Recommendations for dealing with waste contaminated with ebola virus: a hazard analysis of critical control points approach
Abstract
Objective To assess, within communities experiencing Ebola virus outbreaks, the risks associated with the disposal of human waste and
to generate recommendations for mitigating such risks.
Methods A team with expertise in the Hazard Analysis of Critical Control Points framework identified waste products from the care of
individuals with Ebola virus disease and constructed, tested and confirmed flow diagrams showing the creation of such products. After
listing potential hazards associated with each step in each flow diagram, the team conducted a hazard analysis, determined critical control
points and made recommendations to mitigate the transmission risks at each control point.
Findings The collection, transportation, cleaning and shared use of blood-soiled fomites and the shared use of latrines contaminated with
blood or bloodied faeces appeared to be associated with particularly high levels of risk of Ebola virus transmission. More moderate levels
of risk were associated with the collection and transportation of material contaminated with bodily fluids other than blood, shared use of
latrines soiled with such fluids, the cleaning and shared use of fomites soiled with such fluids, and the contamination of the environment
during the collection and transportation of blood-contaminated waste.
Conclusion The risk of the waste-related transmission of Ebola virus could be reduced by the use of full personal protective equipment,
appropriate hand hygiene and an appropriate disinfectant after careful cleaning. Use of the Hazard Analysis of Critical Control Points
framework could facilitate rapid responses to outbreaks of emerging infectious disease.
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