Ebola virus: What physicians need to know

Healthcare workers are in a unique position to separate the facts from the fears concerning the Ebola virus in the United States. Make sure you and your staff members are educated about the virus and able to answer any questions from patients, and are prepared in the unlikely event of an Ebola case in your practice.

Discovered in 1976, Ebola is a hemorrhagic fever thought to come from bats. Since its discovery, the virus has had five major outbreaks in West Africa, and has caused more than 2,700 deaths. Though experimental treatments have been effective in some patients outside West Africa, there is currently no cure or vaccine for the Ebola virus.

Despite the enormous amount of news coverage devoted to Ebola, it’s important to remember that actual infections are extremely rare. Ebola is not an air- or water-borne disease. According to the Centers for Disease Control and Prevention (CDC), it can  be spread only through direct contact with the blood or bodily fluids of someone with the disease, with objects contaminated with the virus, or with infected animals. While the disease can take up to 21 days to incubate, it is not contagious during the incubation period. As of mid-October only two people in the U.S have become infected with Ebola, and one person had died after contracting the disease in Liberia.

The latest outbreak of the Ebola virus has been spreading through the West African countries of Guinea, Liberia, Sierra Leone and Nigeria beginning in March 2014. Because symptoms take between two and 21 days to appear, make sure that you have signage in your practice prompting anyone who has traveled internationally in the past month to inform a staff member

The highest risk of exposure to Ebola comes from percutaneous (e.g., needle stick) or mucous membrane exposure to blood or body fluids, and direct contact with a dead body in an Ebola-affected area without appropriate personal protective equipment (PPE), according to the CDC. Low-risk exposures are brief contact with an Ebola patient (e.g., shaking hands) and exposure to a patient without appropriate PPE. People also can become sick with Ebola after coming in contact with infected wildlife.

Symptoms of Ebola include fever higher than 38.6°C or 101.5°F, severe headache, muscle pain, weakness, diarrhea, vomiting, abdominal pain, and unexplained hemorrhage, according to the CDC. Symptoms usually appear eight to 10 days after exposure, but can present anywhere from two to 21 days.

Many EHR systems have settings to collect travel history information. If your system is operating with ICD-10, it will also have codes for Ebola. Some systems, including athenahealth, have already updated its software with CDC-approved questions to diagnose Ebola. Check with your EHR vendor if you have questions on communicable disease alerts.

Changes and updates to safety protocols will be posted first on the CDC website, so make sure a staff member is designated to check the website regularly. The website also features printable infographics and posters that can be used to train your staff about handling patients who might  have Ebola.

The American Medical Association has created an Ebola Resource Center for physicians and hospitals to reference. The resource center includes a provider checklist, created by the CDC,that encourages all healthcare facilities to review infection control policies and the proper protocol for notifying officials of potential cases. The CDC recommends that healthcare providers stay alert to patients who show symptoms of Ebola and who have recently traveled to one of the affected countries.

The U.S. Food and Drug Administration also has issued a warning to consumers about fraudulent treatments and products claiming to prevent the virus.