Archive for Public Health

California-Based Measles Outbreak Reported in 14 States

Throughout the month of January, approximately 84 individuals from 14 different states were reported to have contracted measles as part of a larger outbreak. A majority of these cases are part of a series that originated in the Disneyland theme park in Anaheim, California. The outbreak is still ongoing, with at least 50 of the measles cases in California linked to Disneyland, while at least 13 cases in other states are linked to the outbreak.

The measles outbreak surfaced among Disneyland visitors who came down with the virus after visiting the park between December 15 and December 20, and cases have continued to be reported since. The measles virus has affected at least five Disneyland employees. Dr. Gil Chavez, deputy director of the Center for Infectious Diseases in California, the state with the highest number of reported cases, has recommended that people who have never had a measles vaccination and children under 12 months do not visit the park while the outbreak is ongoing. Dr. Chavez also recommended that individuals in those categories stay away from places such as airports and shopping malls where large crowds are likely to be present.

The Centers for Disease Control and Prevention (CDC) have issued an official Health Advisory to notify public health departments and healthcare facilities about the outbreak and to provide guidance about treatment of the disease. Measles is a respiratory illness caused by an airborne virus similar to influenza. It is highly contagious and may be spread through bodily fluids or through the air when a carrier coughs or sneezes. Symptoms include fever, dry cough, runny nose, skin rash, red eyes, sore throat and little white spots inside the mouth. After the initial symptoms, comes an uncomfortable spot-like rash that covers much of the body. Complications from measles are relatively common, and are usually more severe in adults who catch the virus.

Measles is common around the world, with 20 million new cases reported yearly around the globe. In 2000, the United States declared that measles was eliminated from this country, but travelers with measles can continue to bring the disease to American shores. The United States experienced a record number of measles cases during 2014, with 644 cases from 27 states reported to the CDC’s National Center for Immunization and Respiratory Diseases (NCIRD). The majority of people who contract measles are unvaccinated. Health officials have stated that individuals who have been vaccinated are at little risk from the disease, and would in fact be safe visiting Disneyland in California, the outbreak’s epicenter. However, the disease is extremely contagious to those without immunization. The CDC reports that 90 percent of unvaccinated people in close proximity to an infected person will catch measles.

The current outbreak and the higher number of measles infections in recent years may be attributable to some people declining to have their children immunized. Some parents fear a link between immunization and autism in children, while medical experts have continually asserted that there is no evidence for any such link. According to the CDC, 79 percent of the people who opted out of the measles vaccine in 2013 did so because they did not believe in vaccinations. Amy Schuchat, assistant surgeon general for the United States Public Health Service and the NCIRD, noted that one out of every 12 children are not receiving their measles vaccines on time, rendering them vulnerable to catching and spreading the disease. Schuchat also urges adults who are not sure whether they have been vaccinated for measles to contact their doctor. “There’s no harm in getting another MMR vaccine if you’ve already been vaccinated,” Schuchat noted. Schuchat and other medical authorities state that anyone exhibiting measles-like symptoms, such as skin rash, should seek medical evaluation and treatment.

Flu Prevention in the Workplace

Hear that sniffling and sneezing around you? There is no doubt about it: flu season is upon us once again. This frigid time of year brings with it many workplace concerns, from winter weather driving to winter work safety, and flu prevention is a serious issue among them. A case of the flu can spread like wildfire around a workplace. No one likes getting sick, and, beyond that, when influenza puts several employees down for the count, it can significantly reduce workplace productivity over the long winter months. But there is good news! By following a few easy prevention tips, employers can gain the upper hand and significantly reduce the flu’s impact on workplaces this season.

Increase Awareness

One of the foremost steps an employer should take to enact flu prevention in the workplace is to raise flu awareness among employees. It is, of course, common knowledge that this is flu season. Even so, reminding employees of this fact can be immensely helpful. Putting the flu toward the forefront of employees’ consciousness can increase the precautions they take. Employers should make an effort to educate workers on influenza signs and symptoms. For instance, employees should know that the flu typically comes on quickly and is different from a cold, although it shares many of the same symptoms, such as: cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue. In some cases, an individual who has contracted the flu will also have a fever, feverish chills, vomiting or diarrhea, but an individual may still have the flu in the absence of these particular symptoms. Employees who come down with flu-like symptoms should monitor their health and take extra preventative measures to avoid potentially spreading the virus in the workplace.

