An Ebola toolkit for dentists by the Organization for Safety Asepsis and Prevention (OSAP)

The Organization for Safety Asepsis and Prevention (OSAP) released the Ebola toolkit for dentists. Drs. Nita Mazurat and Suham Alexander prepared the following resource based on the OSAP toolkit.

The OSAP website has just been updated. Click here for the updated toolkit. 

The guiding principle “triage, cohort, and isolate” during times of acute emerging disease or pandemics has been developed as a result of past experience with SARS and H1N1 and outbreaks of other infectious diseases resulting in many people becoming infected over a short period of time.  In both SARS and H1N1 outbreaks, the stages were:

• recognition of an emerging disease
• increased surveillance
• increased vigilance
• plans for reduced elective care in the event of a full pandemic
• pandemic plans for schools and businesses

Although it is highly unlikely that a patient with full symptoms of Ebola Virus Disease (EVD) would present for dental care in Canada, the potential (albeit, very small) exists that a patient with EVD may also have emergent dental needs and require treatment to relieve pain.   According to the Public Health Agency of Canada (PHAC), the risk in Canada is considered very low with no reported cases.¹

However, it is also expected that such care, if needed, would occur in a hospital setting and the oral healthcare personnel would be governed by the standard and transmission-based precautions that would be established in the hospital setting.  All the infection control procedures that are the daily standard operating procedures in dental offices in Canada are the standard infection control procedures recommended for healthcare workers working with Ebola patients (for example, correct hand hygiene, correct use of personal protective equipment, and correct decontamination of instruments and surfaces).^3,4

Signs & Symptoms: ⁶

• Similar to influenza: fever (>38.6°C or 101.5°F), severe headache, muscle pain, vomiting, diarrhea, stomach pain, or unexplained bleeding or bruising
• Signs and symptoms appear from 2 to 21 days post-exposure to Ebola (most commonly 8-10 days)
• Question patients with these symptoms about recent travel to countries in Africa where cases of Ebola are confirmed
• Question patients about contact with friends or family members with a confirmed case of Ebola

Spread: ⁶

• Spread through direct contact (via broken skin or mucous membranes) with blood and body fluids (urine, feces, saliva, vomit, and semen) of a person with Ebola
• Spread can also occur through indirect contact from contaminated objects (e.g. needles)
• Ebola is not spread via air, water or, in general food. (Ebola may be spread through handling bushmeat and contact with infected bats, in Africa.)

Infection: ⁶

• A person infected with Ebola is not contagious until symptoms appear
• Once someone recovers from Ebola, they can no longer spread the virus
• Ebola virus has been found in semen for up to 3 months. (People who recover from Ebola are advised to abstain from sex or use condoms for 3 months.)

Resources

1. Public Health Agency of Canada: http://www.phac-aspc.gc.ca/cpho-csp/statements/20140808-eng.php

2. https://osap.site-ym.com/?page=Ebola

3. http://www.cdc.gov/vhf/ebola/hcp/case-definition.html

4. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Setting.

5. http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html

6. http://www.cdc.gov/vhf/ebola/outbreaks/guinea/qa.html

 

The following resources were brought to our attention by the Ontario Dental Association (ODA):

Memorandum for medical officers of health, health workers and health sector employers regarding updated guidance for Ebola virus disease on the Public Health Ontario website

Ebola virus disease (EVD) screening tool for dental offices & allied health professionals