Video: Watch the DUH Clinic PPE Train-the-Trainer Course

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This is a video recording of the training session provided by the DUH Infection Prevention and Control Team. The course provided an opportunity to practice donning and doffing PPE in preparation for potential Ebola patients that may present to your clinic. Watch the training session recordings.**

**Please note that in order to view the video, you must be on the Duke Medicine Network as well as signed in using your Duke NetID and password.

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Q&A on Student Travel in an Era of Heightened Ebola Awareness

In light of the Ebola virus outbreak in Liberia, Guinea and Sierra Leone, many questions have arisen about student-related travel in general. Below are responses to several common issues based on the most recent information we have available.

It should be noted that the risk of contracting Ebola is extremely low for anyone who has not traveled to Liberia, Guinea and Sierra Leone or had direct contact with an individual who has the Ebola virus and is symptomatic. Ebola is not an airborne virus and can only be transmitted through exposure to bodily fluids of an infected and symptomatic individual.

  1. What should a student who is traveling do if he/she has a fever or other symptoms similar to Ebola?
    Seek medical attention. The symptoms of Ebola are similar to many other illnesses. A health care professional should be able to assess and advise the student appropriately. Be sure to advise your health care provider of your travel itinerary. If a student needs a recommendation for an area health care provider, contact International SOS, which is available 24 hours a day, 7 days a week at any of the following numbers: Philadelphia + 1 215 942 8226; London + 44 20 8762 8008; or Singapore + 65 6338 7800.
  1. What should a student who is traveling do if he/she is unwell during a trip or in the first three weeks after returning?
    Seek medical attention. If the student is still in the Durham area, the Duke Student Health Center or Duke Urgent Care are options for non-severe symptoms, and the Duke Emergency Room for those with more severe symptoms. If not in the Durham area, then seek medical care from their customary provider or local urgent care or emergency department. Regardless of where the student is seen, be sure to advise your provider of your travel itinerary.
  1. What steps can students take to help protect themselves from infectious diseases while traveling internationally?
    See a medical travel clinic before travel to get immunization and medications that can prevent illness, and take any medications as prescribed before, during, and after the trip. Be sure to follow standard hygiene practices such as frequent hand washing, drinking bottled water, being careful with foods eaten, and wear appropriate protective clothing/insect repellant if needed. 
  1. How should Duke administrators counsel students who are considering travel to Africa?
    Travel to Liberia, Guinea and Sierra Leone is currently restricted due to the Ebola outbreak. Graduate students, faculty and staff can request an exemption to the travel policy if they wish to travel to these countries. Other countries in Africa are restricted for various other reasons. See the Restricted Regions List for other areas of Africa that are restricted for non-Ebola related reasons.
  1. How should Duke administrators counsel students who are considering travel to Madrid or other areas where Ebola patients or suspected Ebola patients have been identified?
    All countries other than Liberia, Guinea and Sierra Leone are considered safe for travel. Infectious disease screening and monitoring protocols are in place for those traveling from Liberia, Guinea and Sierra Leone to other countries. These efforts greatly reduce the potential exposure in other countries. If an individual in another country is suspected or identified to have the Ebola virus, the risk is still extremely low to students unless they were directly exposed to the bodily fluids of the infected and symptomatic individual.
  1. How should we advise students if they are quarantined in another country for suspicion of Ebola?
    Be sure to communicate with the consulate to let them know that they have been quarantined. As a standard precaution, students should be advised to have a personal communications plan while traveling (e.g., cell phone access, periodic check-ins with Duke staff if on a University-funded trip or with parents/friends if traveling independently).
  1. What type of health coverage is available to students traveling internationally?
    Students who are enrolled in the Duke Student Medical Insurance Plan (SMIP) have worldwide health insurance coverage. You can get information about the plan’s international benefits at the BlueCard WorldWide website. Students who are not enrolled in the Duke SMIP should refer to their health insurance policy for details about international coverage. 
  1. Should students or departments consider purchasing additional travel insurance for students traveling internationally?
    Duke has contracted with International SOS (ISOS) to provide additional travel assistance at no additional charge. The service includes seamless coverage and evacuation services in the event of an illness or injury while abroad. Current policy restricts reimbursement for “optional travel or baggage insurance,” which are considered personal expenses. However, departments interested in purchasing additional travel insurance (trip cancellation, baggage, accident, life or medical insurance), should contact Employee Travel and Reimbursement at employeetravel@duke.edu or 919-668-3877 to discuss options.
  1. What are symptoms of Ebola? How easily is it transmitted? How is it treated?
    Symptoms of Ebola include:

    • Fever
    • Severe headache
    • Muscle pain
    • Weakness
    • Fatigue
    • Diarrhea
    • Vomiting
    • Abdominal (stomach) pain
    • Unexplained hemorrhage (bleeding or bruising)

    Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days.

