caregivers when Thomas Eric Duncan became the first patient diagnosed with Ebola in this country.
Two Dallas nurses were infected with the deadly virus while treating Duncan at Texas Health Presbyterian Hospital Dallas, where he died in early October.
By that time, some specialized treatment centers were already handling Ebola cases with more stringent protocols. hospitals to use a set of guidelines issued in 2007, which infectious disease experts say were insufficient and outdated.
“The first time I saw the procedure actually saw what people were doing in terms of the handling of the patient himself, I was horrified,” said Dr. Joseph McCormick, an infectious disease specialist who has cared for African patients with Ebola as far back as the first known outbreak in 1976. “I thought, ‘Where did this come from?'”
The CDC maintains that the guidelines in place this summer were adequate when followed correctly. hospitals should have been able to handle a case of Ebola using the original guidance,” said agency spokeswoman Melissa Brower.
The CDC issued tougher guidelines in late October after the nurses were infected. It’s not known exactly how they contracted the virus.
Brower said the agency didn’t tighten its regulations because the previous recommendations were inadequate, but “to try to make it harder for health care workers to make a mistake while caring for Ebola patients.”
Disease experts learned in 1976 that Ebola spreads from person to person by direct contact with body fluids such as blood and the extensive diarrhea that patients can produce.
Ebola can enter the body through a puncture, a cut, or exposure to the eyes, nose or mouth. Health care workers not only need to wear clothing and gear that protects their bodies, but must also take off dirty gear safely.
A 1995 outbreak killed about 250 in Kikwit, Congo. When CDC experts arrived to help, 65 hospital workers were already infected. After protective gear was provided and the CDC and other organizations offered training, just one more health care worker became sick. She said she had inadvertently rubbed her eyes with soiled gloves.
The 1998 CDC guidelines, posted online and published in a manual, were written based on lessons learned in Kikwit. There were many detailed precautions to take, such as wearing gowns, masks and goggles.
Health care workers also were told to wear two pairs of gloves and shoe covers. Gloves should be disinfected during undressing, and a certain sequence was to be followed for putting on and taking off gear.
That sequence is critical, said Sean Kaufman, a biosafety expert. Some gear is more likely to have been exposed to the virus.
For example, outer gloves, more likely to be exposed to the virus, are taken off first because they are “dirty.” The face stays protected as long as possible and the “cleaner” inner gloves are taken off last.
Kaufman trained Emory University Hospital staff before their first two Ebola patients arrived cheap jerseys from Africa in August and provided safety expertise during their treatment. He said the 1998 manual’s undressing or “doffing” sequence is sound.
“Whoever did this doffing process understands containment of infectious disease,” he said.
But in 2005, the CDC published another set of guidelines. was available through another link. health care workers that would be issued by the CDC in 2007 based on the advice of a committee of infectious disease experts.
Dr. Jane Siegel, a UT Southwestern pediatrician who specializes in infectious disease, co chaired the committee. She said people who weighed in on a draft of the guidelines during the comment phase questioned “whether there was sufficient evidence to support the benefit of double gloving and leg covers.”
Dr. Peters was a virologist for the CDC during the Kikwit outbreak. He helped edit the manual that contains the 1998 guidelines.
“CDC knew, available from their website, was wholesale jerseys china a manual that has how to dress and how to undress and what to dress cheap nfl jerseys with,” said Peters, now a professor at the University of Texas Medical Branch Galveston. wholesale jerseys “, how to take them off, etc., etc., and if they had read this, they would have had a little different recommendations.”
Siegel said the committee did read the 1998 manual.
The committee also considered a 2002 medical journal article that Peters helped write, which recommended double gloves and leg and shoe covers. And it examined a 1995 CDC article that said leg and shoe covers “may be used.”
Those measures remained the same from 2007 until they were tweaked in August of this year: The CDC expanded its description of dangerous body fluids that would warrant more gear, saying double gloves and leg and shoe covers “might be required” in certain situations involving “copious amounts of blood, other body fluids, vomit or feces.”Articles Connexes：
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