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CDC offers Ebola virus guidance

September 08, 2014

By Craig Palmer

Atlanta – In response to an ADA member inquiry, the Centers for Disease Control and Prevention offered guidance on treating patients recently returned from Africa. The CDC is working closely with the World Health Organization and other partners to understand and manage public health risks posed by Ebola virus disease, which is epidemic in West Africa.

The CDC offered the following Q&A reply to an ADA inquiry.

"Can I provide dental services to someone who has recently been in West Africa?

"CDC works with partners at ports of entry into the United States to help prevent infectious diseases, like Ebola, from being introduced and spread in the United States.

"A person infected with Ebola is not contagious until symptoms appear. Signs and symptoms of Ebola include fever (greater than 38.6°C or 101.5°F) and severe headache, muscle pain, vomiting, diarrhea, stomach pain or unexplained bleeding or bruising.

"The virus is spread through direct contact [CDC emphasis] (through broken skin or mucous membranes) with blood and body fluids (urine, feces, saliva, vomit and semen) of a person who is sick with Ebola, or with objects (like needles) that have been contaminated with the virus. Ebola is not spread through the air or by water or, in general, by food.

"Dental providers should continue to follow standard infection control procedures."

The CDC offers additional information on Ebola virus disease for clinicians in U.S. health care settings at cdc.gov.

The ADA Principles of Ethics and Code of Professional Conduct, Advisory Opinion 4.A.1. PATIENTS WITH BLOODBORNE PATHOGENS, offers guidance on the ethical response. "A dentist has the general obligation to provide care to those in need. A decision not to provide treatment to an individual because the individual is infected with Human Immunodeficiency Virus, Hepatitis B. Virus, Hepatitis C Virus or another bloodborne pathogen, based solely on that fact, is unethical. Decisions with regard to the type of dental treatment provided or referrals made or suggested should be made on the same basis as they are made with other patients. As is the case with all patients, the individual dentist should determine if he or she has the need of another's skills, knowledge, equipment or experience. The dentist should also determine, after consultation with the patient's physician, if appropriate, if the patient's health status would be significantly compromised by the provision of dental treatment."

ADA policy supports the implementation of standard precautions and infection control recommendations appropriate to the clinical setting as described in 2003 Guidelines for Infection Control in Dental Health Care Settings from the CDC.