Infection prevention and control principles and recommendations for Ebola virus disease

Principles of Ebola virus disease infection prevention and control

1. Ebola virus transmission Asymptomatic people do not transmit Ebola virus by routine clinical or household contact.
   The predominant mode of Ebola virus transmission is by contact (direct, or indirect via contaminated fomites) with body fluids of a patient with EVD, usually in the later stage of infection or after death. Airborne transmission between people has not been demonstrated, but spread during events that generate aerosols has not been excluded.
2. Management of HCWs who have treated a patient in the Australian healthcare setting with suspected or confirmed EVD While they remain asymptomatic, HCWs who have been caring for patients with EVD:
   • will not transmit Ebola virus by routine clinical or household contact
   • can continue to work in the healthcare setting and do not require quarantine, if they have used adequate PPE with supervision. They should closely monitor their health, including twice-daily body temperature measurements, and immediately report any relevant symptoms to their designated supervisor
3. EVD and PPE principles and recommendations The risk of transmission is managed by IPC measures, including patient isolation, environmental hygiene (cleaning and, when appropriate, disinfection) and use of adequate PPE, supported by training.
   
   When providing clinical care for patients with confirmed EVD or treating symptomatic patients with suspected EVD where there is potential exposure to body fluids, the following is recommended:
   • PPE should be chosen to ensure that the mucous membranes of the eyes, mouth and nose are protected.
   • PPE should also cover all areas of the body to prevent exposure of skin, hair or clothing to a patient’s body fluids and subsequent risk of self-contamination by the HCW. Ebola virus is not thought to penetrate intact skin, but contamination of skin or hair with body fluids of a patient with EVD can result in transfer via the HCW’s hands to their mucous membranes or broken skin.
   • Hands are known to transmit pathogens to other parts of the body or face, and to other individuals. Therefore, hand hygiene and double gloves are essential, both to protect the HCW and to prevent transmission to others.