Yesterday, the Centers for Disease Control and Prevention confirmed the first diagnosis of the Ebola virus outside of West Africa. The newly-diagnosed patient is currently undergoing treatment and supportive therapy at the Texas Health Presbyterian Hospital in Dallas, Texas after moving from Liberia a week ago. This patient was tested for Ebola and was confirmed to have the disease by the CDC late yesterday afternoon. For more information, visit the CDC website.
The implications of Ebola disease and treatment for home health care providers are minimal at this time. Because of the seriousness of the disease and its complications, a patient infected with the Ebola virus and active disease would not leave a hospital during the contagious period, but would be quarantined until the staff determines there is no risk of infection to others.
One possible scenario for home health care would be treatment of a patient who is no longer contagious but needs assistance recovering in the home due to severe weakness or for continued supportive treatment of dehydration, post-hemorrhagic anemia, or other symptoms. In this scenario, the patient would no longer have active fever, diarrhea, vomiting, or contagious aspects of the disease. Universal or standard precautions such as hand washing, donning of gloves, gowns, and masks would be appropriate recommended protection for the healthcare worker in this scenario.
At the current time, Ebola is primarily found in the countries of Guinea, Liberia, Sierra Leone, and Nigeria (where no additional cases have been documented recently). Since home health patients must be homebound to receive Medicare-covered Home Health, it is highly unlikely that a homebound patient receiving home health care would be able to travel to these areas and return home with Ebola. Should any patient’s family or guests return from trips to West Africa and subsequently begin running fever, universal/standard precautions should be observed by the clinician in the home until Ebola is ruled out as a cause of fever or illness. The CDC has stated that “Any U.S. hospital that is following CDC’s infection control recommendations and can isolate a patient in their own room with a private bathroom is capable of safely managing a patient with Ebola”.
The CDC continues to work with affected countries, stepping up aid and monitoring, and has put protocols in place to screen and quickly apprehend cases. As long as the continued vigilance and universal precautions are maintained, cases of Home Health workers contracting the disease will be highly unlikely.
