Infection prevention and control guideline for Ebola and Marburg disease

Published by World Health Organization on Aug 11, 2023

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Abstract

WHO/WPE/CRS/HCR/2023.1

© World Health Organization 2023

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Language

en

PICOS

PICO 1.1

Population
Health workers conducting Ebola disease or Marburg disease related screening activities when a distance of at least 1m cannot be maintained
Intervention
Face shield and medical mask
Comparator
Face shield alone
Outcomes

PICO 1.1

Population
Staff, communities, and organizations responsible for management of Ebola or Marburg disease cases
Intervention
Implementation of the ring approach, which includes identification of nearby health centres, household and public places visited by the positive case for case finding; environmental cleaning/decontamination; IPC assessment; education; PPE supplies
Comparator
Single intervention, single health facility prioritization
Outcomes

PICO 1.1

Population
Surfaces and materials in facilities providing care to patients with EVD or Marburg disease
Intervention
Spraying
Comparator
Wiping
Outcomes

PICO 1.2

Population
Health workers performing screening activities in health care facility or ETU ;Health care facilities, ETU  *Contexts to consider: ETU use vs. healthcare facility; outbreak vs readiness vs. high alert scenario. 
Intervention
Wearing a gown  (in addition to medical scrubs, mask and face shield, gloves)
Comparator
Wearing coverall  (in addition to medical scrubs, mask and face shield, gloves)
Outcomes

PICO 1.3

Population
Health workers conducting screening activities where 1 m distance and no touch technique can be maintained and PPE (such as gown, and facial protection) is not expected
Intervention
No gloves and perform hand hygiene
Comparator
1 pair of gloves
Outcomes

PICO 2.1

Population
Health workers conducting EVD or Marburg virus disease related triage activities .
Intervention
Face shield and medical mask
Comparator
Face shield alone
Outcomes

PICO 2.1

Population
Heavily soiled linen resulting from care to patients with EVD or Marburg disease in health care, ETUs, or community settings
Intervention
Elimination
Comparator
Disinfection
Outcomes

PICO 2.2

Population
Health workers conducting Ebola or Marburg virus disease related triage activities
Intervention
Coverall
Comparator
Gown
Outcomes

PICO 3.1

Population
Health workers in health care facilities
Intervention
Goggles
Comparator
Face shield
Outcomes

PICO 3.2

Population
Health workers in health care facilities
Intervention
Particulate respirators (N95 or equivalent mask) for use by staff for whom the respirators have been fit-tested, who are medically cleared and trained.
Comparator
Medical (surgical) mask.
Outcomes

PICO 3.3

Population
Health workers conducting screening and/or triage activities where at least 1 m distance cannot be maintained, and PPE (such as gown, and facial protection) is expected
Intervention
2 pair of gloves
Comparator
1 pair of gloves
Outcomes

PICO 3.4

Population
Health workers caring for patients with filovirus disease in health care facilities
Intervention
Impermeable gown
Comparator
Surgical gown or coverall
Outcomes

PICO 3.5

Population
Staff working in health care facilities, ETU 
Intervention
Wear a disposable waterproof apron 
Comparator
1) Wear a reusable waterproof heavy-duty apron, 2) wear a biodegradable waterproof apron
Outcomes

PICO 3.6

Population
Health workers in direct contact and/or indirect contact to patients with Ebola Virus Disease (EVD) or Marburg virus disease
Intervention
A cover for the head and neck
Comparator
No cover for the head and neck
Outcomes

PICO 3.7

Population
Health care workers in direct contact or indirect contact to patients with EVD or Marburg
Intervention
A cover for the head and neck
Comparator
No cover for the head and neck
Outcomes

PICO 3.8

Population
Health care workers in direct contact or indirect contact to patients with EVD or Marburg
Intervention
A cover for the head and neck
Comparator
No cover for the head and neck
Outcomes

PICO 3.9

Population
HCWs providing direct/indirect care during EVD/Marburg outbreaks
Intervention
Eye protection be worn under head/neck covering
Comparator
Eye protection be worn over head/neck covering
Outcomes

PICO 3.10

Population
HCWs providing direct/indirect care during EVD/Marburg outbreaks
Intervention
Eye protection be worn under head/neck covering
Comparator
Eye protection be worn over head/neck covering
Outcomes

PICO 3.11

Population
HCWs prior to doffing
Intervention
Chlorine spray of PPE
Comparator
No chlorine spray of PPE
Outcomes

PICO 3.12

Population
HCWs prior to doffing
Intervention
Chlorine spray of PPE
Comparator
No chlorine spray of PPE
Outcomes

PICO 3.13

Population
Staff working in health care facilities, ETU 
Intervention
Wear a disposable waterproof apron 
Comparator
1) Wear a reusable waterproof heavy-duty apron, 2) wear a biodegradable waterproof apron
Outcomes

PICO 13.1

Population
Health workers working in health care facilities, ETU
Intervention
Hand hygiene (including glove disinfection) between patients  .
Comparator
1.Removal of outer glove and hand hygiene (inner glove) w/ soap and water    2.Removal of both gloves and hand hygiene w/ soap and water   3. Disinfecting outer glove w/ soap and water  
Outcomes

PICO 13.2

Population
Health workers working in health care facilities, ETU
Intervention
Hand hygiene (including glove disinfection) between patients  .
Comparator
1.Removal of outer glove and hand hygiene (inner glove) w/ alcohol-based hand rub    2.Removal of both gloves and hand hygiene w/ alcohol-based hand rub    3.Disinfecting outer glove w/ alcohol-based hand rub
Outcomes

PICO 13.3

Population
Health workers working in health care facilities, ETU
Intervention
Hand hygiene (including glove disinfection) between patients  .
Comparator
1.Removal of outer glove and hand hygiene (inner glove) w/ chlorine    2.Removal of both gloves and hand hygiene w/ chlorine   3.Disinfecting outer glove w/ chlorine (concentration)  
Outcomes

PICO 14.1

Population
Staff working in health care facilities, ETU  ; Subgroup-Intermediate or low risk patient care activities
Intervention
Continue with normal duties (no work exclusion)  
Comparator
Exclude from work for 21 days 
Outcomes

PICO 17.1

Population
Health workers and Burial teams handling bodies of Ebola and Marburg patients
Intervention
No disinfection of dead bodies prior to handling/moving
Comparator
1) Disinfection of dead bodies by wiping prior to handling/moving, 2) Spraying dead bodies with disinfectant prior to handling/moving
Outcomes