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HICprevent

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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Out of Africa: As American doc becomes first U.S. Ebola patient, CDC and Emory craft a difficult message to a wary public

March 18th, 2015

As the first case of Ebola ever treated in the U.S. was admitted to a special containment unit at Emory University Hospital in Atlanta on Aug. 2, clinicians and public health officials continued to reassure a jittery public that infection control measures would prevent transmission and contain the virus.

“We are talking about a virus that is spread in a way that we are quite used to -- HIV, hepatitis B, hepatitis C. It’s the same algorithm and we use the same kind of precautions on those patients on a daily basis,” Bruce Ribner, MD, an infectious disease physician at Emory, said at an Aug. 1 press conference. “All of these viruses are spread by close contact with blood and body fluids. I will be one of the individuals coming into direct contact with the patients. I have no concerns about either my personal health or the health of the other health care workers who will be working in that unit.”

This reassurance, while accurate from a medical standpoint, could nevertheless be seen as something of a disconnect when you are admitting a patient into a specially designed unit with elaborate and redundant systems to contain any pathogen within. There are a few such units in the country, so the Ebola patient – a volunteer American physician infected in the ongoing West African outbreak – was hospitalized under extreme infection control precautions that belie Ribner’s business-as-usual tone.

The Centers for Disease Control and Prevention often finds itself delivering a similar mixed message with an exotic pathogen, reassuring that there is little threat to public safety while taking extensive measures with the first cases out of an abundance of caution. Though this combination of reassurance and high-level risk prevention may inspire a conspiracy theorist or two, this approach has proven to be the best way to deal with such situations.

The truth is there are probably a few things about Ebola that clinicians and public health officials wish they knew a lot more about, and the high tech isolation unit provides a margin of error with a very unforgiving virus.

Photo credit: Emory Hospital isolation unit photo by Jennifer Johnson McEwen, Emory Hospital.