Federal and state organizations have released new Ebola guidance for healthcare workers in long-term care and other settings, following the second case of a nurse acquiring the virus in the United States.

Both infected nurses came into contact with Thomas Eric Duncan, the Liberian man who traveled to the United States, fell ill with Ebola and died Oct. 8 at a Dallas hospital. The second nurse to be diagnosed with Ebola, Amber Vinson, traveled on a plane to Ohio while experiencing early symptoms, raising concerns that the virus might have spread outside the Dallas area.

The Ohio Health Care Association has posted online guidance for long-term care workers, noting that it is “prudent” for all facilities in the state to be on the lookout for Ebola symptoms and know what precautions to take. Fever and other flu-like symptoms, unexplained hemorrhage and severe headache are among the signs to watch for.

An individual with suspected Ebola likely would be transferred quickly to a hospital, but LTC workers should know what precautions to take while in contact with the patient, OHCA emphasized. Protective clothing is necessary, although full body suits have not officially been recommended by federal authorities, OHCA noted. Visits to the patient’s room should be restricted and logged, single-use equipment should be used as much as possible and needles should be avoided.

In Ohio, a 24-hour hotline has been set up to answer Ebola-related questions. Facilities also should be aware that any case of Ebola must be immediately reported to local, state and federal public health authorities, OHCA stressed.

The Occupational Safety and Health Administration launched a dedicated Ebola webpage Wednesday, with guidance for workers in healthcare and other environments. But critics said this information should have been disseminated sooner, and that the agency has been flat-footed in implementing infection control regulations first floated during the H1N1 flu outbreak in 2010.

Nurse organizations have been among the groups protesting that safety protocols have not been rapidly established and shared. The nurses in Dallas did not know “what the protocols were or were able to verify what kind of personal protective equipment should be worn and there was no training,” according to a statement issued by National Nurses United, the country’s largest registered nurses union. The Service Employees International Union and the American Nurses Association have issued similar statements.