Infection Prevention and Control Recommendations for Hospitalized Patients Under Investigation (PUIs) for Ebola Virus Disease (EVD) in U.S. Hospitals
Recommendations on this page apply to Ebola Disease and Marburg Virus Disease in healthcare settings. This page is currently being reviewed and terminology will be updated to reflect this broader application.
Who this is for: Healthcare personnel in any healthcare setting. The guidance is most relevant for hospital staff caring for a patient under investigation (PUI) or patient with confirmed Ebola virus disease (EVD).
What this is for: Guidance to help healthcare personnel follow recommended infection prevention and control practices when caring for a PUI or patient with confirmed EVD.
How this relates to other Ebola guidance: This guidance outlines the key areas for infection prevention and control for EVD in U.S. hospitals and healthcare settings.
- CDC recommends a combination of measures to prevent transmission of EVD in hospitals including PPE. These should be implemented in addition to routine IPC practices that are implemented on a daily basis to prevent transmission of infectious diseases from patient to patient and patient to healthcare personnel.
- Healthcare personnel might need to take additional infection control steps if a PUI or patient with confirmed EVD has other conditions or illnesses caused by specific infectious diseases, such as tuberculosis.
- Healthcare personnel can be exposed to Ebola virus by touching a patient’s body fluids, contaminated medical supplies and equipment, or contaminated environmental surfaces. Splashes to unprotected mucous membranes (for example, the eyes, nose, or mouth) are particularly hazardous. Procedures that can increase environmental contamination with infectious material or create aerosols should be minimized.
Precautions outlined in the table below are recommended for management of a hospitalized PUI or patient with confirmed EVD. Note that this guidance outlines only those measures that are specific for EVD; duration of specific infection control measures need to consider if a patient has other conditions or illnesses for which other measures are indicated (tuberculosis, multidrug resistant organisms).
Though these recommendations focus on the hospital setting, the recommendations for personal protective equipment (PPE) and environmental infection control measures are applicable to any healthcare setting. In this guidance healthcare personnel (HCP) refers all people, paid and unpaid, working in healthcare settings who have the potential for exposure to patients and/or to infectious materials, including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces, or aerosols generated during certain medical procedures. HCP include, but are not limited to, physicians, nurses, nursing assistants, therapists, technicians, emergency medical service personnel, dental personnel, pharmacists, laboratory personnel, autopsy personnel, students and trainees, contractual personnel, home healthcare personnel, and people not directly involved in patient care (clerical, dietary, housekeeping, laundry, security, maintenance, billing, chaplains, and volunteers) but potentially exposed to infectious agents that can be transmitted to and from HCP and patients. This guidance is not intended to apply to people outside of healthcare settings.
As information becomes available, these recommendations will be re-evaluated and updated as needed. These recommendations are based upon the following considerations:
- High rate of morbidity and mortality among infected patients
- Risk of human-to-human transmission
For full details of routine infection control measures that should be implemented day-to-day in U.S. healthcare settings see 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Setting.
For information on symptoms of EVD infection and modes of transmission, see the CDC Ebola Virus Disease Website.
|Personal Protective Equipment (PPE)||
Guidance on Personal Protective Equipment (PPE) To Be Used By Healthcare Workers during Management of Patients with Confirmed Ebola or Persons under Investigation (PUIs) for Ebola who are Clinically Unstable or Have Bleeding, Vomiting, or Diarrhea in U.S. Hospitals, Including Procedures for Donning and Doffing PPE
For U.S. Healthcare Settings: Donning and Doffing Personal Protective Equipment (PPE) for Evaluating Persons Under Investigation (PUIs) for Ebola Who Are Clinically Stable and Do Not Have Bleeding, Vomiting, or Diarrhea
|Patient Care Equipment||
|Patient Care Considerations||
|Aerosol Generating Procedures (AGPs)||
|Environmental Infection Control||Hospital Guidance|
|Safe Injection practices||
|Duration of Infection Control Precautions||
|Monitoring and Management of Healthcare Personnel||
Facility HCP monitoring and sick leave policies
HCP with high-risk exposures
*Direct contact means physical contact with a person with Ebola disease (alive or dead) or with objects contaminated with the body fluids of a person with Ebola disease (alive or dead) while not wearing recommended PPE or while experiencing a breach in PPE that could result in unprotected contact with the patient or their blood or body fluids.
Additional Considerations for HCP with potential unrecognized ebolavirus exposures
Considerations for HCP who develop signs or symptoms after caring for patients with known or suspected EVD or with potential unrecognized Ebola exposures
|Monitoring, Management, and Training of Visitors||
* For laboratory personnel, the recommendations for PPE only apply when in the patient care area. Laboratory personnel who are in the laboratory, not the patient care area, need to follow the recommendations outlined in CDC’s Ebola Laboratory Guidance https://www.cdc.gov/vhf/ebola/healthcare-us/laboratories/index.html.