Transcript Ebola Virus Disease (EVD) Outbreak 2014 (Template slide

Ebola Virus Disease (EVD)
Outbreak 2014
(Template slide set designed to be edited to meet VAMC needs)
DATE/MONTH 2014
2014 West Africa Outbreak
•
The 2014 Ebola outbreak is the
largest Ebola outbreak in history
and the first in West Africa.
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The current outbreak is affecting
multiple countries in West Africa.
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Insert Current Case Counts
http://www.cdc.gov/vhf/ebola/out
breaks/guinea/index.html
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Current as of 10/2/2014
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Impact on United States
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On September 30, CDC confirmed the first
travel-associated case of Ebola to be
diagnosed in the United States in a person
who had traveled to Dallas, Texas from
Liberia. The patient did not have symptoms
when leaving West Africa, but developed
symptoms approximately five days after
arriving in the U.S. (arrived Sept. 20).
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Contact tracing, a standard public health
procedure, is immediately employed in
order to identify and monitor those who
may have been potentially exposed to a sick
patient.
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Even with the first U.S. confirmed case, 3
Ebola does not pose a significant risk to the
General EVD Background
• Ebola Virus Disease (EVD) is one of numerous viral hemorrhagic fevers
(VHFs).
• The first Ebola virus species was discovered in 1976 in what is now the
Democratic Republic of the Congo near the Ebola River. Since then,
outbreaks have appeared sporadically in Africa.
• EVD is often severe in humans, with case fatality rates reaching 50-90% in
developing countries.
• After an incubation period of a few days, symptoms usually begin abruptly.
• The natural reservoir host of Ebolaviruses remains unknown. However,
evidence suggests it is a zoonosis (animal-borne) with bats being the most
likely reservoir. Four of the five subtypes occur in an animal hosts native to
Africa.
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General EVD Transmission
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Because the natural reservoir of Ebola viruses has not yet been clearly
demonstrated, the manner in which the virus is first introduced in to the human
population at the start of an outbreak is not well understood. It appears the first
patient becomes infected through direct contact with the body fluid of an infected
animal.
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Ebola virus is spread from one person to another through direct contact with:
o Ebola-infected blood or body fluids, such as, but not limited to, urine, saliva, feces,
vomit, and semen
o Objects, such as needles, that have been contaminated with infected body fluids
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Healthcare workers, family and friends, and others who come into close contact
with Ebola-infected patients (including corpses of those who expired due to EVD)
have the highest risk of exposure.
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General EVD Transmission
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General EVD Presentation
• Symptoms may appear
anywhere from 2 to 21 days
after exposure to Ebola virus,
although 8-10 days is most
common.
• Only symptomatic Ebolainfected patients are able to
transmit EVD; Patients
without symptoms who are
infected with Ebola virus are
not contagious.
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General EVD Assessment
• Timely diagnosis and treatment of EVD is
important but challenging because the disease
is difficult to diagnose clinically in the early
stages of infection.
• Because early symptoms, such as headache
and fever, are nonspecific to EVD, cases of EVD
may be initially misdiagnosed.
• It is important to obtain an accurate and
complete history of travel or potential contact
with an Ebola case from a patient exhibiting
Ebola-like symptoms.
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Excerpt from CDC checklist for Patients Being Evaluated for EVD in US
General EVD Treatment
• There is no specific cure for Ebola virus infection.
• There are currently no specific vaccines to prevent Ebola
infection.
• There are no specific medications (e.g., antiviral drug) that
have been proven to be effective against Ebola.
• Symptoms of Ebola are treated supportively, as they appear.
The following basic interventions, when used early, can
increase the chances of survival.
• Providing intravenous fluids and balancing electrolytes (body salts)
• Maintaining oxygen status and blood pressure
• Treating other infections if they occur
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Development of Treatments and Vaccines
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A number of potential candidate drugs and vaccines are in development.
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The CDC maintains a FAQ on current candidates at:
http://www.cdc.gov/vhf/ebola/outbreaks/guinea/qa-experimentaltreatments.html
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For further information on drug development, approval process, and research
please contact the appropriate agency:
FDA media office: [email protected]
NIH media office: [email protected]
CDC media office: [email protected]
ASPR media office: [email protected]
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Infection Prevention and Control Recommendations
• CDC recommends standard, contact, and droplet precautions for
management of hospitalized patients with known or suspected Ebola Viral
Disease (EVD).
• Generally, VHA follows the most up-to-date CDC guidance, which is
periodically updated and can be found at:
http://www.cdc.gov/vhf/ebola/hcp/index.html.
• Though these recommendations focus on the hospital setting, the
recommendations for personal protective equipment (PPE) and
environmental infection control measures are applicable to any healthcare
setting.
• VA-specific guidance, including any deviations from CDC guidance, will be
issued to VA facilities, as appropriate.
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Donning PPE
Current VA PPE Recommendations
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All persons entering the patient room
should wear at least:
o
o
o
o
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Gloves
Gown (fluid resistant or impermeable)
Eye protection (goggles or face shield)
Facemask
Additional PPE might be required in
certain situations (e.g., copious
amounts of blood, other body fluids,
vomit, or feces present in the
environment), including but not
limited to:
o
o
o
o
Double gloving
Disposable shoe covers
Leg coverings
Head covering
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Doffing PPE
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To prevent self-contamination,
it is important to remove the
most contaminated PPE first.
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This will help to prevent
contaminants from spreading to
other places as additional PPE
items are removed.
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Potential VHA Impacts
Scenario 1
An individual presents to local VA emergency/urgent care with a fever of 102°F (38.9°C) and
recent travel to Africa where he may have been in an area experiencing EVD cases.
Scenario 2
A VA employee has a concern about EVD based on epidemiological history (i.e. recent travel to
high-risk countries and/or contact with a known of suspected EVD patient), but is asymptomatic.
Additional discussion of these scenarios was transmitted to VHA September 16th, 2014:
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For Additional Information
• Ebola Fact Sheet
• Ebola Update (as of August 2014)
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For Additional Information
For VA Questions: contact the VHA National Infectious Diseases Service at
513-246-0270 or Aaron Eagan in the VHA Office of Public Health via email at
[email protected]
For general information:
• Centers for Disease Control and Prevention (CDC)
http://www.cdc.gov/vhf/ebola/index.html
• World Health Organization (WHO)
http://www.who.int/csr/disease/ebola/en/
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