Protecting healthcare personnel from acquiring Ebola virus disease.
Protecting healthcare personnel from acquiring Ebola virus disease.
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保护医护人员免遭埃博拉病毒病感染。
DOI：
10.1017/ice.2015.205
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发表时间：
2015
影响因子：
4.5
通讯作者：
Rutala,WilliamA
中科院分区：
文献类型：
--
作者：
Weber,DavidJ;Fischer,WilliamA;Wohl,DavidA;Rutala,WilliamA
西非正在爆发历史上规模最大的埃博拉病毒病（EVD），给受影响国家造成了严重破坏，并引发了全世界的公共卫生担忧。美国疾病控制与预防中心 (CDC) 与世界卫生组织 (WHO) 联合报告，截至 2015 年 7 月 8 日，西非共有 16,913 例病例（疑似、可能和确诊病例）（其中 11,965 例为实验室确诊病例），死亡 6,446 例。 1 CDC 估计，漏报的可能性为 2.5 倍。 2 埃博拉疫情有史以来第一次跨越国际边界，最初在邻国之间从几内亚传播到利比里亚和塞拉利昂，然后蔓延到尼日利亚、塞内加尔、马里、西班牙、英国和美国等非毗邻国家。 1 据世界卫生组织称，截至 2015 年 7 月 5 日，几内亚、利比里亚和塞拉利昂共报告确诊 875 例医护人员 (HCP) 感染，其中 509 人死亡。 3 截至 2015 年 3 月 12 日，已有 11 名感染埃博拉病毒病的医护人员从西非转移至美国医院。 4 美国和西班牙也有埃博拉病毒病患者向医疗保健提供者二次传播的报告。埃博拉传播流行病学研究表明，埃博拉病毒主要通过直接接触有症状的人或其体液传播，特别是在临床疾病的后期。 5, 6 埃博拉病毒病后期传播风险升高可能是由于体液中病毒滴度增加和体液排出量（即呕吐物、粪便和血液）增加共同造成的。死后接触也与埃博拉病毒传播的高风险有关。 5 人们对“通过源患者附近的大液滴或小颗粒”进行气溶胶传播的可能性提出了担忧。 7 尽管动物研究表明，当病毒通过实验雾化时，可能会发生飞沫/空气传播，但流行病学研究表明，
The ongoing outbreak of Ebola virus disease (EVD) in West Africa, the largest in history, has devastated the affected countries and raised public health concerns throughout the world. The Centers for Disease Control and Prevention (CDC) in conjunction with the World Health Organization (WHO) has reported that as of July 8, 2015, there have been 16,913 total cases (suspected, probable and confirmed) in West Africa (of which 11,965 were laboratory confirmed) and 6,446 deaths. 1 The CDC has estimated that there is potential underreporting by a factor of 2.5. 2 For the first time ever, an Ebola outbreak has crossed international boundaries, initially moving among neighboring countries from Guinea to Liberia and Sierra Leone, and then spreading to non-contiguous countries including Nigeria, Senegal, Mali, Spain, the United Kingdom, and the United States. 1 According to the WHO, as of July 5, 2015, a total of 875 confirmed healthcare personnel (HCP) infections had been reported from Guinea, Liberia, and Sierra Leone, with 509 deaths. 3 As of March 12, 2015, 11 EVD-infected HCP had been transferred from West Africa to US hospitals. 4 Secondary transmission from a patient with EVD to healthcare providers has also been reported in the United States and Spain. ebola transmissionEpidemiological studies have suggested that the Ebola virus spreads primarily through direct contact with a symptomatic person or their body fluids, especially in the latter stages of clinical disease. 5, 6 The elevated risk of transmission in the latter stages of EVD is likely due to a combination of increased viral titers in body fluids and increased body fluid discharges (ie, vomitus, stool, and blood). Post-mortem contact is also associated with a high risk of Ebola virus transmission. 5 Concern has been raised regarding the possibility of aerosol transmission “either via large droplets or small particles in the vicinity of source patients.” 7 Although animal studies suggest that droplet/airborne transmission may occur when the virus is experimentally aerosolized, epidemiologic studies of