exposure, say without gloves, we’d probably say you’d want to quarantine at home.

Q: Are our hospitals prepared for the type of isolation necessary for Ebola?

A: Hospitals have the type of equipment they need to deal with something like this.

Q: Have we had an epidemic of this nature in Pierce County before? If so, of what disease?

A: Not that I know of. We deal with diseases that require isolation, such as tuberculosis. That is very, very routine for us.

There’s always epidemics, but nothing like this. Every year we get an epidemic of influenza. Things come and go. Most of the time we have vaccines. With Ebola, we don’t.

It’s a high-stakes situation, but it’s important that people understand we have a very different system here in Pierce County than in West Africa, one that’s equipped to prevent transmission.