Ebola and the Health Care Worker

Anyone following West Africa’s recent and largest Ebola outbreak understand that even one case of Ebola diagnosed in the United States is concerning. Because Ebola is an often fatal virus with a lack of FDA-approved vaccine, it demands the attention of all health care personnel in Phoenix, Scottsdale, Paradise Valley and the surrounding area.  It is expected that health care personnel are alert to the potential for an outbreak, and to understand the transmission of the disease, symptoms and the precautions necessary to prevent further spread.

It seems, the infected individual must have symptoms in order to spread the disease. Ebola cannot be transmitted through airborne contact with an infected individual. To transfer from person-to person there must be direct contact with broken skin or mucous membranes with the sick person’s blood or body fluids; or by objects that have been contaminated with infected body fluids. Ebola symptoms usually begin after an incubation period ranging from 2 days to 21 days.

Early symptoms of Ebola develop suddenly within 2 to 21 days of infection and are similar to the Flu virus:

  • Weakness
  • Severe headache
  • Fever
  • Joint and muscle aches
  • Sweating
  • Chills

Over time, symptoms become increasingly severe and may include:

  • Red eyes
  • Raised rash
  • Nausea and vomiting
  • Diarrhea (may be bloody)
  • Chest pain and cough
  • Stomach pain
  • Severe weight loss
  • Bruising
  • Bleeding, beginning usually in the eyes. People nearing death from Ebola may bleed from other orifices, such as ears, nose and rectum.
  • Internal bleeding

During Ebola outbreaks, the disease can spread quickly within families and in healthcare settings. Close contacts of the infected person require quarantine and daily monitoring for 21 days after exposure. The CDC reminds us that rapid identification of cases is critical along with the use of proper personal protective equipment (PPE): masks, gloves, gowns, and goggles.  Proper cleaning and sterilization techniques must be followed to prevent spread. In the CDC guidance, Health Care Personnel (HCP) include ALL individuals, paid or unpaid, working in any healthcare setting in Phoenix, Scottsdale or the surrounding area, who have the potential for exposure to patients with the virus and/or to infectious materials, including: body substances, contaminated medical supplies and equipment, contaminated surfaces, or aerosols generated during certain medical procedures.

As directed by the CDC: ALL HCP are required to follow Standard Precautions.  If you are not certain of Standard Precautions procedures, please see Section 7 of Nightingale’s Clinical Policies or contact your Nursing Supervisor prior to caring for any client. If you have any question or concern about a patient and/or their potential exposure to Ebola, or questionable symptoms, notify your nurse manager immediately.

The CDC is working closely with all Local and State Public Health Department to prepare HCP’s for a potential outbreak within the US. There are several experimental treatment and vaccine medications in development. ZMAPP is one treatment medication viewed by experts as being the most promising for those infected with the disease.  Federal officials are rapidly increasing the production of ZMapp.

All Nightingale employees are asked to review the signs and symptoms of Ebola and to ensure, as per our policy, that there is an intact Nightingale supplied Standard Precautions Kit available either in each client’s home, or in their home care bag during every shift or visit.

For the CDC’s details of standard, contact, and droplet precautions see 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Setting.

For further information on symptoms of Ebola Hemorrhagic Fever infection and modes of transmission, see the CDC Ebola Hemorrhagic Fever Website.