Petti Stefano, Protano Carmela, Messano Giuseppe Alessio, Scully Crispian
Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
University College London, London, UK.
Biomed Res Int. 2016;2016:8054709. doi: 10.1155/2016/8054709. Epub 2016 Nov 27.
During the 2014-2016 West-African Ebola virus disease (EVD) outbreak, some HCWs from Western countries became infected despite proper equipment and training on EVD infection prevention and control (IPC) standards. Despite their high awareness toward EVD, some of them could not recall the transmission routes. We explored these incidents by recalling the stories of infected Western HCWs who had no known directly exposures to blood/bodily fluids from EVD patients. We carried out conventional and unconventional literature searches through the web using the keyword "Ebola" looking for interviews and reports released by the infected HCWs and/or the healthcare organizations. We identified fourteen HCWs, some infected outside West Africa and some even classified at low EVD risk. None of them recalled accidents, unintentional exposures, or any IPC violation. Infection transmission was thus inexplicable through the acknowledged transmission routes. We formulated two hypotheses: inapparent exposures to blood/bodily fluids or transmission due to asymptomatic/mildly symptomatic carriers. This study is in no way intended to be critical with the healthcare organizations which, thanks to their interventions, put an end to a large EVD outbreak that threatened the regional and world populations.
在2014 - 2016年西非埃博拉病毒病（EVD）疫情期间，一些来自西方国家的医护人员尽管配备了适当的设备并接受了埃博拉病毒病感染预防与控制（IPC）标准的培训，但仍被感染。尽管他们对埃博拉病毒病的认知度很高，但其中一些人却记不起传播途径。我们通过回顾那些没有已知直接接触埃博拉病毒病患者血液/体液的受感染西方医护人员的故事，来探究这些事件。我们通过网络使用关键词“埃博拉”进行了常规和非常规的文献检索，寻找受感染医护人员和/或医疗机构发布的访谈和报告。我们确定了14名医护人员，其中一些人在西非以外地区被感染，有些人甚至被归类为埃博拉病毒病低风险人群。他们中没有人回忆起有事故、意外暴露或任何违反感染预防与控制措施的情况。因此，通过公认的传播途径无法解释感染的传播。我们提出了两个假设：隐性接触血液/体液或由无症状/症状轻微的携带者传播。本研究绝不是要批评医疗机构，多亏了他们的干预，才结束了一场威胁地区和世界人口的大规模埃博拉病毒病疫情。
