With the ongoing outbreak of Ebola in West Africa, the British Medical Journal this week carries an editorial by experts at LSTM to advise medical professionals of the procedures and advice available to counteract the small risk of a traveller with Ebola or another viral haemorrhagic fever arriving in the UK.
Senior Clinical Lecturer Dr Nick Beeching and Wellcome Trust training fellow, Dr Tom Fletcher worked on the editorial with Dr Timothy Brooks from Public Health England at Porton Down. They advise medical professionals in the UK of the guidance that is available to them and the importance of rapid diagnosis in patients presenting with fever or a history of fever who have returned from an endemic region in the last 21 days. They point out the greater likelihood that those returning from such areas may have other infections such as malaria, which also require rapid diagnosis and management.
Dr Beeching, who also works with the NIHR funded Health Protection Research Unit on Emerging Infections and Zoonotic Infections and with the UK’s Imported Fever Service, is keen to reassure that the risk remains small and that the UK has all it needs to manage and contain any cases. He said: “Imported cases of haemorrhagic fever in the UK are rare and patients will often be health workers, military personnel or those working in rural environments. Unlike other infections like influenza these diseases are transmitted by direct contact with blood or other body secretions and are not airborne.”
National guidance on how to deal with imported cases of haemorrhagic fever has been available since the 1970s and has been updated on several occasions including within the last month. Dr Beeching emphasizes the need for health care workers to take a simple travel history from all patients with fever. For the guidance to be most effective it needs to be supported by the training of medical, nursing and laboratory staff in risk assessment, universal precautions, and the use of personal protective equipment. He concludes: “It is time that all frontline hospital doctors and managers make sure that they can answer yes to the following questions: have you considered that someone with viral haemorrhagic fever could present at your facility? Do you have a local protocol? If so can your staff find it? And, lastly, have you adequately trained your staff in the use of personal protective equipment? If the answer to any of these is no – now is the time to act.”
You can read the full editorial by following this link.