Specialized care centers may be needed to contain ebola

(HealthDay)—Specialized medical centers may be necessary to adequately treat and contain the Ebola virus in the United States, according to an ideas and opinions piece published online Oct. 16 in the Annals of Internal Medicine.

Mark G. Kortepeter, M.D., M.P.H., of the Uniformed Services University of the Health Sciences in Bethesda, Md., and colleagues discuss the challenges of treating patients with Ebola in conventional medical care settings and a strategy for creating a network of specialized treatment centers.

According to the authors, the U.S. Centers for Disease Control and Prevention has developed a hospital preparedness checklist for treating patients with Ebola in conventional medical centers. Barrier methods are required to protect medical staff. However, specialized precautions may be needed to safely treat patients with the most serious types of infections, such as Ebola, with attention to patient entry and movement pathways, control of patient location and access, safe donning and doffing of personal protective equipment, proper handling and testing of laboratory specimens, disposal of large volumes of waste, safe clean-up of spills and bodily waste, and minimal use of sharps. Currently, only four high-level containment care (HLCC) units are operating in the United States: Emory University Hospital in Atlanta; University of Nebraska Medical Center in Omaha; Saint Patrick's Hospital in Missoula, Mont.; and the National Institutes of Health Clinical Center in Bethesda, Md. For long-term preparedness, a network of regional referral centers, with the capability to rapidly convert to an HLCC unit, may be necessary to handle emerging outbreaks.

"Despite this necessary reliance on conventional facilities, we recognize the challenges inherent in maintaining a high nationwide state of readiness over the long term," the authors write. "Hence, we envision the need for a network of strategically located regional referral centers serving designated catchment areas tied to biosafety level-4 laboratories or airport quarantine stations."

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