Good outbreak control relies on a package of
interventions, namely case management, surveillance and contact tracing, a good
laboratory service, safe burials and social mobilization. Community engagement
is key to awareness of risk factor to Ebola infection and an effective way to reduce
human transmission. Risk reduction messaging should focus on several factors;
interventions, namely case management, surveillance and contact tracing, a good
laboratory service, safe burials and social mobilization. Community engagement
is key to awareness of risk factor to Ebola infection and an effective way to reduce
human transmission. Risk reduction messaging should focus on several factors;
·
Reducing the risk of wildlife to human
transmission from contact with infected fruit bats or monkeys/apes and the
consumption of raw meat. Animals should be handled with gloves and other
appropriate protective clothing. Animal products (blood and meat) should be
thoroughly cooked before consumption.
Reducing the risk of wildlife to human
transmission from contact with infected fruit bats or monkeys/apes and the
consumption of raw meat. Animals should be handled with gloves and other
appropriate protective clothing. Animal products (blood and meat) should be
thoroughly cooked before consumption.
·
Reducing risk of human-to-human transmission
from direct or close contact with people with Ebola symptoms, particularly with
their bodily fluids. Gloves and appropriate personal protective equipment
should be worn when taking care of ill patients at home. Regular hand washing
after visiting patients in hospital, as well as after taking care of patients
at home.
Reducing risk of human-to-human transmission
from direct or close contact with people with Ebola symptoms, particularly with
their bodily fluids. Gloves and appropriate personal protective equipment
should be worn when taking care of ill patients at home. Regular hand washing
after visiting patients in hospital, as well as after taking care of patients
at home.
·
Outbreak containment measures including prompt
and safe burial of the dead, identifying people who may have been in contact
with someone infected with Ebola, monitoring the health of contacts for 2 days,
the importance of separating the healthy from the sick to prevent further
spread, the importance of good hygiene and maintaining a clean environment.
Outbreak containment measures including prompt
and safe burial of the dead, identifying people who may have been in contact
with someone infected with Ebola, monitoring the health of contacts for 2 days,
the importance of separating the healthy from the sick to prevent further
spread, the importance of good hygiene and maintaining a clean environment.
·
Controlling infection on health care settings.
Health care workers should always take standard precautions when caring for
patients, regardless of their presumed diagnosis. These include basic hand
hygiene, respiratory hygiene, use of personal protective equipment (to block
splashes or other contact with infected materials), safe injection practices
and safe burial practices.
Controlling infection on health care settings.
Health care workers should always take standard precautions when caring for
patients, regardless of their presumed diagnosis. These include basic hand
hygiene, respiratory hygiene, use of personal protective equipment (to block
splashes or other contact with infected materials), safe injection practices
and safe burial practices.
·
Health care workers caring for patient with
suspected or confirmed Ebola virus should apply extra infection control
measures to prevent contact with the patient’s blood and body fluid and
contaminated surfaces or materials such as clothing and beddings. When in close
contact (within 1 metre) of patients with EBV, health workers should wear face
protection (a face shield or medical mask and goggles), a clean, sterile
long-sleeves gown and goggles (sterile gloves for some procedures).
Health care workers caring for patient with
suspected or confirmed Ebola virus should apply extra infection control
measures to prevent contact with the patient’s blood and body fluid and
contaminated surfaces or materials such as clothing and beddings. When in close
contact (within 1 metre) of patients with EBV, health workers should wear face
protection (a face shield or medical mask and goggles), a clean, sterile
long-sleeves gown and goggles (sterile gloves for some procedures).
·
Laboratory workers are also at risk. Samples
taken from humans and animals for investigations of Ebola infection should be
handled by trained staff and processed in suitably equipped laboratories.
Laboratory workers are also at risk. Samples
taken from humans and animals for investigations of Ebola infection should be
handled by trained staff and processed in suitably equipped laboratories.
Prevention
·
Wash hands as needed
Wash hands as needed
·
Isolate the patient
Isolate the patient
·
Wear protective clothing
Wear protective clothing
·
Dispose off needles and syringes safely
Dispose off needles and syringes safely
·
Dispose of waste safely
Dispose of waste safely
·
Use safe burial practices
Use safe burial practices
Infection Control
People who care for those infected with Ebola
virus should wear protecting clothing, including masks, gowns and goggles. The
infected person should be barrier isolated form other people. All equipment,
medical waste, patient waste and surfaces that may have come into contact with
body fluid need to be disinfected.
virus should wear protecting clothing, including masks, gowns and goggles. The
infected person should be barrier isolated form other people. All equipment,
medical waste, patient waste and surfaces that may have come into contact with
body fluid need to be disinfected.
