Infection Rates and Risk Factors for Infection Among Health Workers During Ebola and Marburg Virus Outbreaks: A Systematic Review

Saranya A. Selvaraj, Karen E. Lee, Mason Harrell, Ivan Ivanov, Benedetta Allegranzi (Lead / Corresponding author)

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    Abstract

    Background: Infection in health workers (HWs) has characterized outbreaks of Ebola virus disease (EVD) and Marburg virus disease (MVD). We conducted a systematic review to investigate infection and mortality rates and common exposure risks in HWs in EVD and MVD outbreaks.

    Methods: We searched the EMBASE and PubMed databases to identify articles posted before 27 December 2017, with no language restrictions. Data on the number, frequency, and mortality of HW infection and exposure risks were extracted.

    Results: Ninety-four articles related to 22 outbreaks were included. HW infections composed 2%-100% of cases in EVD and 5%-50% of cases in MVD outbreaks. Among exposed HWs, 0.6%-92% developed EVD, and 1%-10% developed MVD. HW infection rates were consistent through outbreaks. The most common exposure risk situations were inadequate personal protective equipment and exposure to patients with unrecognized EVD/MVD. Similar risks were reported in past EVD/MVD outbreaks and in the recent outbreak in West Africa.

    Conclusions: Many outbreaks reported high proportions of infected HWs. Similar HW infection rates and exposure risk factors in both past and recent EVD and MVD outbreaks emphasize the need to improve the implementation of appropriate infection control measures consistently across all healthcare settings.

    Original languageEnglish
    Pages (from-to)S679-S689
    Number of pages11
    JournalJournal of Infectious Diseases
    Volume218
    Issue numberSupplement 5
    Early online date7 Sept 2018
    DOIs
    Publication statusPublished - 15 Dec 2018

    Keywords

    • Ebola virus disease
    • Marburg virus disease
    • infection prevention and control
    • healthcare workers
    • occupational health

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