I had to stop by the library on the way home from a day of work and unfun helping a colleague with a video production. More on that Wednesday....
I wasn't sure if I should add this to one of the Ebola threads and if so which one, so I decided to make it a stand alone.
Ebola is in the news. (Yea real bright Sherlock)
While most (>99.999%) of all human to human spread has been via bodily fluids, it is accepted that a vanishingly small percentage may be spread through the air.
From Richard Preston's "The Hot Zone" it is well known that Ebola Reston was spread from monkey to monkey with no direct contact, it is presumed the vector was airborne as Monkey's spread throughout the research facility became infected.
Terry
(Youall may want to go to the link to read the article, the formating sucks!!!! and I don't have time to fix it today.)
The CDC (http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/ebola/Ebola_airline.pdf> says: (sorry for the bad formating, cut and paste is flaky from PDFss
"Interim Guidance about Ebola Virus Infection for Airline Flight Crews, Cargo and Cleaning Personnel, and Personnel Interacting with Arriving Passengers
This interim guidance is intended to assist commercial passenger airlines, cargo and charter carriers, and the Transportation Security Administration (TSA), Bureau of Customs and Border Protection (BCBP), and other relevant agencies in establishing appropriate precautions for Ebola virus infection. Recommendations are based on standard infection control practices and on available epidemio
logic information about the Ebola virus.
Overview of Ebola Disease
Ebola hemorrhagic fever is a severe, often fatal disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzees).
The disease is caused by infection with Ebola virus, named
after
a river in the Democratic
Republic of the Congo (formerly Zaire) in Africa, where it was first recognized
in 1976
. The virus is one of two
members of a family of RNA viruses called the Filoviridae. There are f
ive identified species of Ebola virus. Four
of the five have caused disease in humans:
Zaire ebolavirus,
Sudan ebolavirus, Cote d'Ivoire ebolavirus
. and
Bundibugyo ebolavirus. The fifth,
Reston ebolavirus, has caused disease in nonhuman primates and was associated
with disease in pigs, but no disease has been described in humans.
Although the disease is rare, it has the potential for person
-
to
-
person s
pread, especially among health
-
care staff
and family members or others who care for the patient. Transmission to humans may occur through direct
contact with blood or body fluids (e.g., saliva, and urine) of an infected person or animal or through contact
with objects that have been contaminated with the blood or other body fluids of an infected person. Spread of
the virus between humans has occurred in settings of close contact* with infected persons, such as in hospitals.
The likelihood of contracting an
y viral hemorrhagic fever (VHF), including
Ebola
, is considered extremely low
unless there has been travel to the affected area and direct contact with the body fluids of symptomatic infected
persons or animals or with objects that have been contaminated w
ith body fluids. The cause of fever in persons
who have traveled or live in areas where VHF is present is more likely to be a common infectious disease, but
such persons would need to be evaluated by a health
-
care provider to be sure.
The incubation perio
d for Ebola hemorrhagic fever ranges from 2 to 21 days.
Early symptoms of
the disease
include
with sudden fever, chills, and muscle aches. Around the fifth day after onset of symptoms, a skin rash
can occur. Nausea, vomiting, chest pain, a sore throat, ab
dominal pain, and diarrhea may follow. Symptoms
become increasingly severe and may include jaundice, severe weight loss, mental confusion, shock, and multi
-
organ failure.
The prevention of
Ebola
virus infection includes measures to avoid contact with bloo
d and body fluids of
infected individuals and with objects contaminated with these fluids (e.g., syringes).
When to See a Health
-
care Provider
Any personnel who think they have been exposed to
Ebola
virus either through travel, assisting an ill passenger
,
handlin
g a contaminated package, or cleaning a contaminated aircra
ft should take the following precautions:
•
Notify your employer immediately.
