Ebola: protection of health-care workers

Abstract

The Ebola outbreak in west Africa has taken a substantial toll on health-care workers in Guinea, Liberia, and Sierra Leone—not only doctors and nurses, but also other cadres including ambulance drivers, hospital cleaners, and burial team members. More than 600 of the nearly 17 000 cases of Ebola virus disease have been in health-care workers, more than half of them fatal. In today's issue of The Lancet we pay tribute to several of the health workers who have lost their lives to the disease since the outbreak began a year ago. Many of the doctors who have died were medical educators in their nations, representing a tragic loss for the next generation of health workers in Africa. The risks remain high for medical staff. On Dec 9, the US Centers for Disease Control and Prevention published an analysis of Ebola infections in health-care workers in Sierra Leone. Incidence of Ebola infection among this group was 103-times higher than that in the general population during the period from May 23–Oct 31, 2014. Of 3854 laboratory-confirmed Ebola infections in the country during this period, 199 (5·2%) were in health-care workers. According to the report, 65 cases of confirmed Ebola infections were found in Kenema District, mostly from Kenema General Hospital. A broad range of challenges were reported in implementing infection prevention and control measures, including gaps in infection control protocols, training, and supplies. In response, the Sierra Leone's Ministry of Health and Sanitation is developing standard operating procedures for several aspects of infection prevention; recruiting and training staff; procuring needed commodities and equipment, including personal protective equipment; and investigating new cases of Ebola in health-care workers to identify and address ongoing prevention failures. Health authorities in Guinea and Liberia must also be alert to gaps in the protection and treatment of health workers, which could propagate transmission and worsen the Ebola outbreak. Prevention of Ebola in health-care workers is crucial to improve the health response to all causes of morbidity and mortality in affected countries. Sierra Leone doctors call for better Ebola care for colleaguesLocal doctors went on strike in Sierra Leone after it emerged that they would not be able to access a specialised British-run Ebola treatment unit for health-care workers. Miriam Shuchman reports. Full-Text PDF Remembering health workers who died from Ebola in 2014The Ebola outbreak in west Africa has had a devastating effect on health workers in the three countries most affected by the virus. Of the nearly 17 000 cases of Ebola virus disease in Guinea, Liberia, and Sierra Leone, at least 600 have been among health-care providers. More than half of them have died. The outbreak has also claimed the lives of doctors, nurses, and technicians from Mali, Nigeria, Spain, and the USA. Full-Text PDF UK Defence Medical Services Ebola Treatment FacilityMiriam Shuchman in her World Report (Dec 20, p e67)1 and the Lancet editorial (Dec 20, p 2174)2 raise the very important issue of the need for better care for doctors and other health-care workers putting their lives at risk managing Ebola in west Africa. However, some of the assertions and conclusions need to be balanced and indeed corrected. Full-Text PDF Ebola: better protection needed for Guinean health-care workersThe situation for health-care workers affected by Ebola in Guinea is quite similar to that of Sierra Leone described in a recent Editorial (Dec 20, p 2174).1 Full-Text PDF