Dr. Munday updates the county on Ebola danger and Enterovirus 68

Dr. Stephen Munday, Imperial County Health Official
Dr. Stephen Munday, Imperial County Health Official

EL CENTRO – Tuesday, Dr. Stephen W. Munday, Health Officer for the Imperial County, gave an update on the potential dangers of an Ebola outbreak in the Imperial Valley and the country, and his concern about the more prevalent danger of enterovirus 68, an infectious virus that began in the mid-west and has now spread throughout the nation according to Dr. Munday.


Dr. Munday began by discussing the Ebola breakout, which he cited has happened previously, but never to this extent. The problem, he said, was that the Ebola virus had reached the cities of Liberia, Sierra Leone, and  Guinnea, where before it had been mainly a rural problem.


Dr. Munday said the disease was severe, two decades ago it had a70-90% death rate, but now of the 6500 people identified with the disease in this break out, there was a 50 % mortality today. He added that the numbers only were for the ones actually identified with the virus.


Munday said there is a real concern it could come here. He stated the one case presented in Dallas.


“In my opinion, there will be additional cases. It will be impossible for them to not occur, however I am not concerned about a wide outbreak of Ebola because it is not easily spread. It is spread by direct contact, it is not air born. That makes controlling it a lot easier.”


Munday explained to the board that after 9/11, public health instituted an infrastructure for bio-terror attacks as well as pandemic situations. “We have all the tools needed to deal with an outbreak,” Munday said.


He explained of three levels of defenses the county has in place. “One is the influenza-like surveillance in the county. This goes on all the time. It is how we originally identified H1N1 back in the Valley in 2009. So we know that it works.”


“We also have SARI which is Severe Acute Respiratory Illness which basically looks at the hospitals, the people that get admitted for pneumonia, or go to the ICU, we look to make sure nothing unusual is happening or that there isn’t a cluster of common ailments hitting the hospitals all at once.”


Finally, we have in operation, syndromic surveillance, which is the surveillance (collection and analysis) of health data about a clinical syndrome that has a significant impact on public health. Syndromic surveillance watches for clusters of people with the same symptoms. If hospitals or clinics see this, they know to contact us so we can investigate.


Munday verified that more screening is taking place for people leaving West Africa countries, yet admitted nothing is 100 % effective “or we wouldn’t have had this one case.”


He stressed that Ebola is only infectious when the person is systematic. That is why they were not worried about the people in the plane who rode with the Ebola patient ,at the time he wasn’t symptomatic. The man eventually died last Wednesday morning, October 8.


According to Dr. Munday it takes three weeks after exposure to get ill and show symptoms.


“Imperial County Health facilities are aware of what is going on and if any thing triggers one of our defenses we will be prepared,” Robin Hodgkins, Director of Public Health added.


Munday said the health department was meeting Tuesday with appropriate health care people including those from the border to make sure all were on the same page and that everyone was prepared to screen people as they come through.


Director Jack Terrazas (Dist. 2) asked if there was a test for Ebola which Munday said there was not, until the person is ill and symptomatic.


Mainly Munday wanted to put everyone’s fears to rest. He emphasized that alerts can go out at any time, there is appropriate written materials, written at a level the community can understand, and the county continues to work on outreach.


However, he did want to warn the board on the more imminent threat of enterovirus 68. Munday said it had pretty much spread around the nation. The virus had caused acute respiratory illness in children, with many admissions in the ICU nationwide.


Munday said, “We have started to see some cases in California, but we do not have any confirmed case in the Imperial County.”


A case recently was confirmed in Riverside County.


Munday said that accompanying the virus, the patients have had acute flaccid paralysis. He said it is what polio use to look like. But polio was eradicated through vaccination.


“These viruses are cousins of the polio virus, they cause neurological damage, which we did have one case in spring, but we didn’t find cause. We are prepared to test for it and deal with it if we see it show up here.”