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Ebola training helps improve health care worker safety

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ORLANDO, Fla. — Improved training on the handling of patients with infectious diseases may have contributed to a sharp decline in the rate of health care workers infected with Ebola.

As of Aug. 18, confirmed cases of the Ebola virus reported to the World Health Organization since the recent outbreak began in 2014 totaled 18,383, with 11,299 deaths for a case fatality rate of 61%.

“Ebola has now become an epidemic where before it was an outbreak,” Donna Haiduven, associate professor and infectious disease specialist at the University of South Florida’s College of Public Health in Tampa, Florida, said at the Workers’ Compensation Institute conference in Orlando, Florida, on Monday. “It is the biggest we have seen for this disease.”

The World Health Organization reported 815 confirmed and probable Ebola cases among health workers, defined by the organization to include clinical staff, ambulance drivers, cleaners, burial teams and community-based workers.

Of all the cases of Ebola, the highest percentage of health workers infected with the disease was 12% in July 2014, a rate that dropped to 1% in February 2015.

“We hope that education and some of the training has been the reason for this decline,” she said.

Overall, a health worker is 21 to 32 times more likely to be infected with Ebola than the general public, and the case fatality rate is generally about 56-71%, varying depending on the country, she said.

Only one of the nine U.S. medical professionals infected with the disease died, with the most recent case reported in March 2015.

There are numerous reasons for the vulnerability of health care workers, including lack of supplies and training, inappropriate point of care risk assessment, problems with personal protective equipment, inadequate isolation of infected patients and contaminated equipment and areas, she said.

Ms. Haiduven joined other specialists in conducting a three-day training session sponsored by the Centers for Disease Control and Prevention for more than 600 health care workers heading to West Africa. During the training session held in Alabama in October, students learned the principles of high-risk personal protective equipment and the importance of protecting themselves safely, including how to remove their equipment in a certain order to minimize the risk of infection.

For these workers, the handling of corpses of Ebola patients is a “highly infectious situation” because of the high level of viral particles, she said. The most common mode of transmission of the Ebola virus is person to person, with no reports of mosquitoes or other insect infections. Indirect transmission can also occur from surfaces that are not adequately cleaned, but there’s no evidence of the disease spreading via inhalation as other diseases such as tuberculosis, she said.

“Transmission is how health care workers get it from patients and we need to have health care workers to take care of patients,” Ms. Haiduven said.