TOPIC

APPLICATION OF HSE IN EBOLA MANAGEMENT

OBJECTIVES
1. To create an awareness of viruses with specific focus on ebola
2. Reasons for prevalence of ebola in africa
3. HSE in Ebola management and control
4. Recommendations for reduced prevalence

INTRODUCTION
• First appeared in Africa 1976
• known then as
“African Hemorrhagic Fever”
– Acute mostly fatal disease
– causes blood vessel “bursting”
– systemic (all organs/tissues)
– humans and nonhuman primates
• Excluding Year 2000 outbreak
– 1,500 cases
– over 1,000 deaths
• The 2014 Ebola epidemic is the largest in history, affecting multiple countries
in West Africa.
• Ebola is spread through direct contact with blood and body fluids of a person
infected by, and already showing symptoms of Ebola.
• Ebola is not spread through the air, water, food, or mosquitoes. There is no
evidence indicating that Ebola virus is spread by coughing or sneezing.
BASED ON HSE CLASSIFICATION
 EBOLA IS
 A BIOLOGICAL HAZARD
 A CAUSE OF HYPOVOLEMIC SHOCK
 A CONTAGEOUS DISEASE

VIRUS INFORMATION
What is a Virus
• A virus is a small amount of protein with a nucleus which replicates by
invading cells in a host.
• Virus is a micro organism that is smaller than a bacterium, that can not grow
or reproduce apart from a living cell.
medicinenet.com
• Mode of Operation
A virus invades a living cell, and uses the chemical machinery of the host body,
to keep itself alive and to replicate itself.
Many viruses are host specific, capable of infecting and causing disease in
humans or specific animals only.
Scientific Classification
Order: Mononegavirales
Family: Filoviridae
Genus: Ebola like viruses
Species: Ebola
Subtypes
– Ebola-Zaire, Ebola-Sudan,Ebola-Bundibugyo
• disease in humans
– Ebola-Reston
• disease in nonhuman primates
– Early symptoms
– red eyes,
– skin rash
– Fever
– Fatigue
 – Severe headache
– Diarrhea
– Muscle pain
– Vomiting
– Weakness Abdominal (stomach) pain
– Symptoms may appear anywhere from 2 to 21 days after exposure to
Ebola,
The average is 8 to 10 days.
• Acute symptoms
– bleeding/hemorrhaging from skin, orifices, internal organs
• Early Diagnosis
• very difficult
• signs & symptoms very similar to other infections.
• Laboratory Test
• ELISA (enzyme-linked immuno-absorbant) assay
• Antigen-capture detection tests
• Serum neutralization test
• Reverse transcriptase polymerase chain reaction (RT-PCR) assay
• Electron microscopy
• Virus isolation by cell culture
• MODE OF TRANSMISSION
• Nosocomial transmission(spread of a disease within a health-care setting,
• Non disposabel needles or syringes:they, or may not have been sterilized, but
only rinsed before reinsertion into multi-use vials of medicine.
• lack of protective clothing
• contact with contaminated objects
• improper sterilization of medical equipment
• General Exposure to body fluids.
 Prevention
• The trial will continue to assess whether the vaccine is effective in creating
herd immunity to Ebola virus infection. In December 2016, a study found the
VSV-EBOV vaccine to be 95-100% effective against the Ebola virus, making it
the first proven vaccine against the disease.
• Patients are isolated
• Medical Staff Training
– western sanitation practices
• intake
• care during stay
• after patient dies
• Infection-control Measures
– complete equipment and area sterilization
• TREATMENT
• No Standard Treatment available
• Patients receive supportive therapy
• treating complicating infections as they arise
• balancing patient’s fluids and electrolytes
• maintaining oxygen status and blood pressure
• Treatment of viruses is difficult because they continually mutate.
• These mutations become more rapid when they gain access into the Human
body leading to multiple existing strains of the virus.
EBOLA IN AFRICA
WHY DISEASES ARE SO PREVAILENT
• CONSIDER THE FOLLOWING
• WE DO NOT HAVE INFECTED INDIVIDUALS IN OUR IMMEDIATE
SURROUNDING.
• EBOLA IS PREVAILENT IN HIGHLY RURAL COMMUNITIES.
• IT WAS UNABLE TO IMPACT NIGERIA DUE TO OUR PROMPT AND EFFICIENT
RESPONSE.
 COMMON FACTORS INCLUDE:
• Poor Hygiene
• Poor Handling Blood and body fluids
• Funeral rites.
• Contact with bats and nonhuman primates or blood, fluids, and raw meat
prepared from these animals.
• Ebola from other patients .
• Direct contact with the bodies of people who have died from Ebola.
• General population is uneducated about Ebola
• Mixed messages about Ebola precautions
● Lack of proper training throughout medical staff/administration
● Discouraged health care workers from participating in travel care programs
● Difference between state and federal quarantine regulations
● Lack of positive media coverage
• General population is uneducated about Ebola
• Mixed messages about Ebola precautions
● Lack of proper training throughout medical staff/administration
● Discouraged health care workers from participating in travel care programs
● Difference between state and federal quarantine regulations
● Lack of positive media coverage
SAFETY PRECAUTIONS RECOMMENDATIONS
• FOLLOW THE IRISH MODEL
Ireland is well prepared to deal with the possibility of a case of Ebola,
although the risk of that occurring is very low. National plans for dealing with
Ebola have existed since 2002. These plans were updated again in 2012, have
been tested in a dry run in 2013 and put into operation to ensure we are
prepared for the outbreak of Ebola in West Africa.
http://www.thejournal.ie/inmo-nurses-hse-ebola-plan-1717786-Oct2014/
• Practice careful hygiene.
 Proper house keeping
 Use of sanitizers
 Fumigants
• Effective healthcare Delivery
 Proper medication
 Diagnostics
• Proper education of masses and healthcare workers about epidemic
• Do not handle items that may have come in contact with an infected person’s
blood or body fluids (such as clothes, bedding, needles, and medical
equipment).
• Avoid funeral or burial rituals that require handling the body of someone who
has died from Ebola.
• Avoid contact with bats and nonhuman primates or blood, fluids, and raw
meat prepared from these animals.
• Avoid hospitals in West Africa where Ebola patients are being treated. In case
of visit, must monitor your health for 21 days and seek medical care
immediately if you develop symptoms.
• Isolate patients with Ebola from other patients.
Avoid direct contact with the bodies of people who have died from Ebola