South Korea has set out response rules under which anyone confirmed to have Ebola virus disease will be transferred immediately to the National Medical Center for treatment. Procedures needed in the field, including blood tests for suspected cases, handling of the dead and care for pregnant women and newborns, have also been spelled out.
The Korea Disease Control and Prevention Agency said on the 2nd that it is revising and distributing its response guidelines for Class 1 infectious disease viral hemorrhagic fevers to include these measures. Response procedures for local governments and medical institutions were reworked in preparation for possible entry of the disease and domestic cases, after Ebola virus disease began spreading in the Democratic Republic of the Congo and Uganda in May.
The revised guidelines clarify the roles that quarantine stations and community health centers must each take when an arriving traveler shows symptoms. If a traveler is classified as a suspected case following an epidemiological investigation, the health center with jurisdiction transfers the person to a state-designated inpatient treatment bed and requests testing. If confirmatory testing by the agency returns a positive result, the patient is moved to the National Medical Center for treatment.
New biosafety standards were also created for the hematology and biochemistry tests required for suspected cases. As a rule, testing is to be carried out in a separate dedicated laboratory inside a negative-pressure isolation ward, but where no dedicated laboratory exists, testing may be performed in a Biosafety Level 3 (BL3) facility. Testing is also possible at BL2 facilities equipped with a biosafety cabinet, a sealed centrifuge and a sterilizer, provided that staff wear enhanced personal protective equipment including respirators rated KF94 or N95 or higher, face shields and double gloves.
Standards were added to reduce accidents such as needlestick injuries to medical staff during specimen collection. Blood draws are to be minimized while personal protective equipment is worn, and blood draws are not recommended when a patient's cooperation is difficult to obtain.
Procedures for handling the body when a confirmed patient dies were also set out in greater detail. The body is to be placed in a body bag and sealed at the place of death, and transport is to be kept to a minimum. Step-by-step safety measures after death were reinforced, including a requirement that mortuary staff wear personal protective equipment.
Separate care standards for pregnant women and newborns were newly established. Recommendations for Ebola care that take account of pregnancy and delivery were added, and newborns delivered by mothers who are suspected or confirmed cases are to be subject to separate management and clinical safety measures.
The agency has issued a "attention" level infectious disease crisis alert domestically and is operating an Ebola response task force, after the World Health Organization declared a Public Health Emergency of International Concern (PHEIC) over the Ebola virus disease outbreak on May 17. There have been no cases to date of viral hemorrhagic fever, including Ebola virus disease, entering the country.
"We have made response procedures at each stage considerably more concrete, from reporting of suspected cases through epidemiological investigation, diagnostic testing, treatment and follow-up care," KDCA Commissioner Lim Seung-kwan said. "We will prepare so that local governments and medical institutions can respond quickly and safely in any situation."
