Cone HealthEbola Preparedness

October 2014

Cynthia Snider, MD, MPH

Infectious Diseases

Medical Director of Infection

Prevention

In the last 4 weeks, there has been exponential growth of cases in this devastating outbreak that has created urgency for immediate action.

Total: 7470 cases:3431 deaths

-------------------Liberia:

3834cases;2069deathsSierra Leone: 2437 cases;

623 deathsGuinea: 1199cases;735

deathsNigeria: 20 cases; 8 deaths

Senegal: 1 case-------------------

United States: 1 case

Nigeria and Senegal have not had any further cases since Sep 5 & Aug 29, respectively.

Why is the Mortality rate in Sierra Leone not as steep … not as severe as in Liberia?

Worst case scenario unlikely to occur due to

current response from US, Canada, England, France and NGOs such as MSF,

PIH and others.

Ebola enters the patient through mucous membrane, breaks in the skin -> to infect cells.

How is the Ebola Virus infection transmitted in humans?

• Ebola is spread by direct contact (through broken skin or

mucous membranes) with the blood, urine, sweat, saliva,

feces, vomit or semen of infected persons.

• It is also spread by contaminated objects like needles and

equipment.

• You’re also at risk when in direct contact with infected animals

(bats, monkeys, gorillas, chimpanzee or their bush meat).

• Ebola is not spread by air/water/food or when someone is

asymptomatic.

How contagious is Ebola?

Ebola may be highly lethal, but not actually that contagious in comparison to other diseases such as measles or chickenpox.

Signs and Symptoms

Symptoms occur 2-21 days after exposure, but on average 8-10 days.

Treatment options

• Supportive care

– Electrolyte replacement

– Nutritional support

– Fluid resuscitation for hypovolemia

– Blood product transfusion for DIC

• Convalescent Serum/Plasma transfusion

• Experimental Drugs via Compassionate Use

– Polymerase inhibitor

– Monoclonal antibodies

Success in treatment Ebola patients & prevention of 2nd cases

in the US?• Access to rapid diagnostic tests for

assessment

• Medications/repletion of electrolytes

• ICU monitoring

• Excellent dedicated medical care

• Access to PPE

• PPE monitoring

Screening for symptoms

1. Do you have fever,

headache, joint or

muscle pain,

D/V/abdominal pain?

2. In the last 3 weeks, have

you travelled outside of

the US or had close

contact with someone

who has?

At first point of entry into Cone Health, you

will be asked about your symptoms and TRAVEL

HISTORY.