As Texas health workers prepare two new biocontainment units to help treat any future Ebola patients the state might have, they're are using one piece of training equipment from a neighboring state that may surprise you: Tabasco sauce.
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At the University of Texas Southwestern Medical Center, where one of the units is being established, the staff has been practicing treating fake patients who have been sprayed at random with the peppery sauce as a stand-in for Ebola virus-laden fluids. Doctors and nurses practice dressing and undressing in their protective gear to avoid contamination, but if they feel the tingle of Tabasco on their skin, they know they've been contaminated.
"In a way, it gives feedback immediately," said Dr. Bruce Meyer, an executive vice president at the hospital, giving credit to the hospital's director of infection prevention, Doramarie Arocha, for the idea.
Tabasco sauce is made by Louisiana-based McIlhenny Co. from red peppers called Capsicum frutescens, which are made spicy by the chemical capsaicin. When skin comes in contact with this chemical, the brain's pain and temperature receptors get activated at the same time, causing that tingly, hot feeling. The hot pepper chemical has also been used in other medical settings, including dermatology and neurology for pain and itch relief.
Nurse Elizabeth Thomas, who works in the hospital's infection prevention department, said health workers were originally drilling with ketchup mixed with water when Arocha came up with the idea to use Tobasco sauce instead. When workers took off protective gear at the end of a drill, Arocha told everyone to rub their eyes and touch their lips.
"But we didn't have the burning sensation," Thomas said. "So that's how we knew we were doing the right thing."
In the aftermath of Texas being home to the first two Ebola transmissions on American soil, Gov. Rick Perry this week promised to create two biocontainment units in the state to treat any future Ebola patients that may arise.
Two nurses who treated Liberian national Thomas Eric Duncan for Ebola at Texas Health Presbyterian Hospital in Dallas last month -- Nina Pham, 26, and Amber Vinson, 29 -- contracted the deadly virus and are being treated in isolation units at the National Institutes of Health isolation facility in Bethesda, Maryland, and Emory University Hospital in Atlanta, Georgia, respectively.
Though it's not clear exactly how the nurses caught the virus, some have speculated that they may have been contaminated while taking off protective gear.
"When you have gone into contaminated gloves, masks or other things to remove those without risk of contaminated material touching you and being then on your clothes or face or skin and leading to an infection is critically important and not easy to do right," Centers for Disease Control and Prevention Director Dr. Thomas Frieden said during a news conference the day Pham's preliminary Ebola test came back positive.
Vinson's family announced that she had been declared virus-free on Wednesday, and Pham's condition was upgraded from "fair" to "good" earlier this week.
One new Texas biocontainment unit will be at the University of Texas Medical Branch at Galveston, which is also home to a high-security biolab that is already prepared to treat Ebola in the unlikely event that one of its workers becomes infected while studying the virus in the lab setting. The other biocontainment unit will be at the University of Texas Southwestern Medical Center in Dallas, which has already spent "north of half a million dollars" retrofitting rooms and training staff to treat Ebola patients in isolation over the last several weeks, Meyer said.
Dr. W. Ian Lipkin, who directs Columbia University's Center for Infection and Immunity, called the move a "sensible investment," and said that other communities should be able to replicate centers like the ones at Emory University Hospital, Nebraska Medical Center and the NIH facility, where other Ebola patients have been treated in the United States.
"The unit itself physically isn't that complicated," said Dr. William Schaffner, chairman of preventive medicine at Vanderbilt University Medical Center in Nashville, Tennessee, adding that training staff is much more crucial to the effort.
"Virtually any hospital of any size" can build one of these units, he said. And though it might not be as "elaborate" as the ones at Emory and the NIH, it should work.
The United States currently houses four facilities with biocontainment units, and they have the capacity to treat 11 patients. Texas would be adding two new facilities, and the ability to treat several more patients.
"When I heard about this, I said 'Good for them,'" Schaffner said. "They'll add to the U.S. capacity to take care of Ebola patients in these units."