State Epidemiologist Megan Davies, MD, told local health directors Thursday that “all hospitals and medical providers in North Carolina need to be prepared if someone walks in with Ebola.” State officials are working with the North Carolina Medical Society and the NC Hospital Association to make sure that message is getting to their members across North Carolina.

Wednesday evening the state issued updated guidelines and a decision tree/flow chart for providers outlining the protocols to follow if a patient presents with symptoms that could be the Ebola Virus Disease (EVD).

Dr. Davies’ statements echoed those of the head of the Centers for Disease Control and Prevention (CDC) Dr. Tom Frieden, who told the press that “every hospital in the U.S. needs to know how to diagnose Ebola, including taking a travel history from any patient with a fever. The fact is that usually infections in health care settings spread from someone who’s not yet diagnosed. We have to shore up the diagnosis of people who have symptoms and who have traveled.”

Dr. Davies asked the assembled health directors to quash rumors about the disease that are not based on scientific evidence. Over the course of her nearly 90-minute presentation she outlined the steps the state is taking to prepare for any cases that arise in North Carolina and addressed some of the conflicting reports in the media.

For instance:

• A person with Ebola would not shed the virus before they become symptomatic. “We are strong in our science on that,” Dr. Davies said. She also said that as the disease progresses it becomes more infectious.
• All viruses mutate continually, but there is no evidence that this strain of Ebola has mutated into something different or more virulent.
• It is unknown how long the virus will remain infectious once it is outside of the body. The research in this area is lacking, Davies said. One study found that fragments of the virus remained six days after leaving the body.
• The virus can be transmitted by the sweat of a patient infected with Ebola.

One reassuring point is that the state does have experience in isolation and quarantine orders thanks to previous infectious disease outbreaks like SARS and H1N1, Davies said. Local health departments have the authority to invoke such an order. The state lab is prepared to begin testing blood samples for the virus with the necessary safety precautions, and special couriers have been contracted to safely transfer samples to the lab.

Weekly calls are being held with the CDC, state officials and stakeholder groups like the NCMS. Watch your email and the NCMS website for updates as they become available.