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Ebola Assessment Centers Will Make Speedy Diagnoses, Transfers

ATLANTA – With 44 hospitals designated as Ebola treatment centers by public health officials as of mid December, more than 80% of returning travelers from Ebola-stricken countries now live within 200 miles of such a facility in the United States.

The CDC notes that an increasing number of U.S. hospitals are now equipped to treat patients with Ebola, giving nationwide health system Ebola readiness efforts a boost. The CDC reported that state health officials had identified and designated the first group of hospitals with Ebola treatment centers and that facilities would be added to the list weekly.

“As long as Ebola is spreading in West Africa, we must prepare for the possibility of additional cases in the United States,” said CDC Director Tom Frieden, MD, MPH. “We are implementing and constantly strengthening multiple levels of protection, including increasing the number of hospitals that have the training and capabilities to manage the complex care of an Ebola patient. These hospitals have worked hard to rigorously assess their capabilities and train their staff.”

Now, CDC is turning its attention to working with state and local public health officials to identify Ebola assessment hospitals. Assessment hospitals or, more specifically, their emergency departments, would have the capability to:

  • evaluate and care for someone who is having the first symptoms of Ebola virus disease (EVD) for up to 96 hours;
  • initiate and coordinate testing for Ebola and for other diseases alternative diagnoses; and
  • either rule out Ebola or transfer the individual to an Ebola treatment center, as needed.

CDC recently released guidance for states and hospitals to use as they identify Ebola assessment hospitals.

Patients who had traveled to an Ebola-affected area or had potential exposure to someone with EVD within the past 21 days and developed signs and symptoms of EVD would be referred to the assessment hospitals. The designated centers also might receive patients transferred from frontline healthcare facilities that are not prepared to provide evaluation, arrange for testing, and care for patients with possible EVD.

“Ebola assessment hospitals should ensure there is no delay in the care for these patients by being prepared to test, manage, and treat alternative etiologies of febrile illness (e.g., malaria, influenza) as clinically indicated,” the CDC emphasizes.

Public health officials note that EVD is likely to be detected early in the clinical course among patients already involved in active monitoring. Those patients probably would present for evaluation with mild symptoms such as isolated fever and could be managed using standard Ebola infection control practices and personal protective equipment. On the other hand, some patients might present with more severe symptoms or may exhibit vomiting, copious diarrhea, or obvious bleeding, and Ebola assessment hospitals must be equipped and ready to handle those situations, public health officials point out.

Because confirming an EVD may take up to 72 hours or longer, and potentially require an additional 12-24 hours for specimen transport, testing, and identification of another facility for transfer, Ebola assessment hospitals would need to be able to provide care for a potential Ebola case for up to 96 hours.

Once diagnosis is confirmed, the patient would be transferred to an Ebola treatment center.

Already, the additional Ebola treatment centers supplement the three national bio containment facilities at Emory University Hospital in Atlanta, Nebraska Medical Center in Omaha, and the National Institutes of Health in Bethesda, MD, which the CDC said would continue to play a major role in the overall national treatment strategy, especially for patients medically evacuated from overseas.

The priority areas for Ebola treatment and assessment centers are jurisdictions served by the five international airports screening returning travelers for Ebola, cities with high proportions of returning travelers from West Africa, and cities with large populations of individuals from West Africa. Federal health officials explained that, because of the active monitoring program of returning travelers from countries where Ebola is present, they have a good idea of where travelers from affected countries in West Africa are going and where Ebola care is most likely to be needed.