With the arrival of the first Ebola case in the United States, hospitals here Thursday revealed protocols designed to quickly diagnose and isolate suspected cases of the lethal virus.
Hospitals on Long Island and in New York City have had plans in place for months as key staff members have kept an eye on the exponentially expanding epidemic in West Africa.
One hospital has an Ebola task force, another performs Ebola drills. All have isolation units designed with negative-pressure airflow, which means air in the unit can't escape the room to other areas of the hospital.
"We've had signs up for months in all the patient entryways," said Dr. Aaron Glatt, head of Mercy Medical Center, a Catholic Health Services hospital in Rockville Centre. The signs list each of the countries where the disease is endemic and asks patients to tell the admitting nurse whether they've traveled to any of them.
Glatt, an infectious diseases specialist by training, said it was only a matter of time before the highly contagious hemorrhagic fever virus was diagnosed in this country.
Texas health authorities have identified the patient as Thomas Duncan, who was admitted to a Dallas hospital this week. He tested positive for Ebola in separate federal and state screenings, officials said Tuesday.
Dr. Brian Koll, executive director for infection prevention at the Mount Sinai Hospital in Manhattan, said the false alarm there several weeks ago involved a patient who had traveled to West Africa. The hospital's system of quickly isolating the patient moved smoothly, Koll said.
Meanwhile, at North Shore-LIJ, a vast system of 17 hospitals throughout Long Island and New York City, doctors and nurses are making certain they don't miss a serious case. In Dallas, Duncan was initially sent home with a prescription for antibiotics.
"We've been testing our triage protocols to make sure this kind of thing does not happen," said Dr. Mark Jarrett, chief quality officer for the health system.
"If you present with headache, fever and myalgia," he said of muscle pain, "then the next question is whether you have been to any of those countries.
"It's the pickup at the front door that is often the most difficult step," Jarrett said of making the initial diagnosis.
Using the triage protocol, North Shore-LIJ medical personnel have identified several cases of "traveler's malaria," which has vague, early symptoms similar to Ebola.
Dr. Susan Donelan said plans are in place to identify a wide range of dangerous pathogens: Ebola, pandemic flu, SARS and MERS-COV -- Middle East Respiratory Syndrome Coronavirus.
Donelan, medical director for health care epidemiology at Stony Brook University Hospital, said doctors there have an electronic triage system, which aids in questioning patients and quickly isolating those with highly infectious conditions.
At Winthrop University Hospital, Dr. Audie Liametz, vice chairman of emergency medicine, said he and colleagues have held meetings for months, discussing plans on how best to handle a possible Ebola case. The hospital also formed an Ebola task force. "This past month we have seen people who had traveled to the area and had concerning symptoms," he said.