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: 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: 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: 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.
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: 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: 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: 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.
Authors: John S Schieffelin; Jeffrey G Shaffer; Augustine Goba; Michael Gbakie; Stephen K Gire; Andres Colubri; Rachel S G Sealfon; Lansana Kanneh; Alex Moigboi; Mambu Momoh; Mohammed Fullah; Lina M Moses; Bethany L Brown; Kristian G Andersen; Sarah Winnicki; Stephen F Schaffner; Daniel J Park; Nathan L Yozwiak; Pan-Pan Jiang; David Kargbo; Simbirie Jalloh; Mbalu Fonnie; Vandi Sinnah; Issa French; Alice Kovoma; Fatima K Kamara; Veronica Tucker; Edwin Konuwa; Josephine Sellu; Ibrahim Mustapha; Momoh Foday; Mohamed Yillah; Franklyn Kanneh; Sidiki Saffa; James L B Massally; Matt L Boisen; Luis M Branco; Mohamed A Vandi; Donald S Grant; Christian Happi; Sahr M Gevao; Thomas E Fletcher; Robert A Fowler; Daniel G Bausch; Pardis C Sabeti; S Humarr Khan; Robert F Garry Journal: N Engl J Med Date: 2014-10-29 Impact factor: 91.245
Authors: Timothy M Uyeki; Aneesh K Mehta; Richard T Davey; Allison M Liddell; Timo Wolf; Pauline Vetter; Stefan Schmiedel; Thomas Grünewald; Michael Jacobs; Jose R Arribas; Laura Evans; Angela L Hewlett; Arne B Brantsaeter; Giuseppe Ippolito; Christophe Rapp; Andy I M Hoepelman; Julie Gutman Journal: N Engl J Med Date: 2016-02-18 Impact factor: 91.245
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Authors: P Guillaume Poliquin; Mia Biondi; Charlene Ranadheera; Mable Hagan; Alexander Bello; Trina Racine; Mark Allan; Duane Funk; Gregory Hansen; B J Hancock; Murray Kesselman; Todd Mortimer; Anand Kumar; Shane Jones; Anders Leung; Allen Grolla; Kaylie N Tran; Kevin Tierney; Xiangguo Qiu; Darwyn Kobasa; James E Strong Journal: Sci Rep Date: 2017-04-26 Impact factor: 4.379
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Authors: Travis Warren; Elizabeth Zumbrun; Jessica M Weidner; Laura Gomba; Franco Rossi; Roy Bannister; Jacqueline Tarrant; Matthew Reed; Eric Lee; Jo Lynne Raymond; Jay Wells; Joshua Shamblin; Kelly Wetzel; Ginger Donnelly; Sean Van Tongeren; Nicole Lackemeyer; Jesse Steffens; Adrienne Kimmel; Carly Garvey; Holly Bloomfield; Christiana Blair; Bali Singh; Sina Bavari; Tomas Cihlar; Danielle Porter Journal: Viruses Date: 2020-01-13 Impact factor: 5.048