l. NIH has issued an update on the Partners in Health HCW now hospitalized with EBOV at the NIH Center. His/her condition has been downgraded from serious to critical. I calculate this is Day 7 or 8 of his/her symptoms so this is the stage of highest viremia and most fluid loss with accompanying respiratory and renal problems. See official NIH update (without much detail) at: http://www.nih.gov/news/health/mar2015/nih-16.htm
2. NEJM has produced a video showing the proper method to doff and don a PPE. The video may be viewed at: http://www.nejm.org/doi/full/10.1056/NEJMvcm1412105?emp=marcom&query=NEW
3. Until the genome of the EBOV which infected the NIH case is determined to be unchanged from prior cases AND the genome still detectable by current RT-PCR tests, both standard and ‘quick’ versions, contacts of the current NIH case must be brought to the U.S. on private, ‘EBOV-proof’ aircraft. No commercial aircraft should be used to transport contacts to the U.S. from West Africa until scientists have determined the genome of the current NIH EBOV case and the accuracy of RT-PCR tests for his/her EBOV genome. Remember this patient had two negative EBOV tests before the test turned positive..
4. Now that EBOV cases are decreasing in West Africa, some EBOV Treatment Centers are being ‘de-commissioned’. This process must be approached with the same diligence and caution that contact tracing and isolation of EBOV patients has been done. Many EBOV Treatment Centers will be re-purposed as non-EBOV health centers or schools. So decontamination is a critical part of the de-commissioning, and something that is new for everyone in research and in the field.
Postings to this blog will less frequent than daily as the EBOV epidemic continues to be overcome. I appreciate everyone’s interest in making this blog a success. Thank you.