Dental Tribune U.S. Edition

Dental Tribune U.S. Edition | February 2012XX XXXXX A4 Dental Tribune U.S. Edition | September 2014 Ad A member of the Centers for Disease Control and Prevention team leads a training session on Ebola infection control in Lagos, Nigeria, on Aug. 11. Health officials say the Ebola outbreak in West Africa is the deadliest ever. Note that the instructor has donned the personal protective equipment needed to avoid viral contamination when in contact with infected patients: head-to-toe white impermeable suite, goggles, filtered breathing mask and blue rubber gloves. Photo/Benjamin Park, provided by CDC outbreak of Ebola virus infection is a per- fect storm created by a lethal combina- tion of some of these factors and also in- cluding rampant deforestation, poverty and the war-stricken situation in many African countries. So how does Ebola spread? According to World Health Organization reports, Ebola virus disease (EVD) is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. Human-to-human transmission is through direct contact (through bro- ken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids, such as saliva, of infected people, and indirect contact with environments contaminated with such fluids. Transmission through the air has not been documented in the natural envi- ronment, nor have there been any case reports of transmission through saliva contamination. Infection in health care settings has been due to health care work- ers treating patients with suspected or confirmed EVD, especially when infec- tion control precautions were not strictly practiced. Reports indicate that those who recovered from the disease could transmit the virus through their semen for up to two months after recovery. EVD is a severe acute illness character- ized by the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhea, rash, impaired kidney and liver function, and both internal and external bleeding in some cases. Oral manifesta- tions, such as acute gingival bleeding, have been reported. The mortality rate of EVD is very high and 50–90 percent of patients die owing to the profound sys- temic hemorrhage or its complications. The incubation period of EVD is two to 21 days. Up to now, there have been no reported cases of transmission of EVD in any den- tal settings. However, the fact that it is transmitted through human secretions, which includes saliva, and that the in- cubation period could last up to 21 days implies that dental care workers in the endemic areas of the virus, such as West Africa and sub-Saharan Africa, may run the risk of acquiring the disease if strict standard infection control measures are not routinely followed. In dentistry, we are constantly exposed to these emerging and re-emerging in- fectious threats, and we cannot afford to let our guard down. Vigilance, awareness and good clinical practice with standard infection control at all times are funda- mental to prevention, as-yet-unimagined new diseases surely lie in wait. Although we have made spectacular technical and scientific advances since the release of the original IOM report some two de- cades ago, it appears that humans are still defenseless in the face of the relentless march of our microbe foes. “ EBOLA, page A1 Lakshman Samaranayake, Hon DSc, BDS, DDS (Glas), FRCPath, FDSRCSE (Hon), FRACDS, FCDSHK, FHKCPath, FHKAM, is head and professor of oral microbiomics and in- fection at the University of Queensland School of Dentistry in Bris- bane, Australia. He can be reached at dent.execassistant@uq.edu.au. from page one

Dental Tribune U.S. Edition

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