Ebola Virus Information

Ebolavirus Transmission Mechanics

Recently, much has been published by reputable sources regarding the methods by which the Ebola virus is transmitted from one human to another.  Organizations such as: CDC, NIH, APC and other authoritative sources have provided physicians and Media an ongoing litany of information relating to this subject. It is well recognized the virus’s primary conduits are body fluids, i.e. blood, feces, urine, semen and respiratory–throat secretions by physical contact.  It is the latter category of transmission we would like to address in this “Current Comments” issue.

It is well documented aerosolized sputum generated by sneezing or coughing can exit the body at high velocities, with droplets extending several feet beyond the body.  It has been documented that Ebolavirus can be virulent for up to 50 days in blood outside the body at ambient temperatures down to 4C (39.2F).  Additionally, it has been demonstrated viral hemorrhagic fevers have an effective dose of 1-to 10 organisms by aerosol.  Or even more importantly, a live pathogen which is defused throughout a room’s atmosphere.  

Thus a strong case for having enough Airborne Infectious Isolation Rooms (AIIR)) strategically located throughout the majority of hospitals in the US.  The CDC published, several years ago that by 2010 there should be 10% of hospital patient beds certified as an AIIR, by 2014, 20% should be AIIR and by 2018, 30% of all hospital patients’ bedrooms.  As of this writing near the end of 2014, the 2010 goal of 10%, is far from being achieved.    

 These AIIR should be adequately designed, not only for air changes per hour ((ACH), but for a frequently overlooked characteristic, “air-flow dynamics”.  Are the negative pressure HEPA air purification units correctly positioned in the room’s ceiling to directly expedite contaminated air removal affording maximum protection to the healthcare worker. Is the correct type of open structured furniture in the room allowing free air flow avoiding stagnant or dead air spots.  Are there room pressure monitors providing not only a digital display of negative room pressure, but are there both visual and audible alarms to notify staff if variances occur.  

Additionally, a modern AIIR would incorporate UVGI in the upper room atmosphere providing a layer of lethality to any living organism.  Recently a joint study between Harvard University, Stanford University, and the University of Colorado, Denver sponsored by NIOSH proved without out a doubt, that by inclusion of UV-C in an AIIR, improved the room’s efficiency by 33⅓%. 

The threat of spreading lethal, airborne, bacteria, virus, chemicals, or other insidious pathogens will always be present even in an advanced society.  Given the liquidity of human transport worldwide it is only a matter of time when the next Ebola-like outbreak will occur.  The CDC has warned the healthcare profession of the need for adequate AIIR protection and control. The equipment and mechanics are available to achieve what the CDC recommends.  The cost benefit ratio to implement the CDC’s recommendations is obvious.     

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