Ebola Hemorrhagic Fever: CDC Guidance
About the transmission of the Ebola Virus Disease:
The natural reservoir host of ebolaviruses, and the manner in which transmission of the virus to humans occurs, remain unknown. This makes risk assessment in endemic areas difficult. During outbreaks of Ebola, those at highest risk include health care workers and the family and friends of an infected individual.
When an infection does occur in humans, there are several ways in which the virus can be transmitted to others, including:
- direct contact with the blood or secretions of an infected person
- exposure to objects (such as needles) that have been contaminated with infected secretions
Medical professionals in the U.S. should consult the Centers for Disease Control and Prevention (CDC) Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Hemorrhagic Fever in the U.S., which have been recently updated. Standard, contact, and droplet precautions are recommended for any patients with known or suspected Ebola. 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. This guidance is not intended to apply to persons outside of healthcare settings.
To help prevent the transmission of the Ebola Virus Disease, the CDC recommends the following measures:
Environmental Cleaning and Disinfection:
- Medical Equipment: All non-dedicated, non-disposable medical equipment used for patient care should be cleaned and disinfected according to manufacturer’s instructions and hospital policies. Dedicated medical equipment should be used for the provision of patient care 2.
- Environmental Cleaning and Disinfection: Use a U.S. Environmental Protection Agency (EPA)-registered hospital disinfectant with a label claim for a non-enveloped virus (e.g., norovirus, rotavirus, adenovirus, poliovirus) to disinfect environmental surfaces in rooms of patients with suspected or confirmed Ebola virus infection. Although there are no products with specific label claims against the Ebola virus, enveloped viruses such as Ebola are susceptible to a broad range of hospital disinfectants used to disinfect hard, non-porous surfaces. In contrast, non-enveloped viruses are more resistant to disinfectants. As a precaution, selection of a disinfectant product with a higher potency than what is normally required for an enveloped virus is being recommended at this time. EPA-registered hospital disinfectants with label claims against non-enveloped viruses (e.g., Norovirus, Rotavirus, Adenovirus, Poliovirus) are broadly antiviral and capable of inactivating both enveloped and non-enveloped viruses.
- Proper Use of Healthcare-Grade Disinfectants for Ebola Virus: Disinfectant products should be used in accordance with the manufacturer’s instructions for the specific label claim and in a manner consistent with environmental infection control recommendations.
- 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.
Personal Protective Equipment (PPE):
- Disinfection of PPE prior to taking off: CDC recommends disinfecting visibly contaminated PPE using an EPA-registered disinfectant wipe prior to taking off equipment. Additionally, CDC recommends disinfection of gloved hands using either an EPA-registered disinfectant wipe or alcohol-based hand rub between steps of taking off PPE.
- Step-by-step PPE removal instructions that include: Disinfecting visibly contaminated PPE using an EPA-registered disinfectant wipe prior to taking off equipment.
- Disinfection of gloved hands: using either an EPA-registered disinfectant wipe or alcohol-based hand rub between steps of taking off PPE. Also, the World Health Organization (WHO) has released a detailed report on proper handling of Ebola virus patients by Healthcare Providers, as well as proper steps for.
As additional information becomes available, these recommendations will be re-evaluated and updated as needed.
- Ebola Hemorrhagic Fever, Electronically Accessed from http://www.cdc.gov/vhf/ebola/hcp/index.html, October 2014, US Centers for Disease Control and Prevention.
- Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Hemorrhagic Fever in U.S. Hospitals, Electronically Accessed on August 20, 2014 from http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html, US Centers for Disease Control and Prevention.
- Interim Guidance for Environmental Infection Control in Hospitals for Ebola Virus, Electronically Accessed August 20, 2014 from http://www.cdc.gov/vhf/ebola/hcp/environmental-infection-control-in-hospitals.html, US Centers for Disease Control and Prevention.
Ebola Guidance Quicklinks:
Environmental Protection Agency (EPA)
- Disinfectant guidance: http://epa.gov/oppad001/ebola-efficacy-claims.html
Centers for Disease Control and Prevention:
- Overview: http://www.cdc.gov/vhf/ebola/index.html
- Information for Healthcare Workers and Settings: http://www.cdc.gov/vhf/ebola/hcp/index.html
- Infection Prevention and Control Recommendations: http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html
- Personal Protective Equipment: http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html
- Interim Guidance for Environmental Infection Control in Hospitals: http://www.cdc.gov/vhf/ebola/hcp/environmental-infection-control-in-hospitals.html
- Safely Performing Acute Hemodialysis in Patients: http://www.cdc.gov/vhf/ebola/hcp/guidance-dialysis.html
- Ebola-Associated Waste Management: http://www.cdc.gov/vhf/ebola/hcp/medical-waste-management.html
- Resources for Environmental Service Professionals: http://www.ahe.org/ahe/learn/ebola_reference.shtml
- Infection Prevention and Control Resources: http://apic.org/Resources/Topic-specific-infection-prevention/Ebola
World Health Organization
- Personal Protective Equipment: http://www.who.int/csr/disease/ebola/put_on_ppequipment.pdf?ua=1
Emory Healthcare Ebola Preparedness Protocols: http://www.emoryhealthcare.org/ebola-protocol/pdf/ehc-evd-protocols.pdf
Joint Commission Ebola Preparedness Resources: http://www.jointcommission.org/topics/ebola_preparedness_resources.aspx