Download Ebola - Allegan County

ALLEGAN COUNTY HEALTH DEPARTMENT
3255 – 122ND Ave., Suite 200, Allegan, MI 49010
Office Administration
(269) 673-5411
Bioterrorism Preparedness
(269) 686-4523
Personal Health
(269) 673-5413
Communicable Disease
(269) 686-4551
Environmental Health
(269) 673-5415
Resource Recovery
(269) 673-5415
August 6, 2014
Ebola hemorrhagic fever update
The Center for Disease Control stresses that the threat of Ebola spreading outside of West Africa is low and the
virus poses little risk to the U.S. No one has caught the disease in the U.S., however, in an effort to be proactive,
the Allegan County Health Department is distributing disease information.
Background
(Source of Information: CDC)
Ebola hemorrhagic fever (Ebola HF) is a severe, often fatal disease in humans and nonhuman primates. The natural reservoir
remains unknown, though new evidence strongly implements bats as the reservoir host.
Transmission
Human to human transmission occurs by direct contact with the blood or secretions of an infected person or exposure to
objects (such as needles) that have been contaminated with infected secretions.
The risk for person-to-person transmission of hemorrhagic fever (including Ebola) viruses is greatest during the latter stages of
illness when virus loads are highest; latter stages of illness are characterized by vomiting, diarrhea, shock, and in less than half
of infected patients, hemorrhage.
Signs and Symptoms
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Fever
Headache
Joint and muscle aches
Weakness
Diarrhea
Vomiting
Stomach pain
Lack of Appetite
Other Symptoms
Rash
Red Eyes
Hiccups
Cough
Sore throat
Chest pain
Bleeding inside and outside of body
Difficulty breathing and swallowing
Symptoms may appear from 2-21 days after exposure, though 8-10 days is most common.
Risk of Exposure
In Africa, confirmed cases have been reported in Guinea, Liberia, Sierra Leone, Democratic Republic of the Congo, Gabon,
South Sudan, Ivory Coast, Uganda, Republic of Congo, South Africa (imported)
Case Definition for Ebola Virus Disease (EVD)
Early recognition is critical for infection control. Healthcare providers should be alert for and evaluate any patients
suspected of having EVD.
Suspected Case
Illness in a person who has both consistent symptoms and risk factors as follows: 1) Clinical criteria, which includes fever of
greater than 38.6 degrees Celsius or 101.5 degrees Fahrenheit, and additional symptoms such as severe headache, muscle pain,
vomiting, diarrhea, abdominal pain, or unexplained hemorrhage; AND 2) Epidemiologic risk factors within the past 3 weeks
before the onset of symptoms, such as contact with blood or other body fluids of a patient known to have or suspected to have
EVD; residence in—or travel to—an area where EVD transmission is active; or direct handling of bats, rodents, or primates
from disease-endemic areas. Malaria diagnostics should also be a part of initial testing because it is a common cause of febrile
illness in persons with a travel history to the affected countries.
Confirmed Case
A suspected case with laboratory-confirmed diagnostic evidence of ebolavirus infection.
Diagnosis
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Within a few days after symptoms begin – Antigen-capture ELISA testing; IgM ELISA; PCR; Virus isolation
(not to be attempted in hospital labs).
2. Later in disease course or after recovery – IgM and IgG antibodies
3. Deceased patients – Immunohistochemistry testing; PCR; Virus isolation
Treatment
Limited to supportive therapy consisting of balancing the patient’s fluids and electrolytes; maintaining their oxygen status and
blood pressure; treating them for any complicating infections. If a person has the early symptoms of Ebola HF and there is
reason to believe that Ebola HF should be considered, the patient should be isolated and public health officials notified.
Supportive therapy can continue with proper protective clothing until samples from the patient are tested to confirm infection.
Prevention
Hospital Protocol for Possible Infected Patient with Ebola HF
Prior to Arrival to ED by Ambulance ( EMS considerations)
Emergency Department Protocol after Arrival of Patient to ED with Above Described Symptoms
Transfer to Floor
Specimen Handling
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CDC recommends a class II biological safety cabinet following biosafety level 3 practices.
If labs drawn, routine cleaning and disinfecting procedures can be used for automated analyzers – use ¼
cup household bleach to 1 gallon water.
Environmental Infection Control Procedures
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Environmental surfaces or inanimate objects contaminated with blood, other body fluids, secretions, or
excretions should be cleaned and disinfected using standard procedures.
Disinfection can be accomplished using a U.S. Environmental Protection Agency-registered hospital
disinfectant or a 1:100 dilution of household bleach (1/4 cup bleach to 1 gallon water). For grossly soiled
surfaces, (vomitus or stool), use 1:10 dilution of household bleach.
Soiled linens should be placed in clearly labeled leak-proof bags at the site of use, transported directly to
the laundry area, and laundered following routine healthcare laundry procedures.
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Liquid medical waste such as feces and vomitus can be disposed of in the sanitary sewer following local
sewage disposal requirements. Care should be taken to avoid splashing when disposing of these
materials.
When discarding solid material waste (needles, syringes, and tubing) contaminated with blood or other
body fluids from Ebola HF patients, contain the waste with minimal agitation during handling. Incinerate
on-site or off-site medical waste treatment resources.
Handling of Human Remains
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If patient dies, handling of the body should be minimized. The remains should not be embalmed, washed
or prepared in any way. Remains should be wrapped in sealed leak-proof material and cremated or
buried promptly in a sealed casket.
If an autopsy is necessary, the state health department and CDC should be consulted regarding
appropriate precautions.
Management of Exposures
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Persons with percutaneous or mucocutaneous exposures to blood, body fluids, secretions, or excretions
from a patient with suspected Ebola HF should immediately wash the affected skin surfaces with soap
and water.
Mucous membranes (e.g., conjunctiva) should be irrigated with copious amounts of water or eyewash
solution. Exposed persons should receive medical evaluation and follow-up care, including fever
monitoring twice daily for 21 days after exposure. Consult Infectious Disease expert when exposed
person develops fever within 21 days of exposure.
For more information go to: http://www.cdc.gov/vhf/ebola/index.html
If you have any questions please contact me.
Jackie Skelton RN, BSN, MPH
Communicable Disease Coordinator
Allegan County Health Department
269-686-4551
[email protected]