CDC Advises Cruise Industry on Handling Ebola
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Almost six months after a hospital worker suspected of handling an Ebola patient’s lab samples was quarantined on a cruise ship, the Centers for Disease Control and Prevention issued guidance on how crew members should deal with such cases.
The situation occurred in mid-October during an Ebola panic that grounded several flights around the world, led to screening procedures in some places, and raised talk of travel bans. The near-hysteria has for the most part died down, however.
Here’s what happened on the cruise ship: A hospital lab supervisor for a Texas hospital embarked the Carnival Magic for a vacation. After a Liberian man at that hospital died from Ebola and two nurses were infected, the worker fell under an “active monitoring category,” but she boarded before becoming aware of that fact.
Although she had no contact with the Ebola patient, there was a possibility she had handled his lab samples. The lab worker was “self-monitoring” for Ebola symptoms by taking her temperature and then was isolated in a cabin with her spouse.
During a scheduled call at Cozumel, Mexico denied clearance to the entire ship, so it headed back to its homeport of Galveston. The worker never did exhibit any symptoms and a blood test confirmed she did not have the Ebola virus.
But the incident prompted increased screenings by cruise ships, which began asking more pointed questions about whether boarding passengers had contact with a person with Ebola or someone who helped care for such a patient, or traveled to a country with a Level 3 Travel Health Warning, which urge people to “avoid nonessential travel” to those countries. The Level 3 warnings currently apply to Guinea, Liberia and Sierra Leone.
The guidance from the CDC is for cruise ship workers, including medical staff, administrators, and other crew members who may come in contact with an ill traveler prior to boarding or aboard a cruise ship.
“The majority of cruise lines have implemented their own pre-boarding screening policies that will deny boarding to all people who have visited a country with widespread Ebola transmission in the previous 21 days, who had physical contact with or helped care for anyone suspected of or diagnosed as having Ebola, or who are currently being monitored for possible exposure to Ebola,” the CDC said. “Some cruise lines may have more restrictive policies. If cruise lines learn of a passenger’s travel to a country with widespread Ebola transmission or other possible exposure to Ebola after the ship has sailed, the ship will generally require the traveler to stay in his or her cabin or in the ship’s health clinic for the duration of the voyage.”
The CDC guidance also said the master or medical staff on any ship bound for the U.S. should contact the CDC Quarantine Station or Emergency Operations Center if any passengers or crew members have risk factors for Ebola. In such a case, the CDC would work with the U.S. Coast Guard and Customs and Border Protection, as well as state and local health departments, to ensure an appropriate public health response.
The CDC guidance also details the type of protective garments that should be worn by crew members who have contact with the sick person — including full-face shields, two pairs of gloves, fluid-resistant gowns and boot covers — as well as how to dispose of the protective gear and items used. It also outlines cleaning and sanitizing procedures.
Symptoms consistent with Ebola include 100.4-degree fever or having chills, severe headache, fatigue, muscle pain, vomiting, diarrhea, stomach pain, or unexplained bleeding or bruising.
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