1. Ebola Virus Status Update; Personal Protective Equipment October 24, 2014

2. 2 Outline Overview of Ebola situation Point of Care Risk Assessment process Personal Protective Equipment

3. 3 Ebola Update Ebola outbreak is of primary concern in Sierra Leone, Liberia, and Guinea. Risk to Canadians is very low Transmission to humans: Contact with infected wild animals in West Africa (fruit bats, non-human primates, rodents) Direct contact with infected humans –Blood, other body fluids, tissues from infected individuals –Environmental contamination Incubation is 2 to 21 days Communicable from symptom onset to symptom resolution

4. 4 Ebola Update Roles of various Agencies: WHO is coordinating response in Africa PHAC is coordinating response in Canada Alberta Health and Alberta Health Services are coordinating response in Alberta –FNIHB AB Region is included in update meetings

5. 5 Ebola Update PHAC Response Screening at ports of entry into Canada Quarantine for 21 days if required Assisting in international response Expert response teams on standby to support case management anywhere in Canada if requested by jurisdiction Development of Guidance Documents FNIHB working in coordination with PHAC nationally

6. 6 Ebola Update Response in Alberta Screening occurring at airports Designated hospitals in Edmonton (2) and Calgary (2) Process for notification to Public Health AHS developing guidance documents - with related training - for designated hospitals, front line workers (doctors, first responders, community based staff) Phased approach based on risk assessment Purchasing appropriate PPE Plan for regular communications: Health care providers Public FNIHB AB Region working in coordination with AH/AHS.

7. 7 Community Response Preference is for people to contact Health Link where triage will occur vs coming into health centre. If people present: Guidance for triage in patients with fever: Is temperature at least 38 0 C? Any travel or residence in Guinea, Sierra Leone, or Liberia within past 21 days? Ebola Update

8. 8 Where there is relevant travel and symptom history: Does the person need immediate emergency treatment? –Call 911, ensuring to notify dispatcher of potential risk If does not need immediate treatment: –Separate room, implement droplet and contact precautions –Call on-call number: 780-218-9929 If there is no relevant travel and symptom history, not considered an Ebola risk. Ebola Update

9. 9 Remember: fevers are associated with many disease processes, including malaria, influenza, dehydration (for any cause). The risk for Ebola to be present without history of travel to affected countries is extremely low. Ebola Update – Canadian Context

10. 10 Key information websites: World Health Organization: http://www.who.int/csr/disease/ebola/en/ http://www.who.int/csr/disease/ebola/en/ Public Health Agency of Canada: http://www.phac- aspc.gc.ca/id-mi/vhf-fvh/ebola-eng.phphttp://www.phac- aspc.gc.ca/id-mi/vhf-fvh/ebola-eng.php Alberta Health: http://www.health.alberta.ca/health- info/ebola-virus.htmlhttp://www.health.alberta.ca/health- info/ebola-virus.html Alberta Health Services: http://www.albertahealthservices.ca/10289.asp http://www.albertahealthservices.ca/10289.asp Ebola Update

11. 11 POINT OF CARE RISK ASSESSMENT

12. 12 Point of Care Risk Assessment Algorithm and related resources were rolled out spring 2014. PCRA Algorithm Additional Precautions Overview See: OneHealth, CDC Manual, under “CDC Manual Forms”

13. 13 PERSONAL PROTECTIVE EQUIPMENT

14. 14 Personal Protective Equipment Routine PPE: Gowns Current stock is not impermeable Gloves Masks Procedure mask N95 masks Face shields Don’t forget hand hygiene!

15. 15 N95 masks: Only required where respiratory precautions are indicated (TB, measles, aerosol-generating medical procedures) Fit tests have been done in the past, during on-boarding –FNIHB AB region does not currently have process to update fit testing –Remember to do seal test with N95 masks Personal Protective Equipment

16. 16 Ensure that there is supply of routine PPE. Ensure that there is a supply of procedure masks available: For use with clients presenting in the health centre or clinic with new cough Ensure that there is access to hand hygiene: soap and water is adequate for public Waterless hand gels is preferred product for HCWs Personal Protective Equipment

17. 17 It is important to understand principles behind PPE to ensure best protection:  area to be protected should be completely covered  Prevent contamination during doffing Personal Protective Equipment

18. 18 Alberta Health Services Video – demonstrating proper technique for donning and doffing PPE http://www.albertahealthservices.ca/6422.asp All staff should: review the PCRA tool as it is applicable to your practice and various settings practice donning and doffing full PPE with a partner Personal Protective Equipment

19. 19 Environmental Cleaning During respiratory season, ensure that high touch surfaces are regularly cleaned. Virox TM products do inactivate viruses.

20. 20 Thank you! Contacts: Ruth Richardson780-495-5439 ruth.richardson@hc-sc.gc.ca Dr. Parminder Thiara403-861-8447 parminder.thiara@hc-sc.gc.ca Dr. Wadieh Yacoub780-495-3391 wadieh.yacoub@hc-sc.gc.ca