The development of a protocol for post-mortem management of Ebola virus disease in the setting of developed countries
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TECHNICAL REPORT
The development of a protocol for post-mortem management of Ebola virus disease in the setting of developed countries Jodie Leditschke • Toby Rose • Stephen Cordner Noel Woodford • Michael Pollanen
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Accepted: 26 December 2014 Ó Springer Science+Business Media New York 2015
Abstract The management of the recent Ebola virus disease (EVD) epidemic continues to pose currently insuperable challenges to health care providers in the resourcedeprived countries of West Africa. In an age where air travel facilitates rapid movement of people between countries and continents, there is an urgent requirement for health systems around the globe to develop management strategies and protocols in the event that EVD cases are suspected or confirmed. Departments of forensic pathology play an important, and underestimated, role in public health service delivery, particularly at times of novel infectious disease emergence. This role can include disease identification, characterization, and notification, as well as close engagement with agencies responsible for disease surveillance and treatment provision. A mass outbreak of EVD in the Western world is considered highly unlikely; however, there is clear responsibility on departments of forensic pathology to develop protocols for rapid assessment of sporadic or suspected cases while ensuring the health and safety of mortuary and pathology personnel. The Ontario Forensic Pathology Service and the Victorian Institute of Forensic Medicine have collaborated on the development of a protocol for management of EVD cases presenting at a scene or in the J. Leditschke S. Cordner N. Woodford Victorian Institute of Forensic Medicine, Melbourne, Australia J. Leditschke S. Cordner N. Woodford Monash University, Clayton, Australia T. Rose M. Pollanen Ontario Forensic Pathology Service, Toronto, Canada N. Woodford (&) Victorian Institute of Forensic Medicine, 65 Kavanagh St, Southbank, VIC 3006, Australia e-mail: [email protected]
mortuary. It is hoped that this trans-national, inter-departmental exercise will serve as a model for future co-operative endeavors. The protocol has been distributed to forensic pathology departments around Australia and may be modified to accommodate local resource capabilities. Keywords
Ebola virus Post-mortem Management
Introduction About Ebola virus disease Ebola virus disease (Ebola; formerly known as Ebola Hemorrhagic Fever) is a severe, often fatal illness with a death rate of up to 90 %. The illness affects humans and non-human primates: monkeys, gorillas, and chimpanzees [1]. Ebola viruses are part of the family of Filoviridae which also includes Marburg virus. Five species of Ebola virus have been identified: Zaire, Sudan, Reston, Tai Forest, and Bundibugyo [2]. The origin of the virus is unknown but fruit bats (Pteropodidae) are considered the likely host of the Ebola virus, based on available evidence [1]. Transmission of Ebola virus disease Ebola virus disease is introduced into the human population through close contact
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