Ebola Virus Update from Nevada County Public Health
To date there have been no confirmed cases of Ebola in California and there have been no reported suspect cases in Nevada County. The Centers for Disease Control and Prevention (CDC) did confirm on September 30, 2014 the first case of Ebola to be diagnosed in the United States in a person who traveled to Dallas, Texas from Liberia. The Ebola outbreak in Guinea, Liberia, and Sierra Leone has been growing with over 7400 cases diagnosed and over 3400 deaths. Until the outbreak in these West African countries is controlled, we run the risk of having more travel-related cases of infection in the United States. Liberia, Sierra Leone, and Guinea have terrible poverty, very limited healthcare resources, and have not been able to control the outbreaks in their countries on their own. An assessment in August of the healthcare infrastructure in Southeastern Liberia, for example, showed only 3 physicians for 4 counties. Supplies of non-sterile and sterile gloves were depleted or absent and hand washing stations in most healthcare settings consisted of water jugs and even these were scarce. Tragically, without proper resources like isolation rooms, gloves, gowns, and face shields, those who care for victims of Ebola are themselves put at risk and family members, caregivers, and healthcare workers have fallen ill and died in these countries.
Conversely, in the United States, Dr. Thomas Frieden, the CDC director, has stated that “I remain quite confident we will not have a widespread outbreak.” There are several reasons for that confidence including two very important factors that help in the control of Ebola transmission that don’t always get emphasized: first, Ebola is transmitted by direct contact with blood or body fluids of a person who is sick with Ebola (or contact with objects like needles and syringes that have been contaminated by blood or body fluids). It is not transmitted through the air like measles. Second, someone with Ebola infection does not transmit the disease until they are already sick. There are many diseases, including influenza that spread even before symptoms appear but fortunately this has not been true of Ebola. These two key facts combined make it possible to reduce the numbers of those exposed if the patient is isolated as quickly as possible after falling ill. It is also important to be aware that two countries, Senegal and Nigeria, have been able to limit the spread of Ebola during the outbreaks in West Africa. Senegal had a travel-related case of Ebola (from Guinea) and contacts to that individual were identified and followed and they have completed their 21-day follow-up with no further cases of Ebola identified. Nigeria had 20 cases of Ebola but reacted more quickly and more robustly than other countries in the region and has had no reports of new cases since September 5, 2014. It is critical to contain the outbreaks in West Africa to decrease the spread of the disease. Locally, we do not anticipate an outbreak of Ebola to occur; however, if a suspected case of Ebola should occur, the Nevada County Public Health Department has prepared to work with local hospitals to identify and diagnose any suspected Ebola case through public health laboratories, to assure isolation of the patient, and to work closely with those who have had contact with the patient in order to limit any spread. For frequently updated information on Ebola Virus Disease, please see: http://www.cdc.gov/vhf/ebola/