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HomeMy WebLinkAboutalameda-county-ems-memo-ebola William McClurg Interim Agency Director Zita Konik, MD Medical Director 1000 San Leandro Blvd., Suite 200, San Leandro, CA 94577 | Health.AlamedaCountyCA.gov | TEL (510) 618-2050 FAX (510) 618-2019 MEMORANDUM DATE: June 4th, 2026 TO: Alameda County EMS Clinicians, and Designated Infection Control Officers FROM: Alameda County EMS Agency SUBJECT: Highly Infectious Disease (HID) Guidance: Ebola This memorandum provides guidance for EMS clinicians to safely identify and care for suspected Highly Infectious Disease (HID) patients, regarding the recent Ebola outbreak in sub-Saharan Africa. There are no confirmed or suspected Ebola cases in the United States. The risk to Alameda County EMS clinicians remains extremely low. If suspected cases are confirmed locally the Alameda County EMS Agency, in coordination with Public Health, will notify emergency dispatch centers to flag relevant addresses within the computer-aided dispatch (CAD) system to ensure responding clinicians are aware prior to arrival. In line with the California Emergency Medical Services Authority (EMSA) guidance, the Alameda County EMS Agency is providing a screening process for EMS clinicians and working with the emergency medical dispatch (EMD) centers to implement an emerging infectious disease (EID) screening tool. Additionally, local Emergency Departments are beginning to screen patients for HID. This preliminary guidance is intended to address immediate concerns. We understand it may not answer every question at this stage. Additional details will be shared as available. BACKGROUND Ebola is a viral illness, originating from sub-Saharan Africa and is spread through direct contact (via broken skin or mucous membranes) with the body fluids (e.g., blood, urine, feces, saliva, semen, or other secretions) of a person who is sick with or has died from Ebola disease. Ebola can also be transmitted to humans from infected animals, or through contact with objects like needles that are contaminated with the virus. Ebola is not spread through airborne transmission. The current outbreak in the Democratic Republic of the Congo (DRC) and Uganda, is the Bundibugyo strain of Ebola. For this particular Ebola strain, there is no vaccine available; treatment includes managing symptoms. EMS SCREENING PROCESS Initial signs and symptoms of HID infections are frequently nonspecific. Patients presenting with fever, muscle pain, vomiting, diarrhea, unexplained bleeding, respiratory distress, weakness, or abdominal pain should be assessed for potential exposure history including: Recent international travel Exposure to known or suspected HID patients Residence in or travel to outbreak areas Contact with potentially contaminated environments, animals, or materials Page 2 of 3 “DRY” VERSUS “WET” HID PRESENTATION “Dry HID” The suspected HID patient does not have vomiting, diarrhea, bleeding, copious secretions, or aerosol-generating procedures. These patients typically present lower environmental contamination and occupational exposure risk, although appropriate infection control precautions and PPE remain necessary. “Wet HID” The suspected HID patient has vomiting, diarrhea, bleeding, copious secretions, respiratory compromise requiring aerosol-generating procedures, or severe illness likely to result in significant body fluid exposure or environmental contamination. These patients present substantially increased occupational exposure and contamination risk and enhanced PPE is necessary. PERSONAL PROTECTIVE EQUIPMENT (PPE) TREATMENT AND DECONTAMINATION Aerosol-generating procedures should be avoided whenever possible. If clinically necessary, personnel should utilize the highest level of respiratory protection available and minimize the number of providers involved. Strict adherence to infection control practices, including proper donning and doffing of PPE, is essential to prevent occupational exposure. EMS clinicians who experience any suspected exposure to blood, body fluids, secretions, or contaminated materials should immediately stop patient care activities when safe to do so, wash affected skin surfaces with soap and water, irrigate exposed mucous membranes, and report the exposure to their supervisor. Following transport of a “Wet HID” patient or any patient resulting in significant contamination, the ambulance should be removed from service until appropriate decontamination procedures have been completed. Level 1 PPE Initial Screening  Gloves  Surgical Mask  Eye Protection  Isolation Gown Level 2 PPE “Dry HID”  Impermeable gown or Tyvek suit  Double gloves  Fit-tested N95 respirator or PAPR  Eye protection  Boot covers Level 3 PPE “Wet HID”  PAPR preferred  Fully impermeable suit  Double gloves  Head covering  Neck covering  Impermeable boot or shoe coverings Page 3 of 3 NOTIFICATION AND TRANSPORTATION Notify the EMD Duty Officer immediately through dispatch, if a suspected HID patient is identified. The EMS Duty Officer will contact Public Health and assist coordinating a destination. Notify the receiving hospital as soon as possible before transporting a suspected HID patient so appropriate infection control precautions can be implemented prior to patient arrival. Stay with the patient in the ambulance until hospital staff are prepared to receive the patient. Anticipate patient handoffs to hospital staff occurring at the ambulance to minimize potential exposures. Patients should be transported to the closest, most appropriate receiving facility. There are no destination restrictions currently, however, this is subject to change. EHR SCREENING FORM For agencies utilizing ESO for electronic health record (EHR) documentation, an older version of the Ebola screening tool is available and can be enabled if desired, please see instructions below. While this tool captures HID symptom screening, the travel questions are limited to West Africa, which is incorrect, as the location of the current outbreak is the DRC and Uganda. A support ticket has been submitted for review, although we cannot guarantee the travel questions will be corrected. Admin > EHR > Forms Tab > Forms > Ebola Screening > On For agencies using ImageTrend, Traumasoft, ZOLL, or other EHR platforms, please contact your vendor support representative to determine whether an Ebola screening form is available and can be enabled or configured. EMS agencies are encouraged to review the full EMSA guidance document on the News and Notifications page, to become more familiar with procedures regarding PPE, patient transport, decontamination, and exposures. Changes or updates to this guidance will be communicated accordingly. Please contact Naila Francies directly with any questions.