Awareness and Information File - Ebola- update Nov. 04 Published Oct. 1, 2014 By Public Health Flight 82d AMDS SHEPPARD AIR FORCE BASE, TEXAS -- Update 24 October, 2014 Ebola FAQs from http://www.health.mil/Frequently-Asked-Questions/Military-Health-System-Ebola-FAQs Q: What are you doing to protect DoD personnel from contracting Ebola? A: We are making every effort to ensure that U.S. personnel on the ground are working in an environment where their personal safety and security are protected. Deployed U.S. personnel contracting Ebola would be treated in the most effective manner possible, including evacuation to the U.S. We are confident that this is a risk we can manage through protective measures in the field as well as screening measures both overseas and here at home. Q: Will DoD personnel be going into hot zones and at risk for contracting Ebola? Will they be in contact with infected individuals? A: The Africa Command Surgeon's Office is closely monitoring the situation, which includes reviewing procedures and providing command members information on Ebola. We are not planning for U.S. military personnel to provide direct patient care. In the event there is a requirement for U.S. military personnel to work in areas where there is a risk of contracting Ebola, U.S. military personnel will follow the protection guidelines issued by the CDC, and will be issued appropriate personal protective equipment. As a general matter, Ebola virus is spread through direct contact with the blood or body fluids of a person who is sick with Ebola. It is not spread through the air or by water or, in general, by food. Q: What type of pre-deployment medical care are DoD personnel receiving? What type of instruction are they getting to prevent vector-borne infections? A: All DoD personnel receive region-specific training before deploying. Personnel are receiving training on Ebola prevention, malaria prevention, other medical threats, and medical readiness requirements. Here is the prescribed list of required immunizations for a deployment to the Africa region: Chickenpox; Hepatitis A/Hepatitis B; Influenza, Meningococcal; Yellow Fever; Tetanus; Typhoid; Measles; Mumps, Rubella (MMR), Polio; Rabies (for veterinary and certain other personnel); and Pneumococcal (for any specific health issues or anyone over 65 years of age). Q: Has the Department issued official health guidance to the Services for their units deploying to the affected outbreak areas? A: Yes, we have issued pre-deployment, deployment and post-deployment training, screening and monitoring guidance for DoD personnel deployed or deploying to West Africa. The policy guidance outlines required medical protocols, including medical threat briefings, deployment ebola monitoring and screening procedures to minimize exposure, risk evaluation, and personnel protective equipment use. Q: What is considered a risk of exposure? What makes something a high risk versus a moderate risk? A: DoD policy defines high exposure risk as a: · Needle stick or mucus membrane (e.g., eyes, mouth, etc) exposure to Ebola-infected blood or bodily fluids · Direct contact with blood or body fluids of a confirmed Ebola patient without appropriate protect equipment · Direct contact with a dead body in a country where an Ebola outbreak is occurring DoD policy defines some risk of exposure as: · Household-type contact with an Ebola patient · Other close contact with an Ebola patient in healthcare facilities or community settings · Contact with Ebola patients while not wearing proper protective equipment · Direct brief contact with an Ebola patient (e.g., shaking hands) Q: Will service members be screened and quarantined if symtomatic? A: Once deployed, all personnel will be evaluated by their unit twice each day for temperature and their exposure to risks. We will have a tiered model for risks based on both symptoms and / or risk exposures. Anyone who is identified as having symptoms will be quickly evaluated by medical personnel. Medical authorities will make the decision based on a structured set of criteria as to whether the service member can return to duty or should be medically evacuated back to the U.S. Personnel, if determined to have an exposure that represents more than a minimal risk, will be evacuated back to the United States for observation and treatment if required. If someone at risk is moved back to the U.S., they will be quarantined for 21 days at a DoD designated facility to monitor for signs and symptoms of the disease. Q: How will the Department monitor individuals coming back from deployment? A: Once individuals are back in the US after their deployment, monitoring will continue for 21 days. There will be face-to-face interviews, twice a day, to review for symptoms and perform a temperature check. Anyone who is not showing any symptoms will be allowed to return to work, and resume daily activities with their families. Individuals will not be authorized leave or temporary duty outside of their local area during these 21 days so we can assure continued face to face monitoring. -------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Press Release from the Texas Department of State Health Services, dated October 15, 2014 The Texas Department of State Health Services' laboratory reported positive test results for two new Ebola patients on October 11 and October 15, 2014. The Centers for Disease Control and Prevention confirmed these positive diagnoses. Both newly infected individuals are Presbyterian Hospital nurses who were involved in the care of the index Ebola patient in Dallas, and were rapidly tested after onset of symptoms. All community and healthcare-worker contacts of the index and second Ebola patients have been identified and are being monitored by a joint team from local, regional, and state health departments, as well as the Centers for Disease Control and Prevention (CDC). These contacts do not represent an increased risk to Texas' general population. The CDC, Dallas County Health Department, and Texas Department of State Health Services are currently working to identify the third Ebola patient's potential contacts, including those who may have been in contact with on a flight from Cleveland to Dallas on Monday. ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- On September 30, 2014, the Centers for Disease Control and Prevention (CDC) confirmed, through laboratory tests, the first case of Ebola to be diagnosed in the United States in a person who had traveled to Dallas from Liberia. The patient did not have symptoms when leaving West Africa, but developed symptoms approximately four days after arriving in the U.S. on Sept. 20. "Ebola can be scary. But there's all the difference in the world between the U.S. and parts of Africa where Ebola is spreading. The United States has a strong health care system and public health professionals who will make sure this case does not threaten our communities," said CDC Director, Dr. Tom Frieden, M.D., M.P.H. "While it is not impossible that there could be additional cases associated with this patient in the coming weeks, I have no doubt that we will contain this." The CDC is confident that it 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. The U.S. public health and medical systems have had prior experience with sporadic cases of diseases such as Ebola. In the past decade, the United States had 5 imported cases of viral hemorrhagic fever (VHF) diseases similar to Ebola (1 Marburg, 4 Lassa). None resulted in any transmission in the United States. The data health officials have seen in the past few decades since Ebola was discovered indicate that it is not spread through casual contact or through the air. Ebola is spread through direct contact with bodily fluids of a sick person or exposure to objects such as needles that have been contaminated. The illness has an average 8-10 day incubation period (although it ranges from 2 to 21 days); CDC recommends monitoring exposed people for symptoms a complete 21 days. People are not contagious after exposure unless they develop symptoms. Information for this Awareness and Information File was pulled from the latest CDC Press Release (www.cdc.gov/media/releases/2014/s930-ebola-confirmed-case.html ). More information is available at www.cdc.gov/ebola and frequently asked questions with answers can viewed at: www.cdc.gov/vhf/ebola/transmission/qas.htm l. For further details about the prevention of communicable diseases, please contact the 82d AMDS Public Health flight at 676-3052.