Abstract
Objective: To assess, within communities experiencing Ebola virus outbreaks, the risks associated with the disposal of human waste and to generate recommendations for mitigating such risks.
Methods: A team with expertise in the Hazard Analysis of Critical Control Points framework identified waste products from the care of individuals with Ebola virus disease and constructed, tested and confirmed flow diagrams showing the creation of such products. After listing potential hazards associated with each step in each flow diagram, the team conducted a hazard analysis, determined critical control points and made recommendations to mitigate the transmission risks at each control point.
Findings: The collection, transportation, cleaning and shared use of blood-soiled fomites and the shared use of latrines contaminated with blood or bloodied faeces appeared to be associated with particularly high levels of risk of Ebola virus
transmission. More moderate levels of risk were associated with the collection and transportation of material contaminated with bodily fluids other than blood, shared use of latrines soiled with such fluids, the cleaning and shared use of fomites soiled with such fluids, and the contamination of the environment during the collection and transportation of blood-contaminated waste.
Conclusion: The risk of the waste-related transmission of Ebola virus could be reduced by the use of full personal protective equipment, appropriate hand hygiene and an appropriate disinfectant after careful cleaning. Use of the Hazard Analysis of Critical Control Points framework could facilitate rapid responses to outbreaks of emerging infectious disease.
Methods: A team with expertise in the Hazard Analysis of Critical Control Points framework identified waste products from the care of individuals with Ebola virus disease and constructed, tested and confirmed flow diagrams showing the creation of such products. After listing potential hazards associated with each step in each flow diagram, the team conducted a hazard analysis, determined critical control points and made recommendations to mitigate the transmission risks at each control point.
Findings: The collection, transportation, cleaning and shared use of blood-soiled fomites and the shared use of latrines contaminated with blood or bloodied faeces appeared to be associated with particularly high levels of risk of Ebola virus
transmission. More moderate levels of risk were associated with the collection and transportation of material contaminated with bodily fluids other than blood, shared use of latrines soiled with such fluids, the cleaning and shared use of fomites soiled with such fluids, and the contamination of the environment during the collection and transportation of blood-contaminated waste.
Conclusion: The risk of the waste-related transmission of Ebola virus could be reduced by the use of full personal protective equipment, appropriate hand hygiene and an appropriate disinfectant after careful cleaning. Use of the Hazard Analysis of Critical Control Points framework could facilitate rapid responses to outbreaks of emerging infectious disease.
| Original language | English |
|---|---|
| Pages (from-to) | 424-432 |
| Number of pages | 9 |
| Journal | Bulletin WHO |
| Volume | 94 |
| Issue number | 6 |
| Early online date | 3 Mar 2016 |
| DOIs | |
| Publication status | Published - Jun 2016 |
Keywords
- Ebola
- rapid response
- filovirus
- excreta
- EBOV
- HACCP
Access to Document
Profiles
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Diana Bell
- School of Biological Sciences - Emeritus Professor
- Centre for Ecology, Evolution and Conservation - Member
- Water Security Research Centre - Member
Person: Honorary, Research Centre Member
-
Roger Few
- School of Global Development - Professorial Research Fellow
- Tyndall Centre for Climate Change Research - Member
- Water Security Research Centre - Member
- Area Studies - Member
- Climate Change - Member
- Global Environmental Justice - Member
- Health and Disease - Member
- ClimateUEA - Steering Committee Member
Person: Research & Analogous, Research Group Member, Research Centre Member
-
Paul Hunter
- Norwich Medical School - Professor in Medicine
- Population Health - Member
- Water Security Research Centre - Member
- Epidemiology and Public Health - Member
- ClimateUEA - Member
Person: Research Group Member, Research Centre Member, Academic, Teaching & Research