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

 

CDC message regarding Ebola outbreak in DRC

Ebola virus and other emerging pathogens remain an ongoing international concern. Due to the current Ebola outbreak in eastern Democratic Republic of Congo (DRC) and this year’s earlier outbreak in western DRC, healthcare facilities should remain aware of the possibility of imported cases of viral hemorrhagic fevers or other infections in returning travelers. In the current outbreak, no cases of Ebola Virus Disease have been reported outside North Kivu and Ituri provinces in northeastern DRC as of September 23, 2018.  For current information about this outbreak, including the most up-to-date number of cases, see WHO’s Ebola situation reports: Democratic Republic of the Congo. This outbreak 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.

Identifying Patients at Triage

Initial triage at entry to a healthcare facility is the best time to identify patients in need of isolation. Rapid identification and isolation prevents unnecessary infectious exposures among patients and visitors in waiting areas and alerts healthcare personnel to the appropriate precautions needed to protect themselves and others during patient care activities.

Here are the steps that facilities should implement as a routine part of triage:

  • Document travel histories. These histories can alert healthcare personnel to the possibility of communicable infections, such as viral hemorrhagic fevers or emerging respiratory viruses, as well as other health conditions, such as malaria, that need specific treatment and are not commonly seen in U.S. healthcare settings.
  • 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.

In addition to the general triage measures mentioned above, CDC’s Division of Healthcare Quality Promotion has reviewed the Healthcare Infection Prevention and Control Recommendations and Personal Protective Equipment (PPE) recommendations for Ebola Virus Disease and continues to recommend the following resources:

Overall infection control considerations: https://www.cdc.gov/vhf/ebola/clinicians/evd/infection-control.html

PPE: https://www.cdc.gov/vhf/ebola/healthcare-us/ppe/index.html

Additional Domestic Ebola Resources

Main CDC Ebola portal: https://www.cdc.gov/vhf/ebola/index.html

CDC Ebola clinician portal: https://www.cdc.gov/vhf/ebola/clinicians/index.html