Download Minnesota Ebola Community Risk Assessment (PDF: 92KB/2 pages)

Minnesota Ebola Community Risk Assessment
Purpose
It is important that Minnesota is prepared to evaluate
patients at risk for Ebola infection and to care for
persons with Ebola Virus Disease (EVD). Ensuring the
preparedness of Minnesota’s healthcare system is the
responsibility of the Minnesota Department of Health
(MDH). This document provides a current Minnesota
Ebola community risk assessment. This information is
important for decisions about Minnesota’s healthcare
preparedness.
Minnesota’s traveler monitoring program
Monitoring of travelers began on Oct. 27, 2014 and
since then, 292 who have entered the monitoring
program (as of Jan. 16, 2015).
In Minnesota, among the 292 returned travelers the
countries of exposure include:
Guinea,
13, 4%
Sierra
Leone,
18, 6%
Current risk of Ebola globally
• Current countries with widespread EVD are Sierra
Leone, Liberia, and Guinea.
• Activity in the three affected countries has decreased
since November 2014 based on WHO reports.
• Previously affected countries with localized
transmission but with no current risk include Mali,
Nigeria, Senegal, Spain, United States, and United
Kingdom.
Number of Confirmed Cases
Mali, 2,
1%
Liberia,
259, 89%
Ninety percent resided in the seven-county metropolitan
area (64% Hennepin, 10% Ramsey, 8% Anoka, 6%
Dakota, 1% Washington, 1% Carver, and <1% Scott).
Additional counties include Cottonwood, Mower,
Stearns, Sherburne, Rice, Itasca, and Wright.
Number of Confirmed Ebola Cases by Week:
Nov. 8, 2014 to Jan. 30, 2015
700
600
Nearly 65 percent of the returned travelers had passports
from Liberia, 33 percent from the United States and 2
percent from Sierra Leone.
500
400
300
200
100
0
45 46 47 48 49 50 51 52 53
Week 2014-2015
Guinea
Liberia
1
2
3
Sierra Leone
Average number of weekly confirmed cases over last
three months:
Average confirmed cases
per week
Guinea
Liberia
Sierra
Leone
Nov. 8 - Dec. 6, 2014
119
71
513
Dec. 7, 2014 - Jan. 3, 2015
120
72
319
Jan. 4 - 31, 2015
34
7
123
For Liberia, there has been a tenfold decrease in the
number of confirmed cases from December 2014 to
January 2015.
4
Ebola assessment and treatment facilities
Four Ebola assessment and treatment facilities have been
established in Minnesota. All have received visits from
the CDC/MDH Rapid Ebola Preparedness (REP) team.
Each facility made recommended changes to their
facilities and have developed EVD-specific protocols
that address preparation and receiving of EVD Persons
Under Investigation (PUI) and EVD cases. Capacity
exists for multiple beds serving pediatric patients, adults,
and pregnant women. They include:
• Mayo Clinic, Saint Marys Hospital – Rochester
• Children’s Hospital, St. Paul Campus – St. Paul
• University of Minnesota Fairview, Riverside
Campus – Minneapolis
• Allina Health Systems, Unity Hospital – Fridley
(2/2015) Page 1 of 2
Minnesota Ebola Community Risk Assessment
Proximity to an Ebola assessment and
treatment facility
Of the 292 returned travelers to date:
• 94% live within 30 miles of one of the four hospitals
• 98% live within 45 miles of one of the four hospitals
Clinical assessment by MDH
The MDH Clinical Ebola Team provides 24-7 clinical
consultation to travelers being monitored via telephone
if they have health concerns. Other states have chosen to
refer all monitored travelers with clinical concerns to a
healthcare facility, thus increasing the number of
encounters and admissions to an Ebola assessment and
treatment facility.
MDH Clinical Ebola Team:
• Protects resources at Ebola assessment and treatment
facilities from unnecessary use,
• Directs patients entering the healthcare system to the
most appropriate location in a coordinated fashion,
and
• Provides additional health and exposure information
when in-person health care is needed, to care for
patients more efficiently.
Because of the information MDH receives as part of the
traveler monitoring program, MDH fields many calls
from healthcare facilities and is able to inform them that
a patient is unlikely to be at risk for Ebola because there
was no known exposure.
MDH Clinical Ebola Team efforts by the numbers
Since the start of the traveler monitoring program, there
have been no cases of EVD in Minnesota; however, the
MDH Clinical Ebola Team has been contacted about
many travelers.
Of these many travelers:
• 30 had some symptoms consistent with possible EVD
• 9 were less than 18 years old
• 21 were 18 years or older
• 3 were pregnant
• 21 were evaluated only as outpatients,
o 9 were managed by the Clinical Team without
in-person health care
o 12 had outpatient care only
• 9 were admitted to a hospital for more than 24 hours
• 2 were tested for Ebola; both were negative
Some of the diagnoses/clinical concerns among travelers
to Ebola affected countries since the start of the outbreak
included:
•
•
•
•
Malaria
Salmonella Typhi
Dehydration
Peri-menopausal
hot flashes
• Congestive heart
failure
•
•
•
•
Constipation
Enterovirus
Lassa Fever
Chronic kidney
disease
• Respiratory
syncytial virus
•
•
•
•
Dementia
Pregnancy
Anxiety
C-Section pre-term
delivery
• Urinary tract
infection
Expected future needs
It is difficult to predict future travel patterns. In general,
the number of persons being monitored has remained
stable in the past 8 weeks. At this time, there are no large
groups expected to return from the affected countries
that would increase the number of persons requiring
monitoring.
Current Ebola clinical care capabilities and
expected clinical need for the future
Minnesota is well positioned to meet the medical needs
of the returning travelers from the affected countries.
Liberia accounts for almost 90 percent of all returning
travelers and the tenfold decrease in EVD frequency
means that the risk of traveler’s symptoms attributable to
EVD continues to decrease.
Continued training and preparation is needed to ensure
that the healthcare system is prepared to meet the needs
of monitored returning travelers. The four Ebola
assessment and treatment facilities are well prepared to
meet the needs of our returning travelers.
Minnesota Department of Heath
Infectious Disease Epidemiology, Prevention,
and Control Division
PO Box 64975, Saint Paul, MN 55164-0975
651-201-5414 or 1-877-676-5414
www.health.state.mn.us
(2/2015) Page 2 of 2