Queen’s University infectious-disease specialist Dr. Dick Zoutman, Chaired the SARS scientific advisory committee for Ontario and spent time in Kosovo after the 1998-99 war working with local doctors treating patients with a different kind of hemorrhagic fever, Crimean-Congo hemorrhagic fever. Photo: Lars Hagberg/For Postmedia News/Files A prominent doctor who was a leading adviser during the SARS crisis in 2003 is urging hospitals to prepare for the remote chance of Ebola coming to Canada.
“Sitting here in southern Ontario, I could be complacent and say, ‘well, it’s never going to happen here, why would I worry?’ In fact, we are prepared,” said Queen’s University infectious-disease specialist Dr. Dick Zoutman, chief of staff at Quinte Health Care in Belleville, Ont., which operates four hospitals. “We have a protocol. We have updated all of the contacts in the province we would call if a patient gives us a history of having been in western Africa and has what could be interpreted as early signs, or later signs, of a hemorrhagic fever like Ebola.”
Zoutman chaired the SARS scientific advisory committee for Ontario and spent time in Kosovo after the 1998-99 war working with local doctors treating patients with a different kind of hemorrhagic fever, Crimean-Congo hemorrhagic fever.
“I think every hospital, I hope, is doing the same, and needs to be doing the same,” he said.
The World Health Organization says the Ebola outbreak in West Africa is unprecedented in its scale, with at least 1,323 cases and 729 deaths as of Friday.
At a crisis summit with the heads of four West African nations, WHO director-general Dr. Margaret Chan said the virus is outrunning every effort to halt it. Chan warned of “catastrophic” consequences, including a high risk of spreading to other countries, if the situation continues to deteriorate.
In some areas, “chains of transmissions have moved underground,” she said.
Villagers are hiding the infected or turning to traditional healers rather than allow the sick to be sent to special isolation units, which are seen as death beds where Ebola victims go to die.
WHO will convene an emergency committee meeting next week to determine whether the outbreak constitutes a “public health emergency of international concern,” and, if it does, “to recommend appropriate temporary measures to reduce international spread,” the health body said in a statement Friday.
Meanwhile, Canada’s public health agency is warning Canadians to avoid all nonessential travel to Guinea, Liberia and Sierra Leone.
The agency said the outbreak is straining health systems and travellers could find it difficult to get medical care if they get sick. They also risk being exposed to the virus if they seek treatment in a clinic or hospital.
The outbreak in West Africa is being caused by the most lethal strain of Ebola known to humankind.
The risk of the virus coming to Canadians is low, but it isn’t non-existent, said Zoutman. However, there are stark differences in the conditions that would allow its spread, he said.
In Africa, fruit bats are believed to be the natural reservoir for Ebola, and outbreaks are occurring in remote villages without the medical resources to cope. The death rate is extraordinarily high (up to 90 per cent) because the virus attacks the cells lining the blood vessels “throughout your whole body,” Zoutman said.
There is no cure for Ebola, or antivirals. Severely sick patients require intensive supportive treatment — preventing dehydration from vomiting and diarrhea, controlling fever and blood loss and transfusing blood if necessary.
This Oct. 7, 2013 photo provided by Jeremy Writebol show his mother, Nancy Writebol, with children in Liberia. Writebol is one of two Americans working for a missionary group in Liberia that have been diagnosed with Ebola. Plans are underway to bring back the two Americans from Africa for treatment. (AP Photo/Courtesy Jeremy Writebol)
Canadian hospitals have sophisticated infection control procedures and systems to limit the spread of contagious diseases, including high-containment isolation.
”We have private rooms, we have infection control systems — we have all these resources, so that if we did get an isolated case of hemorrhagic fever we would take it very seriously and put all the precautions in place,” Zoutman said. “The chance of it spreading in our hospital setting is not zero but it’s pretty remote, if we have our guard up and we ask the right questions at the right time and use the right precautions.”
In addition, procedures set out under the Quarantine Act are in place at borders to identify sick travellers arriving in Canada, Dr. Gregory Taylor, Canada’s deputy chief public health officer, said this week.
Taylor said the agency is working closely with provincial and territorial partners, as well as the National Microbiology Laboratory in Winnipeg and its network of provincial labs, “to ensure we are ready to detect and respond quickly in the unlikely event that a case arrives in Canada.”
Plans were underway Friday to return two American aid workers sick with Ebola to the U.S.
A small private jet equipped with a portable tent designed for transporting patients with highly infectious diseases was dispatched to Liberia, where the two work for missionary groups.
In Canada, Medecins San Frontieres/Doctors Without Borders said there is minimal risk of staff bringing Ebola home to Canada. Two Canadian MSF doctors — Montreal’s Marc Forget and Tim Jagatic, of Windsor — recently returned from Ebola missions in Guinea.
The organization said it ensures a high level of infection control measures in the field to minimize the risk of infection in the first place.
“With Ebola, you are not infectious if you have no symptoms, which means there is no risk for a staff member to infect anyone when they come home if they are not sick,” the group said in an email.
When returning home, staff is asked to stay within a short driving distance of a hospital that can rule out Ebola “and has the capacity to provide the necessary infection control measures and treat the other illnesses the person may actually have.”
Zoutman said medical missionaries should wait an appropriate number of days after treating their last patient before boarding planes home.
“Be aware of how your body is feeling, take your temperature, limit your social contacts,” Zoutman said. “You don’t necessarily lock yourself in a room, but you try to give a buffer of five, 10 days before you board a plane, if you can at all do that, which is what I tried to do when I was working in Kosovo.”
— With files from The Associated Press
skirkey@postmedia.com
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