Encourage Vaccination

The Center for Disease Control and Prevention (CDC) recommends encouraging influenza vaccination among workers. According to the CDC, every individual over six months of age should be getting a flu vaccine every season. An annual flu vaccine is the most surefire way to prevent yourself from catching the flu and spreading it to others in the workplace. Vaccines are available in both traditional shot form and as a nasal spray, which is particularly convenient for those with a phobia of needles. A certain degree of misinformation and urban myths surround flu vaccines and vaccinations in general. It may be helpful to dispel myths in order to make employees more comfortable and confident in getting a flu vaccination as a prevention measure. For instance, it is important to emphasize that the flu vaccine cannot cause flu illness. Employees who are over 65, who are pregnant or who suffer from certain chronic medical conditions should be made aware that they are at increased risk of complications from flu that could lead to serious health problems. It is particularly important for such individuals and those in the workplace around them to consider getting vaccinated for the flu. Employers should encourage any such employees who contract flu should consult a physician and should take time off from work until they have fully recovered.

Start Small

Simple but crucial ways to prevent the spread of influenza in the workplace include proper hand and respiratory hygiene practices. Employees should wash their hands regularly with soap and hot water, particularly after using the restroom or shaking hands. In fact, it may be wise to advise employees to avoid shaking hands during flu season. Hand sanitizers are another useful tool, but they should be used in moderation, and are not a substitute for soap and water. Covering coughs and sneezes is not only common courtesy, but also helps prevent the spread of airborne flu pathogens. Posting signage throughout the workplace politely reminding employees to wash their hands thoroughly and cover their coughs can help to maintain workers’ flu mindfulness and safe practices. Email can also be useful to inform workers about safe practices in more detail. Surfaces can play a large, underestimated role in spreading influenza. Employers should frequently disinfect work surfaces such as telephones computers, and office equipment with sanitizing wipes. Flu prevention products, like healthcare masks, can also be helpful. A designated workplace health monitor can keep track of the above policies and see that they are maintained to ensure flu prevention.

Offer Work-From-Home Options

It is always a safe bet to establish a policy of sending employees with the flu or flu-like symptoms home. While employees may be inclined to be troopers and work through their illness, it is best for the workplace as a whole for them to stay at home in order to prevent the spread of the flu to others. Employers should consider expanding their work-from-home options and capabilities in order to maintain productivity throughout flu season and to encourage sick employees to stay home while still feeling like they have put in their fair share of work.

Practice these simple steps, and remember that the health and well-being of individual workers should always come first, and you should be able to effectively tough out and prevent the flu in your workplace this season.

Latest Ebola Virus News: 46 U.S. Hospitals Named Treatment Centers

America is now better prepared for the possibility of additional cases of the Ebola virus, as 46 U.S. hospitals are now designated Ebola treatment centers. The U.S. Department of Health and Human Services has responded to new concerns about Ebola by designating the 46 hospitals as part of a nationwide health system to treat infected patients and stem potential spread of the illness. The Centers for Disease Control and Prevention (CDC) announced the designation of the first 35 facilities in early December 2014 , and promised that more would be assigned in the following weeks. “We continue our efforts to strengthen domestic preparedness and hospital readiness,” Health and Human Services Secretary Sylvia Burwell said in the CDC news release.

State health officials have chosen the Ebola virus treatment centers in collaboration with local health authorities and the administrators of each designated hospital. The designated control centers have specially trained staff, appropriate Ebola personal protective equipment (PPE), from Ebola suits to the proper disposable gloves, and ample resources available to provide the particular kinds of treatments necessary to care for Ebola patients.

The designation of the Ebola treatment centers follows in the wake of concerns over whether most hospitals were prepared to care for patients potentially carrying the highly infectious disease. Almost half of hospitals responding to a recent survey conducted by Environmental Health & Engineering, a prominent environmental and engineering consulting service, reported that finding time to train staff to properly treat Ebola patients was a top challenge. Nurses’ groups have also expressed dissatisfaction with the level of training they’ve received in such crucial areas as the proper use of PPE. Nationwide nurses strikes over Ebola occurred in November.  The CDC asserts that the staff at the 46 designated treatment centers is trained and the facilities are optimized to minimize the risk health care workers face of contracting the disease while treating infected patients.

