Evening Ebola Update, Tues, 10/7: Latex gloves in Spain not impermeable; new PLoS from Sierra Leone   Leave a comment

10/7/14

Dear Colleagues:

l. NIH reports  that the patient with high risk exposure to EBOV admitted Sept. 28th for observation was discharged today to a 21 day quarantine at his home.  The patient had a needle stick while taking care of an EBOV patient in Sierra Leone and then spiked a fever.  His tests for EBOV were negative at NIH.

2.  Becker’s Hospital Review reports today that JCAHO, the accreditation corporation for all U.S. hospitals has issued a Quick Safety Advisory on EBOV.  The Advisory has all of the usual recommendations and includes advice not to do any aerosol-producing procedures on EBOV patients.  That would inelclude bronchoscopy or endoscopy or suctioning ET tubes in my opinion.  See the entire JCAHO advisory at: http:/www.beckershospitalreview.com/quality/joint-commission-launches-ebola-preparedness-safety-advisory-tools.html.

3.  Washington Post reports today that the Spanish ‘nurse’ who was diagnosed with EBOV after caring for a Spanish priest with EBOV was in fact a ‘sanitary tech’ who changed the priest’s diaper one time and collected his bed linen one time.  The tech wore latex gloves with tape attaching the gloves to the wrist.  Spanish workers at the hospital are not protesting the poor PPE and the fact that infected EBOV linens were transported in a hospital elevator used by staff and patients.  Several errors were made: latex gloves are NOT impermeable (if surgeons double glove and remove one pair of gloves half way through their operations, the post-op infection rate is decreased by 50%); EBOV linens and waste must be sterilized and placed in sealed bags in sealed barrels  before transport in non-patient elevators; no designated staff for EBOV patients; tech only interacted with EBOV patient two times.

4.  Boston Globe reports that NBC reporter with EBOV who was attached to Dr. Nancy Synderman’s team in West Africa is now in hospital.  He will be treated with one of two experimental drugs: brincidofovir, the anti-DNA polymerase from Chimerix or TKM-Ebola, interfering RNA (iRNA) which inactivates 3 of the 7 EBOV genes-the L polymerase, VP24, and VP35.

5.  PLoS Current Outbreaks has a new article by T. Stader, et. al. about the R0 and length of infectious period of EBOV in Sierra Leone.  The data was collected on 72 patients last May, June.  R0 median is 2.2 individuals and median length of infectious period is 2.6 days.  Incubation period has a median of 5 days.  See DOI: 10.1371.currents.outbreaks.02bc6d927ece7bbd33532ec8ba6a25f for the entire article.

6.  CNN News reports that 99 contacts have been identified who had contact with the Ugandan radiographer who died on September 28th of Marburg virus (MARV).  No statements whether or not all patients radiographed by the radiographer had been contacted and tested for MARV.  All patients radiographed need to be contacted and tested and quarantined.  Likely it is one of these patients who is the index case.

RGL, MD

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Posted October 8, 2014 by levittrg in Uncategorized

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