CDC Emergency Operations Center (EOC) for hospitals and health departments: 770-488-7100 or via email at email@example.com
CDC Ebola Hotline – for medical personnel to be connected to public health experts, call
2014 West Africa outbreak
The 2014 Ebola outbreak is one of the largest Ebola outbreaks in history and it is affecting countries in West Africa, including Guinea, Liberia, Nigeria, Sierra Leone, and Mali. As of January 23, 2015, there have been 21,797 cases and 8675 deaths. There have been two imported cases, including one death, and two locally acquired cases in healthcare workers have been reported in the United States (details on cases).
A person infected with Ebola virus is not contagious until symptoms appear. The virus is spread through direct contact (through broken skin or unprotected mucous membranes in, for example, the eyes, nose, or mouth) with the blood or body fluids such as, but not limited to, feces, saliva, urine, vomit, and semen of a person who is sick with Ebola, or with objects like needles that have been contaminated with the virus, or infected animals. Ebola is not spread through the air or by water or, in general, by food.
Healthcare worker risks
In healthcare settings, Ebola is spread through direct contact (e.g., through broken skin or through mucous membranes of the eyes, nose, or mouth) with blood or body fluids of a person who is sick with Ebola or with objects (e.g., needles, syringes) that have been contaminated with the virus.
For all healthcare workers caring for Ebola patients, personal protective equipment (PPE) with full body coverage is recommended to further reduce the risk of self-contamination. To protect healthcare workers during care of an Ebola patient, healthcare facilities must provide onsite management and oversight on the safe use of PPE and implement administrative and environmental controls with continuous safety checks through direct observation of healthcare workers during the PPE donning and doffing processes.
CDC has provided updated guidance on PPEs , including the type of PPE to be used and on the processes for donning and doffing (i.e., putting on and removing) PPE for all healthcare workers entering the room of a patient hospitalized with Ebola virus disease (Ebola). The guidance in this document reflects lessons learned from the recent experiences of U.S. hospitals caring for Ebola patients and emphasizes the importance of training, practice, competence, and observation of healthcare workers in correct donning and doffing of PPE selected by the facility.
Early recognition is critical to controlling the spread of the Ebola virus and all healthcare personnel must be alert in evaluating patients for possible Ebola virus disease.
- Inquire about travel to West Africa 21 days before illness
Early recognition includes vigilance in inquiring about a history of travel to West Africa 21 days before illness onset for any patient presenting with fever or other symptoms consistent with Ebola.
- Evaluate for Ebola symptoms
The symptoms of possible include fever, myalgia, severe headache, abdominal pain, vomiting, diarrhea, or unexplained bleeding or bruising. If the patient reports a history of recent travel to one of the affected West African countries (Liberia, Sierra Leone, and Guinea) and exhibit such symptoms, immediate action should be taken to isolate the patient and notify the local-state health department.
- CDC Ebola traveler evaluation algorithm and checklist
CDC has provided an Ebola algorithm for evaluation of returned traveler and Ebola checklist to evaluate a patient for Ebola .
- Isolate if positive travel history and Ebola symptoms
Isolate patients who report a travel history to an Ebola-affected country (currently Liberia, Sierra Leone, and Guinea) and who are exhibiting Ebola symptoms in a private room with a private bathroom and implement standard, contact, and droplet precautions. Review and implement the CDC’s updated (Oct 20, 2014) Guidance on PPD to be used by healthcare workers during management of patients with Ebola virus disease in U.S. hospitals, including procedures for putting on (donning) and removing (doffing)
Assess your hospitals readiness for accepting Ebola patients
CDC has provided a Detailed hospital checklist for Ebola preparedness to review your organization’s overall readiness for accepting Ebola patients
Role of environment
The precise role of the environment in transmission has not been established. However, Ebola virus can remain viable on solid surfaces, with concentrations falling slowly over several days. Given the apparent low infectious dose, potential of high virus titers in the blood of ill patients, and disease severity, higher levels of precaution are warranted to reduce the potential risk posed by contaminated surfaces in the patient care environment. As such, CDC has provided guidance for environmental control in hospitals that includes the use of personal protective equipment and appropriate US EPA-registered hospital disinfectant Hospitals also should have the capability to request diagnostic tests or prepare samples for shipping and testing elsewhere.
