Sunday, October 19, 2014

Ebola - How did the two nurses get infected?

Ebola and Infection - Multiple Choice Question

The spread of ebola occurs through physical contact during which bodily fluids from the infected patient is transferred to the mucus membranes or skin lesions (breaks/tears) of another person. Nina Pham and Amber Vinson, the two nurses in Texas who were infected because they treated Thomas Eric Duncan, were infected even though there was no report of obvious unprotected physical contact between them and the patient. How might have this infection occurred?

(a) Bodily fluids such as saliva can become aerosols through coughing and sneezing. The microscopic aerosol particles cannot be seen with the naked eye, but persist on table surfaces, door knobs, arm rests, etc. The nurses touched these surfaces and then touched their faces, rubbed their eyes, or combed their hair (scraped their scalp) with their hands. 

(b) The skin has many microscopic lesions (breaks/tears) due to day-to-day activities. A chip in your fingernail can cause a tear in the skin of your arms, face, etc. These lesions can become ebola's entry way. This is why it is important for healthcare providers who treat ebola patients to have protective gear that fully covers their entire body.

(c) When liquids (urine, diarrhea, blood, etc.) splash, they often produce aerosol particles. This is why when men urinate while standing, urine still gets outside the toilet even if the men did not miss the bowl. If you've had to clean toilets that were frequently used by men, you will know what I'm talking about. 

(d) The nurses washed their hands (even though they wore gloves while treating the patient; standard procedure), but did not wash their wrists/forearms or face with soap and water.

(e) Something along the lines of all of the above.

Note: This question was written without full knowledge of the details of what happened at the hospital where the infections occurred.

Answer: e

Here is an article about dealing with ebola, written by a healthcare provider who has haz-mat (hazardous materials) training.

Abby Norman. “I'm a Hazmat-Trained Hospital Worker: Here's What No One Is Telling You About Ebola.”  Huffington Post Blog. Posted: 10/17/2014 10:18 am EDT Updated: 10/18/2014 12:59 pm EDT

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