The current Ebola outbreak is centered on three countries in West Africa: Liberia, Guinea, Sierra Leone, although there is the potential for further spread to neighboring African countries.
Ebola does not pose a significant risk to the U.S. public. The CDC is surging resources by sending 50 more workers to the area to help bring the outbreak under control.
What is Ebola?
Ebola virus is the cause of a viral hemorrhagic fever disease. Symptoms include: fever, headache, joint and muscle aches, weakness, diarrhea, vomiting, stomach pain, lack of appetite, and abnormal bleeding. Symptoms may appear anywhere from 2 to 21 days after exposure to ebolavirus though 8-10 days is most common.
How is Ebola transmitted? Ebola is transmitted through direct contact with the blood or bodily fluids of an infected symptomatic person or though exposure to objects (such as needles) that have been contaminated with infected secretions.
Can Ebola be transmitted through the air? No. Ebola is not a respiratory disease like the flu, so it is not transmitted through the air.
Can I get Ebola from contaminated food or water? No. Ebola is not a food-borne illness. It is not a water-borne illness.
Can I get Ebola from a person who is infected but doesn’t have any symptoms? No. Individuals who are not symptomatic are not contagious. In order for the virus to be transmitted, an individual would have to have direct contact with an individual who is experiencing symptoms.
Are there any cases of individuals contracting Ebola in the U.S.?No.
What is being done to prevent ill passengers in West Africa from getting on a plane? CDC is assisting with active screening and education efforts on the ground in West Africa to prevent sick travelers from getting on planes. In addition, airports in Liberia, Sierra Leone and Guinea are screening all outbound passengers for Ebola symptoms, including fever, and passengers are required to respond to a healthcare questionnaire. CDC is also surging support in the region by deploying 50 additional workers to help build capacity on the ground.
What is CDC doing in the U.S.? On the remote possibility that an ill passenger enters the U.S., CDC has protocols in place to protect against further spread of disease. These include notification to CDC of ill passengers on a plane before arrival, investigation of ill travelers, and, if necessary, isolation. CDC has also provided guidance to airlines for managing ill passengers and crew and for disinfecting aircraft. CDC has issued a Health Alert Notice reminding U.S. healthcare workers of the importance of taking steps to prevent the spread of this virus, how to test and isolate suspected patients and how they can protect themselves from infection.
What about ill Americans with Ebola who are being brought to the U.S. for treatment? How is CDC protecting the American public? CDC has very well-established protocols in place to ensure the safe transport and care of patients with infectious diseases back to the United States. These procedures cover the entire process -- from patients leaving their bedside in a foreign country to their transport to an airport and boarding a non-commercial airplane equipped with a special transport isolation unit, to their arrival at a medical facility in the United States that is appropriately equipped and staffed to handle such cases. CDC’s role is to ensure that travel and hospitalization is done to minimize risk of spread of infection and to ensure that the American public is protected. Patients were evacuated in similar ways during SARS.
What does the CDC’s Travel Alert Level 3 mean to U.S. travelers? On July 31, the CDC elevated their warning to U.S. citizens encouraging them to defer unnecessary travel to Guinea, Liberia, and Sierra Leone over concerns that travelers may not have access to health care facilities and personnel should they need them in country.
For more information please see this statement from the Department of State. -###-
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Contact CDC–INFO About VSPB (Viral Special Pathogens Branch) Ebola Homepage About Ebola Transmission Signs and Symptoms Risk of Exposure Diagnosis Treatment Prevention Resources Information For: Working and Living Abroad Travelers Health Care Workers More File Formats Help: Page last updated: August 1, 2014 @TJCommission: @CDCGov has released a guide for health care organizations on how to treat patients with or suspected to have #Ebola http://t.co/lnE4wjNhjC Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Hemorrhagic Fever in U.S. Hospitals Standard, contact, and droplet precautions are recommended for management of hospitalized patients with known or suspected Ebola hemorrhagic fever (Ebola HF), also referred to as Ebola Viral Disease (EVD) (See Table below).
Note that this guidance outlines only those measures that are specific for Ebola HF; additional infection control measures might be warranted if an Ebola HF patient has other conditions or illnesses for which other measures are indicated (e.g., tuberculosis, multi-drug resistant organisms, etc.).
Though these recommendations focus on the hospital setting, the recommendations for personal protective equipment (PPE) and environmental infection control measures are applicable to any healthcare setting.
In this guidance healthcare personnel (HCP) refers all persons, paid and unpaid, working in healthcare settings who have the potential for exposure to patients and/or to infectious materials, including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces, or contaminated air.
