Commentary discusses conventional medical centers and Ebola; Ebola resources available

Conventional U.S. medical centers may be unprepared and ill equipped to manage Ebola, and a national network of specialized containment and treatment facilities may be needed to reduce the virus' spread, according to a commentary published in Annals of Internal Medicine.

The commentary, which appeared online Oct. 16, states that conventional hospitals may not be able to prepare and train staff to meet the challenge of a virus that requires significant attention to every detail of care, from the safe use of personal protective equipment to waste disposal. Reinforcing policies and procedures through repetitious training may be more than traditional medical centers are equipped to handle.

The authors wrote, “Although patients infected with such diseases as Lassa and Marburg have been safely managed in conventional settings, the serious nature of filoviral and arenaviral infections, their rarity and unfamiliarity to clinicians in developed settings, the lack of effective treatments and vaccines, their propensity to infect health care staff, and the infection control challenges they present argue for, in our opinion, specialized containment and treatment facilities.”

Since very few high-level biocontainment patient facilities exist in the U.S. today, the authors suggested creating a network of strategically located regional referral centers that would serve as designated catchment areas tied to biosafety level 4 laboratories or airport quarantine stations. These units would be associated with major medical centers and provide day-to-day routine care but could quickly convert to a high-level containment care unit.

As the situation with the Ebola virus outbreak continues to evolve, ACP encourages physicians to be aware of resources to help them and their health care teams.

ACP encourages clinicians to visit the CDC Ebola website for the most updated information on the Ebola virus outbreak and to share this information with their colleagues and networks. The CDC recently posted the following resources to help practicing physicians and health care teams best identify risks related to Ebola and treat accordingly:

• Checklist for Patients Being Evaluated for Ebola Virus Disease (EVD) in the United States
• Ebola Virus Disease (Ebola) Algorithm for Evaluation of the Returned Traveler

Additionally, the Department of Health and Human Services' Assistant Secretary for Preparedness and Response, Nicole Lurie, MD, MACP, issued an open letter to all U.S. health care professionals regarding the current Ebola situation.

As a reminder, ACP has free clinical information and resources available to all members of the health care community and the public at large. Annals of Internal Medicine has published several articles about the virus on an emergency access initiative page. ACP Smart Medicine, the College's Web-based clinical decision support tool, includes a module on Ebola and Marburg viruses that contains evidence-based information about prevention, diagnosis, and therapy. The Ebola module is designed to help physicians advise patients who present with symptoms and who traveled to rural sub-Saharan Africa or had occupational exposure. ACP's website also includes links to information on volunteer opportunities with AmeriCares, USAID, and Medical Teams International.