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Serosurvey on healthcare personnel caring for patients with Ebola virus disease and Lassa virus in the United States

Published online by Cambridge University Press:  20 January 2020

Colleen S. Kraft Open the ORCID record for Colleen S. Kraft [Opens in a new window] ,
Aneesh K. Mehta ,
Jay B. Varkey ,
G. Marshall Lyon III ,
Sharon Vanairsdale ,
Sonia Bell ,
Eileen M. Burd ,
Mary Elizabeth Sexton ,
Leslie Anne Cassidy  and
Patricia Olinger
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Colleen S. Kraft*
Affiliation:
Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia
Aneesh K. Mehta
Affiliation:
Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia
Jay B. Varkey
Affiliation:
Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia
G. Marshall Lyon III
Affiliation:
Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia
Sharon Vanairsdale
Affiliation:
Emory Healthcare, Atlanta, Georgia
Sonia Bell
Affiliation:
Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia
Eileen M. Burd
Affiliation:
Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia
Mary Elizabeth Sexton
Affiliation:
Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia
Leslie Anne Cassidy
Affiliation:
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
Patricia Olinger
Affiliation:
Environmental, Health and Safety Office, Emory University, Atlanta, Georgia
Kalpana Rengarajan
Affiliation:
Environmental, Health and Safety Office, Emory University, Atlanta, Georgia
Vanessa N. Raabe
Affiliation:
Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia Department of Pediatrics, Emory School of Medicine, Atlanta, Georgia
Emily Davis
Affiliation:
Emory Healthcare, Atlanta, Georgia
Scott Henderson
Affiliation:
Emory Healthcare, Atlanta, Georgia
Paula DesRoches
Affiliation:
Houston Methodist Hospital, Houston, Texas
Yongxian Xu
Affiliation:
Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia
Mark J. Mulligan
Affiliation:
Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia
Bruce S. Ribner
Affiliation:
Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia
*
Author for correspondence: Colleen Kraft, MD, MSc, E-mail: [email protected]
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Abstract

Objective:

Healthcare personnel (HCP) were recruited to provide serum samples, which were tested for antibodies against Ebola or Lassa virus to evaluate for asymptomatic seroconversion.

Setting:

From 2014 to 2016, 4 patients with Ebola virus disease (EVD) and 1 patient with Lassa fever (LF) were treated in the Serious Communicable Diseases Unit (SCDU) at Emory University Hospital. Strict infection control and clinical biosafety practices were implemented to prevent nosocomial transmission of EVD or LF to HCP.

Participants:

All personnel who entered the SCDU who were required to measure their temperatures and complete a symptom questionnaire twice daily were eligible.

Results:

No employee developed symptomatic EVD or LF. EVD and LF antibody studies were performed on sera samples from 42 HCP. The 6 participants who had received investigational vaccination with a chimpanzee adenovirus type 3 vectored Ebola glycoprotein vaccine had high antibody titers to Ebola glycoprotein, but none had a response to Ebola nucleoprotein or VP40, or a response to LF antigens.

Conclusions:

Patients infected with filoviruses and arenaviruses can be managed successfully without causing occupation-related symptomatic or asymptomatic infections. Meticulous attention to infection control and clinical biosafety practices by highly motivated, trained staff is critical to the safe care of patients with an infection from a special pathogen.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 41 , Issue 4 , April 2020 , pp. 385 - 390
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved

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Footnotes

a

Emory Serious Communicable Diseases Unit: Administration: Catherine Maloney, Pam Cosper, Nancye Feistritzer, John Lewin, Bryce Gartland, Ira Horowitz, David Pugh, Chad Ritenour, Jerry Lewis, Brian Frislie, David Hatcher, Lynne Ometer, Kip Hardy. Nursing: Toni Ash, Christopher Barnes, Jamie Breedlove, Bob Bridgman, Lane Darragh, Tracey Daye, Dustin Hillis, Crystal Johnson, Julie-Ann Johnson, Danni LaFond, Courtney Lyons, Josia Mamora, Anna McCord, Samantha McDaniel, Haley Morgan, Jill Morgan, Alexander Sanchez, Marissa Simon, Jason Slabach, Kevin Tirado, Sally Watkins, Terrica Wilson, Ken Logan. Emory Medical Labs: Juli Buchanan, John Cardella, Brenda Eaves, Crystal Evans, Charles Hill, Doris Igwe, Karen Jenkins, Maureen Lindsey, Jordan Magee, Stacy McCarthy, Randall Powers, James Ritchie. Pharmacy: Jan Pack, Susan Rogers. Emory Health & Safety: Scott Thomaston, Esmeralda Meyer. Occupational Health: Cynthia Hall, Celeste Walker. Infection Prevention: Esther Baker, Betsy Hackman. Environmental Services: Jeff Broughton, Robert Jackson, Samantha Thomas. Pastoral Care: Robin Brown-Haithco, Faith Richardson. Emory Faculty and Staff Assistance: Art Krasilovsky, Clevevoya Jordan, Sue Matthews, Marilyn Hazzard Lineberger, Paula G. Gomes. Supplies/Logistics: Gentrice McGee, Porcia Jones. EUH Security: Linda Scott-Harris, James Cain, Roderick Davis, Tyrone Johnson, Tyrone Pickett, Anthony Shaw, Tenina Truesdale. Emergency Medical Services (EMS): Alex’Isakov, Sam Shartar, Wade Miles, Aaron Jamison, John Arevalo, Gail Stallings. Communications/Media Relations: Janet Christenbury, Vince Dollard, Melanie De Gennaro, Holly Korschun. Nutrition: Tom Ziegler, Daniel P. Griffith, Nisha Dave.