    Recovery from Ebola depends on good supportive clinical care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years.

    Ebola is transmitted by:

    • When an infection occurs in humans, the virus can be spread to others through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with
    • blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola
    • objects (like needles and syringes) that have been contaminated with the virus
    • infected fruit bats or primates (apes and monkeys)

    Treatment of Ebola is by:

    • Symptoms of Ebola and complications are treated as they appear. The following basic interventions, when used early, can significantly improve the chances of survival:
    • Providing intravenous fluids (IV) and balancing electrolytes (body salts).
    • Maintaining oxygen status and blood pressure.
    • Treating other infections if they occur.

     From the CDC (www.cdc.gov)

  2. Are students who travel internationally required to complete a health review prior to returning to Duke’s campus?
    Students who travel internationally will follow whatever protocols that are set up by governmental agencies. Additionally, students who travel internationally are told in advance by the Duke Travel Clinic in Duke Student Health if and when they need to return to be seen.Undergraduate students are restricted from travel to Guinea, Sierra Leone, or Nigeria. But any graduate student who travels to Guinea, Sierra Leone, or Nigeria must contact Duke Student Health for an evaluation prior to their return to campus. It is likely that anyone who has traveled to the endemic Ebola area for any reason will be required to self quarantine for 21 days following the completion of travel before returning to Duke.
  1. Are we making any special provisions for international students who are abroad and come back to the U.S. with an illness?
    Any student who travels from Liberia, Guinea and Sierra Leone must go through the CDC screening before returning to the United States. In addition, Duke requires any student, faculty or staff member who has traveled to Liberia, Guinea and Sierra Leone to visit Student Health or Employee Occupational Health & Wellness prior to returning to campus.
  1. What is the best way for me to stay informed about Duke’s travel safety advice while I am traveling internationally?Students, faculty and staff traveling internationally should complete the Travel Registry prior to travel. The Travel Registry allows Duke to contact individuals with pertinent information based on their location of travel. All members of the Duke community are automatically enrolled in International SOS and can also register with International SOS, which provides students and parents with peace of mind when traveling away from home on a Duke program. International SOS offers a network of multilingual specialists for immediate help with medical, personal, travel, security information, emergencies and legal referrals.

 

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New Maestro Care Patient Travel History Screening Form

As part of our ongoing efforts to actively screen patients for potential risk of infection for Ebola virus, a travel history/risk screening tool has been implemented in the Maestro Care system for areas in which patients are arrived or where first contact potentially occurs across the health system. The new functionality will enable thorough documentation and monitoring of responses to screening questions provided by patients. (More…)

Ambulatory Clinics: Watch the Ebola Information Session – Nov. 6

Ebola-Ambulatory-InfoSession

As part of our ongoing Ebola planning and preparedness efforts, Duke infectious disease experts hosted an Ebola information session to share important information with all ambulatory clinic physicians and staff, as well as answered questions from clinics across the health system.

The session includes the latest information about the virus, as well as review DUHS’ infection control system and plans in place to screen and care for patients with a focus on the ambulatory clinic setting.

Watch a recording of this information session.**

**Please note that in order to view the video, you must be on the Duke Medicine Network as well as signed in using your Duke NetID and password.

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N.C. DHHS News Release: Additional Testing Confirms a Negative Result for Ebola for Patient at Duke

A subsequent test of a new specimen provided by the patient at Duke University Hospital in Durham has resulted in a confirmed negative laboratory diagnosis for Ebola. This test, conducted 72 hours after an initial test was negative for the virus, confirms the patient is currently Ebola free.

The testing was conducted at the State Laboratory of Public Health, located in the N.C. Department of Health and Human Services (NC DHHS), one of 15 state labs approved by the federal Centers for Disease Control and Prevention to test blood specimens for Ebola. (More…)

Final test results negative for Ebola in hospitalized patient

The patient who was transported to Duke University Hospital on November 2 with a reported fever and a travel history to West Africa has tested negative for Ebola in a confirmatory lab test. As a result, the patient is considered to be free of the virus. The North Carolina Department of Health and Human Services (NCDHHS) notified Duke of these results this evening which support the findings of the preliminary test conducted on November 3 that was negative for the virus. (More…)

DUHS Ambulatory Clinic Ebola Information Session — Thursday, November 6, 12:00p.m.

