Ebola Transmitted in Hospital: Do Workers Need Respirators, Asks AAPS

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The CDC (Centers for Disease Control and Prevention) suggested that the first Dallas nurse who became infected while caring for the index patient may have “breached protocol” by touching the outer, contaminated surface of her protective equipment. Now that a second worker is infected, spokesmen are noting that the protective equipment leaves the neck exposed.

“But what if they got the disease by breathing?” asks the Association of American Physicians and Surgeons (AAPS).

The CDC website states categorically that you “can’t get Ebola through the air.” Larger particles in aerosols, as generated by a sneeze, travel only a few feet and are filtered out by masks. The virus is not supposed to survive drying as droplets evaporate.

Droplet nuclei remain suspended in the air for a long time, can travel long distances, and are not removed by masks. They are inhaled deep into the lungs. And the human respiratory tract does contain target cells for Ebola.

“Transmission by tiny droplet nuclei may be relatively inefficient for this virus,” stated AAPS executive director Jane M. Orient, M.D., “But that doesn’t mean it’s impossible.”

Research has shown that Ebola could remain infectious in an aerosol for more than an hour, Dr. Orient pointed out.
Aerosols are generated by patients, as in vomiting or having explosive diarrhea; by medical procedures such as intubation; or even by flushing a toilet.

“Should chlorine bleach be added to the toilet water and allowed to stand 10 minutes before flushing—with the lid closed?” asks Orient.

Workers caring for Ebola patients need adequate respiratory protection, Orient states. Professors Lisa Brosseau and Rachael Jones of the University of Illinois at Chicago recommend powered air-purifying respirators (PAPRs).

“With the current rapidly expanding Ebola outbreak…,” they write, “it’s imperative to favor more conservative measures.”

“Instead, the CDC is, in the absence of scientific certainty, assuming the best-case scenario about Ebola,” Orient states, “and betting the lives of our nurses that they are right.”

The Association of American Physicians and Surgeons (AAPS) is a national organization representing physicians in all specialties, founded in 1943 to preserve private medicine and the patient-physician relationship.

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