Buncombe County Health & Human Services Aging and Veteran’s Services ~ Social Work Services Public Assistance & Work Support Strategies ~ Public Health Amanda Stone, MSW Health and Human Services Director To: Buncombe County Medical Providers From: Dr. Jennifer Mullendore, Medical Director Date: Thursday, October 16, 2014 RE: Health alert from the Buncombe County Department of Health Updated Ebola guidance for NC Providers and Labs Please see the updated provider and laboratory guidance regarding Ebola (attached with key changes highlighted below). This version has been updated to include clinical observations shared through the Infectious Disease Society of America by physicians who provided care to Ebola cases at Emory University; updated infection control guidance; and updated testing guidance. I am also attaching an updated algorithm for evaluation of the returned traveler. This has been revised to reflect two changes made by CDC: A change in the fever criterion used (≥100.4 rather than 101.5), and A focus on persons who resided in or traveled to “a country with wide-spread Ebola transmission”, rather than “an Ebola-affected area”. **If you encounter a patient with fever or compatible Ebola symptoms (headache, weakness, muscle pain, vomiting, diarrhea, abdominal pain, or hemorrhage) AND they have resided in or traveled to a country with wide-spread Ebola transmission (currently Guinea, Liberia, & Sierra Leone) in the 21 days before illness onset, you need to: 1. 2. 1. Isolate patient in single room (with a private bathroom if inpatient setting) and with the door to hallway closed. 2. Minimize the number of staff interacting with the patient. 3. Implement standard, contact, and droplet precautions (gown, facemask, eye protection, and gloves). 4. If inpatient setting, notify the hospital Infection Control Program and other appropriate staff. -MORE- HHS Administration p. 828.250.5700 f. 828.250.6235 PO Box 7408 Asheville, NC 28802 Aging & Veteran’s Services p. 828.250.5726 PO Box 7408 Asheville, NC 28802 Social Work Services p. 828.250.5500 f. 828.250.6235 PO Box 7408 Asheville, NC 28802 Public Assistance p. 828.250.5500 f. 828.250.6235 PO Box 7408 Asheville, NC 28802 Public Health p. 828.250.5000 f. 828.250.6235 PO Box 7407 Asheville, NC 28802 Page 2 – BC Health & Human Services, Provider Health Alert – NC Ebola Guidance 10/16/14 5. Immediately contact your local health department (250-5109 for Buncombe County Disease Control) or the NC Communicable Disease Branch (919-733-3419) to discuss next steps. Infection Control • Detailed guidance on putting on and removing PPE is available at www.cdc.gov/vhf/ebola/pdf/ppe-poster.pdf • The NC Division of Public Health recommends having a dedicated monitor observe putting on and removing of PPE by all healthcare personnel caring for patients with suspected or confirmed Ebola Virus Disease. • If a patient with suspected EVD is going to be transported to another facility, the transport staff and the receiving facility should be notified before transport so that appropriate precautions can be taken. Ebola Virus Testing at the NC State Lab • Since all specimens tested at the State Lab will be forwarded to the CDC for further testing, you must send 2 purple top tubes. • It may take up to 3 days after symptoms appear for the virus to reach detectable levels. o Therefore, if specimens are collected < 3 days after onset, a later specimen may be needed to completely rule-out Ebola. See the attachments for further details. For your understanding, the role of the local health department related to Ebola is: • providing updates and guidance to the local medical community; • identification, interviewing and active monitoring of contacts (not testing and treatment of sick individuals); and • keeping the public informed and educated on this issue. Buncombe County Health and Human Services staff have been and will continue to be in communication with state and federal public health officials, Mission Hospital infection control staff and leadership, local emergency management organizations, local universities, faith-based organizations, and the local media to ensure our community is prepared to respond if needed. -MORE- HHS Administration p. 828.250.5700 f. 828.250.6235 PO Box 7408 Asheville, NC 28802 Aging & Veteran’s Services p. 828.250.5726 PO Box 7408 Asheville, NC 28802 Social Work Services p. 828.250.5500 f. 828.250.6235 PO Box 7408 Asheville, NC 28802 Public Assistance p. 828.250.5500 f. 828.250.6235 PO Box 7408 Asheville, NC 28802 Public Health p. 828.250.5000 f. 828.250.6235 PO Box 7407 Asheville, NC 28802 Page 3 – BC Health & Human Services, Provider Health Alert – NC Ebola Guidance 10/16/14 This is an evolving situation and recommendations are likely to change as new information becomes available. • Updated information and guidance are available from the CDC at http://www.cdc.gov/vhf/ebola and from North Carolina Public Health at http://epi.publichealth.nc.gov/cd/diseases/hemorrhagic.html. As always, if you have any questions or concerns related to this or any other communicable disease, please contact your local health department (250-5109 for Buncombe County Disease Control; available 24/7). Thanks, Jenni Jennifer Mullendore, MD, MSPH Medical Director Buncombe County Health and Human Services Office: (828) 250-6308 [email protected] "Health care is vital to all of us some of the time, but public health is vital to all of us all of the time." -Dr. C. Everett Koop, former US Surgeon General -END- HHS Administration p. 828.250.5700 f. 828.250.6235 PO Box 7408 Asheville, NC 28802 Aging & Veteran’s Services p. 828.250.5726 PO Box 7408 Asheville, NC 28802 Social Work Services p. 828.250.5500 f. 828.250.6235 PO Box 7408 Asheville, NC 28802 Public Assistance p. 828.250.5500 f. 828.250.6235 PO Box 7408 Asheville, NC 28802 Public Health p. 828.250.5000 f. 828.250.6235 PO Box 7407 Asheville, NC 28802
© Copyright 2024