Individuals who believe they may have contracted the Ebola virus are encouraged to go to go to one of the designated centers for treatment. The centers are strategically placed to help ensure that they are within reach of those individuals who are most likely to need the resources they provide. The CDC has indicated that more than 80 percent of travelers returning to the United States from West African countries affected by Ebola live within 200 miles of one of the designated centers. The designated control centers will play an important supplementary role to the nation’s three bio containment facilities at Emory University Hospital, Nebraska Medical Center and the National Institutes of Health, which are the main care centers for patients who are medically evacuated from overseas, among others.

Current Ebola treatment entails isolation of the potential carrier, combined with active monitoring throughout the virus’ 21- day incubation period. During that time, state and local health authorities remain vigilantly attentive to the situation, communicating every day with the potentially exposed individuals to check for fever or other symptoms of the virus.

Ebola is a highly contagious disease transmitted through exposure to the bodily fluids of infected individuals. In West Africa, where the epidemic is centered, Ebola has killed more than 6,000 people, according to the World Health Organization. There have been eight cases on U.S. soil thus far, two of which were nurses who contracted the virus while treating an Ebola patient, fueling concern over the danger faced by health care workers. The designated Ebola treatment centers are prepared to reduce the danger of such risks. The CDC has released guidance for hospitals and state health officials to refer to when selecting more hospitals to be designated as Ebola treatment centers in the future, potentially further reducing the risks faced by non-designated hospitals. However, all hospitals still need to be prepared for potential Ebola patients.

Recent Outbreaks Highlight Need for Norovirus Prevention

From New Mexico to Minnesota, numerous cases of the highly contagious norovirus have been reported in recent weeks. Today, 30 people fell ill with the sickness at a Duluth, MN, restaurant, marking the latest outbreak. The incident follows a larger occurrence of norovirus that took place on board a New Zealand cruise ship and infected 200 passengers with the ailment commonly referred to as the stomach flu. The ship, the Dawn Princess, is owned by Princess Cruises, a division of Miami-based Carnival Corporation. Princess Cruises officials have encouraged affected passengers to remain in their cabins, and have enacted strict disinfectant protocols.

Previous Norovirus Outbreaks

In November, another norovirus outbreak aboard the Princess Cruises ship the Crown Princess infected at least 172 people, according to the U.S. Centers for Disease Control and Prevention (CDC). The Crown Princess had sailed from Los Angeles to Hawaii and Tahiti on a 28-day journey. The virus, which can spread more easily in closed quarters, is a frequent problem for cruise ships in particular. More than 150 passengers and crew from the Crown Princess were sickened with norovirus in April, and in January more than 600 people on cruise ships sailing the Caribbean fell ill with the virus.

Of course, norovirus also affects many people on land. San Mateo County health officials have confirmed that at least 60 guests and employees at the luxury Hotel Sofitel in Redwood City, California contracted the virus sometime after October 28. In response to the norovirus outbreak, San Mateo County’s Environmental Health Services inspected the hotel’s food operations and found no violations that could have led to food-borne illness. After disinfecting and training staff, the hotel’s food services reopened. Officials have noted that most of the individuals who contracted the virus were temporary guests of the hotel who are no longer in the area.

How Is Norovirus Spread?

Norovirus spreads after contact with infected people or contaminated food or water, making it highly infectious. Symptoms include stomach pain, nausea and diarrhea. The gastrointestinal illness typically lasts one to three days. Each year, the norovirus causes 19-21 million cases of acute gastroenteritis (inflammation of the stomach or intestines or both) and contributes to about 56,000-71,000 hospitalizations and 570-800 deaths, mostly among young children and the elderly.

Norovirus is the leading cause of illness and outbreaks from contaminated food in the United States: about 50 percent of all outbreaks of food-related illness are caused by norovirus. Foods most commonly involved in outbreaks of norovirus illness include: leafy green, such as lettuce; fresh fruits; and shellfish, such as oysters. In addition to cruise ships, the most common norovirus outbreak settings are restaurants, catered events, healthcare facilities, schools and other institutional settings.

