How can Ebola transmission be prevented?

Preventing Ebola Virus Transmission

Ebola virus transmission can be effectively prevented through a comprehensive infection control strategy that includes proper personal protective equipment (PPE), vaccination, and strict adherence to infection control practices.

Key Prevention Strategies

Personal Protective Equipment (PPE)

PPE is crucial for preventing direct contact with infected patients and their bodily fluids, which is the primary mode of Ebola transmission 1:

• Complete body coverage with impermeable materials:
  • Gloves (double gloving recommended)
  • Fluid-resistant gowns or coveralls
  • Face shields or goggles for eye protection
  • Masks (surgical or respirators depending on procedure)
  • Boots or closed, impermeable shoe covers

Healthcare workers should be properly trained in donning and doffing procedures, as improper removal of contaminated PPE is a significant risk factor for transmission 2.

Hand Hygiene

Hand hygiene remains the single most important method of preventing transmission of infectious agents 3:

• Use alcohol-based hand rubs as the preferred method in most situations
• Wash hands with soap and water when visibly soiled or contaminated with blood/body fluids
• Perform hand hygiene before and after each patient contact, between procedures, and after removing gloves

Vaccination

The Ervebo vaccine (rVSV-ZEBOV) is recommended for prevention of Ebola virus disease 3:

• Vaccination should be considered for:
  • Healthcare workers caring for Ebola patients
  • Laboratory workers handling Ebola specimens
  • Close contacts of infected individuals
  • Outbreak response teams

Vaccinated individuals should still follow all infection control precautions, as the duration of protection is unknown 3.

Post-Vaccination Precautions

After receiving the Ebola vaccine, recipients should take specific precautions to prevent potential vaccine virus transmission 3:

• No blood donation for at least 6 weeks post-vaccination
• Avoid sharing personal items (needles, razors, eating utensils, toothbrushes) for 2 weeks
• Use barrier protection during sexual activity for 2 months
• Avoid close contact with high-risk individuals (immunocompromised persons, pregnant women, young children) for 6 weeks
• Cover any post-vaccination rashes with bandages until healed

Standard Infection Control Practices

Standard precautions should be applied with all patients 3:

• Proper handling and disposal of sharps
• Respiratory hygiene/cough etiquette
• Safe injection practices
• Proper handling of potentially contaminated equipment or surfaces
• Use of masks and eye protection during procedures likely to generate splashes or sprays

Special Considerations

Healthcare Settings

Healthcare facilities caring for Ebola patients should implement:

• Isolation of confirmed or suspected cases
• Designated areas for donning and doffing PPE with trained observers
• Regular disinfection of environmental surfaces
• Proper disposal of contaminated materials and waste
• Limiting patient transport within facilities

Community Settings

In community settings, prevention focuses on:

• Avoiding contact with infected individuals or their bodily fluids
• No contact with bodies of deceased Ebola patients
• Avoiding consumption of bushmeat or contact with bats and primates in endemic areas
• Proper sanitation and hygiene practices

Pitfalls and Caveats

• Heat stress and dehydration are significant challenges when using full PPE, affecting 64-76% of healthcare workers 2. Regular rotation of staff and hydration breaks are essential.
• Impaired visibility due to fogging of eye protection can compromise care quality 2. Anti-fog products should be available.
• Overconfidence in PPE use can lead to errors. Regular training and supervised practice are necessary despite 59% of healthcare workers reporting high confidence in their PPE use 2.
• Vaccination does not provide complete protection; all infection control measures must still be followed 3.

By implementing these evidence-based strategies, the risk of Ebola virus transmission can be significantly reduced, protecting both healthcare workers and communities during outbreaks.