Ebola Virus Status Update; Personal Protective Equipment

1. Ebola Virus Status Update;Personal Protective Equipment October 24, 2014

2. Outline • Overview of Ebola situation • Point of Care Risk Assessment process • Personal Protective Equipment

3. Ebola Update • Ebola outbreak is of primary concern in Sierra Leone, Liberia, and Guinea. • Risk to Canadians is very low • Transmission to humans: • Contact with infected wild animals in West Africa (fruit bats, non-human primates, rodents) • Direct contact with infected humans • Blood, other body fluids, tissues from infected individuals • Environmental contamination • Incubation is 2 to 21 days • Communicable from symptom onset to symptom resolution

4. Ebola Update • Roles of various Agencies: • WHO is coordinating response in Africa • PHAC is coordinating response in Canada • Alberta Health and Alberta Health Services are coordinating response in Alberta • FNIHB AB Region is included in update meetings

5. Ebola Update PHAC Response • Screening at ports of entry into Canada • Quarantine for 21 days if required • Assisting in international response • Expert response teams on standby to support case management anywhere in Canada if requested by jurisdiction • Development of Guidance Documents • FNIHB working in coordination with PHAC nationally

6. Ebola Update Response in Alberta • Screening occurring at airports • Designated hospitals in Edmonton (2) and Calgary (2) • Process for notification to Public Health • AHS developing guidance documents - with related training - for designated hospitals, front line workers (doctors, first responders, community based staff) • Phased approach based on risk assessment • Purchasing appropriate PPE • Plan for regular communications: • Health care providers • Public • FNIHB AB Region working in coordination with AH/AHS.

7. Ebola Update • Community Response • Preference is for people to contact Health Link where triage will occur vs coming into health centre. • If people present: • Guidance for triage in patients with fever: • Is temperature at least 380C? • Any travel or residence in Guinea, Sierra Leone, or Liberia within past 21 days?

8. Ebola Update • Where there is relevant travel and symptom history: • Does the person need immediate emergency treatment? • Call 911, ensuring to notify dispatcher of potential risk • If does not need immediate treatment: • Separate room, implement droplet and contact precautions • Call on-call number: 780-218-9929 • If there is no relevant travel and symptom history, not considered an Ebola risk.

9. Ebola Update – Canadian Context • Remember: fevers are associated with many disease processes, including malaria, influenza, dehydration (for any cause). • The risk for Ebola to be present without history of travel to affected countries isextremely low.

10. Ebola Update Key information websites: • World Health Organization: http://www.who.int/csr/disease/ebola/en/ • Public Health Agency of Canada: http://www.phac-aspc.gc.ca/id-mi/vhf-fvh/ebola-eng.php • Alberta Health: http://www.health.alberta.ca/health-info/ebola-virus.html • Alberta Health Services: http://www.albertahealthservices.ca/10289.asp

11. Point of care risk assessment

12. Point of Care Risk Assessment • Algorithm and related resources were rolled out spring 2014. • PCRA Algorithm • Additional Precautions Overview • See: OneHealth, CDC Manual, under “CDC Manual Forms”

13. Personal protective equipment

14. Personal Protective Equipment • Routine PPE: • Gowns • Current stock is not impermeable • Gloves • Masks • Procedure mask • N95 masks • Face shields • Don’t forget hand hygiene!

15. Personal Protective Equipment • N95 masks: • Only required where respiratory precautions are indicated (TB, measles, aerosol-generating medical procedures) • Fit tests have been done in the past, during on-boarding • FNIHB AB region does not currently have process to update fit testing • Remember to do seal test with N95 masks

16. Personal Protective Equipment • Ensure that there is supply of routine PPE. • Ensure that there is a supply of procedure masks available: • For use with clients presenting in the health centre or clinic with new cough • Ensure that there is access to hand hygiene: • soap and water is adequate for public • Waterless hand gels is preferred product for HCWs

17. Personal Protective Equipment • It is important to understand principles behind PPE to ensure best protection: • area to be protected should be completely covered • Prevent contamination during doffing

18. Personal Protective Equipment • Alberta Health Services Video – demonstrating proper technique for donning and doffing PPE • http://www.albertahealthservices.ca/6422.asp • All staff should: • review the PCRA tool as it is applicable to your practice and various settings • practice donning and doffing full PPE with a partner

19. Environmental Cleaning • During respiratory season, ensure that high touch surfaces are regularly cleaned. • ViroxTM products do inactivate viruses.

20. Thank you! Contacts:Ruth Richardson 780-495-5439 ruth.richardson@hc-sc.gc.ca Dr. ParminderThiara 403-861-8447 parminder.thiara@hc-sc.gc.ca Dr. WadiehYacoub 780-495-3391 wadieh.yacoub@hc-sc.gc.ca