ATLANTA — Under new guidance from the Centers for Disease Control and Prevention (CDC), hospitals treating patients confirmed as having the Ebola virus are advised to forgo laundering all potentially contaminated linens and discard them as regulated medical waste.
The new guidance comes as hospitals prepare for the possibility of treating patients arriving from West Africa with the deadly virus, which has killed more than 2,400 people on that continent, according to the World Health Organization. Currently, only Atlanta’s Emory University Hospital and Omaha’s Nebraska Medical Center have treated patients who arrived in the U.S. from West Africa infected with the virus.
According to the CDC, the Ebola virus is spread through direct contact with blood and body fluids of a symptomatic infected person, as well as through exposure to contaminated needles and other objects, but adds that “the role of the environment in transmission has not been established.”
While the CDC says there is no epidemiologic evidence of the virus being transmitted through “either the environment or fomites that could become contaminated during patient care,” such as bed rails, door knobs or even laundry, the severity of the disease calls for “higher levels of precaution” in reducing potential contamination.
RECOMMENDATIONS
On Aug. 22, the CDC released Interim Guidance for Environmental Infection Control in Hospitals for Ebola Virus, updated from a version released earlier that month. The update includes more details about recommendations for textile care management in healthcare facilities treating patients potentially infected with Ebola.
Among the precautions hospitals are urged to undertake for patients with “probable or confirmed” Ebola virus is the use of personal protective equipment (PPE), including disposable gloves, a fluid-resistant or impermeable gown, eye protection and a face mask during cleaning and disinfection. Leg covers, shoe covers and any additional barriers should be used as needed, and any reusable gloves worn during cleaning should be disinfected and “kept in the room or anteroom.”
The CDC lists even those not directly involved in patient care—including those involved in laundry and housekeeping activities—as “healthcare personnel” who should follow the recommendations for PPE during cleaning and disinfection activities.
The Association for Linen Management (ALM) reports that it obtained clarification from the CDC on several points regarding textile care management during a late August conference call. According to ALM, the CDC stated the following with regard to PPE in cases of a confirmed Ebola patient:
“There should be no concerns with following normal laundering of the care provider’s uniform. If there is a breakthrough in any of the PPE and exposure occurs, the individual would report and follow the healthcare [facility’s] blood or body fluid exposure plan. The additional step would be to contain and discard the uniform exactly the same as other textiles used in that specific room.”
Discarding all “linens, non-fluid-impermeable pillows or mattresses and textile privacy curtains” from a confirmed infected patient as regulated medical waste will reduce the risk of exposure among staff, says the CDC.
Additionally, disposable materials such as “any single-use PPE, cleaning cloths, wipes, single-use microfiber cloths, linens [and] food service” should be placed in a leakproof containment and also discarded as regulated medical waste.
The waste bag should be placed in a rigid waste receptacle to minimize contamination of the exterior of the bag.
Incineration of the materials can also be effective against “viral infectivity,” but facilities should check with their states’ regulated medical waste programs for more guidance, according to the CDC.
A representative of Emory University Hospital summarizes the hospital’s infection control procedures for American Laundry News: “Linens (sheets, blankets, towels) used by patients suffering with Ebola virus infection are placed in leakproof biohazard bags and immediately collected for autoclaving within the Isolation Unit at Emory University Hospital, followed by incineration off-site. This is the standard protocol for linen disposal when caring for patients with Ebola.”
Check back Wednesday for the conclusion!
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