With two American Missionaries infected with Ebola expected to arrive in the United States as soon as this weekend (see State Department statement below) – and the possibility that infected international travelers might find their way to our shores – it is not altogether surprising that the CDC today has issued Infection Prevention and Control Recommendations for health care facilities treating suspected or confirmed Ebola cases.
First, the statement from the U.S. Department of State.
Deputy Department Spokesperson, Office of the Spokesperson
August 1, 2014
The State Department, together with the Centers for Disease Control and Prevention (CDC), is facilitating a medical evacuation for two U.S. citizens who have been infected by Ebola in West Africa. The safety and security of U.S. citizens is our paramount concern. Every precaution is being taken to move the patients safely and securely, to provide critical care en route on a non-commercial aircraft, and to maintain strict isolation upon arrival in the United States.
These evacuations will take place over the coming days. CDC protocols and equipment are used for these kinds of medical evacuations so that they are carried out safely, thereby protecting the patient and the American public, as has been done with similar medical evacuations in the past.
Upon arriving in the United States, the patients will be taken to medical facilities with appropriate isolation and treatment capabilities.
Because of privacy considerations, we will not be able to confirm the names or other specific details of these particular cases.
For matters relating to public health precautions in the United States, we would refer to the CDC, which has the overall lead role on those issues within the U.S. Government.
The CDC’s Infection control guidance (h/t @Influenza_bio for tweeting the link) is too lengthy to try to post in it’s entirety, so I’ll just show an excerpt, and ask those with need for the details to follow the link to the CDC website.
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
Follow the above link for specific information on Patient Isolation, PPEs, Aerosol Generating Procedures, Environmental Infection control, monitoring potentially exposed personnel . . . and more.