Vermont ems Ebola Virus Disease Education

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Vermont ems Ebola Virus Disease Education

• Patsy Kelso PhD, Vermont Department of Health
  State Epidemiologist
• and Vermont EMS

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2014 Ebola Outbreak
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The Outbreak

• Reports as of October 24
• 10,141 cases
• 4,922 deaths
• This is the largest Ebola epidemic in history
• CDCs response is the largest international
  outbreak response in CDCs history
• On August 8, the World Health Organization (WHO)
  declared the current Ebola outbreak a Public
  Health Emergency of International Concern (PHEIC)
• The PHEIC declaration underscored the need for a
  coordinated international response to contain the
  spread of Ebola

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Future Estimates of Ebola Cases in Liberia and
Sierra Leone

• In September 23 edition of MMWR, CDC estimated
  the future number of Ebola cases if current
  trends continue in Liberia and Sierra Leone
• Without additional interventions or changes in
  community behavior, CDC indicated by January 20,
  2015 there will be approximately 555,000 Ebola
  cases in Liberia and Sierra Leone, or 1.4 million
  if correction for underreporting are made.
• Cases in Liberia are currently doubling every
  15-20 days, and those in Sierra Leone and Guinea
  are doubling every 30-40 days.
• The MMWR article Estimating the Future Number
  of Cases in the Ebola Epidemic Liberia and
  Sierra Leone, 2014-2015It is available at
  http//www.cdc.gov/mmwr/preview/mmwrhtml/su63e0923
  a1.htm, and a QA on the report is available at
  http//www.cdc.gov/vhf/ebola/outbreaks/2014-west-a
  frica/qa-mmwr-estimating-future-cases.html

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Outbreak Challenges in West Africa

• Overburdened public health and healthcare systems
• Unpaid healthcare workers
• Insufficient treatment centers, beds, medical
  supplies, and personal protective equipment (PPE)

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Background on Ebola
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Ebola is a rare and deadly disease

• First discovered in 1976 near the Ebola River in
  the Democratic Republic of the Congo
• Outbreaks occur sporadically in Africa
• Family of zoonotic RNA viruses
• Historically, death rates from Ebola range from
  50-90

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Transmission

• Ebola virus is spread through direct contact
  (through broken skin or mucous membranes) with
• A sick persons blood or body fluids, including
  urine, saliva, sweat, feces, vomit, and semen
• Contaminated objects (like needles and syringes)
• Infected animals (by contact with their blood,
  fluids, or infected meat)
• Ebola virus has been detected in breast milk, but
  is not know if the virus can be transmitted
  through breastfeeding
• Not transmitted by mosquitos or other insects

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Symptoms

• Signs of Ebola include fever (greater than 38.0oC
  or 100.40F) (87) and symptoms such as
• Fatigue (76)
• Vomiting (68)
• Diarrhea (66)
• Loss of appetite (65)
• Severe headache
• Muscle pain
• Abdominal pain
• Unexplained hemmorrhage
• The incubation period is 2 to 21 days (average
  8-10 days)
• A person with Ebola is not contagious until
  symptomatic

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Testing Treatment

• Virus is generally detectable in blood by
  real-time RT-PCR between 3-10 days post-onset of
  symptoms, but has been detected for several
  months in certain secretions (e.g., semen)
• No FDA-approved vaccine or antiviral drug is
  available
• Symptoms are treated as they appear. Basic
  interventions, when used early, can significantly
  improve the chances of survival.
• Providing IV fluids and balancing electrolytes
• Maintaining oxygen status and blood pressure
• Treating other infections if they occur

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Patient Recovery

• Recovery from Ebola depends on good supportive
  care and the patients immune response
• People who recover from Ebola infection develop
  antibodies that last for at least 10 years, and
  possibly longer
• It isnt know if people who recover are immune
  for life or if they can become infected with a
  different species of Ebola
• Some people who have recovered from Ebola have
  developed long-term complications (joint and
  muscle pain, and vision problems)

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CDC EMS
Vermont EMS is following the CDCs guidance
please read!

• http//www.cdc.gov/vhf/ebola/hcp/interim-guidance-
  emergency-medical-services-systems-911-public-safe
  ty-answering-points-management-patients-known-susp
  ected-united-states.html

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Vermont EMS Ebola Virus Disease Protocol
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Vermont EMS Ebola Virus Disease Protocol
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CDC EMS PPE
Vermont EMS has developed a check-list following
this guidance!

• http//www.cdc.gov/vhf/ebola/hcp/procedures-for-pp
  e.html

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Vermont EMS PPE Donning Doffing Checklist

• Printable version is attached to this
  presentation as a document and is also viewable.
• Please print as many color copies as necessary.

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Alternative Vermont EMS PPE Donning Doffing
Checklist

• Due to limitation in available PPE, the following
  checklist still adheres to available guidance
• Printable version is attached to this
  presentation as a document and is also viewable.
• Please print as many color copies as necessary.

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Next Steps

• Watch the following video (approximately 21
  minutes) on donning and doffing of PPE
• NOTE Please be cognizant of the poor foot
  hygiene at the end of the video (stepping in
  clean shoes in areas where booties were worn)
• Review the Vermont EMS Ebola Virus Disease
  Protocol
• Review the Vermont EMS PPE Donning Doffing
  Checklist
• Train with your service! (Train the trainer for
  Donning Doffing coming soon)

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Next Steps

• Any questions should be addressed to
  VTEMS_at_state.vt.us
• FAQs are being developed
• This training will be updated as needed