Download 3. Healthcare personnel can be exposed to Ebola virus by

Ebola
Submitted by Jeannie M. Yocum, CHUC of Fresno, California
Learning Objectives:
1. List three subtypes of Ebola that cause disease in humans.
2. List at least three symptoms of Ebola.
3. Describe the treatment plan for Ebola.
Ebola hemorrhagic fever (also just called Ebola) is a potentially fatal, highly contagious illness
caused by the Ebola virus which is one of two members of a family of ribonucleic acid (RNA)
viruses called Filoviridae. There are four identified subtypes of the virus. Three of the four have
caused disease in humans:
 Ebola-Zaire
 Ebola-Sudan
 Ebola-Ivory Coast
The fourth subtype, Ebola-Reston, has caused disease in nonhuman primates, but not in humans.
The Makona strain of Ebola virus that caused the outbreak in West Africa, killing more than
11,000 people and sickening even more, is apparently less virulent than the Mayinga strain
isolated in Central Africa in 1976, according to a study of macaque monkeys published on June
9, 2015 in the U.S. Centers of Disease Control and Prevention (CDC).
Ebola is often fatal in humans and nonhuman primates (monkeys, gorillas and chimpanzees).
The virus was first recognized in the Democratic Republic of the Congo (formerly Zaire), and it
has appeared sporadically since 1976. The exact origin, locations and natural habitat (known as
the natural reservoir) of the virus remain unknown; however, on the basis of available evidence
and the nature of similar viruses, researchers believe that the Ebola virus lives in an animal host
that is native to the African continent. They continue to search for the exact animal. Just as
scientists are unsure of the animal host for the virus, they are also unsure how an outbreak
occurs. Researchers have hypothesized that the first patient with Ebola becomes infected with the
virus through contact with an infected animal.
Once the virus infects the first human, transmission of Ebola continues through direct contact
with an infected person or his or her body fluids (such as blood or secretions). The spread of the
virus from an infected person most often occurs during the late stages of an infection. When a
person becomes infected with Ebola virus, the virus begins to multiply within the body. After
four to six days, on average, symptoms can begin. The period between infection with the virus
and the start of symptoms is called the incubation period. The incubation period for Ebola can be
as short as two days or as long as 21 days.
There are several common symptoms of Ebola, such as fever, sore throat, weakness, severe
headache, joint and muscle aches, diarrhea, vomiting, dehydration, dry/hacking cough, stomach
pain, internal bleeding, external bleeding, rash and hiccups. Sometimes the skin rash is not
recognized until the rash begins to peel. In pregnant women, miscarriage and heavy bleeding are
common Ebola symptoms.
In order to make a diagnosis, the doctor will ask a number of questions and perform a physical
exam. If the doctor suspects an Ebola virus infection, he or she will order lab tests that can
identify either the virus itself or antibodies made by the body against the virus. The CDC states
the following diagnostics tests are available:
 Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing
 IgM ELISA
 Polymerase chain reaction (PCR)
 Virus isolation
Before making a diagnosis of Ebola, the doctor will also consider other conditions that can cause
similar symptoms. Some of these conditions include:
 Influenza (the flu)
 Malaria (disease transmitted by an infected mosquito)
 Typhoid fever (disease transmitted by contaminated food or water)
 Other viral hemorrhagic fevers
There is only one Ebola cure: time. There is currently no proven treatment that can kill the virus.
Thus, treatment focuses on providing relief from symptoms as the body fights the virus. This is
called supportive care. The CDC states the following basic interventions, when used early, can
significantly improve the chances of survival:
 Providing intravenous fluids (IV) and balancing electrolytes (body salts).
 Maintaining oxygen status and blood pressure.
 Treating other infections if they occur.
Death occurs in between 50 and 90 percent of Ebola cases. Research scientists do not understand
why some people are able to recover from Ebola hemorrhagic fever and others are not; however,
it is known that victims usually have not developed a significant immune response to the virus at
the time of death.
Confirmed cases of Ebola virus infections have been reported in the Democratic Republic of the
Congo, the Ivory Coast, Gabon, Sudan, and Uganda. On September 30, 2014 the CDC confirmed
the first laboratory-confirmed case of Ebola to be diagnosed in the United States in a man who
had traveled to Dallas, Texas from Liberia. The man did not have symptoms when leaving
Liberia, but developed symptoms approximately four days after arriving in the United States.
After being admitted to the hospital the patient was isolated and specimens were sent to the CDC
and to a Texas laboratory. Local public health officials identified all close contacts of the index
patient for daily monitoring for 21 days after exposure. The patient passed away on October 8.
By November 7 all contacts of the patient completed the 21-day monitoring period.
The CDC recognizes that any case of Ebola diagnosed in the United States raises concerns, and
any death is too many. Medical and public health professionals across the country have been
preparing to respond to the possibility of additional cases. CDC and public health officials in
Texas, Ohio and New York took precautions to identify people who had close personal contact
with the patients, and healthcare professionals have been reminded to use meticulous infection
control practices at all times.
The CDC lists the following recommendations:
1. CDC recommends a combination of measures to prevent transmission of Ebola Virus
Disease in hospitals including Personal Protective Equipment (PPE). These should be
implemented in addition to routine practices that are implemented on a daily basis to
prevent transmission of infectious diseases from patient to patient and patient to
healthcare personnel.
