Though the Ebola virus was first discovered in 1976, it didn’t emerge to really become a worldwide threat until 2014, when an outbreak spread throughout West Africa and subsequent parts of the world. Known as the largest Ebola epidemic in history, more than 15,000 cases of the virus were recorded across 10 countries, including 11 patients who were treated for it in the United States. In the end, more than 11,300 people died from Ebola by the time the virus was contained in spring 2016.
Ebola is highly contagious, as it can be passed via direct contact with mucous membranes or broken skin, blood secretions, bodily fluids and contaminated surfaces. It’s also very dangerous, with the average fatality rate coming in at around 50 percent. Noting all of this, it’s easy to see why Ebola is such a big challenge for healthcare workers when treating infected patients. Part of this challenge is because the incubation period ranges anywhere from two days to three weeks.
While the West Africa outbreak of 2014 is in the past, there’s always the chance of a new outbreak. In fact, just weeks ago an outbreak was reported in the Democratic Republic of Congo. Noting the ongoing possibility for an outbreak, it’s always worth revisiting how healthcare workers can stay protected from contracting the virus. Do you know what precautions to take? Here’s a closer look:
1. Comprehensive Ebola Training
To put it mildly, anyone who doesn’t have comprehensive training on things like Ebola signs and symptoms, PPE to wear when around infected patients and persons under investigation (PUIs), how to properly remove said PPE, and infection and safety training only risk spreading – and not containing – the disease. This is especially true when you consider Ebola symptoms can be similar to other infectious diseases, like malaria and meningitis. PUIs may exhibit no conditions or experience bleeding, vomiting and/or diarrhea.
The bottom line is that healthcare workers should have a thorough understanding of a means to effectively and efficiently identify patients with Ebola. Site managers should be appointed to ensure that all precautions are being taken when caring for Ebola-infected patients, and at least one should be on duty at all times.
Because Ebola is highly contagious, the personal protective equipment (PPE) required to treat Ebola patients or care for PUIs is comprehensive. Specifically, healthcare workers should be wearing attire that completely covers their skin, clothing and mucous membranes. This is typically accomplished by wearing the following PPE:
- A disposable body suit, gown or coverall. A good Ebola suit must effectively resist blood and bodily fluids
- A mask or respirator to protect the eyes, nose and mouth. PAPR or N95 respirators are suggested.
- A head or neck cover
- Face shields or googles, should the mask or respirator being worn not offer eye/nose protection.
- Double nitrile single-use gloves
- Waterproof boots
Furthermore, PPE must not just be properly worn, but properly discarded of in order to maintain optimum safety in the healthcare environment. PPE removal is carried out in a doffing area that requires structure, a trained supervisor and a defined area to remove protective pieces so as to not risk cross contamination.
3. Regular Infection Control and Safety Training
Proper infection control is also important in Ebola care situations, and patient care areas should be regularly cleaned and disinfected – even if there’s no noticeable signs of contamination. PPE surfaces and equipment are other surfaces that should be properly cleaned with an EPA-registered disinfectant.
4. Establish an Emergency Plan
Even with proper training, PPE and infection control, there’s still the chance that a mistake may occur. If it does, healthcare professionals need a go-to decontamination plan to minimize the damage that has been potentially incurred from any sort of unprotected exposure. While this too can be worked into the “training” point that we mentioned in tip No. 1 of this piece, it’s worth mentioning again.
An emergency plan may also occur, for example, if a tear develops in a worker’s glove or body suit while providing care to a patient. If this were to occur, the worker should move immediately to the doffing area, assess the situation and risk for exposure, and follow any in-place emergency exposure plan from there.
How prepared is your staff to address an Ebola situation?