Ebola containment methods hurriedly exported worldwide

Ebola containment methods honed in virus-stricken parts of Africa are being exported hurriedly around the world as western countries scramble to learn from the experience of front-line charity doctors.

The US agency leading America’s Ebola response has replicated safety training created by Médecins Sans Frontières, a medical group working on the west Africa outbreak, and is exploring ways to give it to more US healthcare workers.

MSF, whose expertise on using protective clothing is in especially high demand, says it has also been called on by organisations ranging from the British and German armies and the UN to myriad hospitals in the west.

The case of a second healthcare worker contracting Ebola from an infected patient in Dallas, Texas, which follows the infection of a Spanish nurse last week, has sparked concern that countries outside Africa are not sufficiently prepared to control the virus.

“We’re overstretched in terms of our capacity to be able to answer all the requests we have for training,” said Fabienne de Leval, learning and development co-ordinator in MSF’s Brussels operations centre.

At the US Centers for Disease Control and Prevention, the agency heading the Ebola effort, its head Tom Frieden said it had created Ebola training based on MSF’s as he stressed the need for every US hospital to be ready for the virus.

Following the positive diagnosis of the Texas nurse over the weekend, he said: “I’m hearing from health workers around the country that they are very distressed [about Ebola].”

Ms de Leval at MSF said central to its training were instructions regarding putting on and taking off protecting clothing that she called “cosmonaut” suits, a process that carries the risk of exposure to pathogens on the outer layers.

“It’s taking your time. It’s strictly respecting the protocol,” she said. “Even if the patient is having a crisis, you can’t quickly get into the personal protective equipment.”

MSF, which first treated Ebola in 1995, also uses a “buddy” system so each healthcare worker is monitored by a colleague as they “don and doff” their equipment.

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In a similar vein, Mr Frieden said that at the Dallas hospital – where a second healthcare worker was diagnosed with the Ebola virus on Wednesday – the CDC would appoint a site manager to oversee infection control, including the use of protective clothing.

“In our work stopping Ebola in Africa, this is the single most important [measure] to protect health workers,” he said.

A CDC spokesman said the agency was discussing how to “box up” its Ebola training so it could be used more widely for US healthcare workers.

The methods of MSF, which has staff in the three Ebola-hit countries of Liberia, Sierra Leone and Guinea, have not been flawless, as two of its 250-odd international staff have been infected. Fourteen local staff have also contracted the virus – nine of whom died – but they did so in their home environments rather than at work.

In addition to MSF, the CDC spokesman said the US agency had learnt from American doctors with extensive experience of Ebola in west Africa.

Mr Frieden announced this week that CDC was establishing an Ebola rapid response team, including experts in infection control, which it would dispatch within hours to any US hospital with an Ebola case.

On lessons from the front line, he said: “One of the challenges is that the African environment and the US environment are different in terms of healthcare, so things done routinely in [African] Ebola wards aren’t necessarily transferable to the US.”

Conversely, MSF in Africa does not perform invasive procedures that increase the risk of infection, such as drawing blood and inserting breathing tubes, which were used in Dallas on the now deceased Liberian patient.