Norovirus Outbreak Prevention

The best means of norovirus prevention begins with proper hand hygiene. Wash your hands thoroughly with soap and water, particularly after using the toilet or changing diapers. Norovirus can be found in your stool even before you start feeling sick, and can remain for two weeks or more after you feel better, so it is important that you wash your hands often. In a pinch, you can use alcohol-based hand sanitizers as a safety measure, but they should not be used as a substitute for soap and water when looking to avoid contracting norovirus. Individuals working in the food service industry should be particularly vigilant about hand-washing, and anyone who has contracted the virus should not prepare food for others until at least 48 hours after the symptoms stop. When preparing food, rinse fruits and vegetables carefully and cook shellfish thoroughly. Be extra cautious when it comes to norovirus disinfection as these germs are fairly resistant and can survive temperatures as high as 140 degrees Fahrenheit. Individuals can also contract the virus from contaminated surfaces, so be sure to thoroughly clean and disinfect any such surfaces. Wear rubber or disposable gloves when handling any potentially soiled clothes or linens and wash at the maximum available cycle.

Health officials at the CDC note that it is currently the cold and flu season, when stomach flu circulates more widely on land. For your own sake and for the sake of those around you, be sure to take these norovirus precautions to stay germ-free during any potential outbreaks.

WHO Revises Ebola-Specific Standards for PPE

The World Health Organization (WHO) has released revised technical specifications for personal protective equipment (PPE) selection, in order to reflect the latest Ebola news updates. According to the International Safety Equipment Association (ISEA), the revisions are “a step in the right direction,” as they make an important addition by including performance standards in the PPE selection guidelines. The update, released October 31, encompasses information on effective test methodologies for ensuring that PPE can protect healthcare workers from transmitting Ebola.

Ebola is very much a global concern, with recent cases occurring in the United States and Europe, in addition to the outbreak in West Africa. The WHO’s new guidelines are meant to help establish standards to assist healthcare workers the world over in protecting themselves from Ebola transmission, in the hope of ultimately stymying the virus’ spread. An international panel developed the new guidelines after consulting with leading infection control experts as well as healthcare workers with field experience caring for Ebola patients. The panel’s findings emphasize the importance of thorough hazard analysis in selecting PPE. The panel’s specifications highlight that medical organizations must properly select and use protective clothing and equipment based on product safety standards to most effectively protect against biological hazards.

The panel’s findings reinforce the crucial role PPE plays in preventing Ebola transmission. Healthcare workers not only save lives, but they are our first and best defense against the virus’ spread. Those who treat Ebola patients directly are at the highest risk of contracting the disease, leading to some popular paranoia regarding healthcare professionals in the United States and abroad. In response to cases of Ebola transmission by healthcare workers in the United States, some nurses’ organizations have demanded better PPE, including hazmat coverall suits, as well as more thorough instruction in the proper methods of wearing and safely removing PPE. Some of these demands were met after a series of Ebola strikes were enacted across the country in mid-November.

The WHO’s guideline updates for Ebola PPE selection based on hazard analysis form an important addition to the WHO’s essential recommendations for the types of PPE that are essential for healthcare workers. The experts on the WHO panel agreed that it is most important to have gear that protects the mucosae — the mouth, nose, and eyes — from contaminated droplets and fluids. This would include fluid-resistant medical masks, paired with safety goggles. Proper hand hygiene and gloves are also essential. The WHO also recommends that healthcare workers wear a gown/coverall and protective footwear; the Center for Disease Control and Prevention (CDC) and other similar organizations provide guidelines concurrent with those of the WHO.

The ISEA believes that, by linking PPE selection guidelines with product performance standards, the WHO has taken important action to guide healthcare providers to choose the right safety products to best protect healthcare workers. The ISEA draws on its member companies’ deep knowledge of protective product performance standards, and has been working with the CDC to develop effective gear and methodologies to keep healthcare workers safe. They report that demand for PPE has acutely increased in response to Ebola, and that manufacturers are working hard to supply protective clothing and equipment.

Update on Ebola Virus Precautions: Training Hospitals’ Top Concern

The latest news on hospitals Ebola virus preparedness shows that they are most concerned about issues surrounding the proper training of staff and Hazmat shipment, according to a recent study by Environmental Health & Engineering (EH&E).

In late October 2014, EH&E, a prominent environmental and engineering consulting service, surveyed hospital environmental health and safety managers (EHS), risk managers and facilities managers in U.S. hospitals to gain an update on Ebola virus precautions and procedures. The results reveal how hospitals have responded to the threat of Ebola and areas of particular concern to those professionals responsible for ensuring hospital safety. Potential vulnerabilities in hospital preparedness may lie in the lack of available time patient care staff members have to participate in training, and uncertainties about the proper certification of staff to ship infectious substances.

