GUIDE FOR HEALTH CARE WORKERS ON EBOLA CONTROL by Gbemisola Leigh

Ebola virus disease is a severe illness in humans caused by infection with the Ebola virus. It is transmitted in human populations through person to person transmission from contact with body fluids, secretions of infected and symptmatic cases of the disease.

Health care workers are at a high risk of getting infected and have frequently been infected while caring for patients and can also spread it to other patients and family members.  

This is a simple Ebola control guide for EVERYONE who works in a health care setting and has the potential for exposure to patients or infectious materials including body fluids, contaminated equipment and contaminated environment. These include Physicians, Nurses, Laboratory scientists, Pharmacists, Nursing assistants, Therapists, Technicians, Students, Clerks, Laundry, Security, Maintenance, Volunteers, Cleaners, Mortuary attendants etc.

Simple ABCD guide for Health care workers on Ebola Control
A        ALERT
B        BARRIER
C        CLEAN
D        DISPOSE

ALERT

• Be alert to any case of Fever and History of Contact (where contact is sleeping in the same household with someone who has Ebola, contact with a case of Ebola whether dead or alive or touching his/her clothing or body fluids) or Travel/visit history from places where there is Ebola outbreak.
•  High Fever and symptoms: Headache, Vomiting, Loss of appetite, Diarrhoea ,Weakness(patient may be unable to sit, talk, stand, eat) ,Abdominal pain, Body aches, sore-throat
•  Unexplained bleeding of any kind 
• Any unexplained death

 If you detect any suspected case, isolate immediately, and contact the nearest Ebola response centre in your state.  

BARRIER

• Always practice universal precautions and standard infection control measures as you do not know who has the infection 
• Use of Personal protective equipment (PPE): The PPE to be used depends on risk assessment. For every day clinical consultations, ensure gloves are worn and hand hygiene performed before and after contact with patients. For handling of patients with Ebola, the full PPE recommended for their care should be used: clean non-sterile gloves, clean gown and head cover, mask and eye protection or a face shield and boots.
•  Follow proper procedures for use of PPE’s. Risk of infection is high when they are not used correctly.

CLEAN

• HAND WASHING is very important. This should be done with soap and water. Wet hands and apply soap, rub all surfaces with soap for about 40-60 seconds. Rinse with water. Alcohol based hand sanitizers can also be used. 
• Hand washing should be done before and after any contact with patients, also after removing gloves and PPE. It should also be done after touching any object near your patient. 
• ENVIRONMENT: routine cleaning and disinfection of the environment and surfaces should be done. (Remember everyone needs to be protected, including the cleaners). 
• LAUNDRY: do not handle soaked or used linen with bare hands; always wear protective clothing and gloves. Handle them in a way that it doesn’t contaminate other patients on the ward.

DISPOSE

• Adequate sanitation and safe disposal of sharps in designated sharp bins Ensure safe waste management to prevent reinfection.
• Waste handlers need to be trained on safe waste disposal, practicing of hand hygiene, disinfection and wearing of PPE to prevent contamination.
•  For mortuary attendants: it is important to note that dead bodies of persons who had Ebola are highly infectious, dispose of bodies in a safe manner that will prevent direct contact with the body or secretions. 

Protect yourself and others around you, together we can stop the spread.    

Dr. Gbemisola Leigh is a Community Medicine Resident Doctor in the University College Hospital, Ibadan. She has a DTM&H from the University of Liverpool.She writes on health issues through her page www.facebook.com/plainhealthtalk .