Information for Health Care Providers

Your role in screening and initial care, and how to coordinate with Strong Memorial Hospital if you have a suspected case

All hospitals in New York State are expected to implement screening, isolation, and initiation of testing for Ebola virus disease (EVD) when indicated:

1. If patients respond affirmatively to both screening questions for EVD (exposure/ travel and symptoms), the hospital will notify their internal Infection Prevention team who will then assist in notifying the local health department (LHD).
2. If LHD in consultation with the hospital team determine that the patient is "suspect" for EVD, the patient is moved to an isolation area within that hospital for admission/observation.
3. If LHD and NYSDOH advise and approve EVD testing, the hospital is accountable for drawing a blood sample for PCR testing.
4. The LHD will provide guidance for proper packaging of the specimen and will arrange for transportation of these specimens to the Wadsworth Lab in Albany.
5. Blood tests other than the EVD PCR test are discouraged in order to avoid blood exposures in central hospital laboratories, except in designated referral hospitals equipped with point-of-care laboratories.
   1. If the patient's condition warrants other testing, in order to provide essential care while awaiting the results of the EVD PCR test, the local hospital can call the Strong Memorial Hospital (SMH) Transfer Center at 585-273-4344 to arrange clinical review of the patient's care needs.
   2. Should it be determined that additional testing is absolutely required for ongoing care,  the Transfer Center, in consultation with Infection Prevention, clinicians, and NYSDOH, may arrange for transfer of a highly suspect EVD patient to the SMH isolation unit which will have capability for point-of-care testing in that unit.

Designated referral hospitals for EVD care, including Strong Memorial Hospital, are expected to:

1. Provide ongoing care for patients with confirmed EVD who are transferred from regional hospitals that are not prepared to provide that care.  Any transfer will occur in consultation with the LHD, NYSDOH, EMS and both hospitals.
   1. Similar transfer may be arranged from small hospitals with a highly suspect case of EVD even before the results of EVD testing are available.
2. Provide care to patients in the community who are identified by 911 and the LHD as highly suspect for EVD.  After consultation with SMH, the LHD (and possibly NYSDOH), and EMS, such patients will be transported directly to SMH for admission to the isolation unit.
3. Coordinate with EMS and the LHD to assure that transport is provided by designated EMS teams trained and equipped to employ the necessary precautions.
   1. Mercy flight will not be used as rotor wing aircraft cannot be safely secured from an infection control perspective given the current PPE requirements.
   2. SMH pediatric transport team will be used in the case of a child needing transfer.

Non-hospital clinical sites (physician offices, imaging, blood draw locations, urgent care centers, etc.) with a suspected EVD patient, based upon screening for exposure and symptoms:

1. Should contact Infection Prevention at their associated hospital, or local health department should they not have an associated hospital.
2. Should one of these locations contact SMH directly, they will be referred to their associated hospital or LHD.

See:   

1. NYSDOH Commissioner’s Order
2. NYSDOH Q&A

Additional resources are available for UR Medicine providers.