EBOLA VIRUS DISEASE

Ebola virus disease (EVD) is a rare and deadly disease caused by the Ebola virus. The virus spreads through direct contact with infected blood or body fluids, objects (e.g., needles) contaminated with infected body fluids, or infected animals (e.g., apes, monkeys). While it is not spread through food or water, it can be transmitted via consumption of “bush-meat” (raw/uncooked wild animal meat, especially monkey meat). A person infected with Ebola virus is not contagious and cannot spread the virus until they show symptoms. EVD symptoms include fever, severe headache, muscle pain, weakness, fatigue, diarrhea, vomiting, abdominal pain, and unexplained hemorrhage. In July 2019, an Ebola outbreak in the eastern region of The Democratic Republic of the Congo (DRC) was declared a public health emergency of international concern (PHEIC) due to its geographic expansion. The CDC estimates that the risk in the US from the current outbreak is low. As with any outbreak situation, an Ebola outbreak can evolve rapidly and it is important to remain up-to-date with notifications provided by DoD and BUMED, as well as CDC and WHO.

Information for Medical Department Personnel

Navy medical departments should maintain familiarity with current Ebola policies:

ASD(HA) Memorandum: PPE for DoD MTF Healthcare Workers Assessing or Caring for EVD Patients and Others Possibly Exposed to Ebola Virus:Provides guidelines for DoD MTF healthcare workers assessing or caring for EVD patients and those exposed to the virus, including direct patient care, contact with blood or body fluids, prolonged close interaction (less than three feet), and contact with deceased persons. Note that these guidelines exceed those issued by the CDC.

BUMED Memorandum: PPE for Navy MTF Healthcare Workers Assessing or Caring for EVD Patients and Others Possibly Exposed to Ebola Virus: Provides a PPE implementation and utilization matrix for determining minimum EVD PPE requirements and the process for selecting PPE based on exposure level and clinical presentation.

Navy medical departments should also maintain familiarity with general emergency preparedness and pandemic influenza/infectious disease policies as they pertain to potential Ebola situations:

OPNAVINST 3500.41A: Pandemic Influenza and Infectious Disease Policy: Defines roles and responsibilities for implementing and sustaining a comprehensive FHP EM program, as well as establishing capabilities for all-hazards preparedness, mitigation, prevention, first receiver response, and recovery to sustain mission readiness, save lives, reduce human suffering, and protect property. All MTFs should have an effective EM program established based on the standards within this instruction. Such a program would include a pandemic influenza/infectious disease response plan.

Defines roles and responsibilities for implementing and sustaining a comprehensive FHP EM program, as well as establishing capabilities for all-hazards preparedness, mitigation, prevention, first receiver response, and recovery to sustain mission readiness, save lives, reduce human suffering, and protect property. All MTFs should have an effective EM program established based on the standards within this instruction. Such a program would include a pandemic influenza/infectious disease response plan.

BUMEDINST 3500.5: Pandemic Influenza Planning Policy: While specific to pandemic influenza, the general procedures and plans within this instruction is applicable for the prevention, mitigation, preparedness, response, and recovery from infectious disease outbreaks in general. https://es.med.navy.mil/bumed

BUMEDINST 3500.6A: Navy Medicine Pandemic Influenza Response Stockpile Logistical Guidance:While specific to pandemic influenza, MTFs should ensure their stockpiles, including PPE, are stocked and maintained for any infectious disease event. (Note: This instruction has restricted access via the CAC enabled site https://es.med.navy.mil/bumed

BUMEDINST 6200.17A: Public Health Emergency Officers:Provides guidance for a development of a Public Health Emergency Officer (PHEO) program at all Navy Medicine Regions and MTFs. All MTFs should have a PHEO and alternate PHEO assigned.

If a case of EVD is suspected in a DON beneficiary, the PHEO and cognizant Navy Environmental and Preventive Medicine Unit (NEPMU) should be immediately notified. EVD cases are also reportable in DRSi within 24 hours (as “hemorrhagic fever, viral”). Include clinical presentation, travel/deployment history, and contact information. Naval research laboratories should immediately notify the cognizant NEPMU of suspect, probable or confirmed cases of EVD encountered while providing laboratory support.

General EVD Information

» WHO Press Release: Ebola Outbreak in the Democratic Republic of the Congo Declared a Public Health Emergency of International Concern

» CDC Press Release: CDC Supports WHO Declaration of PHEIC for Ebola Outbreak in Eastern Region of the DRC

» WHO: Ebola in the DRC 2019 – Current Situation

» WHO: Ebola (EVD) Website

» CDC: Ebola (EVD) Website

» CDC: Travel Alert Level 2 (Practice Enhanced Precautions) for Ebola in the DRC