•
Monitor your health for
21
days following the exposure. If you develop sudden fever, chills, muscle
aches, ras
h, or other symptoms consistent with
Ebola
virus infection, you should seek immediate
medical attention.
o
Before visiting a doctor’s office, alert the health
-
care provider, clinic, or emergency room in
advance about the possible exposure to
Ebol
a
virus, so
that arrangements can be made to prevent
transmission to others in the
health
-
care setting.
o
When traveling to a health
-
care provider, limit your contact with others. All other travel should
be avoided.
General Infection Control Precautions
Personnel sh
ould always follow basic infection control precautions to protect against any type of infectious
disease. For information about these precautions see
IATA's Guidelines for
Suspected Communicable Diseases
.
Guidance for Airline
Crews
Management of possible exposure to
Ebola
virus
Crew members
on a flight with a passenger who is
ill with a
fever, jaundice, and/or bleeding
and who is
travelin
g from an area in which
Ebola
cases have been reported should follow these precautions:
•
Keep the sick person separated from close contact* with others as much as possible.
•
Provide the sick passenger with a surgical mask (if the passenger can tolerate wearing one) to reduce the
number of droplets expelled into the air by talking, sneezing, o
r coughing.
•
Tissues can be given to those who cannot tolerate a mask.
•
Personnel should wear disposable gloves for direct contact with blood or other body fluids (see
IATA's
Guidelines for Suspected Communicable Diseases
).
•
T
he captain of an airliner bound for the United States is required by law to report to the nearest
U.S.
Quarantine Station
any ill passengers who meet
specified criteria
. The ill passenger should be reported
before arrival or as soon as the illness is noted. Quarantine officials will help arrange for medical
assistance to be available when the airpla
ne lands and will work with the airline, state and local health
department officials, and CDC headquarters to assist with medical transportation of the patient upon
arrival, disease control and containment measures, passenger and crew notification, surveil
lance
activities, and airline disinfection procedures.
If exposure occurs abroad
Airline flight crew should familiarize themselves with the symptoms of
Ebola
hemorrhagic fever
.
Personnel who think they have been exposed to
Ebola
virus and who develop symptoms during travel should
take th
e following actions:
•
Notify your employer for help in locating a health
-
care provider. Inform the employer about the possible
exposure to
Eb
ola
virus, and ask about health
-
care options. If you become ill while outside the United
States, the U.S. embassy or consulate can also provide names and addresses of local physicians.
•
Before visiting a doctor’s office, alert the health
-
care provider, cli
nic, or emergency room in advance
about the possible exposure to
Ebola
virus so that arrangements can be made to prevent transmission to
others in the health
-
care setting.
•
When traveling to a health
-
care provider, limit your contact with others. All other
travel should be
avoided.
Guidance for Air Cargo Personnel
Packages should not ordinarily pose a risk to package delivery employees.
Ebola
virus is spread via direct
contact
with blood or body fluids (e.g., urine, saliva) from an infected individual.
•
P
ackages visibly soiled with blood or body fluids should not be handled.
•
Cargo handlers should wash their hands often for prevention of all infectious diseases (see
IATA's
Guidelines for Suspected Communicable Diseases
).
Guida
nce for Airline Cleaning Personnel
Ebola
virus is transmitted by close contact* with a person who has symptoms of
Ebola
infection. Once
passengers have left an aircraft, the main source of infection will have been removed. However, infectious
blood and/or
body fluids that may remain on surfaces of the aircraft interior may pose a risk of infection if those
particles come into direct contact with a person’s eyes, nose, or mouth. Therefore, frequent hand washing is of
primary importance for all personnel wor
king on commercial passenger aircraft (see
IATA's Guidelines for
Suspected Communicable Diseases
).
In addition, the captain of an airliner bound for the United States is required by law to report any ill passenger
who meets sp
ecified criteria to the nearest
U.S. Quarantine Station
. The airline’s ground and cleaning crews
should be notified at the same time so that preparations can be made for cleaning the airc
raft after passengers
have disembarked. When cleaning commercial passenger aircraft after a flight with a possible
Ebola
hemorrhagic fev
er patient, personnel should follow the precautions described below.
