Editor’s Note (Oct 16): See the statement released today by CIDRAP related to this commentary.
Editor’s Note (Sep 17): Today’s commentary was submitted to CIDRAP by the authors, who are national experts on respiratory protection and infectious disease transmission. In May they published a similar commentary on MERS-CoV. Dr Brosseau is a Professor and Dr Jones an Assistant Professor in the School of Public Health, Division of Environmental and Occupational Health Sciences, at the University of Illinois at Chicago.
Authors’ disclaimer: This commentary reflects the personal opinions of the authors. It does not represent the opinion of the University of Illinois at Chicago or any other organization. The authors have not received any compensation for the preparation of this commentary or any associated public statements. The authors do not endorse any specific manufacturer or brand of personal protective equipment (PPE) and have no direct or indirect financial interest in the use of a specific brand of PPE. In the past one or both of the authors have received research funding from numerous government agencies and organizations, including 3M.
Healthcare workers play a very important role in the successful containment of outbreaks of infectious diseases like Ebola. The correct type and level of personal protective equipment (PPE) ensures that healthcare workers remain healthy throughout an outbreak—and with the current rapidly expanding Ebola outbreak in West Africa, it’s imperative to favor more conservative measures.
The precautionary principle—that any action designed to reduce risk should not await scientific certainty—compels the use of respiratory protection for a pathogen like Ebola virus that has:
No proven pre- or post-exposure treatment modalities
A high case-fatality rate
Unclear modes of transmission
We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.1