Two Ebola scares within 24 hours kept Tennessee health officials on their toes Tuesday, highlighting growing tensions after America's first case of local transmission of the virus was reported in Dallas.
Passengers on a plane that arrived at the Nashville International Airport on Sunday night were kept on the tarmac for three hours after a man became ill aboard American Airlines Flight 1676 from Dallas.
A few hours after the emergency health workers in Nashville peeled off their protective gear, doctors and nurses at Chattanooga's Memorial Hospital were suiting up before they admitted a sick man who emergency crews initially believed had come in contact with someone who had recently traveled to Liberia.
Both were false alarms, but the incidents allowed emergency responders and medical workers to practice their own Ebola response tactics in the wake of the news Sunday that a Dallas nurse was diagnosed with the virus after she cared for Ebola victim Thomas Eric Duncan.
Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, on Monday said the agency has to "rethink the way we address Ebola infection control," saying that even one infection is "unacceptable." The virus has killed more than 4,000 people in West Africa.
The two local scares also demonstrated the swift detective work that must go into determining a patient's risk level. In the Nashville case, airport spokeswoman Shannon Sumrall said the airport followed "standard operating procedures" after officials were alerted about the sick passengers.
Multiple agencies were automatically notified, including the Federal Aviation Administration and the CDC. Quickly, state health workers had to go to work identifying the sick passenger and nailing down his recent medical and travel history, said state epidemiologist Dr. Tim Jones. They found that the man had no travel history to Africa or exposure to those infected in Dallas.
Emergency workers responded wearing protective gear and transported the patient to Vanderbilt Medical Center. The remaining passengers finally deplaned at 2:45 a.m. after it was determined the sick passenger posed no risk for Ebola.
"As we get more of these situations the response will become more routine. The system will get quicker," Jones said. "We're learning every time this happens who needs to be notified and in what order. I think all of us would prefer to err on the side of safety."
Chattanooga Airport spokesman Albert Waterhouse said the airport be "maintaining our current emergency and safety procedures, including the ability to mobilize all our emergency partners in a moment's notice regardless of the circumstances."
The Memorial response was triggered after hospital officials received a phone call from emergency responders in a nearby county, saying they had an elderly patient who was very ill with nausea, vomiting and weakness, said head of infection prevention Dr. Mark Anderson.
At the time, the EMS workers had been told that the man had had contact with a relative who had recently traveled to Liberia and was also ill.
While the information was "second and third hand," Anderson said both the EMS workers and hospital staff decided there was enough concern to engage isolation and precaution measures. Both ambulance and hospital staff wore protective gear and transferred the patient to an isolated ICU unit.
Once the man was stabilized, doctors were able to contact family members directly and found no relatives had visited Liberia in the recent past and the man was not at risk for Ebola. The entire episode lasted less than an hour.
"It was a very good drill and practice for our system," said Anderson. "We feel like things worked very well, but it allows us to see what we may need to improve."
Jones said the health department in Nashville has been seeing an uptick of calls with Ebola-related concerns in the state, but none have been substantiated.
When patients are showing possible symptoms of the virus, including a fever, medical officials need to ask whether the patient has traveled in West Africa within the last 21 days, which is the incubation period for the virus.
Meanwhile, local hospitals are continuing to hold strategy sessions about Ebola response and planning more specific training on how to remove protective medical gear safely.
Kathy Winn, spokeswoman for Parkridge Health System, said the hospital is "getting communication frequently" regarding Ebola awareness and prevention.
Dr. James Creel, the chief medical officer for Erlanger Health System, said that the hospital was in the process of creating an "Ebola team," a cadre of medical workers who will be highly trained in response to the virus.
"We should not hit the panic button," Creel said. "This is universal protocol, we just want to pay attention and make sure we're prepared."
Contact staff writer Kate Harrison Belz at email@example.com or 423-757-6673.