THE RAVAGING EBOLA VIRUS: SAFETY

MEASURES FOR HEALTH WORKERS

Dr OBA OwoeyeClinical Grand Round, Department of

Physiotherapy, CMUL/LUTH, Lagos27th August , 2014

Introduction Transmission Signs and Symptoms #ebolascares and #ebolafacts Diagnosis Prevention The Ebola Rules… Hand Hygiene Proper Hand Washing Hand washing Facts Conclusion

Outline

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Ebola virus disease (EVD) or Ebola, formerly

known as Ebola haemorrhagic fever, is a severe and highly contagious illness in humans

EVD outbreaks have a case fatality rate of up to 90%

EVD outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests

Introduction

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Ebola first appeared in 1976 in 2 simultaneous outbreaks, in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. The latter was in a village situated near the Ebola River after which the disease is named

The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission

Fruit bats of the Pteropodidae family are considered to be the natural host of the Ebola virus

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Severely ill patients require intensive supportive

care. No licensed specific treatment or vaccine is available for use in people or animals

The virus has 5 species; the Zaire Ebolavirus species being the most virulent and presently endemic in SW Africa

EVD is so far only endemic in SW Africa

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Ebola virus has receptors in virtually all the

systems in the human body….

Samples from patients are an extreme biohazard risk; testing is conducted under maximum biological containment conditions

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Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals or humans

Burial ceremonies in which mourners have direct contact with the body of deceased persons can also play a role in the transmission of Ebola……….viral load is highest in infected dead bodies

Transmission

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Men who have recovered from the disease can

still transmit the virus through their semen for up to 7 weeks after recovery from illness

Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced

(WHO, 2014)Dr OBA Owoeye - Aug '14 8

Signs and Symptoms

sudden onset of fever intense weakness muscle pain headache sore throat dizziness

vomiting diarrhoea rash coughing internal and external

bleeding

DEATH

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The incubation period (ie time interval from

infection with the virus to onset of symptoms) is 2 to 21 days

Present evidence confirms that the Ebola virus is only infectious when infected persons begin to exhibit symptoms

Suspected cases in other parts of the world have tested –ve to diagnosis

#ebolascares and #ebolafacts

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No licensed vaccine for EVD is available

No specific treatment is available. New drug therapies are being evaluated

Severely ill patients require intensive supportive care as patients are frequently dehydrated and require oral rehydration with solutions containing electrolytes or intravenous fluids

It is not a death sentence if detected early

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…it is not known for now how long the virus

can survive out of its host….

Ebola virus is not airborne but can be aerosolised

Survivors are no longer infectious and of no threat to the community… also said to develop immunity against index spp

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R/O malaria, typhoid fever, cholera, plague, rickettsiosis, relapsing fever, meningitis, hepatitis and other viral haemorrhagic fevers.

Ebola virus infections can be diagnosed definitively in a laboratory through several types of tests:

antibody-capture enzyme-linked immunosorbent assay (ELISA) antigen detection tests serum neutralization test reverse transcriptase polymerase chain reaction (RT-PCR) assay electron microscopy virus isolation by cell culture

Diagnosis

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It is not always possible to identify patients

with EBV early because initial symptoms may be non-specific

For this reason, it is important that health-care workers apply standard precautions consistently with all patients – regardless of their diagnosis

Prevention

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Personal hygiene Environmental hygiene Hand hygiene

I a pair of gloves per patient regular washing/sanitization of hands

Respiratory hygiene use of face masks…. II

PPEs III

Prevention/Protection

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LI …… for asymptomatic patients/individuals

LI + LII ….undiagnosed but suspected patient but with non specific symptoms

LIII….for suspected pts with hx of contacts with index cases & confirmed Ebola pts

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SIN Rule

- Screen, isolate, notify -

Hands Arrest Rule…avoid touching your face and any body openings at work until hands are washed or sanitised -

Metre Rule…maintain a distance of 1m whenever you are

with a suspected patient

The Ebola Rules…

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Invisible vs Visible Dirt…. Sanitise vs

Wash Suspected Hand Contamination … wash

with hypochloride …………………………………………. How to Use Sanitizers Proper Hand Washing Technique

Hand Hygiene

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How well do u wash or sanitize your hands?

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Make sure the product contains at least

60% alcohol Apply enough of the product to the palm

of your hand to wet your hands completely

Rub your hands together, covering all surfaces, until your hands are dry

Antimicrobial wipes are also effective option

Sanitizers

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Proper Hand Washing Tecniques

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Hand-washing doesn't take much time or effort, but it offers great rewards in terms of preventing illness. Adopting this simple habit

can play a major role in protecting your health

#washyourhands

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diarrheal dx-associated deaths by up to 50%

…up to a million deaths a year could be prevented

a large % of foodborne disease outbreaks are spread by contaminated hands….with routine HW…

risk of respiratory infections by 16% The use of an alcohol gel hand sanitizer in the

classroom provided an overall reduction in absenteeism due to infection by 19.8% among 16 elementary schools and 6,000 students

Hand Washing Facts – from cdc.gov

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The Ebola sage is not a war against socialisation

but avoiding unnecessary contacts (with suspected humans and surfaces) is wise

Ebola is only transmissible when the host is symptomatic

Ebola virus is not airborne but can be aerosolized Always remember to apply the Ebola Rules Regular washing of hands is healthy Trust God for absolute protection

Conclusion

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