Responding to the Threat of Ebola: A summary for EMS providers

By Marven Ewen, MD
Medical Director

Ebola is a deadly virus that causes hemorrhagic fever and up until earlier this year has only been seen in a few sporadic outbreaks in small central African communities. The current outbreak is much larger and more sustained than any previously seen, having spread to several West African countries and now with the first ever case diagnosed in the United States. The mortality rate of the strain responsible for this outbreak is approximately 50%.


This is a type of virus that is spread by close contact with bodily fluids such as saliva, blood, urine, feces, breast milk, semen and even sweat. The virus may remain contagious on inanimate objects (known as fomites) such as clothing, bedding, furniture, etc. Anyone within 3 feet of an infected person should be wearing protective gear including gloves, mask, eye protection and gown. The virus gains entrance into the body via mucus membranes (eyes, nose, mouth) and open sores or cuts. While that virus is not airborne, masks should be worn in case droplets splatter.


The symptoms of Ebola start out like the flu with fever, headache, sore throat, achy muscles, vomiting, diarrhea, abdominal pain. These symptoms appear after an 8 to 21 day incubation period during which, it is important to note, it is not possible to transmit the virus to another person. Unfortunately these symptoms are not very specific, making it difficult to distinguish between Ebola and common respiratory illnesses that are not life threatening. Later on, a measles-like rash then red eyes, hiccups and bleeding may present. In an outbreak, flu symptoms are regarded as Ebola until proven otherwise.


Remember to ensure your personal safety when responding to every call. Some of the most dangerous threats are those we can’t see, such as viruses and bacteria. So you have to assume the risk of coming into contact with one of these microbes is always present. The level of risk, depending on the nature of the call, dictates the level of PPE you will need to wear.


Be sure to read this article published by the Centers for Disease Control and Prevention (CDC) regarding guidance to EMS providers that may encounter Ebola. The key points are wearing appropriate PPE, questioning patients about recent travel to West Africa, and alerting hospital personnel in advance of the arrival of a possible Ebola patient so that they can prepare to receive the patient in an isolation room.


It is unlikely that a wider outbreak of Ebola will occur in the US. The fact that Ebola has fairly low levels of transmissibility combined with infection control practices and the monitoring of individuals potentially exposed to the virus will help prevent its spread. By promptly reporting suspected cases of Ebola, wearing appropriate PPE, and practicing other infection control measures as recommended by the CDC, you will play an important role in protecting your community from this virus.


Additional resources:
– An Open Letter to All U.S. Healthcare Professionals
– Ebola Screening Criteria

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