Ebola Virus Status Update;Personal Protective Equipment

October 24, 2014

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Outline

• Overview of Ebola situation

• Point of Care Risk Assessment process

• Personal Protective Equipment

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Ebola Update

• Ebola outbreak is of primary concern in Sierra Leone, Liberia, and Guinea.

• Risk to Canadians is very low• Transmission to humans:

• Contact with infected wild animals in West Africa (fruit bats, non-human primates, rodents)

• Direct contact with infected humans– Blood, other body fluids, tissues from infected individuals– Environmental contamination

• Incubation is 2 to 21 days• Communicable from symptom onset to symptom resolution

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Ebola Update

Roles of various Agencies:• WHO is coordinating response in Africa• PHAC is coordinating response in Canada• Alberta Health and Alberta Health Services are coordinating

response in Alberta– FNIHB AB Region is included in update meetings

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Ebola Update

PHAC Response• Screening at ports of entry into Canada• Quarantine for 21 days if required• Assisting in international response• Expert response teams on standby to support case

management anywhere in Canada if requested by jurisdiction

• Development of Guidance Documents• FNIHB working in coordination with PHAC nationally

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Ebola Update

Response in Alberta• Screening occurring at airports

• Designated hospitals in Edmonton (2) and Calgary (2)• Process for notification to Public Health

• AHS developing guidance documents - with related training - for designated hospitals, front line workers (doctors, first responders, community based staff)• Phased approach based on risk assessment• Purchasing appropriate PPE

• Plan for regular communications:• Health care providers• Public

• FNIHB AB Region working in coordination with AH/AHS.

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Community Response• Preference is for people to contact Health Link

where triage will occur vs coming into health centre.

If people present:• Guidance for triage in patients with fever:

• Is temperature at least 380C?• Any travel or residence in Guinea, Sierra Leone, or

Liberia within past 21 days?

Ebola Update

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• Where there is relevant travel and symptom history:• Does the person need immediate emergency treatment?

– Call 911, ensuring to notify dispatcher of potential risk• If does not need immediate treatment:

– Separate room, implement droplet and contact precautions– Call on-call number: 780-218-9929

• If there is no relevant travel and symptom history, not considered an Ebola risk.

Ebola Update

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• Remember: fevers are associated with many disease processes, including malaria, influenza, dehydration (for any cause).

• The risk for Ebola to be present without history of travel to affected countries is extremely low.

Ebola Update – Canadian Context

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Key information websites:

World Health Organization:http://www.who.int/csr/disease/ebola/en/

Public Health Agency of Canada: http://www.phac-aspc.gc.ca/id-mi/vhf-fvh/ebola-eng.php

Alberta Health: http://www.health.alberta.ca/health-info/ebola-virus.html

Alberta Health Services: http://www.albertahealthservices.ca/10289.asp

Ebola Update

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POINT OF CARE RISK ASSESSMENT

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Point of Care Risk Assessment

Algorithm and related resources were rolled out spring 2014.

PCRA Algorithm

Additional Precautions Overview

See: OneHealth, CDC Manual, under “CDC Manual Forms”

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PERSONAL PROTECTIVE EQUIPMENT

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Personal Protective Equipment

Routine PPE:• Gowns

• Current stock is not impermeable

• Gloves• Masks

• Procedure mask• N95 masks• Face shields

• Don’t forget hand hygiene!

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• N95 masks:• Only required where respiratory precautions are indicated

(TB, measles, aerosol-generating medical procedures)

• Fit tests have been done in the past, during on-boarding– FNIHB AB region does not currently have process to

update fit testing– Remember to do seal test with N95 masks

Personal Protective Equipment

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• Ensure that there is supply of routine PPE.

• Ensure that there is a supply of procedure masks available:• For use with clients presenting in the health centre or clinic

with new cough

• Ensure that there is access to hand hygiene:• soap and water is adequate for public• Waterless hand gels is preferred product for HCWs

Personal Protective Equipment

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• It is important to understand principles behind PPE to ensure best protection:p area to be protected should be completely coveredp Prevent contamination during doffing

Personal Protective Equipment

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• Alberta Health Services Video – demonstrating proper technique for donning and doffing PPE• http://www.albertahealthservices.ca/6422.asp

• All staff should:• review the PCRA tool as it is applicable to your practice and

various settings • practice donning and doffing full PPE with a partner

Personal Protective Equipment

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Environmental Cleaning

• During respiratory season, ensure that high touch surfaces are regularly cleaned.

• ViroxTM products do inactivate viruses.

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Thank you!

Contacts:

Ruth Richardson 780-495-5439

ruth.richardson@hc-sc.gc.ca

Dr. Parminder Thiara 403-861-8447

parminder.thiara@hc-sc.gc.ca

Dr. Wadieh Yacoub 780-495-3391

wadieh.yacoub@hc-sc.gc.ca