Vermont EMS Ebola Virus Disease Education

VERMONT EMS EBOLA VIRUS

DISEASE EDUCATION

Patsy Kelso PhD, Vermont Department of Health State Epidemiologist

and Vermont EMS

2014 Ebola Outbreak

Vermont Department of Health - EMS

The Outbreak

Reports as of October 24: 10,141 cases

4,922 deaths

This is the largest Ebola epidemic in history

CDC’s response is the largest international outbreak response in CDC’s history

On August 8, the World Health Organization (WHO) declared the current Ebola outbreak a Public Health Emergency of International Concern (PHEIC) The PHEIC declaration underscored the need for a

coordinated international response to contain the spread of Ebola


Future Estimates of Ebola Cases in Liberia

and Sierra Leone

In September 23 edition of MMWR,* CDC estimated the

future number of Ebola cases if current trends continue in

Liberia and Sierra Leone:

Without additional interventions or changes in community

behavior, CDC indicated by January 20, 2015 there will be

approximately 555,000 Ebola cases in Liberia and Sierra

Leone, or 1.4 million if correction for underreporting are

made.

Cases in Liberia are currently doubling every 15-20 days,

and those in Sierra Leone and Guinea are doubling every

30-40 days.* The MMWR article: Estimating the Future Number of Cases in the Ebola Epidemic – Liberia and Sierra

Leone, 2014-2015It is available at http://www.cdc.gov/mmwr/preview/mmwrhtml/su63e0923a1.htm, and a

Q&A on the report is available at http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/qa-mmwr-

estimating-future-cases.htmlVermont Department of Health - EMS

http://www.cdc.gov/mmwr/preview/mmwrhtml/su63e0923a1.htm

http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/qa-mmwr-estimating-future-cases.html

Outbreak Challenges in West Africa

Overburdened public health and healthcare systems

Unpaid healthcare workers

Insufficient treatment centers, beds, medical supplies, and personal protective equipment (PPE)


Background on Ebola


Ebola is a rare and deadly disease

First discovered in 1976 near the Ebola River in the Democratic Republic of the Congo

Outbreaks occur sporadically in Africa

Family of zoonotic RNA viruses

Historically, death rates from Ebola range from 50%-90%


Transmission

Ebola virus is spread through direct contact (through broken skin or mucous membranes) with:

A sick person’s blood or body fluids, including urine, saliva, sweat, feces, vomit, and semen

Contaminated objects (like needles and syringes)

Infected animals (by contact with their blood, fluids, or infected meat)

Ebola virus has been detected in breast milk, but is not know if the virus can be transmitted through breastfeeding

Not transmitted by mosquitos or other insects


Symptoms

Signs of Ebola include fever (greater than 38.0oC or 100.40F) (87%) and symptoms such as:

Fatigue (76%)

Vomiting (68%)

Diarrhea (66%)

Loss of appetite (65%)

Severe headache

Muscle pain

Abdominal pain

Unexplained hemmorrhage

The incubation period is 2 to 21 days (average 8-10 days)

A person with Ebola is not contagious until symptomatic


Testing & Treatment

Virus is generally detectable in blood by real-time RT-PCR between 3-10 days post-onset of symptoms, but has been detected for several months in certain secretions (e.g., semen)

No FDA-approved vaccine or antiviral drug is available

Symptoms are treated as they appear. Basic interventions, when used early, can significantly improve the chances of survival.

Providing IV fluids and balancing electrolytes

Maintaining oxygen status and blood pressure

Treating other infections if they occurVermont Department of Health - EMS

Patient Recovery

Recovery from Ebola depends on good supportive care and the patient’s immune response

People who recover from Ebola infection develop antibodies that last for at least 10 years, and possibly longer

It isn’t know if people who recover are immune for life or if they can become infected with a different species of Ebola

Some people who have recovered from Ebola have developed long-term complications (joint and muscle pain, and vision problems)


CDC & EMS

http://www.cdc.gov/vhf/ebola/hcp/interim-guidance-emergency-medical-services-

systems-911-public-safety-answering-points-management-patients-known-

suspected-united-states.html


Vermont

EMS is

following the

CDC’s

guidance –

please read!

Vermont EMS Ebola Virus Disease

Protocol

CDC & EMS PPE

http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html


Vermont EMS

has

developed a

check-list

following this

guidance!

Vermont EMS PPE Donning & Doffing

Checklist

Printable

version is

attached to

this

presentation

as a document

and is also

viewable.

Please print as

many color

copies as

necessary.


Alternative Vermont EMS PPE Donning & Doffing

Checklist

Due to limitation in available PPE, the following checklist still adheres to available guidance

Printable version is attached to this presentation as a document and is also viewable.

Please print as many color copies as necessary.


Next Steps

Watch the following video (approximately 21

minutes) on donning and doffing of PPE

NOTE: Please be cognizant of the poor foot hygiene

at the end of the video (stepping in clean shoes in

areas where booties were worn)

Review the Vermont EMS Ebola Virus Disease

Protocol

Review the Vermont EMS PPE Donning & Doffing

Checklist

Train with your service! (Train the trainer for

Donning & Doffing coming soon)Vermont Department of Health - EMS

Next Steps

Any questions should be addressed to:

[email protected]

FAQs are being developed

This training will be updated as needed


mailto:[email protected]

Vermont EMS Ebola Virus Disease Education

Health & Medicine

Transcript of Vermont EMS Ebola Virus Disease Education