Experts at MUSC talk Ebola preparedness

By Helen Adams

The arrival of the first Ebola patient in an American hospital comes as no surprise to infectious disease experts at the Medical University of South Carolina.

“There have been several false alarms before now, which shows that health care systems are paying attention to patients’ symptoms and epidemiology,” said L.W. Preston Church, M.D., associate professor in MUSC’s Infectious Diseases Division. “People are thinking about Ebola and taking appropriate action.”

Yesterday, the Centers for Disease Control and Prevention (CDC) confirmed that a person who traveled to Dallas, Texas, from Liberia tested positive for Ebola.

The patient is being treated in an isolation unit at Texas Health Presbyterian Hospital. The CDC is not releasing any details about the person’s identity but did say that the patient did not develop Ebola symptoms until after flying from West Africa, and it is not recommending that people on the patient’s commercial flights be monitored since Ebola is only contagious when the person is experiencing symptoms.

“What we are seeing now is a deliberate, thoughtful, organized team approach to investigation and management,” said Church.

A suspected Ebola case at MUSC would be handled in a similar fashion, he said. If MUSC had someone who had recently been to West Africa and had symptoms compatible with Ebola infection (fever, headache, nausea, vomiting, diarrhea), the patient would immediately be placed in isolation – a room that allows doctors to control contact with the patient and ensures the careful use and disposal of protective gear for health personnel and other items used to treat the patient.

“Contact would be established with state health officials and the CDC to address the public health measures – identifying contacts and assessing individual risk,” Church said.

Church recently served on an MUSC panel discussion about Ebola, sponsored by MUSC’s Center for Global Health.

Other panelists included Gail Stuart, Ph.D., dean of the MUSC College of Nursing; John Vena, Ph.D., professor and the founding chair of the Department of Public Health Sciences at MUSC; and Jeffery Deal, M.D., director of Health Studies for Water Missions International, a non-profit organization that helps ensure people in developing countries and disaster zones have access to safe water.

At the Sept. 25 event on the MUSC campus, the panel and a large audience watched the PBS Frontline documentary “Ebola Outbreak,” then discussed the Ebola crisis in West Africa.

The issue was personal for third-year medical student John Odeghe, who is from Nigeria. His country has had eight deaths from Ebola. While his president recently declared Nigeria “Ebola free,” neighboring countries in West Africa are not.

The World Health Organization estimates that more than 3,000 people have died in this Ebola outbreak, making it the worst on record. Guinea, Liberia and Sierra Leone have seen the greatest impact from the disease. The Centers for Disease Control and Prevention recently reported that if effective measures are not found to stop Ebola’s spread, the number of people infected could reach 1.4 million by Jan. 20.

Odeghe asked the MUSC Ebola panel: “Has there been any effort to try involve the leaders of the communities, like the chieftains and other people the villagers listen to?”

Some of the panelists were able to answer from personal experience. Stuart, who has been working with nurses in Liberia in person and via Skype, told Odeghe what they've been doing.

“The strategy we have been using to reduce the stigma of Ebola was to engage the traditional providers - the witch doctors, the family members," Stuart said. "There has been a huge campaign to engage them. I think that has been identified as critically important because they are the first line of caregiving for many people.”

Deal, whose work with Water Missions International took him to Liberia as well, told the audience about what he saw in Ebola treatment units.

“It was patients on the floor, shoulder to shoulder. You had to step over each one to get to the next,” Deal said.

“Half of them had spontaneous bleeding, and that was in the ‘suspected case’ ward. Thirty percent tested negative. If you didn’t have Ebola when you came there, you had it when you left.”

Vena spoke from his perspective as a professor of public health sciences at MUSC.  

“Emerging and re-emerging infectious diseases - this is not going to be the last,” said Vena. “There will be other diseases. There will be people traveling around the world, and it’s only inevitable that there will be cases of these emerging infectious diseases that are going to land in South Carolina. No doubt about that in my mind.

Helen Adams is an intern in the MUSC Office of Public Relations. This article was repurposed for the CGH Newsletter with permission from the MUSC Office of Public Relations. Click HERE to read on!