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Ebola Outbreak Puts Hospital Protocols Under the Microscope

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The cases highlight the risks health-care workers bravely accept in caring for critically ill patients, as well as the importance of infectious-disease protocols.

If you have picked up a newspaper, logged on to a news site, or turned on the evening news of late, you no doubt are aware of the recent epidemic of Ebola virus disease. To recap:

  • The outbreak has been traced to the death of a 2-year-old child in a village in the West African country of Guinea in December 2013. A health-care worker is believed to have triggered the spread of the virus to other towns in Guinea in February 2014. By spring, the virus had reached the neighboring countries of Sierra Leone and Liberia.
  • On Sept. 20, Thomas Eric Duncan arrived in Dallas from Liberia. Approximately four days later, he developed symptoms consistent with Ebola. The diagnosis was confirmed on Sept. 30. Eight days later, Duncan died.
  • On Oct. 10, Nina Pham, a nurse who provided care for Duncan at Texas Health Presbyterian Hospital Dallas, tested positive for Ebola. Five days later, so did Amber Vinson, another nurse who cared for Duncan. That was just after Vinson returned to Dallas following a three-day trip to Cleveland. The news caused quite a stir here in Northeast Ohio, prompting the temporary closing of two schools for thorough cleaning “out of an abundance of caution” after school officials learned a staff member may have traveled aboard the same airplane, though not on the same flight, as Vinson. A store Vinson visited also was closed temporarily.
  • Pham and Vinson recovered and were discharged on Oct. 24 and 28, respectively.

The cases of Pham and Vinson highlight the risks health-care workers bravely accept in caring for critically ill patients, as well as the importance of hospital infectious-disease protocols. At Texas Health Presbyterian Hospital Dallas, the Centers for Disease Control and Prevention (CDC) has cited a “breach in protocol,” while one nurse has questioned the adequacy of that protocol.

Whatever the case—failure to follow procedure or insufficient safeguards—in Dallas, I was reminded of the importance of infectious-disease protocols on Oct. 27, the day my wife and I welcomed our third child—a boy, our second—into the world. As I donned my surgical mask and gown, bouffant cap, and shoe covers for the Caesarean section, I could not help but think of just what was at stake and how vulnerable my wife and our soon-to-be-born son were.

According to the CDC, there are four types of health-care-associated infections (HAIs): central-line-associated bloodstream, which occur when bacteria or other germs travel down a central line and enter the blood; catheter-associated urinary tract, which occur when germs travel along a urinary catheter and cause an infection in the bladder or kidney; surgical site, which occur after surgery in the part of the body where the surgery took place; and ventilator-associated pneumonia, which occur when germs enter the lungs of a patient on a ventilator.

In this month's article “Health-Care-Associated-Infection Control: Reducing Airborne Pathogens,” Forrest Fencl says HAIs kill more people in the United States than AIDS, breast cancer, and automobile accidents combined. In the article, he discusses the four methods of reducing concentrations of airborne infectious agents: dilution, filtration, pressurization, and disinfection, with a focus on disinfection through ultraviolet germicidal irradiation. To learn more about the threat of HAIs and how to combat it, click here.

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The thoughts and musings of HPAC Engineering Executive Editor Scott Arnold.

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Scott Arnold

Described by a colleague as "a cyborg ... requir(ing) virtually no sleep, no time off, and bland nourishment that can be consumed while at his desk" who was sent "back from the...
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