Frequently Asked Questions About Ebola Virus Disease

Transcription

1 Frequently Asked Questions About Ebola Virus Disease Note that many of the answers below are accurate at an identified point in time. For the most recent information, please visit What is Ebola? Ebola is a rare and deadly disease caused by infection with one of several virus strains. It can cause disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzees). Ebola was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of Congo, and viruses are found in several African countries. Since then, outbreaks have appeared sporadically in Africa. The natural reservoir host of Ebola virus remains unknown. However, on the basis of evidence and the nature of similar viruses, researchers believe that the virus is animal-borne and that bats are the most likely reservoir. Four of the five virus strains occur in an animal host native to Africa. What countries are involved in the 2014 West Africa outbreak? The 2014 Ebola epidemic is the largest in history, affecting multiple countries in West Africa, including Guinea, Liberia and Sierra Leone. There were a small number of cases reported in Nigeria and a single case reported in Senegal; however, these cases are considered to be contained, with no further spread in these countries as of October 20, Countries with Widespread Transmission Country Total Cases Laboratory-Confirmed Cases Total Deaths Guinea Liberia Sierra Leone Total

2 2 What cases have been diagnosed outside West Africa? For current information on countries with travel-associated cases and localized transmission, visit What precautions are being taken to prevent further spread? The Centers for Disease Control and Prevention (CDC), state and local government officials are working with hospitals and a variety of health care providers including physicians, nurses and emergency responders to take precautions to prevent the spread of Ebola within the United States. CDC is also working with the World Health Organization (WHO) and other domestic and international partners and has activated its Emergency Operations Center to help coordinate technical assistance and control activities with partners. CDC has also deployed teams of public health experts to West Africa and will continue to send experts to the affected countries. As of October 22, 2014, the US implemented action to restrict travel from West Africa to five designated U.S. airports: New York's John F. Kennedy, New Jersey's Newark, Washington Dulles, Atlanta, and Chicago's O'Hare international airports. Additional patients are being monitored as a result of this activity, including a case in New York where a physician that traveled to West Africa has been diagnosed with Ebola. How is the disease spread or transmitted? Researchers believe that the first patient becomes infected through contact with an infected animal. When an infection does occur in humans, the virus can be spread in several ways to others. Ebola is spread through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with: Blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit and breast milk) of a person who is sick with Ebola Objects (like needles and syringes) that have been contaminated with the virus Infected animals Ebola is not spread through the air or by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling bush meat (wild animals hunted for food) and contact with infected bats. There is no evidence that mosquitos or other insects can transmit Ebola virus. Only mammals (for example, humans, bats, monkeys, and apes) have shown the ability to become infected with and spread Ebola virus. Can Ebola spread by coughing? By sneezing? Unlike respiratory illnesses like measles or chickenpox, which can be transmitted by virus particles that remain suspended in the air after an infected person coughs or sneezes, Ebola is transmitted by direct contact with body fluids of a person who has symptoms of Ebola disease. Although coughing and sneezing are not common symptoms of Ebola, if a symptomatic patient with Ebola coughs or sneezes on someone, and saliva or mucus come into contact with that person s eyes, nose or mouth, these fluids may transmit the disease.

3 3 What does direct contact mean? Direct contact means that body fluids (blood, saliva, mucus, vomit, urine, or feces) from an infected person (alive or dead) have touched someone s eyes, nose, or mouth or an open cut, wound, or abrasion. How long does Ebola live outside the body? Ebola is killed with hospital-grade disinfectants (such as household bleach). Ebola dried on surfaces such as doorknobs and countertops can survive for several hours; however, virus in body fluids (such as blood) can survive up to several days at room temperature. Are patients who recover from Ebola immune for life? Can they get it again the same or a different strain? Recovery from Ebola depends on good supportive clinical care and a patient s immune response. Available evidence shows that people who recover from Ebola infection develop antibodies that last for at least 10 years, possibly longer. We don t yet know if people who recover are immune for life or if they can become infected with a different species of Ebola. Research to identify an Ebola vaccine continues. Can Ebola be spread through mosquitos? There is no evidence that mosquitos or other insects can transmit Ebola virus. Only mammals (for example, humans, bats, monkeys and apes) have shown the ability to spread and become infected with Ebola virus. What are the symptoms of Ebola? Fever (as of October 20, 2014, the threshold fever level set by the CDC is > 38.0 C or F) Severe headache Muscle pain Weakness Diarrhea Vomiting Abdominal (stomach) pain Unexplained hemorrhage (bleeding or bruising) Symptoms may appear anywhere from two to 21 days after exposure to Ebola, but the average is eight to 10 days. What is the treatment for Ebola? No FDA-approved vaccine or medicine (e.g., antiviral drug) is available for Ebola. Symptoms of Ebola are treated as they appear. The following basic interventions, when used early, can significantly improve the chances of survival: Providing intravenous (IV) fluids and balancing electrolytes (body salts) Maintaining oxygen status and blood pressure Treating other infections if they occur