Almost half (48 percent) of hospitals participating in the survey identified ‘available time for patient care staff’ to participate in training as their top challenge to hospital safety. Another 20 percent indicated money or a lack of qualified staff and internal resources to support training as their main limitation. Such limitations prompted widespread strikes amongst nurses across the nation this month. Hospitals believe it is essential to provide direct, hands-on, Ebola-specific training to clinical staff, particularly to those who may treat such patients directly. EH&E indicates that it is particularly important for hospitals to train staff in the correct way to put on and remove Ebola personal protective equipment (PPE). While it may not seem significant to the lay observer, it is crucial for staff to don and doff protective equipment, such as Ebola suits, boots and double sets of disposable nitrile gloves, in the correct order, and to follow proper safety procedure. Experts have identified failure to follow PPE removal protocol as a potential source of Ebola infection among medical staff.

In response to hospitals’ concerns, EH&E recommends that a select number of staff, ranging from physicians and nurses to respiratory therapists and environmental safety staff, receive a high level of Ebola virus training. Since there may not be time to train all staff in effective precautions, members of the select Ebola-trained staff will be available to be called upon to deal with any such patients who may arrive. Bryan Connors, MS, CIH, Senior Scientist and Healthcare Division Practice Leader with EH&E, has added that it is also critical that hospitals train staff to play the role of safety monitor. The safety monitor will observe other staff to ensure that they follow proper Ebola protocol when treating patients at close range. “It works like a buddy system, assuring front line critical staff don and doff PPE appropriately and any safety issues are addressed in real time,” Connors said.

Hospitals are also concerned about providing adequate Hazmat shipment training. More than half (55 percent) of hospitals indicated that they do not have or do not know whether they have staff trained to ship Category A infectious substances. Specimens from patients who have or may have Ebola are considered Category A infectious substances, and so must be shipped in accordance with a rigorous safety protocol to prevent any potential infection. Such training can take upwards of eight hours to complete and requires attendant documentation. Hospitals simply cannot rely on ad hoc training.

On the plus side, a majority (64 percent) of hospitals indicate that they have been actively conducting Ebola training, including courses specifically on the proper use of PPE. Only 5 percent reported having conducted no Ebola training to date. Meanwhile, 21 percent reported having some preparedness, either through training for other infectious diseases, or on Ebola specifically, but without PPE training. Awareness of safety precautions has likely increased across all categories since the survey was taken, but adequate staff training, Hazmat shipment, and PPE preparedness remain areas of concern at hospitals nationwide.

Nurses’ Dissatisfaction with Ebola Safety Standards Heightens; Strikes Enacted

Nurses are making their dissatisfaction with hospitals’ Ebola safety measures heard. On November 11, approximately 18,000 nurses employed by Kaiser Permanente-owned hospitals and clinics in Northern California went on strike. Another 800 nurses employed by other Northern California hospitals also went on strike, and 400 nurses at a Washington, D.C. hospital will also went on strike on November 12, Global Ebola Awareness Day. Efforts were successful for California nurses, who have since won the enactment of regulations requiring hospitals within the state to provide better Ebola safety training and gear for workers. The striking nurses are members of National Nurses United (NNU), a 190,000-strong labor union that has been outspoken about their desire for better safety equipment and training for nurses in preparation for dealing with the virus.

Concern for nurses’ safety increased last month when news broke that two Dallas nurses, Nina Pham and Amber Vinson, contracted the virus after treating Thomas Eric Duncan, the first person to die from Ebola in the United States. After treatment, both nurses are now Ebola-free. The spread of the infectious disease to the nurses highlighted the importance of proper medical safety gear and safety procedures. An official with direct knowledge of the case stated that there were “inconsistencies” in the type of personal protective gear Nurse Pham wore and with the procedure she followed when putting on and removing the gear. However, NNU President Deborah Unger has identified the Dallas hospital’s failure to establish a set of safety rules and standard procedures for dealing with Duncan as a potential cause of the infections.