HCP include, but are not limited to, physicians, nurses, nursing assistants, therapists, technicians, emergency medical service personnel, dental personnel, pharmacists, laboratory personnel, autopsy personnel, students and trainees, contractual personnel, home healthcare personnel, and persons not directly involved in patient care (e.g., clerical, dietary, house-keeping, laundry, security, maintenance, billing, chaplains, and volunteers) but potentially exposed to infectious agents that can be transmitted to and from HCP and patients.
This guidance is not intended to apply to persons outside of healthcare settings. As information becomes available, these recommendations will be re-evaluated and updated as needed.
These recommendations are based upon available information (as of July 30, 2014) and the following considerations: High rate of morbidity and mortality among infected patients Risk of human-to-human transmission Lack of FDA-approved vaccine and therapeutics.
For full details of standard, contact, and droplet precautions see 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Setting.
For information on symptoms of Ebola Hemorrhagic Fever infection and modes of transmission, see the CDC Ebola Hemorrhagic Fever Website. Key Components of Standard, Contact, and Droplet Precautions Recommended for Prevention of EHF Transmission in U.S. Hospitals Component Recommendation Comments Patient Placement Single patient room (containing a private bathroom) with the door closed Facilities should maintain a log of all persons entering the patient's room Consider posting personnel at the patient’s door to ensure appropriate and consistent use of PPE by all persons entering the patient room Personal Protective Equipment (PPE).
All persons entering the patient room should wear at least: Gloves Gown (fluid resistant or impermeable) Eye protection (goggles or face shield) Facemask Additional PPE might be required in certain situations (e.g., copious amounts of blood, other body fluids, vomit, or feces present in the environment), including but not limited to: Double gloving Disposable shoe covers Leg coverings Recommended PPE should be worn by HCP upon entry into patient rooms or care areas. Upon exit from the patient room or care area, PPE should be carefully removed without contaminating one’s eyes, mucous membranes, or clothing with potentially infectious materials, and either Discarded, or For re-useable PPE, cleaned and disinfected according to the manufacturer's reprocessing instructions and hospital policies.
Instructions for donning and removing PPE have been published Hand hygiene should be performed immediately after removal of PPE Patient Care Equipment Dedicated medical equipment (preferably disposable, when possible) should be used for the provision of patient care All non-dedicated, non-disposable medical equipment used for patient care should be cleaned and disinfected according to manufacturer's instructions and hospital policies Patient Care Considerations Limit the use of needles and other sharps as much as possible Phlebotomy, procedures, and laboratory testing should be limited to the minimum necessary for essential diagnostic evaluation and medical care.
All needles and sharps should be handled with extreme care and disposed in puncture-proof, sealed containers Aerosol Generating Procedures (AGPs) Avoid AGPs for Ebola HF patients.
If performing AGPs, use a combination of measures to reduce exposures from aerosol-generating procedures when performed on Ebola HF patients.
Visitors should not be present during aerosol-generating procedures. Limiting the number of HCP present during the procedure to only those essential for patient-care and support. Conduct the procedures in a private room and ideally in an Airborne Infection Isolation Room (AIIR) when feasible. Room doors should be kept closed during the procedure except when entering or leaving the room, and entry and exit should be minimized during and shortly after the procedure. HCP should wear gloves, a gown, disposable shoe covers, and either a face shield that fully covers the front and sides of the face or goggles, and respiratory protection that is at least as protective as a NIOSH certified fit-tested N95 filtering facepiece respirator or higher (e.g., powered air purifying respiratory or elastomeric respirator) during aerosol generating procedures. Conduct environmental surface cleaning following procedures (see section below on environmental infection control). If re-usable equipment or PPE (e.g. Powered air purifying respirator, elastomeric respirator, etc.) are used, they should be cleaned and disinfected according to manufacturer instructions and hospital policies.
Collection and handling of soiled re-usable respirators must be done by trained individuals using PPE as described above for routine patient care Although there are limited data available to definitively define a list of AGPs, procedures that are usually included are Bilevel Positive Airway Pressure (BiPAP), bronchoscopy, sputum induction, intubation and extubation, and open suctioning of airways.
Because of the potential risk to individuals reprocessing reusable respirators, disposable filtering face piece respirators are preferred. Hand Hygiene HCP should perform hand hygiene frequently, including before and after all patient contact, contact with potentially infectious material, and before putting on and upon removal of PPE, including gloves.
