National / Science & Health

Questions remain over how Japan would handle actual Ebola cases

by Eric Johnston

Staff Writer

Health experts have said authorities were correct to intercept a Canadian journalist who subsequently tested negative for the Ebola virus and remains under observation.

But the structure of Japan’s health system remains a cause for concern. There are questions over its ability to respond quickly and effectively to other suspected Ebola cases, and worries persist over the expertise of personnel.

While the Health, Labor, and Welfare Ministry beefed up detection measures last week, the logistics of handling a suspected Ebola victim are not as clear as they need to be, experts say.

Under government guidelines, the National Institute for Infectious Diseases serves as a reference center for Ebola. Blood, urine and spinal fluid samples are supposed to be sent to the NIID by hospitals treating patients suspected of carrying Ebola.

“Local health departments in each prefecture have their own policies, including policies to manage patients with Ebola. But the health ministry hasn’t standardized the logistics for sending samples to the NIID,” said Harumi Gomi, a professor of medicine and director of the Center for Global Health at Mito Kyodo General Hospital, University of Tsukuba in Ibaraki Prefecture.

The government has designated 45 medical facilities around Japan to handle Ebola patients, even though no facility is certified to the level required to handle a virus as easily passed on as Ebola.

There are other problems as well.

“It’s not really clear if we at non-designated hospitals would be allowed to see an Ebola patient at a designated hospital, or whether only medical staff at that designated hospital would have access,” Gomi said. “In addition, I’m concerned about the lack of medical personnel in Japan who have experience in dealing with highly infectious diseases.”

Health ministry official Kazuki Oshima said priority would be placed on making use of available Japanese experts. That could prove harder to manage if a suspected Ebola case arises outside a major urban center, where experts are fewer.

In addition, there is the question of whether hospitals or local health centers might even refuse to examine a patient suspected of having Ebola.

“There’s a mindset among Japanese medical professionals that is different than North America or Europe. Many hospitals don’t want to deal with Ebola patients and we’ve seen past examples of hospitals that didn’t want to deal with SARS patients,” Gomi said.

Oshima, however, said doctors cannot refuse to see such a patient.

“If someone comes in and seeks treatment, the basic law says they have to receive” that person, Oshima said.

However there is a gray zone giving doctors discretion over whether they will treat the patient at that facility or send them elsewhere.

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