Fairfax health director speaks out on Ebola

Gloria Addo-Ayensu, Director of Health for the Fairfax County Health Department says that the county, particularly in the wake of a scare at Inova Fairfax Hospital earlier this month, is keeping apprised daily with recommendations on controlling the deadly disease.

A woman who vomited on a tour bus near the Pentagon Oct. 17 was sent to Inova Fairfax after Virginia Hospital Center in Arlington refused to treat her. It was later determined the woman did not have Ebola.

Below is the statement from Add0-Ayensu, issued Monday:

Dear Fairfax Area Community,

The constant media coverage of the Ebola cases that were diagnosed in Texas and New York continue to fuel concerns among people in the general population and have highlighted risks in health care settings.

Adding to these concerns is the Ebola scare that occurred in the Fairfax area on Friday, October 17, which involved a suspect Ebola patient who was transported from the Pentagon to Inova Fairfax Hospital. Although it was a false alarm, I’d like use the incident to help increase public understanding about how the public health system works and also provide an update about our Ebola readiness.

One of the critical early decisions that must be made when evaluating a suspect case of any disease is whether the individual meets the case definition and therefore warrants confirmatory testing. For Ebola virus disease (EVD), the decision to test is based on the patient’s travel history, determination of exposure risk, and whether the symptoms are consistent with EVD.

The process for testing at the Centers for Disease Control and Prevention (CDC), if necessary, is facilitated by local health departments. While it took some time to validate travel history of the individual involved in the October 17 incident, fortunately, doctors at Inova gathered enough information to determine that the patient did not have any exposures to Ebola and therefore testing was not required.

In the last several months, the Fairfax County Health Department, in collaboration with partners in the medical community, has facilitated the initial evaluation of about half a dozen suspect Ebola cases and in each case determined that testing was not warranted.

Routinely, various public health system partners collaborate to increase their readiness to address a variety of public health threats such as influenza pandemics and other highly infectious respiratory diseases, anthrax, tuberculosis and measles–just to name a few. These information sharing and preparedness and response activities, which typically happen behind the scenes, successfully prevent sustained human-to-human spread of these and other infectious diseases.

Preventing epidemics and the spread of disease is a core public health function that involves tried and true public health actions that successfully limit the introduction and spread of infectious diseases in this country every day. These well-established practices enable the U.S. public health system to rapidly identify/isolate people suspected of being sick and find/contact (and if necessary quarantine) people who have been potentially exposed to the sick person.

Although the Ebola situation is rapidly evolving, I would like to assure you that the Fairfax County Health Department is closely monitoring CDC and Virginia Department of Health (VDH) recommendations and continues to work with public health system partners in the region to ensure our readiness. Some of the Ebola-related steps that our public health system partners have taken in recent months to ensure we are prepared include:

  • Enhanced health care facility infection control practice and training of staff on proper use of personal protective equipment (PPE).

  • Ebola screening and monitoring of all travelers who arrive at Dulles Airport from Liberia, Sierra Leone, and Guinea.

  • Fairfax County Public Schools’ development and implementation of screenings for recent travel history among new students and currently enrolled students who present to school health rooms with fever.

  • Fairfax County Human Services agencies’ adoption of Ebola-specific screening measures developed by the Health Department for the populations that we serve.

  • Review of Fire and Rescue Department infection control policies and use of PPE to optimize personnel protection when responding to suspect Ebola patients.

  • Development of telephone screening protocol for Fairfax County’s Department of Public Safety Communications (911 call center) to provide first responders and hospitals with advanced information about a patient’s travel history, if relevant.

I recognize that many people are wondering what they can do to protect themselves. While the Fairfax County’s planning efforts have been extensive, the risk of exposure to Ebola in the U.S. remains extremely low among the general population.  Although the following recommendations won’t necessarily prevent Ebola, they are prudent steps that all of us can take to improve overall community health and to prevent the spread of many types of disease:

  • Educate yourself about Ebola. The facts will help reduce anxiety over this scary disease. All of the information you need is available on our website, which includes links to the CDC’s website.  Here are three key points to remember:
    • While we have seen a few people diagnosed with Ebola in the U.S. among those who were exposed to people with Ebola,  the possibility of an outbreak of Ebola like the one currently occurring in West Africa remains highly unlikely because the two main factors fueling the epidemic in West Africa are not present in the United States: (1) the lack of a public system; and (2) African burial rituals, such as washing the body of the deceased.
    • The U.S. public health system knows how to stop Ebola’s further spread: thorough case finding, isolation of ill people, contacting people exposed to the ill person, and further isolation of contacts if they develop symptoms.
    • Ebola is not spread through casual contact. Coming into contact with people who do not have symptoms of Ebola poses no risk, even if they have recently traveled to affected countries in Africa. Only people who have  symptoms of Ebola, such as fever, can spread the disease.Transmission  requires direct contact with the bodily fluids of an infected person.
  • Get a flu vaccine, if you haven’t already received one. While the vaccine will not protect you from Ebola, keep in mind that it’s flu season. Each year there are about 200,000 hospitalizations and up to 36,000 flu-related deaths. Flu vaccine is the best way to protect yourself, your family, and your community from the flu.
  • Wash your hands frequently and correctly with soap and water. This will guard against all types of infectious diseases, including Ebola, enterovirus D68, the flu, and the common cold.
  • Cover your coughs or sneezes  with your sleeve. If you use a tissue, wash your hands with soap and water after throwing away the tissue.
  • Stay home from work or school when sick. This will help to prevent the spread of illnesses throughout the community.

Members of our community are understandably cornered about Ebola, so I hope this information helps to reassure you about the Fairfax community’s readiness and provides you with a broader understanding of how the public health system is at work every day of the year.

Thank you,

Gloria Addo-Ayensu, MD, MPH
Director of Health
Fairfax County Health Department

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