Emergency Postexposure Vaccination With Vesicular Stomatitis Virus–Vectored Ebola Vaccine After Needlestick

Abstract

A 44-year-old physician from the United States caring for patients in an Ebola treatment unit in Sierra Leone experienced an unintentional needlestick with an 18-gauge hollow-bore needle that had vented a plastic intravenous bottle. The needle was being placed into a sharps container and inadvertently punctured 2 layers of gloves and caused bleeding of the left thumb. The outer gloves were not visibly soiled but had just been in direct contact with severely ill Ebola patients, including 1 patient with a real-time reverse transcription–polymerase chain reaction (RT-PCR) threshold cycle value of 22, indicating a very high Ebola virus RNA level. Because standard procedures to doff personal protective equipment had to be followed, there was a delay of 10 minutes before decontamination of the wound, which was washed with 0.05% bleach initially, followed by soap and water and 2% chlorhexidine.