Preparing for Ebola in the Caribbean

The Pan American Health Organization (PAHO) wants healthcare workers throughout the Americas, including the Caribbean, to be trained in the use of personal protective equipment and early identification of suspected cases of the Ebola virus disease (EVD).

PAHO’s call on Tuesday comes amid confirmation the day before by the U.S. Centers for Disease Control and Prevention (CDC) of a healthcare worker who became the first case of secondary transmission of Ebola in the United States and the Americas.

PAHO also reminded countries of the importance of maintaining surveillance and updating their procedures for any potential introduction of the virus.

The healthcare worker confirmed as having Ebola worked at Texas Presbyterian Hospital in Dallas, Texas, where she had been involved in the treatment of the first Ebola case diagnosed within the United States, who died on Oct. 8.

The healthcare worker reported a low-grade fever on Oct. 10 and was referred for testing, which came back positive. She has since been in isolation, and contact tracing is underway, according to the CDC.

The deceased Ebola patient had travelled from West Africa, where more than 8,300 cases and 4,000 deaths from Ebola had been reported as of Oct. 10, PAHO said.

“Healthcare workers are at high risk of infection with Ebola unless they take adequate precautions,” it said.

PAHO said that, in Africa, healthcare workers have been one of the most heavily affected groups, with 416 cases and 233 deaths.

It said the virus is not airborne but is transmitted through direct contact with the bodily fluids of infected people.

PAHO said it is working with its member states in the Americas to ensure preparedness for any possible introduction of Ebola virus disease.

The organization issued an epidemiological update on Oct. 10 reminding member countries of the need for measures to ensure early detection of potential cases.

These include heightened awareness among both screening personnel at points of entry and healthcare workers on the clinical features of the disease, especially fever, and screening questions about history of travel to Ebola-affected countries or other means of exposure to the disease.

“Healthcare workers especially should be prepared to report suspected cases immediately to the authorities and to implement the necessary protocols,” PAHO urged.

PAHO is also reminding countries of the need to strengthen measures for infection prevention and control in their health services, including through training of healthcare workers in the use of personal protective equipment.

Toward this end, PAHO has disseminated the document, “Infection Prevention and Control Guidance for Care of Patients with Suspected of Confirmed Filovirus Haemorrhagic Fever in Health-care Settings,” with focus on Ebola 2014.

If and when a case is detected in a country, PAHO said an effective response to prevent the establishment of local transmission includes rigorous infection control measures; isolation of cases; contact tracing; access to and correct use of personal protective equipment by health workers; community education with clear, transparent, up-to-date information; risk communication; and coordinated implementation of public health measures in a manner proportional to the risks.

PAHO said it has been interacting proactively with its member states to support and orient their preparedness efforts to respond to the potential introduction of an EVD case and to prevent the establishment of local transmission.

It said a document defining the strategic approach to preparedness and response was developed and disseminated to member states “through multiple channels.”

To guide PAHO’s actions in this area, PAHO said its Dominican-born director Carissa F. Etienne created a special task force and an operational working group that will advise and support the implementation of the recommendations of the IHR Emergency Committee and coordinate the response to the potential introduction of EVD in the Americas.

PAHO said it has also been supporting the response in West African countries affected by the EVD outbreak with the deployment of staff.

Additionally, the organization said it is assisting its member states with deployments of their nationals and facilitating cooperation among countries.

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