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NM health officials urge Ebola vigilance

Copyright © 2014 Albuquerque Journal

The first Ebola case diagnosed in the United States is a “sentinel event” that has prompted health officials in New Mexico and nationally to re-examine U.S. readiness for the rare but deadly illness, a state Department of Health official said Friday.

Chances are remote that someone with the Ebola virus will turn up at a New Mexico clinic, but state and hospital officials are alerting staff to remain vigilant with guidance from federal authorities.

Infectious disease officials emphasized that the likelihood of an Ebola infection in New Mexico is exceedingly low, even for people who have visited West African nations where Ebola has killed more than 3,000 people.

“Somebody getting off a plane from Nigeria with a fever is statistically much, much more likely to have malaria or even Dengue (fever) … than Ebola,” said Dr. David Stryker, medical director for infection control for Presbyterian Hospital.

Health officials last week confirmed the first case of Ebola diagnosed in the United States. The illness hospitalized a man who had traveled to Dallas from Liberia, one of at least three West African nations affected by an Ebola outbreak.

“Right now, with the first U.S. case having been confirmed … we will be learning a lot from that investigation,” said Dr. Joan Baumbach, New Mexico’s deputy epidemiologist. “People are learning together and modifying guidelines as needed.”

The Centers for Disease Control and Prevention has issued a screening tool to help medical personnel assess the possibility that a patient is infected with the viral illness, she said.

A key indication is travel to the West African nations of Liberia, Sierra Leone and Guinea within 21 days of the onset of symptoms.

“Just that, in and of itself, is a very important screening criteria,” Baumbach said.

Symptoms of Ebola virus disease include high fever, severe headache, muscle or abdominal pain, vomiting, diarrhea and unexplained bleeding.

Patients who turn up at New Mexico clinics with those symptoms are likely to have a viral infection other than Ebola, said Bob Bailey, associate dean for clinical affairs at the University of New Mexico School of Medicine.

“But these days we should ask (patients) about recent travel history or association with people who are from sub-Saharan Africa,” Bailey said. Medical staff must “consider the unlikely diagnoses, as well as the likely ones.”

A 30-year-old Bernalillo County woman was tested for the Ebola virus two months ago at UNM Hospital after she showed up with symptoms of the disease.

The woman, who had taught recently in Sierra Leone, tested negative for the disease.

Bailey said he and medical personnel at hospitals around the state had a conference call Thursday with state health officials to discuss the latest guidelines for assessing the risk of Ebola infection.

Hospital officials and UNMH and Presbyterian Healthcare Services say they routinely send CDC guidelines to medical staff, including urgent care and ambulance personnel.

“One of the few good things about Ebola is that it is basically hard to catch,” Bailey said. “It is not transmitted through the air, so you can only catch it by direct exposure to bodily fluids from somebody who is infectious.”

Bodily fluids can include urine, saliva, sweat, feces, vomit, breast milk and semen.

Stryker said patients who are potentially infected with Ebola need to be held in isolation until CDC tests confirm the cause of the infection.

A potential infection also triggers an alert both to infection-control personnel within the hospital, and officials at the state Department of Health and the CDC, he said.