Can the CUBE isolation unit be of use in the US?

Issue: November 2018

ByDonald Kaye, MD, MACP

ByKeith S. Kaye, MD, MPH

The CUBE as described in the accompanying article may have applications in highly industrialized countries such as the United States. Of course, first we would need a careful evaluation of just how effective in providing contact isolation and how easily used it has been in the field in countries with EVD. However, the concept of an easily moved isolation unit that could be stored in a central location and then moved even long distances and then installed in a large room in a hospital or even outdoors might be of interest.

**Bernard-Alex Gaüzère, MD,** a medical advisor for The Alliance for International Medical Action (ALIMA) during an outbreak of Lassa fever in Nigeria in March 2018, carries out a demonstration of treating a “patient” in ALIMA’s CUBE. The CUBE is a biosecure emergency care unit for outbreaks of highly infectious diseases, which allows health care workers to monitor the patient, check their vital signs and administer certain treatments and care from the exterior, without having to wear full personal protective equipment suits.

One does not need a long memory to remember the two nurses who contracted EVD in Texas while caring for a patient with EVD from Liberia in 2014 and the drills carried on in hospitals for preparation for care of patients with EVD. The CDC announced that every hospital should ensure that it can detect a patient with EVD, protect health care workers so they can safely care for the patient and respond in a coordinated fashion. We are fairly certain that at present very few hospitals have continued, with any real frequency, the extensive drills to ensure the safety of their workers should a patient with EVD actually land in their ED. The CUBE might be of help in decreasing risk even in those EDs that have continued frequent drills.

For more information:
Donald Kaye, MD, MACP, is a professor of medicine at Drexel University College of Medicine, associate editor of the International Society for Infectious Diseases’ ProMED-mail, section editor of news for Clinical Infectious Diseases and an Infectious Disease News Editorial Board member.
Keith S. Kaye, MD, MPH, is a professor of internal medicine at the University of Michigan Medical School, an Infectious Disease News Editorial Board member, and president of the Society of Healthcare Epidemiology of America.

Disclosures: The Kayes report no relevant financial disclosures.