Ebola Virus Disease: Clinical Challenges, Recognition, and Management

Elizabeth L Beam; Michelle M Schwedhelm; Kathleen C Boulter; Angela M Vasa; LuAnn Larson; Theodore J Cieslak; John J Lowe; Jocelyn J Herstein; Christopher J Kratochvil; Angela L Hewlett

doi:10.1016/j.cnur.2019.02.001

Ebola Virus Disease: Clinical Challenges, Recognition, and Management

Nurs Clin North Am. 2019 Jun;54(2):169-180. doi: 10.1016/j.cnur.2019.02.001. Epub 2019 Mar 26.

Affiliations

¹ College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE 68198, USA. Electronic address: ebeam@unmc.edu.
² Emergency Management and Biopreparedness, Nebraska Medicine, 987422 Nebraska Medical Center, Omaha, NE 68198, USA.
³ Nebraska Biocontainment Unit, Nebraska Medicine, 982470 Nebraska Medical Center, Omaha, NE 68198, USA.
⁴ University of Nebraska Medical Center, 986814 Nebraska Medical Center, Omaha, NE 68198, USA.
⁵ Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, NE 68198, USA.
⁶ College of Public Health, University of Nebraska Medical Center, 984388 Nebraska Medical Center, Omaha, NE 68198, USA.
⁷ Global Center for Health Security, University of Nebraska Medical Center, 984388 Nebraska Medical Center, Omaha, NE 68198, USA.
⁸ University of Nebraska Medical Center, Nebraska Medicine, 987878 Nebraska Medical Center, Omaha, NE 68198, USA.
⁹ Division of Infectious Diseases, Nebraska Biocontainment Unit, Nebraska Medicine, University of Nebraska Medical Center, 985400 Nebraska Medical Center, Omaha, NE 68198, USA.

Abstract

The 2014 to 2016 Ebola outbreak response resulted in many lessons learned about biocontainment patient care, leading to enhanced domestic capabilities for highly infectious and hazardous communicable diseases. However, additional opportunities for improvement remain. The article identifies and describes key considerations and challenges for laboratory analysis, clinical management, transportation, and personnel management during the care of patients infected with Ebola or other special pathogens. Dedication to maintaining preparedness enables biocontainment patient care teams to perform at the highest levels of safety and confidence.

Keywords: Biocontainment; Biosecurity; Clinical management; Ebola virus; Emerging diseases.

Publication types

Review

MeSH terms

Africa, Western
Containment of Biohazards / standards*
Disease Outbreaks / prevention & control*
Guidelines as Topic*
Hemorrhagic Fever, Ebola / diagnosis*
Hemorrhagic Fever, Ebola / therapy*
Humans
Security Measures / standards*
United States