Ebola concerns prompt travel questions in Southern Nevada ERs

Questions about travel with an emphasis on any recent visit to West Africa have increased in priority in Southern Nevada emergency rooms because of concerns about the Ebola virus.

Health care workers are being reminded of the protection protocols for all infectious diseases, and with the beginning of October comes renewed vigilance regarding influenza. Because early symptoms of Ebola infection are similar to the flu — fever, nausea, vomiting — questions about travel become a critical identifying factor.

“Now that we’re coming into the flu season, the travel history is really the only way to sort that out,” said Christian Young, an emergency room doctor at University Medical Center.

A patient in Dallas remains the only Ebola case diagnosed in the United States, but the revelation that a nurse was infected through her exposure to an Ebola patient in Spain has heightened awareness among front-line health care workers in the U.S.

Signs have been posted in UMC’s emergency room alerting patients to tell staff immediately about any travel to West Africa. Any patient with a fever who has nausea or has been vomiting will be masked and isolated from other patients, said Dr. J.D. McCourt, medical director of the adult emergency department at UMC.

Any patients who recently traveled to West Africa and showing Ebola symptoms would have blood taken for tests at the U.S. Centers for Disease Control and Prevention, McCourt said. Those patients will remain isolated until testing results are received from the CDC, a process that Southern Nevada Health District officials say should take two to three days.

Nothing illustrates the importance of hospitals following infection control protocols more than the news this week that a third infant has tested positive for tuberculosis after being exposed in Summerlin Hospital Medical Center’s neonatal intensive care unit in summer 2013. The child, one of triplets, tested positive at 15 months, and the mother also has been diagnosed with TB.

Las Vegan Vanessa White, 25, and her premature twins, Emma and Abigail, died of TB-related complications in 2013. The mother was not diagnosed until after she left Summerlin Hospital, and the exposure to hundreds prompted TB testing for of employees and patients, and about 140 babies who had been in the NICU. Some 70 patients also have tested positive for TB since the exposure was reported.

Hospitals would follow existing guidelines for biohazardous waste disposal for any item contaminated by a potential Ebola patient. Procedures for decontaminating any home or other site frequented by an Ebola patient and the disposal of waste from those locations are being developed by the CDC based in part on the experience from the Dallas patient, said Jennifer Sizemore, spokeswoman for the Southern Nevada Health District.

Mandatory training will be provided this week for all MountainView Hospital employees, clinical and nonclinical, regarding the Ebola virus, said hospital spokeswoman Jennifer McDonnell. Communication to all employees continues to be shared through updates from the CDC in team meetings, pre-shift huddles, special bulletins and weekly newsletters to all employees.

President Barack Obama said Monday that the U.S. government passenger screenings for the Ebola virus would increase, but McCarran International Airport officials have received no specific direction that would alter the day-to-day course of travel among the general public, said airport spokesman Chris Jones. McCarran officials will work as directed by the health district, CDC and other agencies on any pandemic response, Jones said.

Health care providers continue to balance preparations for a deadly disease against overapplying resources to a virus that has little chance of becoming much of a public health threat. Southern Nevadans remain more at risk for numerous other infectious diseases such as hepatitis C, enterovirus D-68 or even West Nile virus, McCourt said.