•
Wear nonsterile disposable gloves while cleaning t
he passenger cabin and lavatories.
•
Wipe down passenger lavatory surfaces and frequently touched surfaces in the passenger cabin, such as
armrests, seat backs, tray tables, light and air controls, and adjacent walls and windows with an
Environmental Protec
tion Agency (EPA)
-
registered low
-
or intermediate
-
level chemical household
germicide. Bleach can be used in the absence of an EPA
-
registered germicide. Areas of contamination
with dried secretions should be washed with a 1% sodium hypochlorite solution (bl
each) or hospital
-
approved disinfectant. Allow surfaces to air dry in accordance with manufacturers’ instructions.
•
Special cleaning of upholstery, carpets, or storage compartments is not indicated unless obviously soiled
with fresh blood or body fluids. B
ody fluid or blood spills should be covered with a 1% sodium
hypochlorite solution (bleach) and allowed to remain for 30 minutes prior to wiping.
•
There currently is no evidence to suggest that special vacuuming equipment or procedures are necessary.
•
Do n
ot use compressed air, which might re
-
aerosolize infectious material.
•
If a seat cover is obviously soiled with blood or body fluids, it should be removed and discarded by the
methods typically used for contaminated items.
•
Throw used gloves away according
to the company’s recommended infection control precautions, when
cleaning is done and if they become soiled or damaged during cleaning .
•
Clean hands with soap and water (or waterless alcohol
-
based hand rub when soap is not available)
immediately after gl
oves are removed.
Guidance for Personnel Who Interact with Arriving Passengers
TSA, BCBP, and other personnel who interact with passengers arriving from areas affected by
Ebola
disease
should keep in mind that the cause of fever in persons who have trave
led or live in areas where VHF occurs is
more likely to be a common infectious disease. However, personnel who have to detain or assist a passenger ill
wi
th a
fever, jaundice (yellow skin and eyes), and/or bleeding should follow these precautions:
"
I wasn't sure if I should add this to one of the Ebola threads and if so which one, so I decided to make it a stand alone.
Ebola is in the news. (Yea real bright Sherlock)
While most (>99.999%) of all human to human spread has been via bodily fluids, it is accepted that a vanishingly small percentage may be spread through the air.
From Richard Preston's "The Hot Zone" it is well known that Ebola Reston was spread from monkey to monkey with no direct contact, it is presumed the vector was airborne as Monkey's spread throughout the research facility became infected.
Terry
(Youall may want to go to the link to read the article, the formating sucks!!!! and I don't have time to fix it today.)
The CDC (http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/ebola/Ebola_airline.pdf> says: (sorry for the bad formating, cut and paste is flaky from PDFss
"Interim Guidance about Ebola Virus Infection for Airline Flight Crews, Cargo and Cleaning Personnel, and Personnel Interacting with Arriving Passengers
This interim guidance is intended to assist commercial passenger airlines, cargo and charter carriers, and the Transportation Security Administration (TSA), Bureau of Customs and Border Protection (BCBP), and other relevant agencies in establishing appropriate precautions for Ebola virus infection. Recommendations are based on standard infection control practices and on available epidemio
logic information about the Ebola virus.
Overview of Ebola Disease
Ebola hemorrhagic fever is a severe, often fatal disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzees).
The disease is caused by infection with Ebola virus, named
after
a river in the Democratic
Republic of the Congo (formerly Zaire) in Africa, where it was first recognized
in 1976
. The virus is one of two
members of a family of RNA viruses called the Filoviridae. There are f
ive identified species of Ebola virus. Four
of the five have caused disease in humans:
Zaire ebolavirus,
Sudan ebolavirus, Cote d'Ivoire ebolavirus
. and
Bundibugyo ebolavirus. The fifth,
Reston ebolavirus, has caused disease in nonhuman primates and was associated
with disease in pigs, but no disease has been described in humans.
