COCA Now: Ebola: U.S. Healthcare Infection Prevention and Control Considerations

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Ebola: U.S. Healthcare Infection Prevention 

and Control Considerations

Digitally-colorized, transmission electron microscopic (TEM) image revealed some of the ultrastructural morphology displayed by an Ebola virus virion

The ongoing outbreak of Ebola virus disease (EVD) in the Democratic Republic of Congo (DRC) serves as a reminder for U.S. healthcare facilities to review their infection prevention and control processes to safely identify and manage patients with communicable infections. This COCA Now provides an update about CDC infection prevention and control guidance, and related concerns pertinent to U.S. healthcare facilities and personnel.

Initial Triage of Patients

Here are the steps that facilities should implement as a routine part of triage to quickly identify, isolate, and inform public health authorities about patients who may have communicable infections:

  • Ask about and document international travel histories at initial triage. This information can alert healthcare personnel to the possibility of communicable infections, such as viral hemorrhagic fevers or emerging respiratory viruses, and other health conditions, such as malaria, that need specific treatment.
  • Identify patients who have fever and other signs and symptoms of infection and might warrant isolation pending further evaluation.
  • Post contact information in easily visible locations for infection control personnel and the local public health jurisdiction for reporting of communicable diseases.

Current Infection Prevention and Control Recommendations for Ebola Virus Disease in U.S. Healthcare Facilities

CDC recommendations for infection prevention and control for patients with confirmed EVD or persons under investigation (PUIs) for EVD in U.S. healthcare facilities have been recently reviewed and are considered up to date. To clarify,

The Regional Treatment Network for Ebola and Other Special Pathogens

Healthcare facilities and public health officials should be familiar with the U.S. Regional Treatment Network for Ebola and Other Special Pathogens. This includes facilities understanding their designated role as part of the network, continuing to be willing to serve in that capacity, and maintaining preparedness as a Frontline facility, State-designated Assessment Hospital, State-designated Treatment Center, or HHS Assistant Secretary for Preparedness and Response (ASPR)-designated Regional Treatment Center.

  • Healthcare facilities and public health officials should have established plans for how PUIs or EVD patients are to be managed and referred.
  • Officials with responsibility for infectious diseases epidemiology and healthcare infection control should be in communication with their preparedness counterparts to ensure mutual understanding of the designations and preparedness status of assessment and treatment centers in their jurisdictions.
  • The National Ebola Training and Education Center (NETEC) is co-funded by ASPR and CDC. NETEC has additional online resources and a blog, and remains available to provide on-site readiness assessments to hospitals for Ebola and other special pathogens.

Additional Resources

  • CDC EVD website
  • World Health Organization Ebola situation reports: Democratic Republic of the Congo
  • CDC Travel Health Notice for the current outbreak in DRC, including special recommendations for healthcare personnel and organizations sponsoring healthcare personnel in the outbreak area.
  • The National Institutes of Health (NIH) has an open-label clinical trial, titled “Pre-Exposure Prophylaxis in Individuals at Potential Occupational Risk for Ebola Virus Exposure” or “PREPARE,” to vaccinate adult volunteers (including deploying healthcare personnel and other responders) against Ebola. Study sites are at NIH in Bethesda, MD, and Emory University in Atlanta, GA.