Environmental infection control considerations for Ebola

Lessons about Causes and Management of an Ebola Outbreak

“…32 Wiping and disinfecting fl oors, doors, and walls must be ensured from the facility entry to the isolation room and fi nally, a decontamination step and validation testing, using vaporized hydrogen peroxide or ultraviolet germicidal irradiation. 27 Full PPE (gloves, waterproof gowns, surgical masks, goggles and closed shoes should be available for cleaning professionals. 23 PPE doffi ng process should be correctly ensured to avoid professional contamination.…”

“…5,24,33 An adequate knowledge skill about hand hygiene and the relevant decontamination and disinfection procedures should be acquired by health workers and those who handle dead bodies at the time of post-mortem or burial activities. 27 Furthermore, health workers who are engaged in tracing contacts in the community should avoid shaking hands, maintain a distance of more than one meter during an interview with the contacts, and always carry alcohol-based hand rub solutions. In fact, it is even recommended to constitute a committee in the affected areas and a person should be in charge of coordinating infection prevention and control activities in both hospitals and communities.…”

“…Impervious gowns or aprons that cannot be sent to the hospital laundry facilities must be disinfected with 0.05% sodium hypochlorite. 23,27 For waste management, it is important to distinguish 2 types of wastes: care activity waste (points, syringes, tubing…) and human waste (urine, stool…). Ebola virus can remain viable on solid surfaces for up to fi fty days and even longer when protected in body fl uids such as vomit, blood, or stool.…”

Validation of Autoclave Protocols for Successful Decontamination of Category A Medical Waste Generated from Care of Patients with Serious Communicable Diseases

“…The amount of waste generated during the care of an Ebola patient is also significantly greater than that for routine medical care. This is partly due to the high volume of gastrointestinal losses, but also reflects the higher staff-to-patient ratio and the large amount of disposable personal protective equipment (PPE) required (9)(10)(11). Medical waste that is treated onsite through the use of steam sterilizers, or autoclaves, can be handled as regulated medical waste (9).…”

“…One of the unique challenges of caring for patients with highly infectious diseases is the handling of patient medical waste containing category A infectious substances (7)(8)(9)(10)(11). A category A infectious substance is "capable of causing permanent disability or life-threatening or fatal disease in otherwise healthy humans or animals when exposure to it occurs" (12).…”