Perspectives on the Management of Children in a Biocontainment Unit: Report of the NETEC Pediatric Workgroup

Theodore J Cieslak; Laura Evans; Mark G Kortepeter; Amanda Grindle; Lemuel Aigbivbalu; Kate Boulter; Ryan W Carroll; Sylvia Cumplido; Alison G Danforth; Cecilia Fry; James Gaensbauer; Janet R Hume; Amyna Husain; Arlene Kelleher; Christopher J Kratochvil; Claudia Kunrath; Jill S Morgan; Michelle M Schwedhelm; Andi L Shane; Patricia Tennill; Phoebe H Yager; H Dele Davies

doi:10.1089/hs.2018.0074

Perspectives on the Management of Children in a Biocontainment Unit: Report of the NETEC Pediatric Workgroup

Health Secur. 2019 Jan/Feb;17(1):11-17. doi: 10.1089/hs.2018.0074.

Authors

Theodore J Cieslak¹, Laura Evans², Mark G Kortepeter³, Amanda Grindle⁴, Lemuel Aigbivbalu⁵, Kate Boulter⁶, Ryan W Carroll⁷, Sylvia Cumplido⁸, Alison G Danforth⁹, Cecilia Fry¹⁰, James Gaensbauer¹¹, Janet R Hume¹², Amyna Husain¹³, Arlene Kelleher¹⁴, Christopher J Kratochvil¹⁵, Claudia Kunrath¹⁶, Jill S Morgan¹⁷, Michelle M Schwedhelm¹⁸, Andi L Shane¹⁹, Patricia Tennill²⁰, Phoebe H Yager²¹, H Dele Davies²²

Affiliations

¹ Theodore J. Cieslak, MD, MPH, is Medical Co-Director, Nebraska Biocontainment Unit, University of Nebraska Medical Center, Omaha NE.
² Laura Evans, MD, MSc, is Medical Director of Critical Care and Special Pathogens Program, Bellevue Hospital, New York University School of Medicine, New York, NY.
³ Mark G. Kortepeter, MD, MPH, is Professor of Epidemiology, University of Nebraska College of Public Health, Omaha, NE.
⁴ Amanda Grindle, MSN, Clinical Program Manager, with the Special Care Unit, Children's Healthcare of Atlanta, Atlanta, GA.
⁵ Lemuel Aigbivbalu, MD, is in the Department of Pediatrics, University of Texas Medical Branch at Galveston, Galveston, TX.
⁶ Kate Boulter, RN, MPH, is Nurse Manager, Nebraska Biocontainment Unit, University of Nebraska Medical Center, Omaha NE.
⁷ Ryan W. Carroll, MD, MPH, is with Pediatric Critical Care Medicine, Massachusetts General Hospital for Children, Boston, MA.
⁸ Sylvia Cumplido, MSN, is a Nurse Epidemiologist, Cedars-Sinai Medical Center, Los Angeles, CA.
⁹ Alison G. Danforth, BSN, RN, with the Special Care Unit, Children's Healthcare of Atlanta, Atlanta, GA.
¹⁰ Cecilia Fry is a Pediatric Intensivist, Special Pathogens Unit, Providence Sacred Heart Medical Center, Spokane, WA.
¹¹ James Gaensbauer, MD, is an Assistant Professor, University of Colorado School of Medicine, Denver, CO.
¹² Janet R. Hume, MD, PhD, is an Assistant Professor, Department of Pediatrics, Division of Critical Care Medicine, University of Minnesota Medical School, Minneapolis, MN.
¹³ Amyna Husain, DO, is a Clinical Instructor, Pediatric Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
¹⁴ Arlene Kelleher, MS, RN, is Nurse Director, Pediatric Intensive Care Unit, Massachusetts General Hospital for Children, Boston, MA.
¹⁵ Christopher J. Kratochvil, MD, is Associate Vice Chancellor for Clinical Research, University of Nebraska Medical Center, Omaha NE.
¹⁶ Claudia Kunrath, MD, is Medical Director, Pediatric Critical Care, Denver Health Medical Center, Denver, CO.
¹⁷ Jill S. Morgan, RN, is Lead Nurse for Education, Serious Communicable Disease Unit, Emory University Hospital, Atlanta, GA.
¹⁸ Michelle M. Schwedhelm, MSN, is Executive Director, Emergency Management and Biopreparedness, Nebraska Medicine, Omaha, NE.
¹⁹ Andi L. Shane, MD, is Associate Professor of Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, GA.
²⁰ Patricia Tennill, RN, is Associate Director of Nursing, Special Pathogens Program, Bellevue Hospital, New York, NY.
²¹ Phoebe H. Yager, MD, is Chief, Division of Pediatric Critical Care Medicine, Massachusetts General Hospital, Boston, MA.
²² H. Dele Davies, MD, is Professor of Pediatric Infectious Diseases and Public Health, Department of Pediatrics, University of Nebraska Medical Center, Omaha NE.

PMID: 30779612
DOI: 10.1089/hs.2018.0074

Abstract

During the outbreak of Ebola virus disease that struck West Africa during 2014-2016, a small handful of expatriate patients were evacuated to specialized high-level containment care units, or biocontainment units, in the United States and Western Europe. Given the lower mortality rate (18% versus 40% for those treated in Africa) among these patients, it is likely that high-level containment care will be used in the future with increasing frequency. It is also likely that children infected with Ebola and other highly hazardous communicable diseases will someday require such care. The National Ebola Training and Education Center convened a pediatric workgroup to consider the unique and problematic issues posed by these potential child patients. We report here the results of those discussions.

Keywords: Biocontainment; Ebola; High-level containment care; Pediatric care; Special pathogens.

MeSH terms

Africa, Western
Child
Consensus Development Conferences as Topic*
Containment of Biohazards*
Disease Outbreaks / prevention & control*
Europe
Hemorrhagic Fever, Ebola / therapy*
Humans
Infection Control / methods*
Parents / psychology
Patient Isolation / methods
Pediatrics / methods*
United States