Characterization of Ebola Virus Risk to Bedside Providers in an Intensive Care Environment.
Ebola
critical care
environmental contamination
nosocomial infection
viral shedding
Journal
Microorganisms
ISSN: 2076-2607
Titre abrégé: Microorganisms
Pays: Switzerland
ID NLM: 101625893
Informations de publication
Date de publication:
26 Feb 2021
26 Feb 2021
Historique:
received:
30
01
2021
revised:
20
02
2021
accepted:
23
02
2021
entrez:
3
3
2021
pubmed:
4
3
2021
medline:
4
3
2021
Statut:
epublish
Résumé
The 2014-2016 Ebola outbreak in West Africa recapitulated that nosocomial spread of Ebola virus could occur and that health care workers were at particular risk including notable cases in Europe and North America. These instances highlighted the need for centers to better prepare for potential Ebola virus cases; including understanding how the virus spreads and which interventions pose the greatest risk. We created a fully equipped intensive care unit (ICU), within a Biosafety Level 4 (BSL4) laboratory, and infected multiple sedated non-human primates (NHPs) with Ebola virus. While providing bedside care, we sampled blood, urine, and gastric residuals; as well as buccal, ocular, nasal, rectal, and skin swabs, to assess the risks associated with routine care. We also assessed the physical environment at end-point. Although viral RNA was detectable in blood as early as three days post-infection, it was not detectable in the urine, gastric fluid, or swabs until late-stage disease. While droplet spread and fomite contamination were present on a few of the surfaces that were routinely touched while providing care in the ICU for the infected animal, these may have been abrogated through good routine hygiene practices. Overall this study has helped further our understanding of which procedures may pose the highest risk to healthcare providers and provides temporal evidence of this over the clinical course of disease.
Sections du résumé
BACKGROUND
BACKGROUND
The 2014-2016 Ebola outbreak in West Africa recapitulated that nosocomial spread of Ebola virus could occur and that health care workers were at particular risk including notable cases in Europe and North America. These instances highlighted the need for centers to better prepare for potential Ebola virus cases; including understanding how the virus spreads and which interventions pose the greatest risk.
METHODS
METHODS
We created a fully equipped intensive care unit (ICU), within a Biosafety Level 4 (BSL4) laboratory, and infected multiple sedated non-human primates (NHPs) with Ebola virus. While providing bedside care, we sampled blood, urine, and gastric residuals; as well as buccal, ocular, nasal, rectal, and skin swabs, to assess the risks associated with routine care. We also assessed the physical environment at end-point.
RESULTS
RESULTS
Although viral RNA was detectable in blood as early as three days post-infection, it was not detectable in the urine, gastric fluid, or swabs until late-stage disease. While droplet spread and fomite contamination were present on a few of the surfaces that were routinely touched while providing care in the ICU for the infected animal, these may have been abrogated through good routine hygiene practices.
CONCLUSIONS
CONCLUSIONS
Overall this study has helped further our understanding of which procedures may pose the highest risk to healthcare providers and provides temporal evidence of this over the clinical course of disease.
Identifiants
pubmed: 33652895
pii: microorganisms9030498
doi: 10.3390/microorganisms9030498
pmc: PMC7996731
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : CIHR
ID : FRN143481
Pays : Canada
Déclaration de conflit d'intérêts
The authors declare no competing interest. Correspondence and requests for materials should be addressed to James E. Strong (jim.strong@canada.ca).
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