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County gearing up for Ebola
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MONROE - Green County Emergency Medical Service and those in surrounding areas are quickly gearing up for any possible contact with a patient who may be infected by the Ebola virus.

"Just because we're in the "sticks' doesn't mean we're immune to it," said Chief Dan Nufer, GCEMS.

GCEMS is working with its medical control at the Monroe Clinic Hospital and looking at plans used at other medical facilities to develop its own guidelines and protocol that will be used county-wide by ambulance services.

With the first case of the Ebola virus disease diagnosed in the United States on Sept. 30, Monroe Clinic is following the preparedness guidelines as outlined by State of Wisconsin Department of Health Services and the Center for Disease Control and Prevention.

Developing a protocol "may be ongoing as the CDC learns more about the virus, and things may change," Nufer added.

GCEMS personnel is anxious to get training and asking appropriate questions, Nufer said, and dispatch is asking where the patient has been recently.

Right now, there's a "boatload of people with flu-like symptoms," according to Nufer.

Nufer said medical facilities cannot rule out Ebola virus infection with patients presenting symptoms.

In Rock County, at least one hospital facility is quarantining ambulances and their crews if there is any suspicion of the virus' presence in the patients, until a positive determination by testing has been made, he added.

"If the patient has to be moved to quarantine, that crew (and the ambulance that brought in the patient) does it," Nufer said.

Like all quality health care organizations, Monroe Clinic has proven infection control processes and procedures in place, according to Leslie Schmidt, marketing specialist at the clinic.

On Oct. 1, Wisconsin Division of Public Health issued its recommendations for preparedness.

The division cautioned that primary care settings and emergency departments should be prepared for the possible infection of patients who have visited West Africa, as well as the increased numbers of Americans being deployed to that region to render assistance and being rotated back to the U.S., increasing the likelihood that they may present to U.S. facilities and providers for medical evaluation.

"The time for health care workers and clinical facilities to prepare for such an eventuality is NOW - not when an ill patient presents with a recent history of travel to endemic countries," the report stated.

The division also stated infection control plans need to be practical and individualized for each facility, taking into account as what entrance the patient should use and where the patient will be examined and admitted if necessary. The plans should also identify clinicians, phlebotomists, laboratorians and even housekeeping staff who are trained in the proper infection control precautions.

The Wisconsin Division of Public Health recognizes that recent travelers to West Africa are much more likely to seek treatment for illnesses attributable to diseases other than EVD such as malaria, meningococcemia, typhoid and other enteric infections. Therefore, routine laboratory testing may be required, including traditional chemistry, hematology, cultures, and evaluation of blood smears for malaria diagnosis.

The state has laid out criteria for screening and testing. Testing for the Ebola virus is being considered in a person who has both consistent symptoms and risk factors. Symptoms include fever, severe headache, muscle pain, vomiting, diarrhea, abdominal pain or unexplained hemorrhage. Risk factors present within the past three weeks before the onset of symptoms include residence in or travel to an area where EVD transmission is active; contact with blood or other body fluids of a patient known to have or suspected to have EVD; or participation in funeral and burial rituals, or direct handling of bats or nonhuman primates from disease-endemic areas.

To learn specifics on the CDC recommendations, go to