CDC disease detective explains why ambulance chasing is crucial to tracking Ebola

(CDC) Ambulance chasing is a discouraged practice in the US – but in Liberia it’s exactly what Neil, a CDC disease detective in the Center for Global Health, had to do as part of his efforts to stop the spread of Ebola at its source.

“We would follow ambulances that were called to pick up suspected Ebola cases. We would keep our distance and observe how they collected patients, and would make corrections to any lapse in infection control. As soon as the ambulance left we would start the contact tracing investigation,” says Neil, who recently returned from a month working in Liberia, during which time he was based in Bomi County. Bomi is a rural area about two hours away from Liberia’s capital.

Rapidly identifying contacts of Ebola patients is a key component to stopping the spread of the virus. Each patient with Ebola can have as many as 10 contacts, all of whom need to be monitored for 21 days. “If you skip just one day, it might be the day the contact comes down with Ebola and a whole new chain of Ebola transmission can start all over again,” Neil says.

Over one hundred Ebola cases have been identified in Bomi County, and while Neil was there, he helped local health officials monitor the hundreds of contacts from all of these Ebola cases. “We made major strides in terms of helping them organize their data better, so they can keep better track of who’s a case and who’s a contact,” he says.

Another issue the county faced was Ebola’s spread in community care centers. Community care centers are part of the strategy to combat the ongoing Ebola epidemic and provide a venue for patients to receive care, giving them a chance to survive. Community care centers also help to move Ebola patients out of the community, thereby breaking chains of transmission in the community. Occasionally, patients suspected of having Ebola who actually have another illness will be admitted to a community care center.  There is a risk that these patients might come into contact with others in the community care center who have the virus — putting these Ebola-free patients at risk for getting Ebola. “We made recommendations that completely changed the flow of patients through that center, so hopefully it will reduce the risk of getting Ebola for admitted patients who do not have Ebola to begin with,” Neil says. To promote consistency in infection control within community care centers, the Ministry of Health and Social Welfare and international partners have developed guidelines and are conducting training. (read more)