Arizona Ebola Plans

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A second patient in Texas has been discovered to be infected with the Ebola virus. Arizona Department of Health Services Director Will Humble will talk about Arizona’s plan to deal with the deadly disease if it shows up here.

Ted Simons: Good evening, and welcome to "Arizona Horizon." I'm Ted Simons.

Ted Simons: The presence of Ebola in the U.S. is far from an outbreak, but there are concerns over how cases of the virus have been handled in Texas. Here now to discuss how well Arizona is prepared for an Ebola case is Will Humble, director of the Arizona department of health services. Good to see you again. Thanks for joining us.

Will Humble: Good evening. Thanks.

Ted Simons: Overview. What is Ebola, how is it caught, how is it diagnosed, what are we talking about?

Will Humble: Ebola is a virus, it's been in -- There's been 19 outbreaks since 1976 in Africa, most of them have been very limited in scale and scope. This is the unique outlier, because it's gotten to become a major outbreak, and major cities and three countries in West Africa. We had a travel case that came to Texas and two subsequent cases it looks like from that initial case.

Ted Simons: So how does it spread, and how is it diagnosed?

Will Humble: It's spread through direct contact. So, in other words, if you had the Ebola virus, and I was sitting here talking to you and doing an assessment of you as a physician. I would be at no risk because I'm not in contact with your bodily fluid. But I'm actually going to treat you, run I.V. lines or help you to breathe with certain kinds of equipment and be more evasive, get my hands on you, then -- Or if I were to touch your vomit or diarrhea, something like that, then you get to be to a dangerous situation if you don't have the right kinds of protection.

Ted Simons: And a diagnosis how is that handled?

Will Humble: The diagnosis is the absolute key. That's what we've been focusing on in Arizona over the last couple weeks, really hard with physician and clinicians, emergency departments. Because the real key to having an effective response is to be able to find any case that comes into Arizona right away. So if there's somebody who had been traveling to west Africa, came to Arizona, showed up, for example, at a community health center with Ebola-like symptoms, it's really critical for the triage nurse or clinicians that first assess that patient to get a good travel history so they understand if they have been to west Africa or not, was it in the last 21 days or not, which is the incubation period, and if they were there within the 21 days, what were they doing? Were they working in a clinic, or just going fishing and they weren't around anybody? So those are all real critical components to deciding who are the patients that you're going to place into isolation. Because that's the really key next step. After you've made a determination this patient was in West Africa, has Ebola symptoms, you need to decide what to do. Put that patient in isolation and then the component comes into play where you've got to have the right kinds of protection for the workers so they don't jeopardize their own health by providing care to the patient and that's what we've seen happen in Texas.

Ted Simons: Real quickly, the incubation period, if I have Ebola but I'm only in the incubation period, no symptoms, no signs as yet, is it still a problem if I cough on you, or if -- What if something like that?

Will Humble: One of the things we have to our advantage with this illness, with this virus is that folks are infectious after they really, really start to feel bad.

Ted Simons: But not before.

Will Humble: But not before. Unlike the flu, like influenza, you could be infectious and you're still at work and you don't feel it. It's not so with Ebola. You need to be symptomatic before you're infectious. Again, it takes direct contact. Not like the measles or flu or something like that.

Ted Simons: OK. Any cases at all linked to Arizona so far that we know of?

Will Humble: No not so far that we know of. Like I said, we've really been getting the word out to front line workers to make sure that they have the right protocol, do you match up with the symptoms, to make that designation about whether or not that patient goes into isolation. In Texas, the patient went to an emergency department. In Arizona, it's not happening that way. The person might go to their primary care physician, or urgent care at a strip mall. They might go to a community health center. So we've got to reach out to clinicians, front line clinicians in all those settings so they understand what kinds of questions to ask regarding travel history, and then know what to do from there.

Ted Simons: OK. Are you reaching out, and are they listening, and taking notes and watching what's going on?

Will Humble: I think there's -- We're reaching out, that's for sure. Some people have heard our message, I think more than they need to, and there's probably others that you might be able to find that say, why aren't they contacting me? That's why we're reaching out in various different ways. We have what's called a health alert network, where folks have signed up for the services that goes to infectious practitioners in hospitals, clinicians that are used to working in the preparedness field. So it goes out that way, we're working through the associations, through the newsletter for Arizona medical association. We're working through any vehicle that we can find to get those -- Especially index case identification protocols out to the clinicians followed by what they need to know in terms of isolation, and then protecting their staff in terms of protection.

Ted Simons: What about things like airports? Is the airport aware of what's going on here?

Will Humble: Well, there's a whole believe it or not a whole document that Maricopa County put together with sky harbor, and there's a protocol around should something happen at the airport. Remember, with this virus, the person, A, needs to be sick before they're infectious, and B, it's not airborne. So with those two things in mind, it puts places like airports at lower risk, but health care workers with direct patient care who haven't been trained in the right kinds of personal protection at the higher risk. So this is manageable. Doctors without borders have been working on this epidemic in Africa under primitive conditions for many months now, and they've been keeping their staff safe. If they can do it under those conditions there's no reason why we can't do it here.

Ted Simons: Lesson learned in Dallas.

Will Humble: Training, training, training, and communication.

Ted Simons: All right. Will, good to see you. Thanks for joining us.

Will Humble: Thank you.

Will Humble:Director, Arizona Department of Health Services;

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