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8. Viral diseases
• d isinfectio n (2 % active chlo rine), and safe d isp o sal o f excreta
• d isinfectio n o f co ntam inated laund ry in chlo rine so lutio n (0 .1 % active chlo rine)
• p ro tective clo thing fo r staff: d o uble glo ves, m ask , cap , p ro tective glasses, d o uble
go wn, ap ro n, rubber bo o ts
• entry / exit: clean laund ry fo r staff at entry ; d isinfectio n statio n at the exit. G o wns,
bo o ts and rubber glo ves are so ak ed in a chlo rine so lutio n (0 .1 % active chlo rine) fo r
2 h o urs befo re cleaning. C o ntainers fo r the safe d isp o sal o f d isp o sable m aterial.
H and washing with so ap .
– The caregiver ( m axim um o ne p er p atient) , help ed and sup ervised by the m ed ical
staff, fo llo ws the sam e p ro tective m easures.
– In the event o f a d eath, d o no t wash the bo d y . If it is im p erative fo r cultural reaso ns:
wear p ro tective clo thing, wash the bo d y with chlo rinated water (2 % active chlo rine),
and restrict th e num ber o f p eo p le invo lved . B ury the bo d y as quick ly as p o ssible,
using a bo d y bag when feasible.
– W ear p ro tective clo th ing when h and ling co ntam inated m aterial. N o co ntam inated
m aterial sho uld leave the iso latio n area which includ es an incinerato r, a sharp s p it
and a bio lo gical waste p it.
Confirmed cases of Yellow fever or Rift Valley fever:
– S tand ard p recautio ns
– K eep the p atient und er a m o squito net to p revent transm issio n
For all patients: rep o rt to the M inistry o f H ealth o f the co untry
Treatment
– A etio lo gical treatm ent: o nly fo r L assa fever and C rim ean-C o ngo fever (ribavirine).
– S y m p to m atic treatm ent:
• fever: p aracetam o l ( see Fever, p age 2 6 ) . A cety lsalicy lic acid ( asp irin) is co ntra-
ind icated .
• p ain: m ild (p aracetam o l), m o d erate (tram ad o l), severe (sublingual m o rp hine): see
Pain, p age 2 9 .
• d ehy d ratio n: fo llo w Treatment plans A, B or C to treat dehydration, W H O , p ages
316
to 3 2 1 .
• haem o rrhagic sho ck : see p age
19 8
• seiz ures: see p age 2 3
• vo m iting: promethazine P O
C hild ren fro m 2 to 1 0 y ears: 1 0 to 2 5 m g to be rep eated every 6 ho urs if
necessary
C hild ren o ver 1 0 y ears and ad ults: 2 5 m g to be rep eated every 6 ho urs if necessary
– F o r E bo la and M arburg haem o rrh agic fevers: invasive p ro ced ures m ust be strictly
lim ited . H ealth care staff are at risk o f co ntam inatio n when inserting and m aintaining
intraveno us lines. A n intraveno us line m ust be well secured so that the p atient, o ften
co nfused , canno t p ull it o ut.
Prevention
Mass vaccination campaign during an epidemic
– V accinatio n
• Y ello w fever:
Routine vaccination (EPI)
C hild ren fro m 6 m o nths and ad ults: a single d o se o f 0 .5 m l IM (p referred ) o r
d eep S C ,
in the d elto id m uscle. In p regnant wo m en, o nly ad m inister d uring an ep id em ic.
• R ift V alley fever (o nly d uring an ep id em ic)
– V ecto r co ntro l p ro gram m es fo r k no wn vecto rs.
– H o sp ital hy giene m easures are essential in all cases.
• d isinfectio n (2 % active chlo rine), and safe d isp o sal o f excreta
• d isinfectio n o f co ntam inated laund ry in chlo rine so lutio n (0 .1 % active chlo rine)
• p ro tective clo thing fo r staff: d o uble glo ves, m ask , cap , p ro tective glasses, d o uble
go wn, ap ro n, rubber bo o ts
• entry / exit: clean laund ry fo r staff at entry ; d isinfectio n statio n at the exit. G o wns,
bo o ts and rubber glo ves are so ak ed in a chlo rine so lutio n (0 .1 % active chlo rine) fo r
2 h o urs befo re cleaning. C o ntainers fo r the safe d isp o sal o f d isp o sable m aterial.
H and washing with so ap .
– The caregiver ( m axim um o ne p er p atient) , help ed and sup ervised by the m ed ical
staff, fo llo ws the sam e p ro tective m easures.
– In the event o f a d eath, d o no t wash the bo d y . If it is im p erative fo r cultural reaso ns:
wear p ro tective clo thing, wash the bo d y with chlo rinated water (2 % active chlo rine),
and restrict th e num ber o f p eo p le invo lved . B ury the bo d y as quick ly as p o ssible,
using a bo d y bag when feasible.
– W ear p ro tective clo th ing when h and ling co ntam inated m aterial. N o co ntam inated
m aterial sho uld leave the iso latio n area which includ es an incinerato r, a sharp s p it
and a bio lo gical waste p it.
Confirmed cases of Yellow fever or Rift Valley fever:
– S tand ard p recautio ns
– K eep the p atient und er a m o squito net to p revent transm issio n
For all patients: rep o rt to the M inistry o f H ealth o f the co untry
Treatment
– A etio lo gical treatm ent: o nly fo r L assa fever and C rim ean-C o ngo fever (ribavirine).
– S y m p to m atic treatm ent:
• fever: p aracetam o l ( see Fever, p age 2 6 ) . A cety lsalicy lic acid ( asp irin) is co ntra-
ind icated .
• p ain: m ild (p aracetam o l), m o d erate (tram ad o l), severe (sublingual m o rp hine): see
Pain, p age 2 9 .
• d ehy d ratio n: fo llo w Treatment plans A, B or C to treat dehydration, W H O , p ages
316
to 3 2 1 .
• haem o rrhagic sho ck : see p age
19 8
• seiz ures: see p age 2 3
• vo m iting: promethazine P O
C hild ren fro m 2 to 1 0 y ears: 1 0 to 2 5 m g to be rep eated every 6 ho urs if
necessary
C hild ren o ver 1 0 y ears and ad ults: 2 5 m g to be rep eated every 6 ho urs if necessary
– F o r E bo la and M arburg haem o rrh agic fevers: invasive p ro ced ures m ust be strictly
lim ited . H ealth care staff are at risk o f co ntam inatio n when inserting and m aintaining
intraveno us lines. A n intraveno us line m ust be well secured so that the p atient, o ften
co nfused , canno t p ull it o ut.
Prevention
Mass vaccination campaign during an epidemic
– V accinatio n
• Y ello w fever:
Routine vaccination (EPI)
C hild ren fro m 6 m o nths and ad ults: a single d o se o f 0 .5 m l IM (p referred ) o r
d eep S C ,
in the d elto id m uscle. In p regnant wo m en, o nly ad m inister d uring an ep id em ic.
• R ift V alley fever (o nly d uring an ep id em ic)
– V ecto r co ntro l p ro gram m es fo r k no wn vecto rs.
– H o sp ital hy giene m easures are essential in all cases.
