Yet another Smoking gun: What the US army (USAMARIID) recommends when treating Ebola.

Directly from the PDF: USAMRIID’s MEDICAL MANAGEMENT OF BIOLOGICAL CASUALTIES HANDBOOK, Sixth edition April 2005. (This is the “Blue Book of medical management of Biological casualties published by the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) at Fort Dietrich, Maryland.) These are the people who have handled and studied Ebola and related infections since their discovery in 1976 and have written over 30 years’ worth of papers on Ebola and related its related species of filo viruses.

[link to www.dhhr.wv.gov]


Yet, after watching the 2 recent CSPAN hearings on our government’s response to the Ebola situation, I got the distinct impression that no one “knows anything”, no specific guidance has been given, and no one wants to directly answer any questions, and that we are “making this up” as we go along.

We have direct evidence that effective protocols were not followed in the isolation of the first Ebola patient to be treated in a US hospital that was not a facility that was specially prepared to handle a BSL-4 biological agent. If one were to do a report card on how well that response went, a failing grade would be need to be assigned for the advice given by the CDC in PPE, which clearly failed, resulting in the infections of two nurses caring for that patient. Another “F” would need to be given for the lack of direction in the proper handling of laboratory specimens resulting in a panic aboard a cruise ship due to (as it is by now obvious) that there was inappropriate handling of contaminated laboratory material. An “F” would also be given for the apparent lack of consistent clear direction, such as (paraphrasing): “you can’t get Ebola from someone on a bus, but you may be able to give it to someone on a bus”.

No wonder everyone is confused! There has been a clear lack of leadership and direction to the point that the State of New York has now taken it upon itself to quarantine travelers returning from Ebola endemic areas in Africa, as the federal government has clearly abdicated its role to do so.

In this age of “we can’t hurt anyone’s feelings” we have clearly misplaced our priorities of public safety and national security.

The sad thing about all of this is that the protocols for dealing with Ebola and other viral hemorrhagic fevers (VHF) have been clearly and distinctly outlined by USAMRIID’s MEDICAL MANAGEMENT OF BIOLOGICAL CASUALTIES HANDBOOK, (Blue Book) Sixth edition published in April 2005.
Here is what the people who have probably studied these viral agents the longest, who have probably the most direct experience in handling them, and who have been the among the experts in biological warfare agents have to say about this particular subset of viral infections:

From page 74, under the section of “Viral Hemorrhagic Fevers” (VHF) the category that includes Ebola, Lassa, Marburg and others, quoted directly:

“Isolation and Decontamination:"

"All VHF patients should be cared for using strict contact precautions including hand hygiene, double gloves, gowns shoe and leg coverings, and faceshield or goggles. Airborne precautions should be instituted to the maximum extent possible. At a minimum, a fit tested HEPA filter-equipped respirator (such as an N-95 mask), a battery-powered air-purifying respirator, or a a positive pressure supplied air respirator should be worn by personnel haring an enclosed space with or coming within six feet of a VHF patient. Multiple patients should be cohorted to a separate building or a ward with an isolated air-handling system. Ideally, VHF patients should be isolated in a negative pressure isolation room with 6-12 air exchanges per hour. Environmental decontamination is accomplished with hypochlorite or phenolic disinfectants.”

Then again on page 83:

“ISOLATION AND CONTAINMENT:”

“These viruses pose special challenges for hospital infection control. With the exception of dengue and hantaviruses, VHF patients harbor significant quantities of potentially infectious virus in blood, body fluids or secretions. Special caution must be exercised in handling hypodermic needles and other sharps which could result in parenteral exposure.

Strict adherence to VHF-specific barrier precautions will prevent nosocomial transmission in most cases.
Lassa, CCHF, Ebola and Marburg viruses may be particularly prone to nosocomial spread. In several instances, secondary infections among contacts and medical personnel without direct body fluid exposure have been well documented. These instances suggest a rare phenomenon of aerosol transmission of infection. Therefore, when a VHF is suspected, additional infection control measures are indicated. The patient should be hospitalized in a private room with an adjoining anteroom to be used for putting on and removing protective barriers, storage of supplies and decontamination of laboratory specimen containers. A negative pressure isolation room with 6-12 air exchanges per hour is ideal for all VHF patients and is strongly advised for patients with significant cough, hemorrhage or diarrhea.

All persons entering the room should wear double gloves, impermeable gowns with leg and shoe coverings (contact isolation), eye protection, and HEPA (N-95) masks or positive pressure air-purifying respirators (PAPRs).
In the absence of a large, fixed medical treatment facility, or in the event of an overwhelming number of casualties, isolation rooms may not be available for all casualties. At a minimum, VHF patients should be cohorted in a spate building or in a ward with an air-handling system separated from the rest of the building. Access should be restricted to necessary personnel. Personnel should wear contact and respiratory protection while in this patient care area. Personnel should undergo an external decontamination procedure at the point of leaving the patient care area. A building, room, or designated area that is separated from the patient care area should be established for donning and removing protective gear. All waste (including linens) leaving the patient care area should be decontaminated with bleach or quaternary ammonium compounds and double-bagged in clearly labeled biohazard waste bags. Ideally, this waste will be incinerated or autoclaved.

Laboratory specimens should be double-bagged, and the exterior of the outer bag should be decontaminated before transport to the laboratory. Excreta and other contaminated materials should be autoclaved, or decontaminated by the liberal application of appropriated disinfectants. Clinical laboratory personnel are at significant risk for exposure and should employ a biosafety cabinet (if available) with barrier and respiratory precautious when handling specimens.”

(Continued on page 84)
“No carrier state has been observed for any VHF, but excretion of the virus in urine or semen may occur for some time during convalescence. Survivors should avoid sexual contact for at least 3 months. Should the patient die, there should be minimal handling of the remains, which should ideally be sealed in leak-proof material for prompt burial or cremation.”

[link to www.dhhr.wv.gov]

PS: Better save this PDF, things like this have a habit of disappearing and there is a lot of good information in this one. I sent copies of this PDF to all of my State Representatives, along with a letter.

P.S...I thought about posting this on another thread, but I didn't want to hijack someone else's thread

Last Edited by emerald eye on 10/26/2014 02:42 AM