Members of the NNU have criticized what they see as efforts to blame nurses for such instances of the virus’ spread. They hold hospitals accountable for failing to provide nurses with appropriate gear and adequate training on how to use it. Those staging the strike are calling for powered air-filtration masks and full-body hazmat suits to be available at all of the nation’s hospitals and at the ready to be put to use should an Ebola patient arrive to seek treatment. Putting on and removing medical gear must be performed in a particular order to minimize the risk of infection, with, for example, pant legs needing to be tucked into boots. Full-body suits would potentially minimize the number of steps nurses would be required to follow, thus minimizing the opportunities for risk-causing errors. Nurses are also upset about the lack of preparation they have been provided with. The striking NNU nurses have stated that the Kaiser-Permanente hospitals have failed to address these and other related concerns they have raised.

Since the first cases of Ebola were reported in the United States, much fear and paranoia has surrounded nurses and other medical professionals who work directly with infected patients. For instance, Doctors Without Borders nurse Kaci Hickox has created controversy by riding her bike outside in defiance of New Jersey’s mandatory 21-day quarantine order, despite the fact that she has tested negative for Ebola and is no threat to others. Given the climate of fear, nurses want to ensure not only that they are safe, but also that they are not stigmatized. As Ebola can only be transmitted through the blood and bodily fluids of those who carry it, medical professionals who directly care for such patients are at the highest risk of contracting the virus. The nurses’ strikes join an expanding group of voices calling for the government to lay out federal standards for hospitals to follow in response to Ebola. The NNU argues that such standards should entail better training and Ebola safety products for nurses to minimize the risk they face.

Protecting Medical Professionals from Ebola: What’s the Appropriate Protocol?

As hospitals across America prepare for the potential of handling Ebola cases, concerns are increasing regarding determining a uniform protocol for treating patients while securing the safety of medical staff. Given that two Dallas nurses, Nina Pham and Amber Vinson, contracted the virus in the course of their work, the Centers for Disease Control and Prevention (CDC) and the nation’s medical experts are anxious that hospitals establish guidelines for treating Ebola patients and effectively protecting doctors and nurses. This need has created certain controversies. For instance, medical facilities now face the dilemma of whether or not to forgo certain aggressive treatments for Ebola patients as a safeguard against exposing medical professionals to the virus.

Currently, there are no national guidelines for what procedures to use or to forgo in treating Ebola patients. There are conflicting practices at medical facilities nationwide, giving rise to ethical debates. Some facilities have opted to forgo cardiopulmonary resuscitation, which requires mouth-to-mouth contact with patients, and invasive surgical procedures, which put the several medical professionals necessarily involved in such a procedure at increased risk of contracting the virus. Proponents of this approach argue that such aggressive treatment would only be called for in patients for whom there is little chance of saving, and so pursuing such treatment is not worth the increased risk of spreading the virus. However, it is contrary to the instincts of most doctors to decline to do everything possible to intervene, and some argue that it is not certain what constitutes futile care. The CDC calls for keeping lab testing and medical procedures to a minimum, but states that decisions should be made by attending physicians in each particular case.

There is also some debate over whether just any hospital is prepared to carry out the necessary protocol. Ebola cases present particular challenges. For instance, there is the question of how to properly handle infectious waste, such as garments soiled with bodily fluids, from Ebola patients. Some hospitals have more experience dealing with infectious diseases and perform regular drills in how to handle biohazards. Tom Skinner, a spokesman for the CDC, has been quoted as saying the agency is “exploring further” the idea of making particular hospitals designated Ebola treatment units. Restricting Ebola treatment to the most prepared and well-trained facilities may help prevent the virus’ spread to medical professionals.

Proper training of nurses and medical staff, particularly with regard to the Ebola PPE (personal protective equipment) they wear when treating patients, is essential to ensuring the safety of those professionals and that all vital protocol is performed. It is necessary to have the right gear, from Ebola suits to protective hoods, to put such gear on in the right order, and to remove it properly. CDC Director Tom Frieden identified gear removal as a “major potential area for risk.” Extreme care must be taken to avoid contaminating regular clothing, eyes or mucous membranes. An official with direct knowledge of Nurse Pham’s case reported that there were “inconsistencies” in the type of personal protective gear Pham wore and with the process she used to put the gear on and remove it. Teresa Romero, a nurse’s aide who contracted Ebola while treating a patient in Spain, has said she received only 30 minutes of training in putting on protective gear, prompting her husband to publish a scathing letter and to call for the resignation of Madrid’s regional health minister. The World Health Organization advises that the dressing and undressing of protective wear should be supervised by another trained member of the medical team. A “buddy system,” in which a safety supervisor consistently monitors the worker from the time he or she puts the gear on until the time it is taken it off, has been effective in stopping other kinds of infection in hospitals.

