Clinical update: Ebola claims 700 lives

Tying surgical apron

The Ebola virus has been hitting the headlines this week as  the World Health Organisation announced funding for a large scale operation to help treat the outbreak in West Africa; Ebola has caused more than 700 deaths since February in an outbreak affecting four west African countries. Public Health England (PHE) is monitoring the outbreak but the risk to the UK currently remains very low - no cases of imported Ebola have ever been reported in the UK. 

Ebola is a form of viral haemorrhagic fever and more than 1,000 cases have been reported in Guinea, Liberia and Sierra Leone. This is the first documented Ebola outbreak in west Africa, and it is the largest ever known outbreak of this disease. It kills up to 90% of those infected but patients have a better chance of survival if they receive early treatment.

The virus is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. Once a person comes into contact with an animal that has Ebola and is infected by the virus, it can spread from human to human. Infection occurs from direct contact (through broken skin or mucous membranes) with the blood, or other bodily fluids or secretions (stool, urine, saliva etc.) of infected people.

Infection can also occur if broken skin or mucous membranes of a healthy person come into contact with environments that have become contaminated with an Ebola patient’s infectious fluids such as soiled clothing, bed linen, or used needles. Anyone who has close contact with a person infected with the virus, or someone who handles samples from patients is at risk.

Precautions for protection include wearing protective gowns, gloves, and masks, in addition to wearing eye protection (eg. eye glasses) or a face shield. Infection generally does not occur through routine, social contact (such as shaking hands) with asymptomatic individuals.

Although the likelihood of imported cases is low, health care providers in the UK are reminded to remain vigilant for travellers who have visited areas affected by viral haemorrhagic fever and who develop unexplained illness:

  • Individuals who have sudden onset of symptoms such as fever, headache, sore throat and general malaise within 21 days of visiting affected areas should receive rapid medical attention, and be asked about potential risk factors and their recent travel.
  • Viral haemorrhagic fever should be suspected in individuals with a fever [>38oC] or history of fever in the previous 24-hours who have visited an affected area within 21 days (or who have cared for or come into contact with body fluids or clinical specimens from a live or dead individual or animal known or strongly suspected to have viral haemorrhagic fever).
  • In situations in which viral haemorrhagic fever is suspected, alternative diagnoses (such as malaria) should not be overlooked.

Actions in the event of a possible case

If a VHF/Ebola is considered likely, the patient should be isolated (in a side room if possible) with appropriate infection control measures.

The management of suspected cases of EVD and other forms of viral haemorrhagic fever is laid out in the Department of Health and Health & Safety Executive document and algorithm which are available here: 

In the first instance, clinical advice should be sought from a local consultant microbiologist, virologist or infectious disease physician. Further specialist advice on testing and management is then available from the Imported Fever Service (0844 7788990)

Remember, the risk assessment from Public Health England remains very low. The Trust’s Resilience and Clinical department are fully engaged with wider health, making sure we have all the intelligence and up to date information regarding the outbreak. Any further updates will be shared with you on Need to Know, but if you have any queries in the interim please speak to your local resilience manager.

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