Ebola Outbreak: How Prepared is Rhode Island?
Friday, August 01, 2014
As of Thursday, over 700 recent Ebola-related deaths in West Africa had been confirmed, making it the deadliest outbreak in the history of the disease. The U.S. Peace Corps is now evacuating hundreds of its volunteers in the affected countries, and two Peace Corps workers are under isolationafter having contact with someone who died from the Ebola virus. Now, at least one American is returning to the U.S. for treatment, according to the Chicago Tribune.
SLIDES: See Biggest Epidemics in New England History BELOW
So what would happen if Ebola were to find its way to Rhode Island?
Both the Rhode Island Emergency Management Agency -- along with Governor Lincoln Chafee's office -- deferred questions to the Rhode Island Department of Health (HEALTH).
"This was the first advisory sent out to all providers on July 15 via HEALTH Connections," said Christina Batistini with HEALTH on Thursday. "This was the CDC HAN (Health Alert Network) message from Monday, July 28 that was copied to all RI providers via Mailchimp email."
The HEALTH advisory lists the background of the outbreak, recommendations for healthcare workers, a list of symptoms -- and the directive to immediately report suspect travel-associated cases by phone to the Division of Infectious Disease and Epidemiology.
HEALTH specifically cautioned of Rhode Islanders who have recently traveled to and from Liberia.
"Approximately 15,000 Rhode Island residents are of Liberian descent, and travel back and forth from their country of origin. Importation of Ebola cases to Rhode Island is considered unlikely. However, out of an abundance of caution, it is important to recognize this high-risk sub-population in Rhode Island and take steps to educate travelers of risk and prevention, as well as keep a high index of suspicion when returning travelers from an endemic area present to healthcare settings with infectious disease symptoms."
The two communications to the health care community and general public mark Rhode Island's two statements of record to date in terms of how the state would deal with an outbreak - instead referring primarily to the lead of the CDC who is closely involved with the current situation in West Africa -- and looking to contain it.
CDC on the Record
"Ebola is frightening. It is a dreadful and merciless virus, and this is the biggest, most complex [outbreak] and first time it's been present in this region," said Friedan, of the outbreak in West Africa. "The key means of stopping Ebola is fundamentally doing 3 things-- finding the patients, so we can rapidly ID and isolate patients, find out their contacts, and keep it from spreading. "
CDC provides a comprehensive overview of Ebola on its website, including a signs and symptoms chart for the hemorrhagic fever, as well as fact sheet and information for living and working abroad. The CDC writes that "symptoms may appear anywhere from 2 to 21 days after exposure to ebolavirus though 8-10 days is most common."
"We also are strengthening each of the countries commitment to limiting travel for people who may have been exposed, airport screening to ensure people who shouldn't be traveling aren't traveling," said Friedan, who noted the CDC was issuing a travel advisory recommending against non-essential travel to Guinea, Liberia and Sierra Leonne.
Friedan continued, "We recognize there are concerns in the US but Ebola has little risk to the general population. It's important to recognize how it spreads, if there's little that's reassuring. First, it does not spread between people who aren't sick with it -- so if someone's been exposed, but not sick with severe symptoms....it's body fluids that must be shared that's the infection risk," adding that certain burial rites in Africa are a way of spreading it.
In the U.S., Friedan was confident the response to any exposure here would be sufficient. "We would have health departments do fever checks for 21 days for someone who might have been exposed," said Friedan. "There's not a potential for Ebola to spread in the U.S., it's just not in the cards."
States Responses Measured
Last December, the Robert Woods Johnson Foundation along with the Trust for America's Health put out at report entitled "Outbreaks: Protecting Americans from Infectious Diseases," which evaluated states based on 10 indicators.
Rhode Island scored a 7 out of 10, which placed among the top eight states in the country for general preparedness.
The score included getting a notch for public health lab reports having the capacity in place to assure the timely transportation (pick up or delivery) of samples 24/7/365 days to the appropriate LRN laboratory.
In addition, RI met the criteria for having public health lab reports having a plan and capacity to handle a significant surge in testing over a six to eight week period in response to an outbreak that increases testing over 300%.
Related Slideshow: The History of Disease Outbreaks in New England
New England Smallpox 1633
European settlers brought Smallpox to America in the 17th century, and it is estimated that more than 70% of the Native American population in the northeast was wiped out by the disease between 1633 and 1634.
Smallpox has been eradicated from the United States for over 60 years.
With a near 80% mortality rate among those infected, "The White Plague" struck worldwide and at home in the United States, particularly in industrial areas.
According to research by the Harvard Medical Library, nearly 40% of deaths of working-class people in urban American cities were cause by Tuberculosis.
58,000 cases of Polio and over 3,000 resulting deaths were reported in the 1952 epidemic in the United States.
The disease affects the nervous system, and President Franklin D. Roosevelt is probably the most notable person to live with the disease.
Polio has been eradicated in the United States for over 30 years.
Holy Cross Hepatitis 1969
After being trounced on the second Saturday of the 1969 college football season by Dartmouth, the Holy Cross football team had each member get blood work done to determine if there was a medical reason for their poor performance.
90 out of 97 players on the team had elevated levels of a liver enzyme, and 30 of those 90 players showed symptoms of Hepatitis-A.
Dr. Leonard Morse, who went on to become the Commissioner of Public Health in Worcester, helped determine the cause of the sickness- a contaminated drinking water supply that only the football players had accessed.
The remainder of the season was canceled (an NCAA first) and the 30 players showing symptoms were quarantined in a single dormitory.
AIDS Epidemic 1980s
While not documented until 1981, the HIV virus and AIDS continues to be one of the most debilitating diseases alive today in the United States.
Progress has been made over the years, as education about the virus and how to prevent it have brought the world from "AIDS is Preventable" to "AIDS is Treatable."
NH Hepatitis 2012
30 people were diagnosed with Hepatitis-C in 2012 after a former hospital worker stole syringes and intentionally contaminated them with the disease, of which he was afflicted.
After pleading guilty to charges in New Hampshire, the perpetrator was sentenced to 39 months in jail.
VT Whooping Cough 2012
Whooping cough- also known as Pertussis- is difficult to diagnose initially because it starts with cold-like symptoms and progresses into a life threatening illness.
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