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"If all you're getting from your school system is here's everything that we're doing to reduce the chance of infection, that's not enough," says Dr. Joshua Sharfstein of Johns Hopkins. "People should also know what should happen, when and if there's a case of coronavirus in the schools."(File photo)

Md., counties ramp up Ebola containment strategy

Health officials across the state say they are prepared to keep daily tabs on people who travel from West Africa to Maryland for three weeks after they arrive, as required by federal officials’ expanded Ebola containment effort.

State officials Thursday also announced that three area hospitals – two in Baltimore and one in Washington, D.C. — have been designated to handle any Ebola patients in Maryland should no federal facility be available.

The U.S. Centers for Disease Control and Prevention (CDC) announced Wednesday that Maryland and five other states — where about 70 percent of incoming travelers are headed — would start the daily monitoring program on Monday.

Maryland’s Department of Health and Mental Hygiene will work with county health departments to monitor travelers from Liberia, Sierra Leone and Guinea, who will be required to take their temperature at least once a day and report the information to officials.

Additional protocols are being put in place for how to respond if an individual should report a high fever or other symptoms of the Ebola virus.

Several public health officials said they are confident in their ability to carry out the monitoring program, but some logistical details of how the daily interactions with travelers will take place have not yet been finalized, said DHMH Secretary Dr. Joshua Sharfstein.

For example, some patients might require frequent reminders to check their symptoms, while others will be more diligent about self-reporting. The level of officials’ involvement will vary from case to case, Sharfstein said.

Dr. Maura Rossman, Howard County’s top health officer, said each jurisdiction will be responsible for checking in with travelers who settle in their region. Health departments will receive a list of names from the five U.S. airports that are accepting and screening passengers from West Africa.

“All local health departments have a communicable disease team that monitors folks for things like tuberculosis,” Rossman said. “Certainly this is more than we usually do, but it’s not unfamiliar to us. It’s just on a greater scale.”

Dr. Patrick Chaulk, who is in charge of disease control for the Baltimore City Health Department, said he’s currently working to assign the right employees to the right duties.

“We have different outreach and epidemiology teams that we’re going to use,” Chaulk said. “We’re trying to match talents and skills with what needs to be done.”

Additional costs associated with monitoring travelers will likely be covered largely by the federal government, although states may incur at least some of the expense, Sharfstein said.

Sharfstein said he expects about 10 to 20 people per day will arrive in Maryland from the three African nations. They will all be monitored for 21 days after arrival because symptoms of Ebola can take that long to first appear.

So, the monitoring program could go on for many months as travelers continue to arrive in the state. At this point, officials don’t know how long they will continue to monitor new arrivals.

Health officials continued to work with the CDC on Thursday about how to keep tabs on travelers. Maryland hospital officials and Gov. Martin O’Malley were crafting a strategy for how to actually treat an Ebola patient in the state.

No cases of Ebola have been diagnosed in Maryland to date, despite “at least a few dozen” false alarms, Sharfstein said.

The strategy, announced Thursday, outlines where suspected Ebola patients would be treated. All hospital emergency departments in the state are prepared to evaluate individuals suspected of being infected. But, if a case of Ebola were confirmed, the patient would be transferred to a designated federal facility.

If no federal facility were available, the Maryland patient would instead be transferred to one of three hospitals: Johns Hopkins Hospital; the University of Maryland Medical Center (both in Baltimore); or MedStar Washington Hospital Center, in Washington, D.C.

Providers at those three hospitals are receiving more equipment, such as protective gear, and further training on how to safely treat Ebola patients. Consolidating those resources into three locations means providers there will be better equipped to handle a potential diagnosis, officials said.

About Alissa Gulin

Alissa Gulin covers health care, education and general business at The Daily Record.