Carolina response center ready to treat deadly diseases

If a person arrives in North Carolina showing symptoms of Ebola virus or another deadly pathogen, a UNC School of Medicine center is ready to isolate and treat the patient.

More than 70 medical professionals have trained to care for that patient and contain the disease. They are part of Carolina’s Regional Emerging Special Pathogens Treatment Center, co-led by Dr. William “Billy” Fischer II, Dr. David Wohl and program manager Brooke Brewer in collaboration with UNC Health colleagues.

In 2022, Carolina became one of 13 centers funded through the U.S. Department of Health and Human Services Administration for Strategic Preparedness and Response.

“Through caring for patients and conducting research on dangerous infectious diseases, UNC has built the requisite expertise to prepare for future outbreaks,” said Fischer, who leads emerging pathogens research for the UNC Institute for Global Health and Infectious Diseases. “Our goal is to turn what we’ve learned from the field into stronger preparedness efforts for the state, region and nation.”

Fischer, an associate professor in the medical school’s pulmonary disease and critical medicine division, and Wohl, a professor in the school’s infectious diseases division, have provided care in countries with outbreaks of Ebola, Lassa fever and Marburg virus.

(Left) Dr. Modet Camara of the Rwampara Health Center in the Democratic Republic of Congo and Dr. Billy Fischer (right) at a Médecins Sans Frontières/Doctors Without Borders treatment center during an Ebola outbreak in Guinea in 2014. (Submitted photo)

“Treatable infections”

“UNC’s work over the past 10 years has helped transform these diseases into treatable infections,” Fischer said. “We have demonstrated time and time again that we have the necessary experience to treat these infections, and we can do it safely.”

In June, the World Health Organization deployed Fischer to the Democratic Republic of Congo, where documented Ebola cases have reached 5,200 with nearly 3,000 deaths. After treating patients there, he accompanied an infected American to Germany quarantining in Switzerland.

“We’re seeing an increase in the frequency, size and urbanicity of outbreaks of high-consequence infectious diseases. These pathogens have high lethality and can spread easily with no medical countermeasures available. Historically, they’ve been an important local and regional threat, but increasingly, they represent global public health threats,” he said.

While the viruses are not endemic in the United States, they can travel. “Incubation periods are two to 21 days. That’s enough time for somebody to get infected, to get on a plane and travel anywhere, then develop symptoms and be infectious,” Fischer said.

To prepare, the RESPTC team has created a specialized space and a highly trained team to provide the highest level of care without infecting healthcare personnel or affecting the care of other patients.

RESPTC has subspecialties expertise from obstetrics, pediatrics, internal medicine and critical infectious diseases. The center is also building a neonatal team. “We’ve got a deep bench of people able to respond,” Fischer said.

How a suspected case reaches RESPTC

The protocol begins with any doctor in North Carolina recognizing that their symptomatic patient recently traveled from an area with an active outbreak. The clinician contacts the state health department’s on-call epidemiologist.

The state health department maintains a list of reportable, high-consequence diseases. A confirmed infection isn’t required to trigger a report. If health officials are concerned it could be a real case, they call RESPTC, whose staff join a call with clinicians to determine whether the patient needs to be isolated at Carolina. Staff check with UNC Health and medical school administration before accepting a patient.

The planned lead time before a patient arrives at Carolina is eight hours, with notification coming through ASPR or state public health authorities.