Guidelines for prevention of Ebola Transmission in Hospitals

Ebola transmission

Several people have been admitted into United States hospitals and tested for the Ebola virus. While all of them have tested negative for the disease, until the results came back they were handled with the utmost adherence to safety measures; in other words, even though the odds of an outbreak in American soil are slim and none, the patients weren’t treated as the boy who cried Ebola. Since more suspected cases may appear while the epidemic in West Africa lasts, the CDC has released certain recommendations for hospitalized patients with known or suspected Ebola hemorrhagic fever in U.S. hospitals.

These guidelines apply exclusively to healthcare personnel, including physicians, nurses, nursing assistants, therapists, technicians, emergency medical service personnel, dental personnel, pharmacists, laboratory personnel, autopsy personnel, students and trainees, contractual personnel, home healthcare personnel, &c; as well as persons not directly involved in patient care but who are nevertheless potentially exposed to infectious agents, such as clerical, dietary, house-keeping, laundry, security, maintenance, billing, chaplains, and volunteers. Moreover, the following protocols apply to key elements of Standard, Contact, and Droplet infection control precautions, and are based on high rate of morbidity and mortality among infected individuals, risk of human to human contagion, and lack of approved vaccines and therapeutics.





Patient placement

Single patient room with private bathroom and door closed.

Keep a log of all persons who enter the room.

Post personnel at the door to ensure personal protective equipment (PPE) use by all people who enter.

Personal protective equipment

All persons who enter the room should wear:


Fluid resistant or impermeable gown

Goggles or face shield


Extra PPE may be required in the presence of excessive bodily fluids, for example:

Double gloving

Disposable shoe covers

Leg coverings


Follow instructions for putting on and taking off PPE.

Discard or clean and disinfect re-usable PPE.

Perform hand hygiene immediately after removing PPE

Patient care equipment

Used dedicated medical equipment (disposable whenever possible).

Clean and disinfect all non-dedicated, non-disposable medical equipment used for patient care.


Patient care considerations

Keep use of needles and sharps to the minimum possible.

Limit phlebotomy, procedures, and laboratory testing to the minimum necessary for essential diagnostic evaluation and medical care.

Handle needles and sharps with extreme care and dispose of them in proper containers.


Aerosol generating procedures (AGP)

If possible, avoid for Ebola hemorrhagic fever patients.

If not possible, use a combination of measures to reduce exposure.

Personnel must be limited and visitors not allowed.

Conduct in a private room, preferably an Airborne Infection Isolation Room.

Minimize entry and exits to the room to keep doors closed as much as possible.

In addition to PPE protocols, personnel must wear respiratory protection at least equal to NIOSH certified fit-tested N95 filtering facepiece respirator.

Clean and disinfect surfaces and reusable equipment.

AGP procedures include Bilevel Positive Airway Pressure (BiPAP), bronchoscopy, sputum induction, intubation and extubation, and open suctioning of airways.

Favor disposable filtering face piece respirators.

Hand hygiene

Perform before and after all contact with patients, material, and before and after donning PPE.

The hospital should ensure proper supplies are available.

Use soap and water or alcohol-based hand rubs, unless hands are visibly dirty, in which case soap and water, not alcohol-based hand rubs should be used.

Environmental infection control

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Safe injection practices

As specified under Standard Precautions.

All equipment should be patient-dedicated and discarded immediately after use.

Duration of infection control precautions

Should be determined on a case-by-case basis, together with local, state, and federal health authorities.

Consider factors such as presence of related symptoms, date symptoms resolved, other conditions that would require specific precautions.