Supply and chain and PPE procurement
- Supplies from Premier contracted suppliers: A list of personal protective equipment (PPE) and other supplies, as well as information about ordering and availability from Premier’s contracted suppliers is provided for members on PremierConnect® (password required).
- CDC: Best practices for procuring personal protective equipment for Ebola response (Oct 20, 2014) CDC’s guidance for Personal Protective Equipment (PPE). HHS has been working closely with PPE manufacturers and distributors in order to maintain visibility on availability of PPE.
Education and training
Webinars – On-line and on demand recordings/materials
- Dec 15 2-3:00 p.m. ET: CDC-COCA EMS and Ebola field experience with transporting patients
- Dec 9 2-3:30 p.m. Premier Advisor Live Webinar: Ebola Preparedness and Response
- Dec 9 12-1:30 pm ACHE Webinar: Ebola-the healthcare executive guide to successful treatment
- Nov 24 CDC COCA Caring for Patients in U.S. Hospitals: A Nursing Perspective
- University of Nebraska Ebola Method for Clinicians online training program also available as a downloadable mobile app via the iTunes U app for iPad and iPhone, through this direct link —https://itunesu.itunes.apple.com/enroll/FDL-BXP-WTF — or by searching in iTunes U. The course also is available through Moodle at http://phtc.unmc.edu/moodle for viewing on a desktop, laptop or other mobile devices.
- Oct 31 HHS Webinar: Preparing your healthcare system for Ebola with speakers from HHS, CDC, CMS
- Oct 31 CDC Ebola SLIDES for clinicians for clinical training (SLIDES updated every Friday at 5 pm) visit www.cdc.gov/ebola for updates
- Oct 31 CDC Video series: Guidance for donning and doffing personal protective equipment (PPE) (4 video modules based on PPE combos, N95 or PAPR with gown or coveralls)
- Oct 30 CDC Approaches to clinical management for patients with Ebola treated in US hospitals.
- Oct 21 Greater New York Hospital Association/1199SEIU: PPE donning and doffing training video
- Oct 21 CDC: Healthcare personnel preparedness for Ebola (Dr. Arjun Srinivasan)
- Oct 21 APIC: CDC: New PPE guidance, environmental considerations, Q & A (Dr. Joseph Perz)
- Oct 20 CDC-COCA: Approaches to clinical management of patients with Ebola
- Oct 14 CDC-COCA: Ebola: What U.S. Hospitals Can Learn From Emory Healthcare and Nebraska Medical Center.
Sample policies, resources Ebola
- NorthShore LIJ hospital Ebola preparedness manual
- Emory Healthcare: Ebola Preparedness Protocols
- University of Nebraska Medical Center: PPE for Ebola
- Médecins Sans Frontières (Doctors without Borders): Filovirus Haemorrhagic Fever Guideline, 2008[PDF – 134pages]
- World Health Organization (WHO): Infection prevention and control guidance for care of patients in health-care settings, with focus on Ebola
Selected Ebola guidance in US hospitals
Visit the CDC website for more detailed guidance for all settings (e.g. airlines, EMS, mortuaries, travel)
- Information for Pediatric and OB-GYNE Healthcare Providers (Nov 11, 2014)
- Ebola Virus Disease Information for all Clinicians in U.S. Healthcare Settings
Protecting healthcare workers
- NEW! Considerations for U.S Healthcare Facilities to Ensure Adequate Supplies of Personal Protective Equipment (PPE) for Ebola Preparedness (Dec 31, 2014)
- Oct 31 CDC Video series: Guidance for donning and doffing personal protective equipment(PPE) (4 video modules based on PPE combos, N95 or PAPR with gown or coveralls) Oct 31, 2014
- CDC: Identify, Isolate, Inform: Emergency Department Evaluation and Management for Patients Who Present with Possible Ebola Virus Disease (Oct. 27, 2014)
- CDC: Guidance on Personal Protective Equipment To Be Used by Healthcare Workers During Management of Patients with Ebola Virus Disease in U.S. Hospitals, Including Procedures for Putting On (Donning) and Removing (Doffing) (Oct 20, 2014)