References

WHO Ebola situation report. World Health Organization website. http://apps.who.int/ebola/en/current-situation/ebola-situation-report-6-may-2015, 2015. Published 2015. Accessed November 27, 2018.Google Scholar
Uyeki, TM, Mehta, AK, Davey, RT, Jr, et al.Clinical management of Ebola virus disease in the United States and Europe. N Engl J Med 2016;374:636–646.CrossRefGoogle ScholarPubMed
Hospital preparedness program. Public Health Emergency website. https://www.phe.gov/preparedness/planning/hpp/pages/default.aspx. Accessed December 9, 2019.Google Scholar
Kraft, CS, Hewlett, AL, Koepsell, S, et al.The use of TKM-100802 and convalescent plasma in 2 patients with Ebola virus disease in the United States. Clin Infect Dis 2015;61:496–502.CrossRefGoogle ScholarPubMed
Liddell, AM, Davey, RT Jr, Mehta, AK, et al.Characteristics and clinical management of a cluster of 3 patients with Ebola virus disease, including the first domestically acquired cases in the United States. Ann Intern Med 2015;163:81–90.CrossRefGoogle ScholarPubMed
Lyon, GM, Mehta, AK, Varkey, JB, Brantly, K, Plyler, L, McElroy, AK, et al.Clinical care of two patients with Ebola virus disease in the United States. N Engl J Med 2014;371:2402–2409.CrossRefGoogle ScholarPubMed
Raabe, VN, Kann, G, Ribner, BS, et al.Favipiravir and ribavirin treatment of epidemiologically linked cases of Lassa fever. Clin Infect Dis 2017;65:855–859.CrossRefGoogle ScholarPubMed
Beeching, NJ, Fenech, M, Houlihan, CF.Ebola virus disease, 2014. BMJ 2014;349:g7348.CrossRefGoogle Scholar
Lowe, JJ, Olinger, PL, Gibbs, SG, et al.Environmental infection control considerations for Ebola. Am J Infect Control 2015;43:747–749.CrossRefGoogle ScholarPubMed
Bausch, DG, Towner, JS, Dowell, SF, et al.Assessment of the risk of Ebola virus transmission from bodily fluids and fomites. J Infect Dis 2007;196 suppl 2:S142–S147.CrossRefGoogle Scholar
Clark, DV, Kibuuka, H, Millard, M, Wakabi, S, Lukwago, L, Taylor, A, et al.Long-term sequelae after Ebola virus disease in Bundibugyo, Uganda: a retrospective cohort study. Lancet Infect Dis 2015;15:905–912.CrossRefGoogle ScholarPubMed
Bellan, SE, Pulliam, JR, Dushoff, J, Meyers, LA.Ebola control: effect of asymptomatic infection and acquired immunity. Lancet 2014;384:1499–1500.CrossRefGoogle ScholarPubMed
Richardson, ET, Kelly, JD, Barrie, MB, et al.Minimally symptomatic infection in an Ebola ‘hotspot’: a cross-sectional serosurvey. PLoS Negl Trop Dis 2016;10(11):e0005087.CrossRefGoogle Scholar
Mulangu, S, Alfonso, VH, Hoff, NA, et al.Serologic evidence of Ebolavirus infection in a population with no history of outbreaks in the Democratic Republic of the Congo. J Infect Dis 2018;217:529–537.CrossRefGoogle Scholar
Hewlett, AL, Varkey, JB, Smith, PW, Ribner, BS.Ebola virus disease: preparedness and infection control lessons learned from two biocontainment units. Curr Opin Infect Dis 2015;28:343–348.CrossRefGoogle ScholarPubMed
Isakov, A, Jamison, A, Miles, W, Ribner, B.Safe management of patients with serious communicable diseases: recent experience with Ebola virus. Ann Intern Med 2014;161:829–830.CrossRefGoogle ScholarPubMed
Lai, L, Davey, R, Beck, A, Xu, Y, Suffredini, AF, Palmore, T, et al.Emergency postexposure vaccination with vesicular stomatitis virus-vectored Ebola vaccine after needlestick. JAMA 2015;313:1249–1255.CrossRefGoogle ScholarPubMed
Jacobs, M, Aarons, E, Bhagani, S, et al.Postexposure prophylaxis against Ebola virus disease with experimental antiviral agents: a case series of healthcare workers. Lancet Infect Dis 2015;15:1300–1304.CrossRefGoogle Scholar
Ledgerwood, JE, DeZure, AD, Stanley, DA, et al.Chimpanzee adenovirus vector Ebola vaccine. N Engl J Med 2017;376:928–938.CrossRefGoogle ScholarPubMed
Houlihan, CF, McGowan, CR, Dicks, S, et al. Ebola exposure, illness experience, and Ebola antibody prevalence in international responders to the West African Ebola epidemic 2014–2016: a cross-sectional study. PLoS Med 2017;14(5):e1002300.CrossRefGoogle Scholar
Parham, M, Edison, L, Soetebier, K, et al.Ebola active monitoring system for travelers returning from West Africa to Georgia, 2014–2015. Morb Mortal Wkly Rep 2015;64:347–350.Google ScholarPubMed
Smith, MW, Smith, PW, Kratochvil, CJ, Schwedhelm, S.The psychosocial challenges of caring for patients with Ebola virus disease. Health Secur 2017;15:104–109.CrossRefGoogle ScholarPubMed