Healthcare workers are the nation’s best defense in preventing the further spread of Ebola. Ensuring their safety from infection as they treat Ebola patients is paramount. For more information on the CDC’s current recommended Ebola protocol, visit their website.

How New York is Protecting Against the Latest Ebola Outbreak

On October 23rd, the Ebola virus made its latest appearance in outbreak news in New York City, when Dr. Craig Spencer, a resident of Harlem, had returned on the 17th from treating infected patients in Guinea. He had taken the appropriate actions to keep himself and others safe by regulating his body temperature twice a day and, when he felt sluggish and developed a 100.3 fever, he swiftly sought medical attention and was isolated.

While the Doctors Without Borders participant was asymptomatic for the majority of his time in the Big Apple (and was most likely not contagious), Sal Pain, Chief Safety Officer for Bio-Recover Operation, and his crew have been working diligently to prohibit any spreading of the virus and qualm public fears. Dr. Spencer continues to be the only confirmed Ebola case in New York City and has undergone antiviral and blood-plasma therapies since his hospitalization. On November 3, the doctor’s condition was changed from “serious but stable” to “stable,” according to New York’s Health and Hospitals Corporation. As Ebola becomes an increasing reality for workers in numerous related fields, we take note of what the rest of the world can learn from these New York-based professionals.

What Actions Were Taken to Sterilize Environments

Pain and his crew have handled intense biological incidents similar to an Ebola outbreak, including the New York anthrax scare in 2001, and are well-trained and well-equipped. Given the nature of Dr. Spencer’s fifth-floor apartment and four-feet-wide hallways, the team forwent a typical Ebola decontamination station in favor of a more compact design using 6 millimeters of plastic and a PVC frame. High contact items such as bedding and personal hygiene products were removed from the apartment. The Ebola virus has a tendency to live longer in colder environments, so food was disposed of as well. The process took 12 hours and ended with chemical and water showers for all those involved before they headed back out into the city.

Although the doctor was said not to have a contagious stage of the disease while visiting The Gutter in Williamsburg, the bowling alley opted to close and undergo sterilization for the sake of safety. Outfitted in $1,500 protective suits, Pain’s employees put in seven straight hours of work overnight from October 25 to October 26 to painstakingly sterilize every object – from the interiors of bowling balls to the buttons of arcade games – within the venue. Various methods and tools were used in the decontamination process, including a thorough scrub-down of all surfaces and objects with rags and wire brushes doused in sanitizing products and chemical cleaners developed by the federal government for such disease control scenarios. The floors were cleaned with a solution containing 10 percent bleach, as recommended by the federal Centers for Disease Control and Prevention (CDC).

How Ebola Spreads

Although it is not clear as to how this virus originated, scientists believe that the first patient becomes infected through an animal such as a fruit bat or primate, which is referred to as a spillover event. When an infection is found in humans, the virus can spread through direct contact through bodily fluids (such as urine, saliva, vomit, semen, breast milk, sweat, etc.), needles and syringes, or infected fruit bats or primates. Although a patient who recovers from Ebola can no longer spread the virus, it has been shown to be found in semen for up to three months.

Ebola is not spread through water, air or legally purchased food. According to the CDC, there is no evidence that this decease can be spread through any other animals. For these reasons, healthcare providers are most susceptible to Ebola outbreaks. Wearing the appropriate Ebola protection equipment such as gloves, masks, safety suits and protection goggles is recommended when in an area where exposure to Ebola can occur.

Dedicated and disposable medical equipment should be used by healthcare providers. If instruments used are not able to be disposed, they should be thoroughly sterilized before being used again. Without these precautions and procedures in mind, the virus can continue to be transmitted.

Most of Dr. Spencer’s possessions remain intact, but the apartment will be sterilized and livable when the doctor and his fiancée return. Keeping Ebola under control in New York is the number one priority at the moment, and having a trustworthy and cautious crew like Pain’s is in order for every delicate situation.