Mindful of Ebola threat, North Bay hospitals roll out new steps (w/video)

The European woman visited the emergency department at Petaluma Valley Hospital last week complaining of a fever. But what really caught staff’s attention was when she revealed that she’d recently traveled in West Africa.

Based on that information, the woman was whisked into an isolation room, where medical staff wearing protective gear assessed her condition. They were concerned she might be harboring the Ebola virus, which to date has killed nearly 4,000 people and sickened thousands more, mostly in the West African nations of Guinea, Liberia and Sierra Leone.

The unidentified woman was discharged from the hospital later that day only after staff felt assured that her symptoms weren’t due to Ebola, according to Dr. Richard Carvolth, chief medical officer for St. Joseph Health in Sonoma County.

“It turned out she had some other minor problems, but she presented to us during the initial screening that she could have been an Ebola patient,” Carvolth said Wednesday.

Hospitals and clinics across the North Bay and around the world have implemented new screening procedures and other measures in response to the deadliest Ebola outbreak on record. On Wednesday, a Liberian man who had recently traveled to the United States from that country succumbed to the disease in a Dallas hospital, becoming the first known person to die of the virus on American soil. Several other sufferers treated in American hospitals survived.

Concerns have been raised about the ability of hospitals and clinics to detect suspected cases of Ebola and to treat patients effectively without putting medical staff at risk of contracting the disease. The coming flu season could potentially complicate matters, as Ebola and the flu share some common symptoms.

The nation’s largest labor union representing nurses on Wednesday released member survey results showing that a large majority of respondents felt they aren’t being adequately informed about Ebola or being issued equipment to better protect them from the disease.

Karen Holbrook, Sonoma County’s deputy public health director, said Wednesday that she “completely understands” those concerns, saying nurses are on the “front lines” with Ebola.

“I hope they work with hospitals in voicing those concerns,” Holbrook said.

Holbrook said Sonoma County is “well on our way to being prepared” for Ebola. But she also alluded to “nuances” and “issues that are complicated” that would appear to suggest there’s still room for improvement. She declined to be more specific.

“Am I saying with 100 percent assurance there will be no bumps in the road, that absolutely nobody else will get infected? No, I’m not saying that,” Holbrook said. “I think we all need to be on our best game, and I think we will.”

Holbrook issued her first health alert about the most recent outbreak of Ebola to local health care providers Aug. 1. On Wednesday, she convened the first of what she said will be weekly conference calls with local providers to discuss how they are preparing for the disease. She said her goal at this stage is to get everyone to operate under the guidelines put forth by the Centers for Disease Control, open up the lines of communication and to share the most up-to-date scientific data about Ebola.

“Not everyone has time to go to the CDC website on a daily basis,” she said.

Ebola remains a relatively minor threat worldwide compared with infectious diseases that have killed or sickened millions. But Holbrook said Ebola stands out because of its high mortality rate, now at about 50 percent, according to the World Health Organization.

“That ups the game,” she said. “Everything has to be perfect in terms of what we do, and how we do it.”

Health officials stress that the odds of a person infected with Ebola showing up at a Sonoma County hospital or clinic are very low, given how far afield the county is from major international points of entry.

The major air hub in the Ebola-affected West African countries is Monrovia, in Liberia. After flying out of there, a person would have to take at least three other long flights before he or she arrived at Sonoma County’s airport, which is serviced by Alaska Airlines.

Unlike with previous outbreaks of other diseases such as the H1N1 flu virus, the Sonoma County Airport hasn’t received any direct communication from federal health officials with regard to the Ebola virus, said Jon Stout, the airport’s manager.

“Since we have virtually no international passengers, we are, at this point, a low-risk site,” Stout said.

Still, local health care providers have been updating infectious disease policies and conducting staff training to prepare for Ebola’s possible arrival here.

Sutter Health, for instance, is planning to deploy teams of medical students with mock symptoms of the disease to its Northern California hospitals and clinics to test whether procedures are where they need to be, according to Gail Carberry, manager of infection prevention and control for Sutter Health in Santa Rosa.

She said Sutter this week also updated its script for telephone operators who’ve begun fielding concerns about Ebola.

“It’s kind of a scary thing,”Carberry said. “People have (read) ‘Hot Zone,’” - Richard Preston’s 1995 nonfiction book about viral fevers - “and say, ‘Gosh, it’s Ebola.’ We’ve done a lot to let them know that we are prepared, and that we have a robust health system here.”

One challenge will be to differentiate the fevers and aches associated with Ebola with that of the flu, as the season for the latter approaches. Following CDC guidelines, emergency room staffs are now instructed to ask people who come in with such symptoms whether they’ve traveled to West Africa within the past 30 days, or whether they’ve been in contact with anyone who has.

Those who answer in the affirmative are likely to be examined in what’s known as a negative pressure room, which prevents air from circulating to other parts of the hospital. Santa Rosa Memorial Hospital has five such rooms.

Ebola isn’t transmitted by air, but certain procedures to treat it can produce airborne contaminants, Carvolth said. He said a blood test to confirm the disease typically takes 24 hours.

St. Joseph’s also has placed signs with information about Ebola outside its hospitals and clinics. The signs, which were developed by the California Department of Public Health, urge people to contact staff immediately if they have a fever and any recent connection to West Africa, including contact with “bats, rodents or primates” from the region.

The point is to get potential Ebola sufferers diagnosed and treated immediately at points of entry to hospitals and clinics. Officials at Texas Health Presbyterian Hospital were criticized after they initially sent Thomas Duncan home, before later diagnosing him with Ebola on his return to the facility.

In response to concerns raised by the national nurse’s union, Carvolth said, “I guess, in a sense, you can never do enough for anything. But we’re taking it (Ebola) seriously, and we’re doing a lot.”

He also pointed out the relatively low risk of anyone in Sonoma County becoming ill or dying from the disease.

“The risk is still very, very low,” he said. “You’re much more likely to be injured in a traffic accident, or from the many other things that befall people, than be exposed to Ebola.”

Staff Writer Matt Brown contributed to this report. You can reach Staff Writer Derek Moore at 521-5336 or derek.moore@pressdemocrat.com. On Twitter @deadlinederek.