title: Initiation of a ring approach to infection prevention and control at non-Ebola health care facilities - Liberia, January-February 2015.
abstract: From mid-January to mid-February 2015, all confirmed Ebola virus disease (Ebola) cases that occurred in Liberia were epidemiologically linked to a single index patient from the St. Paul Bridge area of Montserrado County. Of the 22 confirmed patients in this cluster, eight (36%) sought and received care from at least one of 10 non-Ebola health care facilities (HCFs), including clinics and hospitals in Montserrado and Margibi counties, before admission to an Ebola treatment unit. After recognition that three patients in this emerging cluster had received care from a non-Ebola treatment unit, and in response to the risk for Ebola transmission in non-Ebola treatment unit health care settings, a focused infection prevention and control (IPC) rapid response effort for the immediate area was developed to target facilities at increased risk for exposure to a person with Ebola (Ring IPC). The Ring IPC approach, which provided rapid, intensive, and short-term IPC support to HCFs in areas of active Ebola transmission, was an addition to Liberia's proposed longer term national IPC strategy, which focused on providing a comprehensive package of IPC training and support to all HCFs in the country. This report describes possible health care worker exposures to the cluster's eight patients who sought care from an HCF and implementation of the Ring IPC approach. On May 9, 2015, the World Health Organization (WHO) declared the end of the Ebola outbreak in Liberia.
authors.forename: Tolbert
authors.initials: T
authors.lastname: Nyenswah
authors.forename: Moses
authors.initials: M
authors.lastname: Massaquoi
authors.forename: Miatta Zenabu
authors.initials: MZ
authors.lastname: Gbanya
authors.forename: Mosoka
authors.initials: M
authors.lastname: Fallah
authors.forename: Fred
authors.initials: F
authors.lastname: Amegashie
authors.forename: Adolphus
authors.initials: A
authors.lastname: Kenta
authors.forename: Kumblytee L
authors.initials: KL
authors.lastname: Johnson
authors.forename: Disu
authors.initials: D
authors.lastname: Yahya
authors.forename: Mehboob
authors.initials: M
authors.lastname: Badini
authors.forename: Lacina
authors.initials: L
authors.lastname: Soro
authors.forename: Carmem L
authors.initials: CL
authors.lastname: Pessoa-Silva
authors.forename: Isabelle
authors.initials: I
authors.lastname: Roger
authors.forename: Linda
authors.initials: L
authors.lastname: Selvey
authors.forename: Kristin
authors.initials: K
authors.lastname: VanderEnde
authors.forename: Matthew
authors.initials: M
authors.lastname: Murphy
authors.forename: Laura A
authors.initials: LA
authors.lastname: Cooley
authors.forename: Sonja J
authors.initials: SJ
authors.lastname: Olsen
authors.forename: Athalia
authors.initials: A
authors.lastname: Christie
authors.forename: John
authors.initials: J
authors.lastname: Vertefeuille
authors.forename: Thomas
authors.initials: T
authors.lastname: Navin
authors.forename: Peter
authors.initials: P
authors.lastname: McElroy
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Park
authors.forename: Eric
authors.initials: E
authors.lastname: Esswein
authors.forename: Ryan
authors.initials: R
authors.lastname: Fagan
authors.forename: Frank
authors.initials: F
authors.lastname: Mahoney
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D016000:Cluster Analysis; D005260:Female; D006268:Health Facilities; D006282:Health Personnel; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000458:organization & administration*; D007988:Liberia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D055815:Young Adult