Although the disease is rare, it has the potential for person
-
to
-
person s
pread, especially among health
-
care staff
and family members or others who care for the patient. Transmission to humans may occur through direct
contact with blood or body fluids (e.g., saliva, and urine) of an infected person or animal or through contact
with objects that have been contaminated with the blood or other body fluids of an infected person. Spread of
the virus between humans has occurred in settings of close contact* with infected persons, such as in hospitals.
The likelihood of contracting an
y viral hemorrhagic fever (VHF), including
Ebola
, is considered extremely low
unless there has been travel to the affected area and direct contact with the body fluids of symptomatic infected
persons or animals or with objects that have been contaminated w
ith body fluids. The cause of fever in persons
who have traveled or live in areas where VHF is present is more likely to be a common infectious disease, but
such persons would need to be evaluated by a health
-
care provider to be sure.
The incubation perio
d for Ebola hemorrhagic fever ranges from 2 to 21 days.
Early symptoms of
the disease
include
with sudden fever, chills, and muscle aches. Around the fifth day after onset of symptoms, a skin rash
can occur. Nausea, vomiting, chest pain, a sore throat, ab
dominal pain, and diarrhea may follow. Symptoms
become increasingly severe and may include jaundice, severe weight loss, mental confusion, shock, and multi
-
organ failure.
The prevention of
Ebola
virus infection includes measures to avoid contact with bloo
d and body fluids of
infected individuals and with objects contaminated with these fluids (e.g., syringes).
When to See a Health
-
care Provider
Any personnel who think they have been exposed to
Ebola
virus either through travel, assisting an ill passenger
,
handlin
g a contaminated package, or cleaning a contaminated aircra
ft should take the following precautions:
•
Notify your employer immediately.
•
Monitor your health for
21
days following the exposure. If you develop sudden fever, chills, muscle
aches, ras
h, or other symptoms consistent with
Ebola
virus infection, you should seek immediate
medical attention.
o
Before visiting a doctor’s office, alert the health
-
care provider, clinic, or emergency room in
advance about the possible exposure to
Ebol
a
virus, so
that arrangements can be made to prevent
transmission to others in the
health
-
care setting.
o
When traveling to a health
-
care provider, limit your contact with others. All other travel should
be avoided.
General Infection Control Precautions
Personnel sh
ould always follow basic infection control precautions to protect against any type of infectious
disease. For information about these precautions see
IATA's Guidelines for
Suspected Communicable Diseases
.
Guidance for Airline
Crews
Management of possible exposure to
Ebola
virus
Crew members
on a flight with a passenger who is
ill with a
fever, jaundice, and/or bleeding
and who is
travelin
g from an area in which
Ebola
cases have been reported should follow these precautions:
•
Keep the sick person separated from close contact* with others as much as possible.
•
Provide the sick passenger with a surgical mask (if the passenger can tolerate wearing one) to reduce the
number of droplets expelled into the air by talking, sneezing, o
r coughing.
•
Tissues can be given to those who cannot tolerate a mask.
•
Personnel should wear disposable gloves for direct contact with blood or other body fluids (see
IATA's
Guidelines for Suspected Communicable Diseases
).
•
T
he captain of an airliner bound for the United States is required by law to report to the nearest
U.S.
Quarantine Station
any ill passengers who meet
specified criteria
. The ill passenger should be reported
before arrival or as soon as the illness is noted. Quarantine officials will help arrange for medical
assistance to be available when the airpla
ne lands and will work with the airline, state and local health
department officials, and CDC headquarters to assist with medical transportation of the patient upon
arrival, disease control and containment measures, passenger and crew notification, surveil
lance
activities, and airline disinfection procedures.
If exposure occurs abroad
Airline flight crew should familiarize themselves with the symptoms of
Ebola
hemorrhagic fever
.
