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Médecine du travail du personnel hospitalier

Ebola virus disease cases among health care workers not working in Ebola treatment units–Liberia, June-August, 2014

Auteur     Almea Matanock
Auteur     M. Allison Arwady
Auteur     Patrick Ayscue
Auteur     Joseph D. Forrester
Auteur     Bethany Gaddis
Auteur     Jennifer C. Hunter
Auteur     Benjamin Monroe
Auteur     Satish K. Pillai
Auteur     Christie Reed
Auteur     Ilana J. Schafer
Auteur     Moses Massaquoi
Auteur     Bernice Dahn
Auteur     Kevin M. De Cock
Auteur     Centers for Disease Control and Prevention (CDC)
Volume     63
Numéro     46
Pages     1077-1081
Publication     MMWR. Morbidity and mortality weekly report
Date     Nov 21, 2014
Résumé     West Africa is experiencing the largest Ebola virus disease (Ebola) epidemic in recorded history. Health care workers (HCWs) are at increased risk for Ebola. In Liberia, as of August 14, 2014, a total of 810 cases of Ebola had been reported, including 10 clusters of Ebola cases among HCWs working in facilities that were not Ebola treatment units (non-ETUs). The Liberian Ministry of Health and Social Welfare and CDC investigated these clusters by reviewing surveillance data, interviewing county health officials, HCWs, and contact tracers, and visiting health care facilities. Ninety-seven cases of Ebola (12% of the estimated total) were identified among HCWs; 62 HCW cases (64%) were part of 10 distinct clusters in non-ETU health care facilities, primarily hospitals. Early recognition and diagnosis of Ebola in patients who were the likely source of introduction to the HCWs (i.e., source patients) was missed in four clusters. Inconsistent recognition and triage of cases of Ebola, overcrowding, limitations in layout of physical spaces, lack of training in the use of and adequate supply of personal protective equipment (PPE), and limited supervision to ensure consistent adherence to infection control practices all were observed. Improving infection control infrastructure in non-ETUs is essential for protecting HCWs. Since August, the Liberian Ministry of Health and Social Welfare with a consortium of partners have undertaken collaborative efforts to strengthen infection control infrastructure in non-ETU health facilities.

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