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State, local agencies prepare for Ebola
ebola funeral homes
Ben Sivils, assistant manager at Turlock Memorial Park and Funeral Home, displays a hermetically sealed casket, something the Centers for Disease Control recommends be used for deceased Ebola patients. - photo by SABRA STAFFORD / The Journal

There are no confirmed cases of Ebola in California, but state and local entities, from health care workers to funeral directors, are instituting new protocols designed to help keep the public safe.

“There are protocols in place throughout the state public health system to protect Californians from the spread of the disease. As the situation evolves, protocols may change,” said Dr. Ron Chapman, California Department of Public Health director and state health officer.

While the risk for spreading the Ebola virus still remains low in the United States, state and local public health officials in California are monitoring the situation closely and taking steps to keep Californians safe, including communication with healthcare providers and hospitals throughout the state to provide updates and recommendation.

“We have been working with our local hospitals, emergency medical services, and clinic systems to keep them informed regarding preparedness and response measures,” said Dr. John Walker, Stanislaus County public health officer.

The chances that the Ebola virus could appear in the Turlock area is very unlikely, but health care workers at Emanuel Medical Center are making sure they are prepared for any such event.

“Emanuel Medical Center routinely cares for patients with a variety of infectious diseases,” said hospital spokesperson Pennie Rorex. “While the likelihood of receiving a confirmed Ebola patient remains very low, our hospital is increasing training and conducting drills related to the identification, isolation, testing and treatment of such a patient, and the appropriate use of personal protective equipment and other protocols to prevent transmission to a healthcare worker or anyone else. We are also closely following new information being released by the Centers for Disease Control and Prevention providing the latest guidance for hospitals on Ebola-related safety practices.”

As front line responders to many medical emergencies and calls, the Turlock Fire Department is incorporating some new safety practices in reaction to the Ebola virus.

“Turlock is very active in working with our County Office of Emergency Services Division,” said Turlock Fire Chief Tim Lohman. “Fire Warden Dale Skiles has been working closely with Dr. John Walker from Stanislaus County Department of Public Health to provide information to all first responders on preparation and response to Ebola.  They both have been very engaged in working with the State OES and Public Health agencies to monitor the latest data and trends with respect to Ebola, but also Enterovirus D68, seasonal flu, and anything else that presents a risk to the public and first responders.”

The fire department’s infectious control officer uses the information to determine if staff should receive additional training, review protocols, or provide awareness information, Lohman said.

Lohman said the fire department staff already takes an approach to medical and emergency calls that all human blood and certain human body fluids might be infectious.   

“Ebola is a new concern for our nation thus becoming a new concern for our firefighters,” Lohman said.  “We are constantly monitoring publications by the CDC, local and state departments of public health and other credible professional infection control sources to ensure our response practices are adequate. As a result of this we are changing our initial patient assessment questions to include inquiries into recent travel to West Africa.”

The heightened guidelines and protocols don’t end with the living. Ben Sivils, assistant manager at Turlock Memorial Park and Funeral Home, reports the funeral industry is being advised to take new precautions when handling the deceased.

“A few professional organizations have sent out suggested guidelines for handling the remains of someone who has died from Ebola,” Sivils said. "Most of it is using good common sense.”

The CDC recommends that mortuaries keep the remains sealed in body bags and not embalm the bodies because too many body fluids are present, Sivils said. It’s also recommended the body be put into a hermetically sealed casket as soon as possible and morticians should don protective gear when handling the remains.

At the state level the CDPH said they would work with the CDC to arrange specimen testing to investigate the case and monitor the situation.  CDPH will support the local health officers in tracing of individuals who may have had contact with an Ebola patient and continue to monitor the situation. The CDPH also has established an Ebola hotline call center to respond to public inquiries related to Ebola. The hotline, 855-421-5921 will be in operation from 8:00 a.m. to 5:00 p.m. Monday through Friday.

“This hotline has been set up and staffed to answer questions from those concerned about the possibility of Ebola in California,” said Chapman. “Our goal is to be available to eliminate the mystery of this disease and offer the facts to Californians as the situation evolves. This is one in a series of steps we have taken in the last few months.”

On Friday all five UC Medical Centers announced they are positioned to provide in-patient care for Californians who have confirmed cases of Ebola if necessary. This includes Davis, Irvine, Los Angeles, San Diego and San Francisco facilities.

The CDC confirmed the first case of Ebola in the United States on Sept. 30 when Tim Duncan was diagnosed with the virus in Dallas. Duncan had recently traveled from West Africa and developed symptoms of the virus five days after arriving in the United States. He died on Oct. 8. Since that time two nurses who cared for Duncan were diagnosed with Ebola and were recently ruled free of the virus.

Ebola is not spread through casual contact and people who do not have symptoms are not contagious.  The virus has an incubation period of 2-21 days. If a person has travelled to an affected country and develops a fever within three weeks of their return, they should contact their health care provider, let them know of their travel history, and who they may have come into contact with so appropriate case tracking can be performed. CDC officials have advised travelers to avoid all non-essential travel to West African countries.