Infection Rates and Risk Factors for Infection Among Health Workers During Ebola and Marburg Virus Outbreaks: A Systematic Review

Abstract

BackgroundInfection in health workers (HWs) has characterized outbreaks of Ebola virus disease (EVD) and Marburg virus disease (MVD). We conducted a systematic review to investigate infection and mortality rates and common exposure risks in HWs in EVD and MVD outbreaks.MethodsWe searched the EMBASE and PubMed databases to identify articles posted before 27 December 2017, with no language restrictions. Data on the number, frequency, and mortality of HW infection and exposure risks were extracted.ResultsNinety-four articles related to 22 outbreaks were included. HW infections composed 2%–100% of cases in EVD and 5%–50% of cases in MVD outbreaks. Among exposed HWs, 0.6%–92% developed EVD, and 1%–10% developed MVD. HW infection rates were consistent through outbreaks. The most common exposure risk situations were inadequate personal protective equipment and exposure to patients with unrecognized EVD/MVD. Similar risks were reported in past EVD/MVD outbreaks and in the recent outbreak in West Africa.ConclusionsMany outbreaks reported high proportions of infected HWs. Similar HW infection rates and exposure risk factors in both past and recent EVD and MVD outbreaks emphasize the need to improve the implementation of appropriate infection control measures consistently across all healthcare settings.

New and emerging infectious diseases (Ebola, Middle Eastern respiratory syndrome coronavirus, carbapenem-resistant Enterobacteriaceae, Candida auris): Focus on environmental survival and germicide susceptibility

“…23 Importantly, in the 2014-2016 outbreak >850 HCP developed confirmed or probable Ebola virus disease (EVD). 24 The percentage of exposed HCP who developed EVD has ranged from 12.5%-76%. 24 The mortality of HCP who developed Ebola has frequently exceeded 50%.…”

“…24 The percentage of exposed HCP who developed EVD has ranged from 12.5%-76%. 24 The mortality of HCP who developed Ebola has frequently exceeded 50%. 24 Key concerns for HCP include the low inoculating dose required for transmission; high frequency of HCP infections, especially in resource poor countries; and high mortality.…”

“…24 The mortality of HCP who developed Ebola has frequently exceeded 50%. 24 Key concerns for HCP include the low inoculating dose required for transmission; high frequency of HCP infections, especially in resource poor countries; and high mortality. As of 2019, an EVD outbreak is continuing with moderate intensity in the Democratic Republic of the Congo.…”

“…23 Two out of 149 HCP who cared for a patient with EVD in the United States developed EVD; both recovered. 24 The microbiology, epidemiology, diagnosis, clinical features, and treatment of Ebola have been reviewed. 22,[25][26][27][28][29][30] Ebola is caused by a nonsegmented, single-stranded negative RNA virus of the family Filoviridae.…”

Social distancing: implications for the operating room in the face of COVID-19

“…It is now the time to refocus that vigilance to protect anesthesia providers themselves, and in doing so, prevent the consequences to pandemic control of the ''triple threat'' of anesthesia provider infection. 6 Les cliniciens infectés représentent une triple menace au ralentissement de la pandémie actuelle de COVID-19 : ils deviennent des patients dans un système de santé déjà submergé, réduisent le nombre de professionnels de la santé disponibles, et servent de vecteurs dans leurs propres foyers et communautés. C'est pourquoi la protection des travailleurs de la santé de première ligne est essentielle au contrôle de la pandémie.…”