Occupational Exposures to Ebola Virus in Ebola Treatment Center, Conakry, Guinea

Savini, Hélène; Janvier, Frédéric; Karkowski, L.; Billhot, M.; Aletti, M.; Bordes, Julien; Koulibaly, Fassou; Cordier, Pierre-Yves; Cournac, J.M.; Maugey, Nancy; Gagnon, Nicolas; Cotté, Jean; Cambon, A.; Nab, Christine Mac; Moroge, Sophie; Rousseau, Claire; Foissaud, Vincent; Greslan, T. De; Graníer, H.; Cellarier, Gilles; Valade, Eric; Kraemer, P.; Alla, P.; Mérens, Audrey; Sagui, Emmanuel; Carmoi, T.; Rapp, C.

doi:10.3201/eid2308.161804

Cited by 13 publications

(11 citation statements)

References 12 publications

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“…This is comparable to a similar study in an Ebola viral disease treatment center in Guinea, where they reported a high incidence of occupational exposure among HCWs. 27 The translation of HCW exposure to COVID-19 patients into COVID-19 infection has been reported in previous studies. 28 , 29 The high exposure to the COVID-19 virus in this study was expected since the study sites were designated treatment centers for COVID-19.…”

Section: Discussionmentioning

confidence: 63%

Healthcare Workers Exposure Risk Assessment: A Survey among Frontline Workers in Designated COVID-19 Treatment Centers in Ghana

Ashinyo

Dubik

Duti³

et al. 2020

J Prim Care Community Health

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Background: Healthcare workers (HCWs) are faced with an elevated risk of exposure to SARS-COV-2 due to the clinical procedures they perform on COVID-19 patients. However, data for frontline HCWs level of exposure and risk of COVID-19 virus infection are limited. Objective: We investigated the level of exposure and risk of COVID-19 virus infection among HCWs in COVID-19 treatment centers in Ghana. Methods: A cross-sectional study was utilized in this study and HCWs were invited by convenience to participate in the study, 408 HCWs in 4 COVID-19 treatment centers participated in the study. Adherence to infection prevention and control (IPC) measures were used to categorized HCWs as low or high risk of COVID-19 virus infection. The WHO COVID-19 risk assessment tool was used to collect quantitative data from the study participants. Results: There was a high (N = 328, 80.4%) level of occupational exposure to the COVID-19 virus. However, only 14.0% of the exposed HCWs were at high risk of COVID-19 virus infection. Healthcare workers who performed or were present during any aerosol-generating procedures (AGP) were 23.8 times more likely to be exposed compared to HCWs who did not perform or were absent during any AGP (AOR 23.83; 95% CI: 18.45, 39.20). High risk of COVID-19 virus infection was less likely among registered nurses (AOR = 0.09; 95% CI: 0.02, 0.60), HCWs who performed or were present during any AGP (AOR = 0.05; 95% CI: 0.01, 0.50) and HCWs with a master’s degree qualification (AOR 0.06; 95% CI: 0.01, 0.63). Conclusion: Despite the high level of exposure to the COVID-19 virus among HCWs in the treatment centers, only 14.0% were at high risk of COVID-19 virus infection. To protect this group of HCWs, treatment centers and HCWs should continue to adhere to WHO and national IPC protocols in managing of COVID-19 cases.

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Section: Discussionmentioning

confidence: 63%

Healthcare Workers Exposure Risk Assessment: A Survey among Frontline Workers in Designated COVID-19 Treatment Centers in Ghana

Ashinyo

Dubik

Duti³

et al. 2020

J Prim Care Community Health

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“…Among the 5 major categories identified, “insufficient/incorrect use of personal protective equipment [PPE]” was the most frequently cited exposure risk. In many situations, deficiencies in PPE use arose from the lack of availability of appropriate equipment and/or the lack of training in PPE use during patient care, patient transport, and cleaning and environmental disinfection activities [ 5 , 6 , 9–11 , 18 , 22 , 24–26 , 28 , 32 , 36 , 38–40 , 42 , 43 , 50–54 , 56 , 58 , 61–65 , 69–74 , 78–80 , 85 , 86 ]. Less commonly, HWs were observed to engage in behavior such as rubbing the eyes [ 52 ], smoking [ 9 , 39 ], and using a mobile telephone [ 39 ], thus risking exposure to mucus membranes.…”

Section: Resultsmentioning

confidence: 99%

“…Less commonly, HWs were observed to engage in behavior such as rubbing the eyes [ 52 ], smoking [ 9 , 39 ], and using a mobile telephone [ 39 ], thus risking exposure to mucus membranes. One study found that the most frequent type of exposure incident (63 of 77 exposures among 57 HWs) was to skin on the face (including mucosa), because goggles/respirator masks did not stay correctly in place during patient care [ 42 ]. In one outbreak, HWs refused to wear PPE, to support the morale of infected coworkers [ 58 ].…”

Section: Resultsmentioning

confidence: 99%

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

Selvaraj

Lee

Harrell

et al. 2018

The Journal of Infectious Diseases

101

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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.

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“…This risk is even greater in limited resource settings of sub-Saharan Africa and has been documented in several studies assessing the seroprevalence of bloodborne pathogens in these populations [10][11][12][13]. Historically, HCWs have perpetuated the spread and amplification of EVD and serve as axes of viral transmission, often before ebolavirus is even recognized as the causative agent [14][15][16][17][18][19][20][21]. The symptoms of EVD are frequently nonspecific, characterized by fever, headache, fatigue, muscle pain, vomiting, diarrhea, and abdominal pain [22], and can easily be confused with other endemic diseases such as typhoid or malaria [23].…”

mentioning

confidence: 99%

Serologic Markers for Ebolavirus Among Healthcare Workers in the Democratic Republic of the Congo

Hoff

Mukadi²,

Doshi

et al. 2018

The Journal of Infectious Diseases

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Healthcare settings have played a major role in propagation of Ebola virus (EBOV) outbreaks. Healthcare workers (HCWs) have elevated risk of contact with EBOV-infected patients, particularly if safety precautions are not rigorously practiced. We conducted a serosurvey to determine seroprevalence against multiple EBOV antigens among HCWs of Boende Health Zone, Democratic Republic of the Congo, the site of a 2014 EBOV outbreak. Interviews and specimens were collected from 565 consenting HCWs. Overall, 234 (41.4%) of enrolled HCWs were reactive to at least 1 EBOV protein: 159 (28.1%) were seroreactive for anti-glycoprotein immunoglobulin G (IgG), 89 (15.8%) were seroreactive for anti-nucleoprotein IgG, and 54 (9.5%) were VP40 positive. Additionally, sera from 16 (2.8%) HCWs demonstrated neutralization capacity. These data demonstrate that a significant proportion of HCWs have the ability to neutralize virus, despite never having developed Ebola virus disease symptoms, highlighting an important and poorly documented aspect of EBOV infection and progression.

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Occupational Exposures to Ebola Virus in Ebola Treatment Center, Conakry, Guinea

Cited by 13 publications

References 12 publications

Healthcare Workers Exposure Risk Assessment: A Survey among Frontline Workers in Designated COVID-19 Treatment Centers in Ghana

Healthcare Workers Exposure Risk Assessment: A Survey among Frontline Workers in Designated COVID-19 Treatment Centers in Ghana

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

Serologic Markers for Ebolavirus Among Healthcare Workers in the Democratic Republic of the Congo

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