In 2014, the CDC began recommending that medical
personnel receive training on the proper suit-up and removal of personal
protective equipment (PPE). In addition, a designated person, appropriately
trained in biosafety, should be watching each step of these procedures to
ensure they are done correctly in putting on and removing protective equipment.
personnel receive training on the proper suit-up and removal of personal
protective equipment (PPE). In addition, a designated person, appropriately
trained in biosafety, should be watching each step of these procedures to
ensure they are done correctly in putting on and removing protective equipment.
Isolation: isolation refers to separating those who are
sick from those who are not. Quarantine refers to separating those who may have
been exposed to a disease until they either show signs of the disease or are no
longer at risk.
sick from those who are not. Quarantine refers to separating those who may have
been exposed to a disease until they either show signs of the disease or are no
longer at risk.
Quarantine, also known as enforced isolation is
usually effective in decreasing spread. Government often quarantine areas where
the disease outside of an initial area.
usually effective in decreasing spread. Government often quarantine areas where
the disease outside of an initial area.
Contact Tracing: Contact tracing is considered important to
contain an outbreak. It involves finding everyone who had close contact with
infected individuals and watching for signs of illness for 21 days. If any of
these contacts comes down with the disease, they should be isolated, tested and
treated. Then the process is repeated by tracing the contacts’ contacts.
contain an outbreak. It involves finding everyone who had close contact with
infected individuals and watching for signs of illness for 21 days. If any of
these contacts comes down with the disease, they should be isolated, tested and
treated. Then the process is repeated by tracing the contacts’ contacts.
If professional care is not possible, guidelines
by WHO for care at home have been relatively successful. In such situations,
recommendations include using towel soaked in bleach solutions when moving
infected people or bodies and applying bleach on stains. It is also recommended
that the caregivers wash their hands with bleach solutions and cover their
mouth and noise with cloth.
by WHO for care at home have been relatively successful. In such situations,
recommendations include using towel soaked in bleach solutions when moving
infected people or bodies and applying bleach on stains. It is also recommended
that the caregivers wash their hands with bleach solutions and cover their
mouth and noise with cloth.
Intensive care is often in the developed world. This
may include maintaining blood volume and electrolytes (salts) balance as well
as treating any bacterial infections that may develop.
may include maintaining blood volume and electrolytes (salts) balance as well
as treating any bacterial infections that may develop.
Health workers treating those who are infected are at
greatest risk of getting infected themselves. The risk increases when these
workers do not have appropriate protective clothing as well as mask, gowns,
gloves and eye protection; do not wear it properly or handle contaminated
clothing incorrectly. The risk is particularly common in parts of Africa where
health system functions poorly and where the disease mostly occurs.
greatest risk of getting infected themselves. The risk increases when these
workers do not have appropriate protective clothing as well as mask, gowns,
gloves and eye protection; do not wear it properly or handle contaminated
clothing incorrectly. The risk is particularly common in parts of Africa where
health system functions poorly and where the disease mostly occurs.
Hospital-acquired transmission has also occurred in
some African countries resulting from the reuse of needles. Some health care
centres caring for people with the disease do not have running water.
some African countries resulting from the reuse of needles. Some health care
centres caring for people with the disease do not have running water.
Treatment
No specific treatment is currently approved.
However, survival is improved by early supportive care with rehydration and
symptomatic treatment. Treatment is primarily supportive in nature. These
measures may include management of pain, nausea, fever and anxiety, as well as
rehydration via the oral or by intravenous route.
However, survival is improved by early supportive care with rehydration and
symptomatic treatment. Treatment is primarily supportive in nature. These
measures may include management of pain, nausea, fever and anxiety, as well as
rehydration via the oral or by intravenous route.
The WHO recommends avoiding the use of aspirin or
Ibuprofen for pain due to the bleeding risk associated with use of these
medications. Blood products such as packed red blood cells, platelets or fresh
frozen plasma may also be used. Other regulators of coagulation have also been
tried including heparin in an effort to prevent disseminated intravascular
coagulation and clotting factors to decrease bleeding. Antimalarial medications
and antibiotics are often used before the diagnosis is confirmed, though there
is no evidence to suggest such treatment is in any way helpful. Interferon
therapies have been tried as a form of treatment of EVD but were found to be
ineffective
Ibuprofen for pain due to the bleeding risk associated with use of these
medications. Blood products such as packed red blood cells, platelets or fresh
frozen plasma may also be used. Other regulators of coagulation have also been
tried including heparin in an effort to prevent disseminated intravascular
coagulation and clotting factors to decrease bleeding. Antimalarial medications
and antibiotics are often used before the diagnosis is confirmed, though there
is no evidence to suggest such treatment is in any way helpful. Interferon
therapies have been tried as a form of treatment of EVD but were found to be
ineffective
