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To the Editor The Ebola epidemic has shown that it is vital to know better when and how we can prevent contamination of health care staff with possibly contagious body fluids. Thomas et al1 are to be applauded for their contribution to the evidence base with a simulation study. They conclude that training is effective based on an uncontrolled before-after study. Nevertheless, even after training, 12% of the health care personnel in the study could not remove personal protective equipment (PPE) without contaminating themselves. These results indicate that the amount of contamination could be as high as 2 L plaque-forming unit. This would suffice to infect someone with Ebola.2
Mihalache RC, Verbeek J. Better Training to Control Potential Outbreaks. JAMA Intern Med. 2016;176(4):567-568. doi:10.1001/jamainternmed.2016.0354