With the recent Ebola outbreak in West Africa widely considered the worst to date, and British nurse, Pauline Cafferkey, who was diagnosed with the virus in December after returning from work in Sierra Leone, currently being cared for in a special isolation unit at London’s Royal Free Hospital, Jon Otter, scientific director of the Healthcare Division at Bioquell, considers prevention and control strategy for a disease which, by early January this year, had killed well over 8,000 people since the original outbreak just a year before.
Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever (Ebola HF), is a type of viral haemorrhagic fever (VHF) associated with a high rate of mortality, which can spread in hospitals, has no effective treatment, and is challenging to diagnose. Consolidated mortality data from all recorded outbreaks at the World Health Organization yield a case fatality rate of two-thirds of infected patients. Other factors that make EVD a highly problematic disease include the possibility of human-to-human transmission, including the risk of hospital spread; lack of effective treatment, and challenges in diagnosis.1,2 The main routes of transmission for EVD are direct contact with blood or body fluids (through broken skin or mucous membranes), or indirect contact with contaminated environments.1-3
EVD outbreaks have been most commonly reported in Africa, where they circulate in animal reservoirs.1,2 Cases have been reported in many parts of the world, mainly transferred from Africa.1 An outbreak of EVD is currently ongoing in West Africa, with 21,007 reported cases, including 8,274 deaths (as of 8 January 2015), which is the largest EVD outbreak ever recorded.4,5 A number of cases have been transferred to countries outside of Africa, including the USA, the UK, and Saudi Arabia.5 This article reviews a number of aspects of the prevention and control strategy for EVD, including patient isolation and terminal disinfection of patient rooms.
Infection prevention and control
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