Address for Correspondence:
Dr. Ajith K Gopal, MD, FNB, Deputy Chief, Department of
Critical Care Medicine, Baby Memorial Hospital, Kozhikode,
Kerala, India. Email: dr_ajithkgopal@yahoo.com
Key Words:
Ebola, health care workers
Introduction
Ebola virus disease (EVD) outbreak has occurred recently in
several African countries. As we are all aware that being a
disease which cause high mortality appropriate infection
prevention control measures can be implemented to stop
transmission. Appropriate protective measures in places
like clinics, hospitals, community gatherings
helps to prevent the spread of infection.
Current outbreak: a human to human transmission
Epidemics due to Ebola viruses are seen among wild
animals, particularly non-human primates. Potential hosts of
are non-human primates, duikers, bats, small rodents, and
shrews [1].
Contact of human being with wild animals through hunting,
butchering and preparing meat from infected wild animals
("bush meat") was the initial source, with subsequent
transmission from human to human. And the present outbreak,
are a result of human to human transmission.
Food, animals and Ebola
Certain Basic hygiene measures can help to prevent
infection in people in direct contact with infected animals or
with raw meat and by-products.
Hygiene measures include regular hand washing and changing of
clothes and boots before and after touching these animals and
their products.
And one should know that Ebola virus is inactivated through
cooking.However sick and diseased animal should never be
consumed .
Preventive measures for the general public
It is always better to report to the nearest health facility
if you develop symptoms indicative of EVD, including high
fever, body aches, joint pain, vomiting, diarrhoea, or
bleeding manifestations [2].
Certain important points should always remember that include:
1. Seek for professional clinical treatment and
always Isolate the patient.
2. Minimize close contact with others.
3. Virus enters your body through your mouth, nose and eyes,
or a break in the skin.
4. Hand washing with soap and water after every contact with
sick people.
5. Always Provide a sick person with plenty of drinks -
water, soup, tea.
6. You cannot get (infected with) Ebola by talking to
people, walking in the street, or shopping in the market.
7. Ebola patients should always drink water and liters
of Oral Rehydration Solution every day.
8. Aspirin or ibuprofen should not be given to
sick patients because it may worsen the bleed
Preventive measures for health care workers
Preventive measures for health care workers include the
standard and specific measures [3].
Standard measures
1. Hand hygiene.
2. Disposable medical examination gloves before contact with
body fluids, mucous membrane, non-intact skin and
contaminated items.
3. Gown and eye protection before each procedure and
patient-care activities.
4. Safe injection practices and safe handling and
disposal of sharp instruments along with safe laundry and
waste management should be practiced.
Specific measures
1. Isolation: Always Isolate suspected cases
or cohort them in specific confined areas, separate from
confirmed cases. Distance between patient bed should at
least 1 meter and dedicate care equipment to suspected
cases.
2. Assignment and access: Clinical and non-clinical staff to
care areas should be exclusively assigned. Restrict access
to all others to dedicated areas.
3. Personal protective equipment (PPE): Includes
gloves, an impermeable long-sleeve gown, boots/closed-toe
shoes with overshoes, and a mask and eye protection for
splashes. Strict use of PPE prior to entering care areas.
Perform careful removal of PPE to avoid contamination of any
area of the face (i.e. eyes, nose, or mouth) or non-intact
skin .
4. Injection, sharp and phlebotomy safey: Use of
needles and other sharp objects should be limited, cover
abrasions, and wear PPE. Puncture-resistant containers
should be used to dispose sharps.
5. Environmental cleaning, waste and linen disposal: PPE (as
detailed above) including heavy duty/rubber gloves should be
worn by cleaners. Clean surfaces at least once a day with
clean water and detergent. Clean contaminated surfaces as
soon as possible, clean and then use standard hospital
disinfectant (e.g. a 0.5% chlorine solution or a solution
containing 1000 ppm available free chlorine). oiled
linen should be placed in clearly-labelled, leak-proof
bags or buckets and transported to the laundry. Scrape away
solid excrement (i.e. faeces or vomit), wash with detergent
and water, rinse and then soak in 0.05% chlorine for
approximately 30 minutes.
6. Laboratory safety: Ensure safe handling of laboratory
samples, i.e. use of PPE, safe collection and sample
processes from confirmed or suspected cases.
7. Safe care of the dead: Keep the handling of human remains
and dead bodies to a minimum. Wear PPE. Only trained staff
should undertake the recommended procedures for burial while
taking into account cultural and religious concerns.
Exposure Incidents
Evaluate, care for, and if necessary, isolate health-care
workers or any person exposed to blood or body fluids from
confirmed or suspected patients.
As ebola virus disease is associated with high rate of
morbidity and mortality among infected patients and risk of
transmission from human to human being high its better
always general public should be aware of symptoms and attend
medical facilities. Standard as well as specific
contact, and droplet precautions are recommended for
management of hospitalized patients with known or suspected
Ebola virus disease.
References
1. Review of Human-to-Human Transmission of Ebola Virus.
Centers for Disease Control and Prevention, USA. Available at:
http://www.cdc.gov/vhf/ebola/transmission/human-transmission.html.
Accessed on 29th December 2014.
2. Ebola: protective measures for general public, World Health
Organization. Available at:
http://www.who.int/csr/disease/ebola/what-you-need-to-know/en/.
Accessed on 29th December 2014.
3. Infection prevention and control (IPC) guidance summary.
Ebola guidance package, World Health Organization.
http://www.who.int/csr/disease/ebola/evd-guidance-summary/en/.
Accessed on 29th December 2014.