Health Care

Following Ebola scare, South Florida prepares

Infectious disease doctor Dr Jose G Castro decribes the protective gear that UM medical student Christopher Dermarkarian is wearing. The medical team uses the gear when treating patients with infectious diseases, including those at risk of the Ebola virus at Ryder Trauma at Jackson Memorial Hospital.
Infectious disease doctor Dr Jose G Castro decribes the protective gear that UM medical student Christopher Dermarkarian is wearing. The medical team uses the gear when treating patients with infectious diseases, including those at risk of the Ebola virus at Ryder Trauma at Jackson Memorial Hospital. MIAMI HERALD STAFF

Miami-Dade health officials shared their plans on Monday for managing a public health threat from infectious disease following an Ebola scare that triggered swift and conspicuous response from police, healthcare workers and even local politicians.

The main message: “Every hour of every day, we are ready,’’ said Carlos Migoya, chief executive of Jackson Health System, Miami-Dade’s public hospital network, in a memorandum to county commissioners and the hospital’s board of trustees.

To demonstrate Jackson’s readiness, physicians donned protective suits for the media on Monday and explained how they would contain and prevent an outbreak of Ebola, which is spread through direct contact with bodily fluids.

Medical student Christopher Demarkarian wore a green fluid-resistant gown, clear goggles, Latex gloves and a face mask. He also put on a hat resembling a shower cap, and slipped coverings over his brown leather shoes.

“If the patient is vomiting or the patient has diarrhea, you won't get it on you,’’ said Abdul Memon, a physician and chief medical officer for disaster and emergency preparedness at Jackson.

Patients suspected of having Ebola would be isolated in a pressurized room while medical staff perform blood tests over a three-day period, said Jose Castro, a physician who specializes in infectious diseases.

Even if the first test comes up negative, physicians test patients a second time to ensure there's not trace of the virus, which can have an incubation period of 21 days after exposure.

While Florida has no confirmed cases of Ebola, according to state officials, Monday’s demonstration followed a series of events Sunday at two South Florida hospitals — Mount Sinai Medical Center in Miami Beach, and Jackson Memorial Hospital in Miami — when a teenager visiting from West Africa became ill with flu-like symptoms.

The teen’s parents had taken him to Mount Sinai when he became sick, but a special team transferred the patient to Holtz Children’s Hospital at Jackson Memorial for further tests.

The teen, who has not been identified, tested negative on Sunday in a preliminary exam conducted by the Florida Department of Health’s lab in Miami.

Another sample from the patient was sent to the Centers for Disease Control and Prevention’s Atlanta lab for confirmation of the negative result. The CDC’s results are expected on Wednesday.

It is unclear why Miami-Dade health officials tested the teen for Ebola.

According to Migoya’s memo, “This was done out of an abundance of caution, despite the fact that the patient did not meet the criteria set for Ebola’’ by the CDC.

Yet while the threat of Ebola from the teen patient appears to be low, Miami-Dade’s response was high profile.

Teams of workers wearing white protective suits were dispatched. A pediatric unit at Holtz Children’s was quarantined. And streets surrounding Jackson Memorial were barricaded temporarily.

In Tallahassee, state officials also acted.

Gov. Rick Scott announced on Monday that his office was working with Texas officials to learn from their Ebola response, and that Florida agencies had held conference calls with state airport and seaport leaders about preparedness plans at such facilities.

In addition, the state’s health agency requested 30 additional Ebola testing kits from the CDC, and ordered 100 units of additional high-level protective suits for workers.

The additional testing kits will allow each of Florida’s 30 public hospitals to test patients for the deadly virus, and the protective suits will be made available to any county whose health officials need them, according to the governor’s office.

Scott also requested the Division of Emergency Management to activate the Florida Joint Information Center starting Monday in order to keep Floridians informed about any Ebola-related developments in the state.

The center’s first dispatch noted that state health agencies were working to identify and equip Florida hospitals with the ability to treat Ebola patients, to train healthcare workers on response procedures, and to collaborate with federal officials.

Jackson Memorial already tested one patient for Ebola in September, but that test returned negative. Sunday’s events, however, triggered a more visible response.

Despite the sizable deployment of public safety and health resources, though, Migoya said in his memo, Jackson Memorial’s regular operations were not disrupted.

“Admissions, transfers, and emergency-room visits did not stop,’’ Migoya wrote in his memo to commissioners and hospital trustees, “and the impacts on patients and other visitors was little more than a brief inconvenience in some entrances and public areas.’’

Other South Florida healthcare providers, including Baptist Health South Florida — the largest hospital system in the region — said their facilities were stepping up preparedness plans.

Brian Keeley, chief executive of Baptist Health, said the hospital system has spent about $100,000 on additional protective suits for workers, and that physicians, nurses and other staff have been reviewing response procedures.

Still, Keeley said, “The most important thing is prevention.’’

The 2014 Ebola outbreak in West Africa is the largest in history, affecting multiple countries, according to the CDC.

Although the risk of a similar Ebola outbreak in the United States is very low, according to the CDC, hospitals and other healthcare providers are reviewing preparedness plans following the first travel-associated case of Ebola to be diagnosed in the United States, which was confirmed on Sept. 30 in Texas.

Symptoms of Ebola may appear from two to 21 days after exposure to the virus, according to the CDC, and they include a fever (greater than 101.5°F), severe headache, muscle pain, weakness, diarrhea, vomiting, stomach pain, and unexplained bleeding or bruising.

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