Ebola Virus Disease: Experience and Decision Making for the First Patients outside of Africa: e1001857

Abbreviations: BSL, biosafety level; CDC, US Centers for Disease Control and Prevention; CTSA, NIH Clinical and Translational Science Awards; DHCPP, Division of High-Consequence Pathogens and Pathology; ED, Emergency Department; EHC, Emory Healthcare; EHSO, Environmental Health and Safety Office; EL...

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Bibliographic Details
Published in:PLoS medicine 2015-07, Vol.12 (7)
Main Authors: Stephens, David S, Ribner, Bruce S, Gartland, Bryce D, Feistritzer, Nancye R, Farley, Monica M, Larsen, Christian P, Fox, John T
Format: Article
Language:English
Subjects:
Consortia
Decision making
Disease control
Ebola virus
Education
Environmental health
Epidemics
Funding
Global health
Health care
Health sciences
Hospitals
Infectious diseases
Intensive care
Medical laboratories
Mortality
Pathogenesis
Personal protective equipment
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Summary:Abbreviations: BSL, biosafety level; CDC, US Centers for Disease Control and Prevention; CTSA, NIH Clinical and Translational Science Awards; DHCPP, Division of High-Consequence Pathogens and Pathology; ED, Emergency Department; EHC, Emory Healthcare; EHSO, Environmental Health and Safety Office; ELWA, Eternal Love Winning Africa; EPA, US Environmental Protection Agency; EUH, Emory University Hospital; EVD, Ebola virus disease; FDA, US Food and Drug Administration; HEPA, high-efficiency particulate air; ICU, intensive care unit; HHS, US Department of Health and Human Services; ID, infectious diseases; IND, investigational new drug; IRB, Institutional Review Board; IV, intravenous; mAbs, monoclonal antibodies; MICU, medical intensive care unit; MOOC, Massive Open Online Course; NIH, National Institutes of Health; PAPR, powered air-purifying respirator; PPE, personal protective equipment; RCE, Research Centers of Excellence; SARS, severe acute respiratory syndrome; SCDU, Serious Communicable Disease Unit; SERCEB, Southeast Regional Center of Excellence for Emerging Infections and Biodefence; SIM USA, Serving in Mission USA; SOP, standard operating procedure; UHC, University Healthsystem Consortium; WHO, World Health Organization Provenance: Not commissioned; externally peer reviewed Summary Points * Ebola hemorrhagic fever, or Ebola virus disease (EVD), has emerged in the last year as a global threat and humanitarian disaster for the affected countries of West Africa and has also come to the United States (US) and Europe. * The treatment of the first and three subsequent US patients outside of Africa at Emory University provided a number of challenges, as well as strategic and tactical lessons that included detailed planning and team work across multiple academic and health care units, emphasizing biosafety, the importance of institutional communications, addressing unanticipated challenges such as waste management, and the logistics of working closely with governmental agencies and outside collaborators. * In providing effective care for individuals, the value of mobilizing a diverse health and academic community to work collaboratively to addressing a global threat is emphasized. On August 2 and 5, 2014, two medical missionaries who developed EVD in late July while working at Eternal Love Winning Africa (ELWA) hospital in Liberia were evacuated from Monrovia by a specially designed air ambulance to Emory University Hospital (EUH) [7]. [...]August 2, 2014,
ISSN:1549-1277
1549-1676
DOI:10.1371/journal.pmed.1001857