Ebola Continues to Spread Among Health Care Workers

Transmission of the Ebola virus remains widespread in West Africa, with infections among health care workers continuing to rise.

In its latest Ebola response roadmap, the World Health Organization (WHO) reported more than 13,000 confirmed and suspected cases of the virus in 6 countries—Guinea, Liberia, Mali, Sierra Leone, Spain, and the United States—with more than 4900 related deaths. An additional 3792 cases have been reported since October 22, 2014, though that increase resulted from a more comprehensive assessment of patient databases.

“All administrative districts in Liberia and Sierra Leone have now reported at least 1 confirmed or probable case of Ebola virus disease since the outbreak began,” the WHO said in the report. “Cases of Ebola virus disease transmission remain lowest in Guinea, but case numbers are still very high in absolute terms. Transmission remains intense in the capital cities of the 3 most affected countries. Cases and deaths continue to be underreported in the outbreak.”

Of the reported cases, 521 health care workers have been infected with the virus through October 27, 2014, with 272 fatalities. Liberia, in particular, has experienced a significant increase in the number of infected health care workers.

“Infection prevention and control quality assurance checks are now underway at every Ebola treatment unit in the 3 intense-transmission countries,” the WHO stated. “At the same time, exhaustive efforts are ongoing to ensure an ample supply of optimal personal protective equipment to all Ebola treatment facilities, along with the provision of training and relevant guidelines to ensure that all health care workers are exposed to the minimum possible level of risk.”

In an effort to control the spread of the virus in Africa, the WHO has implemented a comprehensive 90-day plan with the objectives of isolating at least 70% of Ebola cases and safely burying at least 70% of patients who die from the virus by December 1, 2014. By the start of 2015, the ultimate goal is to reach capacity to isolate 100% of Ebola cases and safely bury all related fatalities.

To accomplish those objectives, among others, the WHO has requested $260 million in funding, of which 49% has been received, with an additional 15% pledged.

Meanwhile, in an effort to limit a potential outbreak in the United States, the US Centers for Disease Control and Prevention (CDC) revised its guidelines for monitoring people who may have been exposed to the virus.

The guidelines include active post-arrival monitoring of travelers without febrile illness or symptoms consistent with Ebola. Travelers arriving from Liberia, Sierra Leone, or Guinea will be contacted each day by local health departments for 21 days from the date of their departure.

Individuals who face a more elevated risk of infection, including health care workers who provided direct care to Ebola patients in West Africa, will be subject to additional precautions, such as direct active monitoring. Public health authorities are recommended to use an individualized, case-by-case plan to determine whether additional restrictions should be put in place, such as controlled movement or workplace exclusions.

However, those restrictions do not include quarantines.

“Returning health care workers should be treated with dignity and respect,” the CDC said in a press release. “They, along with our civilian and military personnel in the region, are working tirelessly on the frontlines against Ebola, and their success is what ultimately will enable us to eliminate the threat of additional domestic Ebola cases. We must not prevent or unduly discourage them from undertaking this indispensable and selfless work.”