Threats like Ebola, SARS, and now Zika can seem remote, but in reality, they’re all just a plane ride or short drive away in our hyper-mobile society.
What do smaller hospitals do to prepare for these diseases?
Registered nurse Jeannie Sanborn is certified in infection control and serves as the director of Infection Prevention for Heywood Hospital in Gardner, where her policies also become policy for Athol Hospital, a recent addition to the Heywood fold.
She has specialized in infection prevention for 32 years and has seen threats wax and wane and the ability to respond steadily improve.
“I was working in the (Intensive Care Unit) back in the ’80s. We were all exposed to blood and we didn’t have universal standard precautions, so think about how far that has come now,” Sanborn said.
She said all blood is now presumed contagious for the safety of staff, so precautions are taken. Technology is the biggest change, she said.
“The best change is the technology, today. If I have an alert that has to go out, I can get it out to every single employee and every active physician at Heywood and Athol Hospital with just a click. It’s amazing,” Sanborn said.
At a more routine level, Sanborn is able to monitor developments in the latest big outbreak, Zika, through weekly updates from the State Department.
The outsized threat of the biggest Ebola outbreak in history, which ravaged West Africa beginning in 2014 and sowed fear worldwide, has improved communication, she said.
Images on the nightly news spread misconceptions and panic in the absence of a rapid response from the health establishment, she said, but things seem to be going better with Zika.
At the local level, small hospitals face the same threats as the big ones, but on a smaller scale. Just because a small hospital might see a fraction of the patients with any given disease doesn’t mean it can be safely ignored.
Facing Ebola, the Heywood arranged for protective equipment and hired a company to train its staff in an overlooked aspect of infection control. Putting the protective suit on is all well and good, but knowing how to take it off again without exposing yourself to blood spatter was another question, Sanborn said. So they instituted a buddy system, practiced with suits contaminated with gouts of fake blood and held drills at both hospitals.
“With Ebola, that was something that consumed me for three months,” Sanborn said.
Heywood did have one call for the new training, when a potential case was reported at midnight one night, but the patient’s malady was found to be more psychological than viral.
In the end, hospitals in most of the world were able to breathe a sigh of relief as the disease subsided in Africa with few forays off the continent. The World Health Organization declared an end to the public health emergency of international concern in March.
With Zika, education is the best form of prevention.
She said a specimen can now be sent to the state for testing and assessment forms at both hospitals ask patients if they have traveled outside the country or within the U.S. in the past 30 days.
A “yes” will prompt further questions, Sandborn said. It’s a universal precaution. “This will cover Ebola, this will cover Zika, and it will cover the next novel strain of a virus that comes out, because there will always be another,” she said.
Zika isn’t the deadly threat that Ebola was, but it has been strongly linked to a sharp increase in babies born with undersized skulls and brains in Brazil. The continental United States, so far, has seen infection primarily in travelers returning from abroad.
The Centers for Disease Control report seven confirmed cases in Massachusetts as of April 6, among 346 nationwide, with most cases acquired abroad and seven sexualy transmitted.
Mosquito-borne cases have been found in Puerto Rico, the U.S. Virgin Islands and American Samoa, according to the CDC. Sanborn said it is suspected that many people have contracted the disease without knowing it. Like many diseases, Zika can pass for the common cold.
The most common signs and symptoms would usually appear within a few days to a week of infection: a low-grade fever of about 100 degrees, a rash, joint pain or pink eyes. It leaves the blood quickly, but there is no cure.
People who have traveled, or have reason to suspect they may have contracted the disease and discover symptoms, are advised to go to a doctor, who will send blood samples for testing.
The Department of Public Heath states that risk of illness from the virus is low among those who contract it, and even the risk of the associated birth defects are low. The danger is serious enough, however, that pregnant women and women trying to become pregnant are advised to consider postponing travel to areas of active Zika transmission.
Diseases are emerging or re-emerging more frequently in a more connected world, and after Zika subsides or becomes part of the norm, like Lyme disease, something new will crop up, Sanborn said. “It will happen. The footprint of the environment is so different. Next year I’ll probably be talking to you about something else.”
You can reach Chris Curtis at: ccurtis@recorder.com