Recommendations for dealing with waste contaminated with Ebola virus: a Hazard Analysis of Critical Control Points approach

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  • Samira Abd Elrahman
  • Tsimbiri P Fedha
  • Guy Howard
  • Peter Maes
  • Joseph Matofari
  • Harvey Minnigh
  • Ahmed A. Mohamedani
  • Maggie Montgomery
  • Sarah Morter
  • Edward Muchiri
  • Lutendo S Mudau
  • Benedict M Mutua
  • Julius M Ndambuki
  • Katherine Pond
  • Mark D Sobsey

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Objective To assess, within communities experiencing Ebola virus outbreaks, the risks associated with the disposal of human waste and to generate recommendations for mitigating such risks.

Methods A team with expertise in the Hazard Analysis of Critical Control Points framework identified waste products from the care of individuals with Ebola virus disease and constructed, tested and confirmed flow diagrams showing the creation of such products. After listing potential hazards associated with each step in each flow diagram, the team conducted a hazard analysis, determined critical control points and made recommendations to mitigate the transmission risks at each control point.

Findings The collection, transportation, cleaning and shared use of blood-soiled fomites and the shared use of latrines contaminated with blood or bloodied faeces appeared to be associated with particularly high levels of risk of Ebola virus
transmission. More moderate levels of risk were associated with the collection and transportation of material contaminated with bodily fluids other than blood, shared use of latrines soiled with such fluids, the cleaning and shared use of fomites soiled with
such fluids, and the contamination of the environment during the collection and transportation of blood-contaminated waste.

Conclusion The risk of the waste-related transmission of Ebola virus could be reduced by the use of full personal protective equipment, appropriate hand hygiene and an appropriate disinfectant after careful cleaning. Use of the Hazard Analysis of Critical Control Points framework could facilitate rapid responses to outbreaks of emerging infectious disease.


Original languageEnglish
Pages (from-to)424-432
Number of pages9
JournalBulletin WHO
Issue number6
Early online date3 Mar 2016
Publication statusPublished - Jun 2016


    Research areas

  • Ebola, rapid response, filovirus, excreta, EBOV, HACCP

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© 2016. The Authors; licensee the World Health Organization. This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (http://creativecommons.org/licenses/by/3.0/igo/legalcode), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization, products or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.

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