11/25/14 UPDATE – The American Public Health Association (APHA) has published the 20th edition of its “Control of Communicable Diseases Manual” as a key resource for public health professionals fighting infectious disease. In advance of the book’s release and in response to the emerging Ebola outbreak, APHA has made the Ebola-Marburg virus chapter of CCDM available online as a free download to help public health workers respond to the disease. http://www.dentistryiq.com/articles/2014/11/control-of-communicable-diseases-with-an-emphasis-on-ebola-marburg-viral-diseases.html

During the height of the recent outbreak of Ebola in the U.S., we as dentists are forced to consider the potential impact of the spread of the disease among our patients. We know the Ebola virus is only spread through direct contact with bodily fluids, including saliva, so it is important for us to know the best practices in keeping our office safe.

In dental offices the possibility of treating a highly infectious patient is unlikely. However, what if one of my patients had just been exposed to the virus but wasn’t yet showing symptoms and was scheduled to come in for continuing care?

What can we do to ensure that patients exhibiting potential signs of Ebola do not cause harm to our other patients.

• Ask patients if they or someone they have had contact with has visited Guinea, Sierra Leon or Liberia in the past 21 days. If they have, ask them to call and reschedule – This could be done through an automated service.
• Have patients complete a “review of systems” form before they arrive at your office to determine if they have symptoms consistent with an Ebola virus infection.
• As a fail-safe, when the patient enters the office ask them to fill out a short questionnaire (found in the link to the ADA below) to help ensure that they are indeed not at risk of causing harm to others while at your office.

When the first cases appeared in Dallas, the ADA has recommended changes in protocol for suspected Ebola cases.  For instance: (http://www.ada.org/en/member-center/oral-health-topics/ebola-resources)

The ADA recommends Dental professionals and staff in contact with the patient should:

• Immediately protect themselves by using standard precautions with physical barriers (gowns, masks, face protection and gloves).
• Immediately call 911 on behalf of the patient
• Notify the appropriate state or local health department authorities
• Ask the health department to provide you and your staff with the most up-to-date guidance on removing and disposing of potentially contaminated materials and equipment, including the physical barriers.

We are all relieved that the active Ebola infections have appeared to come to a close in the US, however, reported by the New York Times just today, there is a second outbreak of the Ebola virus in the West African nation of Mali reported to be larger and more deadly than the initial outbreak.

See the report here:  http://www.nytimes.com/2014/11/13/health/mali-reports-a-second-larger-ebola-outbreak.html

While we must remain vigilant in keeping our patients and practices safe from infectious diseases such as the Ebola virus, it is time to turn our attention back to West Africa and support our peers and aid workers putting themselves at risk to fight the disease. In the meantime we must learn how to recognize it and implement the systems that guard against the spread of the Ebola virus.