Capitol region Emergency Planning Council: ESF#8 Ebola Situation Briefing: CREPC Membership October 23, 2014

Ebola Overview Ebola, is a type of hemorrhagic fever, and is a rare and deadly disease caused by infection with one of the Ebola virus strains. Ebola viruses are found in several African countries. Ebola was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. The natural reservoir host of Ebola virus remains unknown. However researchers believe that the virus is animal-borne and that bats are the most likely reservoir.

Ebola Overview Symptomology Route of Transmission Fever (greater than 101.5^F) Severe Headache Muscle pain Weakness Diarrhea Vomiting Abdominal pain Unexplained hemorrhage Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8-10 days Direct contact with body fluids of a person who is sick with or has died from Ebola Direct contact with objects contaminated with the virus Direct contact with Infected animals

National Updates The CDC reports that the 2014 Ebola epidemic is the largest in history, affecting multiple countries in West Africa. On 9/30/14 CDC confirmed the first travel associated case of Ebola to be diagnosed in the US. CDC and partners are taking precautions to prevent the spread of Ebola within the US. Countries with Widespread Transmission Totals for Guinea, Liberia & Sierra Leone Total Case Count: 9178 Total Deaths: 4546 Lab Confirmed Cases: 4194 Countries with Travel Associated Cases Totals for Senegal, Spain Total Case Count: 2 Total Deaths: 0 Lab Confirmed Cases: 2 Countries with Localized Transmission Totals for Nigeria, United States Total Case Count: 23 Total Deaths: 9 Lab Confirmed Cases: 22

State Update Coordinating activities statewide for healthcare system partners. Coordinating Epidemiology activities statewide Authorizing suspect cases for laboratory testing at CDC Technical Assistance for Q&I, Contact Tracing Enhancement of MAVEN database to log Ebola related patient activity Declaration of Public Health Emergency (10/7/14)

What is a Public Health Emergency (PHERA) Developed post 9/11, concerns smallpox/anthrax Allows Governor to suspend laws and apply for federal assistance Authorizes temporary suspension of license requirements for certain out-of-state healthcare providers Provides personal liability immunity for personnel acting on behalf of the state in a PHE **Agencies should begin tracking costs for Ebola prep and response in the event federal dollars open up**

Overview of PHERA Governor Commissioner Local Health Implements Commissioner’s Order Quarantine, isolation, vaccination Commissioner Receives order from Governor Can delegate authority to issue PHE isolation, quarantine or vaccination orders to DPH employee or local Health Director Governor Declares PHE Can order DPH to implement response plan, to isolate, quarantine or vaccinate Can suspend statutes, regulations and requirements

Quarantine & Isolation The physical separation and confinement of an individual, group of individuals, or individuals present in a geographic area* who are exposed to a communicable disease or contamination. C.G.S. 19a-131(9) Is the same as quarantine except that it is for those infected not exposed. C.G.S. 19a-131(6) *The italicized language is a significant change from traditional Q & I orders issued by local health directors, limited to one individual at a time. See C.G.S. 19a-221

Conditions and Principals for quarantine or isolation orders Least restrictive means. Separation of those quarantined from those isolated. Monitored. Prompt movement of those infected to isolation from quarantine. Release upon first opportunity Premises maintained in a safe and hygienic manner. To extent possible families together. The needs of individuals addressed in a systematic and competent fashion. To the extent possible cultural and religious beliefs considered.

Contact Tracing Contact tracing is finding everyone who comes in direct contact with a sick Ebola patient. Contacts are watched for signs of illness for 21 days from the last day they came in contact with the Ebola patient. If the contact develops a fever or other Ebola symptoms, they are immediately isolated, tested , provided care, and the cycle starts again – all of the new patient’s contacts are found and watched for 21 days. Even one missed contact can keep the outbreak going.

Region 3 ESF#8 Priorities: 1 Information Sharing 2 Surveillance, Monitoring & Shelter In Place Support 3 Technical Assistance & Best Practices Development

What Have We Been Doing? Participating in all hospital and public health conference calls Disseminating information to locals and across system partners from state, federal and association groups Working with other RESF8 Chairs Working with DPH on response EMS Protocol PSAP Survey

What Have We Been Doing? Working with DPH on ability to outsource patient transport component Conduct and maintain a PPE Inventory for the region Building content for Citizen Preparation& Information (Get Ready Capitol Region) Participating in Hospital and EMS exercises as requested Evaluating & implementing options for the Medical Reserve Corps to assist local health departments

Other Issues, Questions, Comments? Communication Resources: http://www.cdc.gov/vhf/ebola/resources/index.html Most Recent Personal Protective Equipment Guidance: http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html Your best resource for information and guidance: Local Health Director

Thank You For Your Time Today. David Koscuk, Chair Region 3 ESF #8 Public Health & Medical Services David.koscuk@nbems.org 860-770-3979