Healthcare facilities should ensure that supplies for performing hand hygiene are available. Hand hygiene in healthcare settings can be performed by washing with soap and water or using alcohol-based hand rubs.
If hands are visibly soiled, use soap and water, not alcohol-based hand rubs. Environmental Infection Control Diligent environmental cleaning and disinfection and safe handling of potentially contaminated materials is paramount, as blood, sweat, emesis, feces and other body secretions represent potentially infectious materials HCP performing environmental cleaning and disinfection should wear recommended PPE (described above) and consider use of additional barriers (shoe and leg coverings, etc.) if needed.
Face protection (face shield or facemask with goggles) should be worn when performing tasks such as liquid waste disposal that can generate splashes.
Follow standard procedures, per hospital policy and manufacturers' instructions, for cleaning and/or disinfection of: Environmental surfaces and equipment Textiles and laundry Food utensils and dishware Use EPA-registered hospital disinfectants to disinfect hard non-porous surfaces. Follow label instructions for use Searchable EPA website of registered products For additional information on Environmental Infection Control, see the Guideline for Environmental Infection Control in Healthcare Facilities Safe Injection practices Facilities should follow safe injection practices as specified under Standard Precautions.
Any injection equipment or parenteral medication container that enters the patient treatment area should be dedicated to that patient and disposed of at the point of use. Duration of Infection Control Precautions Duration of precautions should be determined on a case-by-case basis, in conjunction with local, state, and federal health authorities. Factors that should be considered include, but are not limited to: presence of symptoms related to Ebola HF, date symptoms resolved, other conditions that would require specific precautions (e.g., tuberculosis, Clostridium difficile) and available laboratory information Monitoring and Management of Potentially Exposed Personnel Facilities should develop policies for monitoring and management of potentially exposed HCP Facilities should develop sick leave policies for HCP that are non-punitive, flexible and consistent with public health guidance Ensure that all HCP, including staff who are not directly employed by the healthcare facility but provide essential daily services, are aware of the sick leave policies.
Persons with percutaneous or mucocutaneous exposures to blood, body fluids, secretions, or excretions from a patient with suspected Ebola HF should Stop working and immediately wash the affected skin surfaces with soap and water. Mucous membranes (e.g., conjunctiva) should be irrigated with copious amounts of water or eyewash solution Immediately contact occupational health/supervisor for assessment and access to postexposure management services for all appropriate pathogens (e.g., Human Immunodeficiency Virus, Hepatitis C, etc.) HCP who develop sudden onset of fever, intense weakness or muscle pains, vomiting, diarrhea, or any signs of hemorrhage after an unprotected exposure (i.e. not wearing recommended PPE at the time of patient contact or through direct contact to blood or body fluids) to a patient with Ebola HF should Not report to work or should immediately stop working Notify their supervisor Seek prompt medical evaluation and testing Notify local and state health departments Comply with work exclusion until they are deemed no longer infectious to others.
For asymptomatic HCP who had an unprotected exposure (i.e. not wearing recommended PPE at the time of patient contact or through direct contact to blood or body fluids) to a patient with Ebola HF Should receive medical evaluation and follow-up care including fever monitoring twice daily for 21 days after the last known exposure.
Hospitals should consider policies ensuring twice daily contact with exposed personnel to discuss potential symptoms and document fever checks May continue to work while receiving twice daily fever checks, based upon hospital policy and discussion with local, state, and federal public health authorities. Monitoring, Management, and Training of Visitors Avoid entry of visitors into the patient's room.
Exceptions may be considered on a case by case basis for those who are essential for the patient's wellbeing. Establish procedures for monitoring managing and training visitors. Visits should be scheduled and controlled to allow for: Screening for Ebola HF (e.g., fever and other symptoms) before entering or upon arrival to the hospital .
Evaluating risk to the health of the visitor and ability to comply with precautions providing instruction, before entry into the patient care area on hand hygiene, limiting surfaces touched, and use of PPE according to the current facility policy while in the patient's room.
Visitor movement within the facility should be restricted to the patient care area and an immediately adjacent waiting area. Visitors who have been in contact with the Ebola HF patient before and during hospitalization are a possible source of EHF for other patients, visitors, and staff.
CDC′s #DiseaseDetectives, more formally known as Epidemic Intelligence Service (EIS) officers, are elite global health sleuths.
Leisha, a CDC Disease Detective, is in West Africa for her second 30-day tour of duty to help get the #Ebola outbreak under control.
Read more about the important work she has been doing on Ebola during her previous deployment: