Characterization of ebola virus risk to bedside providers in an intensive care environment

Mia J. Biondi, Lauren Garnett, Alexander Bello, Duane Funk, Philippe Guillaume Poliquin, Shane Jones, Kevin Tierney, Kaylie Tran, Robert A. Kozak, Anders Leung, Allen Grolla, Cory Nakamura, Geoff Soule, Charlene Ranadheera, Mable Hagan, Amrinder Dhaliwal, Darwyn Kobasa, Darryl Falzarano, Hugues Fausther Bovendo, Heinz FeldmannMurray Kesselman, Gregory Hansen, Jason Gren, Todd Mortimer, Trina Racine, Yvon Deschambault, Jocelyn Edmonds, Sam Aminian, Ray Saurette, Mark Allan, Lauren Rondeau, John Huynh, Sharron Hadder, Christy Press, Christine Degraff, Stephanie Kucas, Julie Kubay, Kim Azanarsky, Bradley W.M. Cook, B. J. Hancock, Anand Kumar, Reeni Soni, Daryl Schantz, Jarrid McKitrick, Bryce Warner, Bryan D. Griffin, Xiangguo Qiu, Gary P. Kobinger, Dave Safronetz, Heidi Wood, Derek R.stein, Todd Cutts, Brad Pickering, James Kenny, Steven Theriault, Liam Menec, Robert Vendramelli, Sean Higgins, Logan Banadyga, Guodong Liu, Md Niaz Rahim, Samantha Kasloff, Angela Sloan, Shihua He, Nikesh Tailor, Alixandra Albietz, Gary Wong, Michael Gray, Friederike Feldmann, Andrea Marzi, George Risi, James E. Strong

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The 2014–2016 Ebola outbreak in West Africa recapitulated that nosocomial spread of Ebola virus could occur and that health care workers were at particular risk including notable cases in Europe and North America. These instances highlighted the need for centers to better prepare for potential Ebola virus cases; including understanding how the virus spreads and which interventions pose the greatest risk. Methods: We created a fully equipped intensive care unit (ICU), within a Biosafety Level 4 (BSL4) laboratory, and infected multiple sedated non‐human primates (NHPs) with Ebola virus. While providing bedside care, we sampled blood, urine, and gastric residuals; as well as buccal, ocular, nasal, rectal, and skin swabs, to assess the risks associated with routine care. We also assessed the physical environment at end‐point. Results: Although viral RNA was detectable in blood as early as three days post‐infection, it was not detectable in the urine, gastric fluid, or swabs until late‐stage disease. While droplet spread and fomite contamination were present on a few of the surfaces that were routinely touched while providing care in the ICU for the infected animal, these may have been abrogated through good routine hygiene practices. Conclusions: Overall this study has helped further our understanding of which procedures may pose the highest risk to healthcare providers and provides temporal evidence of this over the clinical course of disease.

Original languageEnglish (US)
Article number498
Pages (from-to)1-15
Number of pages15
JournalMicroorganisms
Volume9
Issue number3
DOIs
StatePublished - Mar 2021
Externally publishedYes

Keywords

  • Critical care
  • Ebola
  • Environmental contamination
  • Nosocomial infection
  • Viral shedding

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)
  • Virology

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