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Cross-Border Health and Preparing Chicago

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Acting Commissioner, Dr. Julie Morita discusses cross-border health and Ebola at the Loyola University Symposium.

Publié dans : Santé & Médecine
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Cross-Border Health and Preparing Chicago

  1. 1. * HEALTHY -‘ CHICAGO CHICAGO DEPARTMENT OF PUBLIC HEALTH Ebola Virus Disease Preparing Chicago, 2014-2015 Julie Morita, MD Acting Commissioner February 26, 2015
  2. 2. Ebola Virus Disease Symptoms % of cases (from Symptom symptom onset to detection) Fever 87% Fatigue 76% Vomiting 68% Diarrhea 66% Unexplained bleeding 18% Blood in stool 6% Available at: http: //www. cdc. gov/ vhf/ ebola/ hcp/ clinician—information-us—hea| thcare—settings. htm|
  3. 3. EBOLA BASICS Ebola virus is not spread through 0 Casual contact 0 Air 0 Water 0 Food grown or legally purchased in the ll. S. cdc. gov/ ebola Transmitted through contact with infected body fluids (e. g., blood, urine, stool) or from objects like needles that have been in contact with infected body fluids.
  4. 4. . Mali Guinea—Bissau W V’ b umea *5.’ R . ~. Sierra ” Leone .3 ‘ Céte ‘ d'| voire LI; A % Eglfiberia 501 - 4.000 No cases mporled 5 Cases m last 21 days http: //www. cdc. gov/ vhf/ ebola/ outbreaks/2014-west-africa/ distribution-map. htm|
  5. 5. Cases of Ebola virus disease in Guinea, Liberia, and Sierra Leone, Mar 25, 2014- — Feb 8, 2015 12ooo — 10,934 10000 - 8,881 8000 / sooo - I 4000 — 3,044 20(1) ‘ ____. . §’<“ . ° ‘Tl . 5.“. ‘. i ‘. L I ' . . “' *“-" . . . .’T-. _.'. _./ . . . . . . . , . . . . . . . . . . . . . . , , , , .. ,. §§§§§5%35§§§§§§55§§§§§33533§§§§E8E8§§§§§E§E§E§i§i§ Total Cases, Guinea Total Cases, Liberia -Total Cases, Sierra Leone
  6. 6. Countries with widespread transmission Affected area Guinea Entire country Liberia Entire country Sierra Leone Entire country Previously affected countries Spain Madrid United States Dallas, TX, New York City Nigeria Lagos, Port Harcourt Senegal Dakar http: [/www. cdc. gov/ vhf/ ebola/ outbreaks/20l4—west—africa/ case—counts. htm| ; updated Oct. 31
  7. 7. Oct 21, 2014 Oct 23, 2014 Oct 11, 2014 Sept. 30, 2014 Oct 10, 2014 Oct 15, 2014 | Airport Screening Active Monitoring 2'” HCW Dallas, Texas 1st Liberian traveler, Dallas, Texas l 15* Hcw Medical aid worker Dallas, Texas NYC. New York
  8. 8. Entg Point Preparedness Community Preparedness 1. Screening at O'Hare 1. Public Messaging 2. Traveler monitoring protocol 2. Community Engagement Health System Preparedness 1. Network of Providers 2. All Area Hospitals 3. Outpatient Clinics . EMS providers | nter—Government Collaboration 1. Ongoing CDC guidance 2. Inter-agency collaboration 3. State and Fed. collaboration
  9. 9. Airport Screening All individuals leaving Guinea, Liberia, and Sierra Leone screened at exit from their country and entry into the US Exit Screening - Temperature - Questionnaire: Exposures and symptoms Entry Screening in US airports —JFK, Dulles, Newark, Atlanta and Chicago O'Hare ° Customs and Border Protection and CDC staff ° Temperature ° Questionnaire: Exposures and symptoms
  10. 10. Active monitoring* required? Arrival screening at O'Hare Disposition Traveler has fever or other Possibly, if/ when . . . Medical evaluation . . signs/ symptoms consistent with the patient IS ' d Ebola require discharged Traveler is asymptomatic (i. e. no _ _ ” . "High-risk exposure: fever, no signs or symptoms of _ _ Quarantine illness) but reports an exposure to Ebola during the 21 days "Some-risk” exposure: before arrival Controlled movement Traveler is asymptomatic, and doesn't report exposure to "Low-risk” exposure: Ebola during the 21 days before No travel restrictions arrival *Active monitoring: daily checks by public health to assess for symptoms includingfever
  11. 11. Where do sick travelers receive care? Network of hospitals with: ° Specialty care expertise (infectious disease, intensive care, dialysis), ° Resources to support usual care as well as care for an Ebola patient - Advanced infection control systems ° Waste management systems ° Willingness to care for Ebola patients Chicago Ebola Resource Network: Northwestern Medicine, Rush University Medical Center, University of Chicago Medical Center, Lurie Children's Hospital
  12. 12. Active monitoring required? Arrival screening at O'Hare Disposition Traveler has fever or other Possibly, if/ when . . . Medical evaluation . . signs/ symptoms consistent with the patient is ' d Ebola requlre discharged Traveler is asymptomatic (i. e. no ” , _ H . High risk exposure: fever, no signs or symptoms of _ _ Quarantine illness) but reports an exposure to Ebola during the 21 days before "Some risk” exposure: arrival Controlled movement Traveler is asymptomatic, and doesn't report exposure to Ebola during the 21 days before arrival "Low risk” exposure: No restrictions *Active monitoring: daily checks by public health to assess for symptoms includingfever
  13. 13. Monitoring Protocol--Summary Travelers under quarantine, controlled movement and without movement restrictions require monitoring for fever and signs or symptoms of Ebola infection for 21 days after last exposure - Case assigned to public health nurses - One in-person visit daily ° Phone check (1-2 times per day)
  14. 14. Chicago Travelers, Oct 11, 2014 - Feb 20, 2015 Travelers arriving at O'Hare: 457 Travelers monitored by CDPH: 50 ° High risk travelers: 2 - Some risk travelers: 7 ° Low risk travelers: 41
  15. 15. Quarantine and Controlled Movement Orders
  16. 16. HEALTHY -‘ CHICAGO CHICAGO DEPARTMENT OF PUBUC HEALTH 0 @ChiPublicHealth 0 / ChicagoPublicHealth @ HealthyChicago@CityofChicago. org 6 wvvvv. CityofChicago. org/ Health

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