This All Facilities Letter (AFL) is intended to notify all hospitals that the California Department of Public Health (CDPH) has developed interim guidelines for Ebola Virus Disease medical waste management. The interim guidelines provide both general guidance for Ebola medical waste management based on federal guidelines and standards, as well as more specific guidance regarding packaging, labelling, and treatment. The attached interim guidelines can be found at the CDPH Medical Waste Management Program Website:

(https://www.cdph.ca.gov/Programs/CEH/DRSEM/Pages/EMB/MedicalWaste/MedicalWaste.aspx)

On-site treatment of Ebola medical waste (by steam sterilization) may be performed in compliance with the interim guidelines. If on-site treatment is not available, a hospital may package the waste to be transported to an incinerator at an out-of-state facility. California allows for the incineration of Ebola hospital waste; however, California's last medical waste incinerator closed in 2001. The states that currently have operating incinerators are Alabama, Maryland, North Dakota, Oklahoma, Utah and Texas.

CDPH recommends that all hospital Environmental Services personnel and Infection Control staff work together to develop facility-specific protocols for safe handling of Ebola-related medical waste.

Additional information can be found on the Centers for Disease Control and Prevention (CDC) Ebola Medical Waste Management Website:

(http://www.cdc.gov/vhf/ebola/hcp/medical-waste-management.html)  

If you have any further questions, please contact the CDPH Medical Waste Management Program at (916) 449-5671.

Sincerely,

Original signed by Jean Iacino

Jean Iacino
Interim Deputy Director
Center for Health Care Quality

Attachment: Ebola Medical Waste Management- Interim Guidelines