The Ebola outbreak in West Africa is an international public health emergency. As the world responds, there is a risk that American responders working on the ground may be exposed to the virus or become ill. This summer, two American health care workers infected with Ebola while working in West Africa were successfully treated at Emory University Hospital. Their health care team used the proper infection control practices and there was no transmission of the virus to the health care team or others in the hospital and community.
Now two more American health care workers working in West Africa have become infected with Ebola virus and are being treated in the United States.
CDC has already consulted with state and local health departments on almost 100 cases where travelers had recently returned from West Africa and showed symptoms that might have been caused by Ebola. Of those cases, only eleven of were considered to be truly at risk. Specimens from all eleven patients were tested and fortunately Ebola was ruled out in all cases.
There is understandably a lot of fear surrounding Ebola. The health care workers who might need to care for Ebola patients are right to be concerned – and they should use that concern to increase their awareness and motivation to practice the meticulous infection control measures we know will prevent transmission of the virus.
Hospitals and health care facilities must review their infection control practices, including how they’re handling environmental infection control.
When we issued our infection prevention and control recommendations for hospitalized patients with known or suspected Ebola virus disease , we began hearing from those concerned that standard environmental infection control procedures might not be sufficient.
Part of the concern is that no EPA-registered disinfectant has a labeling claim specifying that it is effective against the Ebola virus. You cannot go to the shelf and find a product that says it will be effective in killing Ebola. However, because Ebola is readily killed by soap and water, bleach, or hospital disinfectants that are labeled as being effective against non-enveloped viruses, standard infection control procedures are indeed sufficient.
There has been no evidence of Ebola virus transmission from either the environment, or from surfaces such as bed rails, door knobs, and laundry that could be contaminated during patient care. The Ebola virus is a fragile virus – once the envelope of the virus is destroyed, it cannot survive long-term in the environment. This is unlike non-enveloped viruses such as norovirus, rotavirus, and adenovirus, which do survive and transmit from person-to-person off environmental surfaces.
Early recognition of patients is critical for implementing infection control measures that will ensure other patients and staff are protected. Diligent environmental cleaning and disinfection as well as safe handling of potentially contaminated materials are of paramount importance.
CDC has now issued further specific guidance and answers to frequently asked questions on environmental infection control procedures where there is a confirmed case of Ebola virus disease, such as how to handle disposable materials and patient waste.
Review these guidelines with your staff. Any U.S. hospital that is following CDC’s infection control recommendations, and can isolate a patient in a private room, is capable of safely managing a patient with Ebola virus disease.
Whether for Ebola or any other infectious disease, it is essential to be prepared.
Dr. Thomas Frieden is CDC Director.