4 4 Experimental vaccines and treatments for Ebola are under development, but they have not yet been fully tested for safety or effectiveness. Recovery from Ebola depends on good supportive care and the patient s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years, possibly longer. It isn't known if people who recover are immune for life or if they can become infected with a different species of Ebola. Some people who have recovered from Ebola have developed long-term complications, such as joint and vision problems. Frequently Asked Questions About California Hospital Preparedness The following information relates to California hospitals and the California Hospital Association (CHA) and is current as of. However, changes are occurring daily. What is California doing about Ebola preparation? The Ebola outbreak is a serious issue. Health care leaders, hospitals, public health and safety and other stakeholders have placed the highest priority on executing a careful and comprehensive response. Has there been an Ebola case in California? As of today, there are no confirmed Ebola cases in California. Are California hospitals prepared for an Ebola case? California hospitals prepare for all types of emergencies every day in order to provide necessary care for their patients. All hospitals are prepared to perform medical screening of all patients seeking care, including those who may have an infectious disease. This includes a medical history, detection of any symptoms of illness and specific to Ebola a travel history and potential exposure. Can every California hospital provide comprehensive care for an Ebola patient? All hospitals, regardless of size, play a role in caring for patients with Ebola or any other suspected infectious disease. Hospitals appropriately screen individuals presenting with Ebola symptoms who have a travel history from one of the West African and other affected countries. However, not all hospitals have the capability to manage the extensive treatment and supportive care a confirmed Ebola patient would need. For example, the availability of the needed medical expertise varies; larger hospitals may have a variety of physician specialists (infectious disease, pulmonologists, hematologists) on staff who are needed to properly provide care and manage an Ebola patient. This is in contrast to many smaller, rural and critical access hospitals, which have limited size intensive care units or other units with basic support equipment, staff and no specialty physicians. What would happen to patients who need a higher level of care? Arrangements to transfer to a facility that has that capability is critical to the patient receiving the level of supportive care required. This type of networking activity is well established and movement

5 5 of patients to more appropriate levels of care occurs within the healthcare delivery system on a daily basis. It is also important to note, that within any community managing a patient with Ebola, effective coordination among hospitals, public health and emergency medical services is required. What about the safety of patients, the health care workforce, first responders and the public? Hospital workers should wear personal protective equipment (PPE) whenever they come into contact with a suspected Ebola patient. These precautions are consistent with state standards and are the same universal precautions health care workers use whenever they care for any patient with a potentially infectious disease. Are hospitals, physicians and others working together to prepare for an Ebola patient? Hospitals, physicians, nurses and the health care workforce are partners in a unified response and preparation. Collaboration at the state, local and hospital levels is continuing on a daily basis. See recent joint statement issued by CHA, American Nurses Association California, and the Association of California Nurse Leaders at Is the entire hospital healthcare workforce trained to wear PPE? California hospitals are adopting CDC PPE guidance that was released on October 20, 2014 (See Hospitals have initiated more intense training and competency validation for clinical staff in key areas where a patient with suspected or confirmed Ebola would be cared for in the hospital. Training outside these key areas will be conducted as appropriate. When will this training and competency validation be completed? California hospitals employ over 500,000 highly qualified and dedicated health care employees. The training is being done in an expeditious manner that emphasizes safety and competency. The pace of completion varies by hospital. All hospitals are committed to complete training and competency validation as soon as possible. The most recent revised guidance was issued on October 20, 2014, and hospitals are adjusting their training programs to comply with CDC guidelines. Additional training may be required if Cal/OSHA provides additional guidance. Is there a sufficient supply of PPEs? Hospitals have concerns about the continued availability of protective equipment and are engaged with their suppliers to address these issues. Many hospitals have received back orders for PPE because the equipment is not currently available. What has CHA been doing to assist hospitals? CHA has established an Ebola planning team with expertise in clinical services, environmental services, media relations, employee health and safety and labor relations, as well as state and federal government relations and legislative affairs and health care emergency management surrounding Ebola planning and response. Team members are actively collaborating with state officials, hospital

6 6 representatives, clinicians, professional associations and groups to share information. Information is provided to hospitals on a regular basis. CHA is also conducting webinars to keep hospitals abreast of current information, guidelines and developments. What is government doing? The Governor is exerting leadership within state government and with local government. See Oct. 24 CHA media statement applauding his leadership in Ebola Preparedness at Hospitals, physicians and other stakeholders are also involved. Specific advice, guidelines and information are coordinated and plans are being made for a comprehensive response throughout the state.