Characterization of Ebola Virus Risk to Bedside Providers in an Intensive Care Environment

Area of Science:

• Infectious Diseases
• Virology
• Public Health

Background:

• The 2014-2016 Ebola outbreak highlighted risks of nosocomial spread and healthcare worker exposure.
• Preparedness for potential Ebola virus cases requires understanding transmission routes and high-risk interventions.

Purpose of the Study:

• To assess risks associated with routine care in an intensive care unit (ICU) setting for Ebola virus cases.
• To identify procedures posing the highest risk to healthcare providers during the clinical course of Ebola virus disease.

Main Methods:

• Created a Biosafety Level 4 (BSL4) laboratory ICU for non-human primates (NHPs) infected with Ebola virus.
• Collected blood, urine, gastric residuals, and various swabs during bedside care.
• Assessed the physical environment for contamination at the study's end.

Main Results:

• Ebola virus RNA was detectable in blood early post-infection, but in other samples (urine, gastric fluid, swabs) only in late-stage disease.
• Droplet spread and fomite contamination were observed on frequently touched surfaces.
• Good routine hygiene practices appeared to mitigate contamination risks.

Conclusions:

• The study enhances understanding of high-risk procedures for healthcare providers treating Ebola virus patients.
• Provides temporal data on transmission risks throughout the disease's clinical course.