title: Ebola Virus Infection among Western Healthcare Workers Unable to Recall the Transmission Route.
abstract: Introduction.During the 2014-2016 West-African Ebola virus disease (EVD) outbreak, some HCWs from Western countries became infected despite proper equipment and training on EVD infection prevention and control (IPC) standards. Despite their high awareness toward EVD, some of them could not recall the transmission routes. We explored these incidents by recalling the stories of infected Western HCWs who had no known directly exposures to blood/bodily fluids from EVD patients.Methodology.We carried out conventional and unconventional literature searches through the web using the keyword "Ebola" looking for interviews and reports released by the infected HCWs and/or the healthcare organizations.Results.We identified fourteen HCWs, some infected outside West Africa and some even classified at low EVD risk. None of them recalled accidents, unintentional exposures, or any IPC violation. Infection transmission was thus inexplicable through the acknowledged transmission routes.Conclusions.We formulated two hypotheses: inapparent exposures to blood/bodily fluids or transmission due to asymptomatic/mildly symptomatic carriers. This study is in no way intended to be critical with the healthcare organizations which, thanks to their interventions, put an end to a large EVD outbreak that threatened the regional and world populations.
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
authors.forename: Stefano
authors.identifier: 0000-0001-9996-8860
authors.initials: S
authors.lastname: Petti
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
authors.forename: Carmela
authors.identifier: 0000-0001-7668-5809
authors.initials: C
authors.lastname: Protano
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
authors.forename: Giuseppe Alessio
authors.initials: GA
authors.lastname: Messano
authors.affiliation: University College London, London, UK.
authors.forename: Crispian
authors.initials: C
authors.lastname: Scully
mesh_terms: D000354:Africa, Western / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D006282:Health Personnel; D019142:Hemorrhagic Fever, Ebola / Q000401:mortality / Q000635:transmission* / Q000821:virology; D006801:Humans; D008297:Male