- Tools for Protecting Healthcare Personnel
- CDC Safety Training Course for Healthcare Workers Going to West Africa in Response to the 2014 Ebola Outbreak
Screening and monitoring persons under investigation for Ebola
- CDC: Considerations for Discharging Persons Under Investigation (PUI) for Ebola Virus Disease (Ebola), including (October 31, 2014)
- Criteria for deciding when to discharge a person under investigation
- Information about RT-PCR testing for Ebola virus
- CDC: Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease Exposure (Oct 29, 2014) (includes Q and A and fact sheet)
- CDC: Case Definition for Ebola Virus Disease (EVD)
- CDC: Factsheet: Interim Guidance for Specimen Collection, Transport, Testing, and Submission for Patients with Suspected Infection with Ebola Virus Disease
Laboratory specimen collection, transport, testing, and submission
- NEW Guidance for U.S. laboratories for managing and testing routine clinical specimens when there is a concern about ebola (Jan 30, 2015)
- AACC -American Association for Clinical Chemistry website on Ebola guidance for lab testing(Oct 30, 2014)
- CDC: Interim Guidance for Specimen Collection, Transport, Testing, and Submission for Persons Under Investigation for Ebola Virus Disease in the United States
- CDC: Interim Guidance Regarding Compliance with Select Agent Regulations for Laboratories Handling Patient Specimens that are Known or Suspected to Contain Ebola Virus
- CDC: Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease Exposure (Oct. 29 2014)
- CDC: Guidance on Air Medical Transport for Patients with Ebola Virus Disease
U.S. healthcare settings
- NEW! CDC and state health departments designate U.S. Ebola treatment centers – (Updated Jan 22, 2015)
- Listing of designated treatment centers
- Interim Guidance for Preparing Ebola Treatment Centers
- EPA: Disinfectants meeting CDC criteria for use against Ebola virus on hard surfaces (Oct 31, 2014)
- CDC Recommendations for Safely Performing Acute Hemodialysis in Patients with Ebola CDC: Virus Disease in U.S. Hospitals (Oct. 23, 2014)
- Ebola Virus Disease Information for Clinicians in U.S. Healthcare Settings
- CDC: Safe Management of Patients with Ebola Virus Disease (EVD) in U.S. Hospitals
- CDC: Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Hemorrhagic Fever in U.S. Hospitals
- CDC: Guidance for Safe Handling of Human Remains of Ebola Patients in U. S. Hospitals and Mortuaries
- CDC: Interim Guidance for Environmental Infection Control in Hospitals for Ebola Virus
- CDC: Ebola Screening Criteria Template for Hospitals
- CDC: Detailed Hospital Checklist for Ebola Preparedness
Provides actions U.S. hospitals can take to prepare for managing patients with Ebola and other infectious diseases.
- CDC: Health Care Facility Preparedness Checklist for Ebola Virus Disease (EVD)
- CDC: Health Care Provider Preparedness Checklist for Ebola Virus Disease
Sewage and waste
- CDC: Ebola Waste Management (Oct. 22, 2014)
- NEW! Frequently Asked Questions on Interim Guidance for Managers and Workers Handling Untreated Sewage from Suspected or Confirmed Individuals with Ebola in the U.S. (Dec 16, 2014)
Residence and schools
- Resources for Parents, Schools, and Pediatric Healthcare Professionals (Nov 10, 2014)
- Interim Guidance for the U.S. Residence Decontamination and Waste Removal (Nov 10, 2014)
Preparedness and response
- CDC: Checklist for Healthcare Coalitions for Ebola Preparedness [PDF – 4 pages]
- CDC: Detailed Emergency Medical Services (EMS) Checklist for Ebola Preparedness [PDF – 6 pages]
- CDC: Top 10 Ebola Response Planning Tips: Self-Assessment for State and Local Public Health Officials
- NEW! Questions and Answers about Ebola and Food Safety in the United States (Dec 18, 2014)