We feel the recommendations for masks do not apply
risk analysis methods appropriately, and are solely based
on the low probability of non-contact modes of EV spread.
Previous guidance provided by the WHO and CDC for
‘‘Infection Control for Viral Haemorrhagic Fevers in the
African Health Care Setting’’ in 1999 were more
conservative, with both organizations recommending
the preferred use of respirators first line and surgical
masks and cloth masks as a last option (Centers for Disease
Control, 1998). Why then, during the worst outbreak of
EVD in history, with the most virulent EV strain and with
hundreds of HCWs succumbing to the disease is it
considered adequate for them to wear surgical masks?
The high case-fatality rate warrants the use of better
protection such as a respirator and full body suit with face
shield, where it can be provided.