As part of our ongoing Ebola planning and preparedness efforts, Duke infectious disease experts will be hosting an Ebola information session to share important information with all ambulatory clinic physicians and staff, as well as answer questions from clinics across the health system. (More…)

N.C. DHHS News Release: Preliminary Negative Result for Ebola in Patient at Duke University Hospital

Testing conducted at the State Laboratory of Public Health, located in the N.C. Department of Health and Human Services (NC DHHS), returned a preliminary negative result for Ebola in a patient at Duke University Hospital in Durham. Additional testing will occur 72 hours after his fever first developed to confirm this result.

It is important to note that the patient’s fever could indicate other illnesses.

Read the full press release: N.C. Department of Health and Human Services’ Testing Returned a Preliminary Negative Result for Ebola in Patient at Duke University Hospital.

 

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Preliminary test results negative for Ebola in hospitalized patient

The patient who was transported to Duke University Hospital on November 2, 2014, with a reported fever and a travel history to West Africa has tested negative for Ebola infection in a preliminary lab screening. Duke was notified of the results of this initial test this morning by the North Carolina Department of Health and Human Services who performed the test.  A confirming test will be run in 72 hours.

Until Ebola infection is definitively ruled out, the patient will remain under care in a completely contained, isolated and secured unit at Duke University Hospital and all other aspects of Duke’s comprehensive infection control plan remain in place.

The patient’s care team at DUH has undergone extensive training over the past several weeks in caring for such a patient. This patient is being cared for in a separate unit with no other patients, and staff caring for these patients will have no other patient contact during this time. The team has received hours of training in the proper use of personal protective equipment to prevent their exposure to the virus.

To learn more about Ebola, how we’ve prepared, and get ongoing updates, visit http://sites.duke.edu/ebolainfo/.

Patient being evaluated for potential Ebola virus at Duke University Hospital

As of Sunday evening, November 2, a patient has been admitted to Duke University Hospital for further evaluation and testing for potential Ebola virus infection. We expect to know the results of this test from the N.C. Department of Health and Human Services sometime Monday morning. Meanwhile, the patient is being cared for in the same confined, isolated and secured space in which an actual Ebola patient would be treated. The patient is receiving care from a seasoned team of Duke clinical professionals who have completed extensive training to treat such a patient. We have anticipated this possibility for several weeks now and have a plan in place to manage this situation.

We appreciate that some may be concerned in hearing this news but wanted to review some facts we hope will be helpful.

Duke has planned and prepared.

  • With world-class infectious disease experts and extensive infection prevention and protection protocols in place, we are confident in our ability to successfully care for this patient while awaiting the results of the Ebola test, and also preventing risk of exposure to the virus if, in fact, it is present.
  • We have had a comprehensive infection control plan under development since August and have been actively screening all patients for any risk of exposure to Ebola who have presented to Duke University Health System offices and facilities for the past several weeks.

Transmission risk is extremely low and unlikely.

  • While we don’t yet know this patient’s Ebola status, it’s worth noting that the risk of transmission of the virus to any patients, visitors, employees or healthcare professionals within Duke University Hospital is extremely low and highly unlikely.
  • Ebola can only be transmitted through contact with the bodily fluids of a patient with the virus. Ebola is not spread through the air like the cold or flu virus.
  • Importantly, to date, there are no known cases in the U.S. of transmission of Ebola to patients, visitors or family members at the hospitals in which Ebola patients were being treated, or among the family members and acquaintances of the patients themselves.

Safety is our priority.

  • The team treating the patient has undergone extensive training on the use of personal protective equipment and infection control procedures with Duke’s infectious disease team and the experts in Duke’s state-of-the-art biosafety lab.
  • Our infectious disease team is in continuous contact with the Centers for Disease Control and Prevention and state and local health departments to monitor any new information related to the virus or care for Ebola patients.

We are committed to caring for all Duke Medicine patients.

  • While the situation related to caring for this patient, as we await the results of the Ebola test, will be a high priority, our care providers will continue to deliver outstanding care to all Duke Medicine patients.

As one of the leading academic medical centers in the nation, Duke has a history of responding to serious health and medical challenges. Treating this patient is not only consistent with our institutional values and mission, but also aligns to our commitment to our local communities.

To learn more about Ebola, how we’ve prepared, and get ongoing updates, visit http://sites.duke.edu/ebolainfo/.