title: Assessment of Environmental Contamination and Environmental Decontamination Practices within an Ebola Holding Unit, Freetown, Sierra Leone.
abstract: Evidence to inform decontamination practices at Ebola holding units (EHUs) and treatment centres is lacking. We conducted an audit of decontamination procedures inside Connaught Hospital EHU in Freetown, Sierra Leone, by assessing environmental swab specimens for evidence of contamination with Ebola virus by RT-PCR. Swabs were collected following discharge of Ebola Virus Disease (EVD) patients before and after routine decontamination. Prior to decontamination, Ebola virus RNA was detected within a limited area at all bedside sites tested, but not at any sites distant to the bedside. Following decontamination, few areas contained detectable Ebola virus RNA. In areas beneath the bed there was evidence of transfer of Ebola virus material during cleaning. Retraining of cleaning staff reduced evidence of environmental contamination after decontamination. Current decontamination procedures appear to be effective in eradicating persistence of viral RNA. This study supports the use of viral swabs to assess Ebola viral contamination within the clinical setting. We recommend that regular refresher training of cleaning staff and audit of environmental contamination become standard practice at all Ebola care facilities during EVD outbreaks.
authors.affiliation: King's Sierra Leone Partnership, King's Centre for Global Health, King's College London, and King's Health Partners, London, United Kingdom.
authors.forename: Daniel
authors.initials: D
authors.lastname: Youkee
authors.affiliation: King's Sierra Leone Partnership, King's Centre for Global Health, King's College London, and King's Health Partners, London, United Kingdom.|The Hospital for Tropical Diseases, University College London Hospitals, London, United Kingdom.
authors.forename: Colin S
authors.initials: CS
authors.lastname: Brown
authors.affiliation: King's Sierra Leone Partnership, King's Centre for Global Health, King's College London, and King's Health Partners, London, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Lilburn
authors.affiliation: Public Health England, Salisbury, United Kingdom.
authors.forename: Nandini
authors.initials: N
authors.lastname: Shetty
authors.affiliation: Public Health England, Salisbury, United Kingdom.
authors.forename: Tim
authors.initials: T
authors.lastname: Brooks
authors.affiliation: Public Health England, Salisbury, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Simpson
authors.affiliation: Public Health England, Salisbury, United Kingdom.
authors.forename: Neil
authors.initials: N
authors.lastname: Bentley
authors.affiliation: King's Sierra Leone Partnership, King's Centre for Global Health, King's College London, and King's Health Partners, London, United Kingdom.
authors.forename: Marta
authors.initials: M
authors.lastname: Lado
authors.affiliation: Connaught Hospital, Freetown, Sierra Leone.
authors.forename: Thaim B
authors.initials: TB
authors.lastname: Kamara
authors.affiliation: King's Sierra Leone Partnership, King's Centre for Global Health, King's College London, and King's Health Partners, London, United Kingdom.|Department of Infectious Diseases and Immunity, Imperial College London, London, United Kingdom.|Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Naomi F
authors.initials: NF
authors.lastname: Walker
authors.affiliation: King's Sierra Leone Partnership, King's Centre for Global Health, King's College London, and King's Health Partners, London, United Kingdom.
authors.forename: Oliver
authors.initials: O
authors.lastname: Johnson
mesh_terms: D003666:Decontamination / Q000379:methods*; D004196:Disease Outbreaks; D029043:Ebolavirus; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology*; D006761:Hospitals; D006801:Humans; D012367:RNA, Viral; D012807:Sierra Leone / Q000453:epidemiology
chemical_list: D012367:RNA, Viral