NJ Hospitals, Health Officials Ready for Ebola, Say Safeguards Are in Place

Andrew Kitchenman | October 7, 2014 | Health Care
Cite quick, efficient response to suspected case at Newark Airport, downplay chances of deadly virus spreading in Garden State

ebola hazmat
As concerns grow following the first confirmed case of Ebola virus in the United States, state officials and New Jersey hospitals have a simple message: They are ready.

Few infectious diseases prompt as much fear as Ebola, which has been estimated to have killed 70 percent of the people in West Africa known to have contracted it during the ongoing outbreak there.

But infectious-disease experts have pointed out that there are many public health practices in place in the United States that would prevent a similar outbreak here.

Ebola is spread through direct contact with bodily fluids, like blood and vomit, rather than through airborne particles. While there is no cure for Ebola, medical facilities in the United States can help patients survive by providing intravenous fluids, oxygen and treatments for other infections. They can also quarantine patients. All of these approaches are difficult for the overwhelmed West African facilities, which have struggled due to a lack of hospital beds and personnel.

This holds true in New Jersey, where a sick passenger on a flight arriving Saturday at Newark Liberty International Airport from Belgium briefly led to the plane being quarantined. The patient was taken to University Hospital in Newark, where it was determined that he didn’t have Ebola.

North Jersey’s relatively large West African immigrant population, as well as University Hospital’s contract to handle sick travellers from the airport, made hospital staff particularly well-prepared for potential Ebola cases, according to Dr. David Cennimo, an adult and pediatric infectious diseases attending physician at University Hospital and an assistant professor of internal medicine and pediatrics at Rutgers New Jersey Medical School in Newark.

Hospital staff members are highly attuned to patients returning from an area affected by infectious diseases, like the parts of West Africa currently dealing with Ebola, he said.

“In the American healthcare system, we’re fairly used to protecting ourselves from other things that are spread in similar ways” to Ebola, Cennimo said.

The only thing that could possibly lead to a serious virus spreading would be if a patient with symptoms waited a significant amount of time being going to a hospital, he said.

If people who have visited the parts of West Africa where Ebola is occurring experience flu-like symptoms like a high temperature and severe headache, they should immediately call their primary-care provider or visit a hospital, Cennimo said. Most importantly, they should be upfront if they feel they may have been exposed to Ebola, since hospitals have procedures in place to handle these cases.

“We’re going to err on the side of caution,” and keep patients in isolation until it’s determined that they don’t have the virus, he said. “We’ve been very aggressive” in providing thorough screenings and tests to patients whose recent travel may have exposed them to the virus.

Facilities like University Hospital handle patients who require isolation on a nearly daily basis, including many patients who have the flu.

“That’s why, from an infectious disease standpoint, this is not really different from so many things we do” frequently, Cennimo said.

Every acute-care hospital in the state is equipped to handle patients who need to be isolated.

For example, all patients at Hackensack University Medical Center are screened for whether they’ve traveled recently to areas affected by Ebola, according to Dr. Joseph Feldman, chairman of emergency medicine at the hospital.

If a patient had potential exposure to the virus and exhibited symptoms, the hospital would contact the local health department, which would then contact the state Department of Health, which would contact the U.S. Centers for Disease Control and Prevention. In screening patients, Hackensack hasn’t had any positive results that triggered further action regarding Ebola.

The state has provided more than a dozen Ebola-specific health alerts since the summer to hospitals and other local healthcare providers.

In the case of the only confirmed Ebola patient in this country, a Dallas hospital let the man leave the hospital after he first visited it with symptoms of the virus. The hospital hasn’t been clear about why it allowed him to leave after he told hospital personnel that he had recently arrived from Liberia. He returned to the hospital three days later.

Feldman said the Hackensack’s electronic medical records and communication between staff members – including automatic alerts sent by the nurse who screens patients to the nurse in charge — would prevent a similar incident.

“We have set up a fail-safe system so that the same thing would not recur here,” he said.

The American health system’s systematic approach to recording patients’ travel history and the ability of hospitals to isolate patients are safeguards to prevent Ebola spreading the way it has in West Africa, Feldman said. “We’re trying to cut down on some of the hysteria that’s going on,” he said.

Both the Newark airport and University Hospital are experienced with treating patients who arrive on flights with the flu-like symptoms that could signal more serious viruses like Ebola. The CDC maintains a quarantine station at the airport for cases like this.

On Saturday, the CDC worked with Port Authority of New York and New Jersey police to quarantine the airplane and take the patient suspected of having Ebola to University Hospital. State and Newark city health officials also were involved in planning the response to the case. The passengers and crew of the jet were quarantined for an hour and a half and the passenger — who had been vomiting — was determined to have a minor illness.

State officials said the prompt action was the latest example of how proper procedures are in place to handle suspected cases of serious infectious diseases.

Previous incidents include the 2004 case in which state and local health officials monitored more than 100 residents who had potentially come into contact with a Mercer County man who died from Lassa hemorrhagic fever after visiting Liberia. None of the other residents contracted the acute viral fever.

In addition, a patient was suspected of having Ebola was treated at CentraState Medical Center in Newark in August. Hospital personnel, working with the state and CDC, later determined the patient hadn’t been exposed to Ebola despite recently travelling to West Africa.

“It is natural to have fear of Ebola, but New Jersey hospitals use meticulous infection control measures everyday and are well prepared to deal to deal with patients with infectious diseases,” state Health Commissioner Mary E. O’Dowd said after the August incident.

O’Dowd spoke with 120 hospital and local health officials during an Aug. 11 conference call about Ebola. State officials plan to hold another call soon about the virus, a state spokeswoman said. In addition, there is a wide array of CDC information about Ebola available on the state Department of Health website.