2. Healthcare personnel might need to take additional infection control steps if a patient
under investigation or patient with confirmed Ebola has other conditions or illnesses
caused by specific infectious diseases, such as tuberculosis.
3. Healthcare personnel can be exposed to Ebola virus by touching a patient’s body fluids,
contaminated medical supplies and equipment, or contaminated environmental surfaces.
Splashes to unprotected mucous membranes (for example, the eyes, nose, or mouth) are
particularly hazardous. Procedures that can increase environmental contamination with
infectious material or create aerosols should be minimized.
As stated in the national health unit coordinator certification exam content outline, the certified
health unit coordinator should adhere to infection control standards and identify and correct
potential hazards. For the CHUC, this may involve ordering PPE supplies and posting signage at
the patient’s door to ensure appropriate and consistent use of PPE by all people entering the
patient room.
In the aftermath of the events of September and October 2001, there is heightened concern that
the Ebola virus might be used as an agent of bioterrorism. The deliberate release of Ebola virus is
now regarded as a possibility, and the United States is taking precautions to deal with this.
The Centers for Disease Control and Prevention (CDC) calls the Ebola virus a Category A agent.
Category A agents are believed to present the greatest potential threat for harming public health
and have a moderate to high potential for large-scale dissemination (spread). The public is
generally more aware of Category A agents, and broad-based public health preparedness efforts
are necessary. Other Category A agents include:
 Anthrax
 Plague
 Tularemia
 Smallpox
References
http://www.ebola.emedtv.com/ebola-articles.html
http://www.the-scientist.com/?articles.view/ar
http://www.cdc.gov/vhf/ebola/outbreaks/2014-wes
e-Learning QUIZ
ID # Web-06-01-16
DEADLINE FOR SUBMISSION OF THIS QUESTIONNAIRE IS MAY 31, 2017.
Subject: Ebola
Submitted by: Jeannie M. Yocum, CHUC of Fresno, California
Objective: To identify facts about Ebola.
Resources: Accompanying article submitted by Jeannie M. Yocum, CHUC
Instructions: After reading the article, please write your answers to the following questions on
the answer sheet on the last page.
1. What is Ebola?
a. A highly contagious disease caused by a bacteria found in Africa
b. A non-contagious virus caused by contaminated drinking water.
c. A potentially fatal, highly contagious viral illness.
d. A virus that causes the same symptoms as the measles, mumps and rubella
2. Which of these is not a subtype of the Ebola virus?
a. Ebola-Reston
b. Ebola-Sudan
c. Ebola-Superior
d. Ebola-Zaire
3. Which of these statements about Ebola is false?
a. The Makona strain of Ebola virus caused the death of 11,000 people.
b. There is no cure.
c. Treatment usually consists of providing supportive care while the body fights the infection.
d. You can cure Ebola with light therapy.
4. Researchers have hypothesized that the first patient with Ebola became infected with the virus
through contact with _________________.
a. an infected animal.
b. blood.
c. secretions.
d. urine.
5. When a person becomes infected with Ebola virus when do symptoms usually occur on
average?
a. 24 hours
b. 4-6 days
c. 10-14 days
d. 1 month
6. Which one of these is not a common symptom of Ebola?
a. Discolored nail beds
b. Dry/hacking cough
c. Fever
d. Joint and muscle aches
7. What other conditions cause symptoms similar to Ebola?
a. Anemia
b. Appendicitis
c. Typhoid fever
d. All the above
8. Death from Ebola occurs in what percentage of cases?
a. 10-30 percent
b. 20-80 percent
c. 40-60 percent
d. 50-90 percent
9. Which statement is false?
a. The Ebola virus was first recognized in the United States.
b. There is currently no proven treatment that can kill the Ebola virus
c. Treatment of Ebola focuses on providing relief from symptoms as the body fights the virus.
d. Victims of Ebola usually have not developed a significant immune response to the virus at the
time of death.
10. The Centers for Disease Control and Prevention (CDC) calls the Ebola virus a Category A
agent. Which of the following is not a Category A agent?
a. Anthrax
b. Plague
c. Rabies
d. Small pox
e-Learning QUIZ
ID # Web-06-01-16 Ebola
VALUE: 2 NAHUC CONTACT HOURS
Fee: $5 (U.S. Dollars) for NAHUC members, $10 (U.S. Dollars) for non-members
Do not send cash. Make check payable to: NAHUC.
If overpayment is made, refunds will be issued in the form of NAHUC Buck certificates.
Directions: Print this answer sheet, circle the most correct answer based on the article and mail the
completed answer sheet, self-addressed self-stamped return envelope along with appropriate fee to:
Linda Winslow
2502 Norwood St
Marquette, MI 49855-1240
Only quizzes with at least 70% answered correctly will be awarded contact hours. Please allow up
to 6-8 weeks for quizzes to be returned.
DEADLINE FOR SUBMISSION OF THIS QUESTIONNAIRE IS MAY 31, 2017.
Member #: ________Name: _______________________________________________
Phone number: ___________ Email address: _______________________________
1.
a
b
c
d
2.
a
b
c
d
3.
a
b
c
d
4.
a
b
c
d
5.
a
b
c
d
6.
a
b
c
d
7.
a
b
c
d
8.
a
b
c
d
9.
a
b
c
d
10. a
b
c
d