Doctors discuss emerging diseases, preparations

WINCHESTER — Although Ebola might have slipped out of the national spotlight, a host of other infectious diseases including the virus are still being watched by area hospitals.

A presentation at the Valley Health Corporation meeting on Tuesday in the Winchester Medical Center Conference Center detailed some of the diseases emerging in the world, and how local hospitals have prepared to treat them.

Dr. Jack Armstrong, chief of infectious diseases at the Winchester Medical Center, spoke about the Ebola virus, avian influenza, Middle Eastern Respiratory Syndrome (MERS), dengue fever and, “the most recent virus on the block,” Chikungunya.

Ebola, which is spread by contact with blood or other body fluids, erupted out of West Africa this year. The outbreak has largely been limited to the countries of Guinea, where it started, Sierra Leone and Liberia.

Armstrong said there are about 10,000 Ebola cases today.

“The good news, the reason for some optimism, is regarding controlling the diseases when the traveling cases occurred in Senegal and Nigeria, very prompt health measures were put into place,” he said.

“Because they didn’t have good treatment in those countries, they did not have vaccines, they used isolation and containment to restrict the disease, and as of Sept. 1, neither of these countries have seen another case.”

He said another reason to remain optimistic is that even in Liberia, the country most impacted by Ebola, the number of cases is shrinking.

“At one time, it was measured in the hundreds,” he said, “and now it’s going down to about 80 cases per week, a very significant drop.”

Armstrong said there are other infectious diseases that have been emerging around the world.

Avian influenza, which originated in China and Hong Kong, is relatively low-spread with only about 1,000 cases, he said, but its mortality rate is about 80 percent.

“Fortunately, it’s not contagious from person to person,” Armstrong said, “and you primarily impart this disease by handling chickens and ducks.”

Middle Eastern Respiratory Syndrome, or MERS, began in the Middle East from a rather unlikely source: sneezing camels.

Armstrong said the respiratory infection has a 20 percent mortality rate and is especially prevalent in Saudi Arabia.

Chikungunya, a Tanzanian word for “bent over in pain,” is not fatal, though there is no vaccine or treatment known for it yet.

Armstrong said the virus, which started in Tanzania, has spread to the Caribbean, especially in St. Martin, where nearly half the population has been infected.

He said the virus, contagious through the spread of mosquitoes, is characterized by a high fever, terrible body aches and respiratory problems.

Armstrong compared the emergence of these viruses to the HIV epidemic of the ’80s and the West Nile Virus outbreak in the ’90s.

Dr. Nicolas Restrepo, vice president of medical affairs at the Winchester Medical Center, said the hospital follows a number of principles to prevent the spread of infectious diseases.

One of these, he said, is that there can be no skin exposure with employees treating infected patients, with employees wearing impermeable suits and respirators.

He said a space at the medical center, shaped like a racetrack, is equipped to handle Ebola treatment safely and securely.

A “clean area” at the entrance would be used by an employee to change into personal protective equipment, while under supervision to ensure all areas of the skin are covered.

The employee, properly shielded from the contagion, would then enter a “dirty area” where the patient and all the equipment needed to care for the patient would be.

Both of those spaces are constructed as negative pressure rooms, so that air doesn’t exit back into the building, but out of it through a HEPA filter.

Upon exiting the “dirty area,” a coach would help remove the equipment and the employee would pass through a decontamination shower, “essentially a human car wash,” Restrepo said.

A news release from the Virginia Hospital and Healthcare Association outlines a tiered plan for treating patients with Ebola.

If a patient in Virginia is confirmed to be infected with Ebola, the first step would be to transfer him or her to one of the four national biocontainment facilities across the U.S.

If those facilities do not have available capacity, the next step would be for the patient to be transferred to either the University of Virginia Medical Center or Virginia Commonwealth University Medical Center, each of which can care for two Ebola patients at a time.

If those two hospitals are not available, the patient would be transferred to a regional hospital for care, such as the Winchester Medical Center, which has the capacity to care for one to two patients.

For more information on how travelers can protect themselves from these diseases, Armstrong recommended visiting <a href=“http://www.cdc.gov/travel”>http://www.cdc.gov/travel</a>

<em>Contact staff writer Ryan Cornell at 540-465-5137 ext. 164, or <a href=“mailto:rcornell@nvdaily.com”>rcornell@nvdaily.com</a></em>