US & Canada

Ebola outbreak: US prepares for more infections

A sanitation worker cleans the nurse's home (12 October) Image copyright Reuters
Image caption Specially protected workers cleaned and sanitised the nurse's home on Sunday

Ebola could infect more US health workers, a senior official leading the effort to contain the virus has said.

Investigators are now interviewing hospital staff who cared for Liberian Thomas Duncan, who died in Dallas, said Tom Frieden, of the Centers for Disease Control (CDC).

A woman who treated Duncan has been diagnosed with Ebola, and has been identified by US media as Nina Pham.

The outbreak has killed more than 4,000 people in Africa since March.

Duncan died last week in hospital in Dallas, Texas, after being diagnosed with the disease on 30 September.

The World Health Organisation (WHO) warned the epidemic threatens the "very survival" of societies and could lead to failed states.

The Dallas nurse being treated for Ebola contracted the virus from Duncan despite taking considerable precautions to shield herself.

Ms Pham received an antibody-filled plasma infusion received from a doctor previously treated for the virus.

On Sunday, Dr Frieden said a "breach of protocol" had clearly occurred, though on Monday he clarified that he had not intended to fault the nurse nor Texas Health Presbyterian Hospital.

"We have to rethink the way we address Ebola infection control because even a single infection is unacceptable," Dr Frieden said on Monday.

How not to catch Ebola:

  • Avoid direct contact with sick patients
  • Wear goggles to protect eyes
  • Clothing and clinical waste should be incinerated and any medical equipment that needs to be kept should be decontaminated
  • People who recover from Ebola should abstain from sex or use condoms for three months

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'Think Ebola'

The infection made the nurse the first person to contract Ebola inside the US. She is now said to be in a stable condition in hospital.

Her home has been cleaned and sanitised.

From an interview with the 26-year-old nurse, public health investigators have identified only a single person with whom she had contact during the period when she could have been infectious.

That person, along with 48 contacts of Duncan and the healthcare workers who treated him, are being monitored for signs of the disease.

"All of us have to work together to do whatever's possible to reduce the risk that any healthcare worker becomes infected," Dr Frieden said.

Dr Frieden also said the CDC was encouraging all hospitals in the US to "think Ebola" when presented with patients who had Ebola-like symptoms and who had travelled within the past 21 days to Sierra Leone, Liberia and Guinea, the three West African countries being ravaged by the disease.

  • Protective Ebola suit

  • Surgical cap


    The cap forms part of a protective hood covering the head and neck. It offers medical workers an added layer of protection, ensuring that they cannot touch any part of their face whilst in the treatment centre.

  • Goggles


    Goggles, or eye visors, are used to provide cover to the eyes, protecting them from splashes. The goggles are sprayed with an anti-fogging solution before being worn. On October 21, the US Centers for Disease Control and Prevention (CDC) announced stringent new guidelines for healthcare personnel who may be dealing with Ebola patients. In the new guidelines, health workers are advised to use a single use disposable full face shield as goggles may not provide complete skin coverage.

  • Medical mask


    Covers the mouth to protect from sprays of blood or body fluids from patients. When wearing a respirator, the medical worker must tear this outer mask to allow the respirator through.

  • Respirator


    A respirator is worn to protect the wearer from a patient's coughs. According to guidelines from the medical charity Medecins Sans Frontieres (MSF), the respirator should be put on second, right after donning the overalls.

  • Medical Scrubs


    A surgical scrub suit, durable hospital clothing that absorbs liquid and is easily cleaned, is worn as a baselayer underneath the overalls. It is normally tucked into rubber boots to ensure no skin is exposed.

  • Overalls


    The overalls are placed on top of the scrubs. These suits are similar to hazardous material (hazmat) suits worn in toxic environments. The team member supervising the process should check that the equipment is not damaged.

  • Double gloves


    A minimum two sets of gloves are required, covering the suit cuff. When putting on the gloves, care must be taken to ensure that no skin is exposed and that they are worn in such a way that any fluid on the sleeve will run off the suit and glove. Medical workers must change gloves between patients, performing thorough hand hygiene before donning a new pair. Heavy duty gloves are used whenever workers need to handle infectious waste.

  • Apron


    A waterproof apron is placed on top of the overalls as a final layer of protective clothing.

  • Boots


    Ebola health workers typically wear rubber boots, with the scrubs tucked into the footwear. If boots are unavailable, workers must wear closed, puncture and fluid-resistant shoes.

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