Personnel who think they have been exposed to
Ebola
virus and who develop symptoms during travel should
take th
e following actions:
•
Notify your employer for help in locating a health
-
care provider. Inform the employer about the possible
exposure to
Eb
ola
virus, and ask about health
-
care options. If you become ill while outside the United
States, the U.S. embassy or consulate can also provide names and addresses of local physicians.
•
Before visiting a doctor’s office, alert the health
-
care provider, cli
nic, or emergency room in advance
about the possible exposure to
Ebola
virus so that arrangements can be made to prevent transmission to
others in the health
-
care setting.
•
When traveling to a health
-
care provider, limit your contact with others. All other
travel should be
avoided.
Guidance for Air Cargo Personnel
Packages should not ordinarily pose a risk to package delivery employees.
Ebola
virus is spread via direct
contact
with blood or body fluids (e.g., urine, saliva) from an infected individual.
•
P
ackages visibly soiled with blood or body fluids should not be handled.
•
Cargo handlers should wash their hands often for prevention of all infectious diseases (see
IATA's
Guidelines for Suspected Communicable Diseases
).
Guida
nce for Airline Cleaning Personnel
Ebola
virus is transmitted by close contact* with a person who has symptoms of
Ebola
infection. Once
passengers have left an aircraft, the main source of infection will have been removed. However, infectious
blood and/or
body fluids that may remain on surfaces of the aircraft interior may pose a risk of infection if those
particles come into direct contact with a person’s eyes, nose, or mouth. Therefore, frequent hand washing is of
primary importance for all personnel wor
king on commercial passenger aircraft (see
IATA's Guidelines for
Suspected Communicable Diseases
).
In addition, the captain of an airliner bound for the United States is required by law to report any ill passenger
who meets sp
ecified criteria to the nearest
U.S. Quarantine Station
. The airline’s ground and cleaning crews
should be notified at the same time so that preparations can be made for cleaning the airc
raft after passengers
have disembarked. When cleaning commercial passenger aircraft after a flight with a possible
Ebola
hemorrhagic fev
er patient, personnel should follow the precautions described below.
•
Wear nonsterile disposable gloves while cleaning t
he passenger cabin and lavatories.
•
Wipe down passenger lavatory surfaces and frequently touched surfaces in the passenger cabin, such as
armrests, seat backs, tray tables, light and air controls, and adjacent walls and windows with an
Environmental Protec
tion Agency (EPA)
-
registered low
-
or intermediate
-
level chemical household
germicide. Bleach can be used in the absence of an EPA
-
registered germicide. Areas of contamination
with dried secretions should be washed with a 1% sodium hypochlorite solution (bl
each) or hospital
-
approved disinfectant. Allow surfaces to air dry in accordance with manufacturers’ instructions.
•
Special cleaning of upholstery, carpets, or storage compartments is not indicated unless obviously soiled
with fresh blood or body fluids. B
ody fluid or blood spills should be covered with a 1% sodium
hypochlorite solution (bleach) and allowed to remain for 30 minutes prior to wiping.
•
There currently is no evidence to suggest that special vacuuming equipment or procedures are necessary.
•
Do n
ot use compressed air, which might re
-
aerosolize infectious material.
•
If a seat cover is obviously soiled with blood or body fluids, it should be removed and discarded by the
methods typically used for contaminated items.
•
Throw used gloves away according
to the company’s recommended infection control precautions, when
cleaning is done and if they become soiled or damaged during cleaning .
•
Clean hands with soap and water (or waterless alcohol
-
based hand rub when soap is not available)
immediately after gl
oves are removed.
Guidance for Personnel Who Interact with Arriving Passengers
TSA, BCBP, and other personnel who interact with passengers arriving from areas affected by
Ebola
disease
should keep in mind that the cause of fever in persons who have trave
led or live in areas where VHF occurs is
more likely to be a common infectious disease. However, personnel who have to detain or assist a passenger ill
wi
th a
fever, jaundice (yellow skin and eyes), and/or bleeding should follow these precautions:
"
