WASHINGTON — Federal health officials Monday tightened infection-control guidelines for health care workers caring for Ebola patients, explicitly recommending that no skin be exposed.
The beefed-up guidelines also call for health care workers to undergo rigorous training, and to be supervised by trained monitors when putting on and taking off personal protective equipment. The government will issue step-by-step instructions for workers to follow in doing that.
The revised protocols from the Centers for Disease Control and Prevention are being issued amid a debate over whether protection is adequate for nurses and doctors caring for Ebola patients. The controversy flared when two nurses became ill in Dallas after caring for Thomas Eric Duncan, the Liberian who became the first person diagnosed with Ebola in this country.
Some hospitals, including Texas Health Presbyterian, which treated Duncan, began using the stricter protocols last week.
At a media briefing late Monday, CDC director Tom Frieden said the updated guidelines give a greater margin of safety to health care workers. They are modeled closely on those used by Doctors Without Borders, the aid group that has worked most extensively in West Africa, where the virus has killed nearly 4,500 people in Guinea, Sierra Leone and Liberia. The guidance also reflects the consensus of specialists at Emory University Hospital, Nebraska Medical Center and the National Institutes of Health, which are currently treating Ebola patients.
Previous guidelines did not make clear that all skin must be protected. They also reflected the experience of care in Africa, Frieden said. But health care workers in the United States face greater risk in caring for Ebola patients because hospitals here use more high-risk procedures that can expose workers to more of a patient's bodily fluids.
Meanwhile, dozens of people who had possible contact with Duncan have been deemed free of the virus, officials said Monday.
The 43 people cleared included health care workers, school-age children and other members of the community who may have interacted with Duncan, who later died.
"They have no Ebola symptoms and are not at risk of developing Ebola," the Texas Department of State Health Services said in a statement.
Dallas Mayor Mike Rawlings said five other people who are being monitored as part of the initial group should all be cleared this week. He said authorities are still monitoring about 75 health care workers who came into contact with Duncan while he was being treated at the hospital.