A Commentary on Ebola Virus Testing: Can We Talk?

via www.Michigan.gov by way of The Guardian of Public Health

Submitted by Dr. Janice Matthews‐Greer, MDCH, Bureau of Laboratory Virology Section Manager 

Laboratory testing of potential Ebola patients remains a moving target.  As new information comes out, risk assessments change, personal protective equipment (PPE) is altered and media hype escalates.  Nonetheless, a few things are definitive:  1) Ebola virus does not spread through the air.  Nor is it transmitted through casual contact.  2) Ebola is spread by direct contact with fluids from a patient who is symptomatic with disease.  A list of potentially infectious and/or Ebola RNA‐positive fluids includes blood, feces, vomit, saliva, mucus, tears, breast milk, urine, semen, vaginal secretions and sweat.  If these fluids from an ill individual come in contact with a healthy person’s broken skin, eyes, nose or mouth, transmission may occur.  Bodily fluids from an infected corpse are extremely infectious.  3) An infected patient is not contagious unless he or she is exhibiting symptoms.  Added to this Trinity is one more certainty – the mere word (Ebola) strikes fear in the hearts of many, including healthcare workers (HCW).

Being new to Public Health when we received word that our lab was one of the first initially chosen to test for Ebola virus, I worried about how to allay fears when announcing this to the virology laboratory staff.  My concern was unfounded.  I was overwhelmed with pride as these scientists accepted the task in stride.  I had misjudged them ‐ they told me that this was their job, this is what they do and their responsibility.    

Soon after that I got a call from Specimen Receiving (SR) informing us a box with “Ebola” written on it had just been delivered.  This created quite a stir as we had not yet formulated a plan for how SR would handle potentially (Ebola)‐infectious blood.  They had not been briefed on the virus or on our testing status.  Our relief in discovering it was just the reagents used to test for Ebola rather than an Ebola specimen soon turned to realization that we needed a plan in place immediately.  I met with Receiving and answered their questions openly and honestly.   They too took it in stride.  Next we held brown‐bag symposia for everyone in the building, from chemists and housekeepers to maintenance workers and laboratory information specialists.   There were a lot of questions, mostly about how the virus spreads and stories reported in the news, some second‐hand from friends or family.  It was an enlightening experience for all of us, especially me.  It reiterated once again that what we perceived to be staff concerns were unrealized once an open dialog was in place.  Information may be power, but it also provides a sense of control over the situation.

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