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Are there any additional considerations in the treatment and handling requirements of faeces and urine within communities affected by Ebola?

1 Answer

Margaret Montgomery

Best WASH practices , particularly handwashing with soap, should be strictly applied and maintained as these form an important additional barrier to Ebola virus transmission, and to the transmission of infectious diseases in general (WHO, 2002). All human excreta must be contained in a way that separates it from human contact – at a minimum covered with soil - pending construction of latrines, as detailed elsewhere.

When there are suspected cases of Ebola, immediate action must be taken within the home setting to protect carers and other family members from the risk of contact with body fluids (including urine and faeces). Family members should avoid all direct exposure to body fluids through use of gloves and other PPE and should contain and dispose of such fluids in closed buckets. The same advice applies to the use of latrines: separate latrines should be used by suspected and confirmed Ebola cases. Where there are insufficient latrines to allow for separate use or where suspected and/or confirmed cases are not physically able to use a separate latrine, their body fluids should be contained in a covered bucket and disposed of in a separate latrine, avoiding splashing. Any handling of the excreta should be kept to an absolute minimum and should only be undertaken by individuals wearing, at a minimum, heavy duty gloves, and ideally using full PPE, as detailed above. All disposable protective equipment and/or health-care waste should be put in designated bags and collected by the appropriate service providers or buried. After handling any excreta, handwashing with soap procedures should be followed.

Source: WHO & UNICEF (Reviewed by MSF, CDC, and Tufts 2014) Ebola Virus Disease (EVD) Key questions and answers concerning water, sanitation and hygiene


Actually, the cited WHO 2012 reference recommends "; encouraging hand washing with soap or ashes;" section 11.3 using cholera "as an example". This is a usual advice for WHO and UNICEF, but it seems only to have been used against ebola in Nigeria and DRC (where control was realistic and effective despite a slow start in Nigeria on standard solutions). I have earlier linked at these pages to my brief review also covering ash used as disinfectant / sanitizer (alkaline). It may not be perfect, but available when and where it is needed most, and affordable for toilet floors where some have an undiagnosed fever and no alternatives. Concentration of organics and disinfectants are important as well as time of contact and high impact can be tough on skin and other delicate surfaces.

TorstenMandal gravatar imageTorstenMandal ( 2014-11-18 20:31:50 )