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

2. 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.

3. 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 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

4. 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:
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

5. 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)

6. 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**

7. 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

8. 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

9. 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.

10. 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.

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

12. 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

13. 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

14. Other Issues, Questions, Comments?
Communication Resources:
Most Recent Personal Protective Equipment Guidance:
Your best resource for information and guidance:
Local Health Director

15. Thank You For Your Time Today.
David Koscuk, Chair
Region 3 ESF #8 Public Health & Medical Services