Download Optometrists The College and Association of Optometrists issue

The College and Association of Optometrists issue advice for optometrists
on Ebola virus disease – November 2014
Ebola virus is one cause of viral haemorrhagic fever (VHF). Although the likelihood of imported cases is low,
health care providers, including optometrists, should remain vigilant for those who have visited areas affected by
Ebola and who develop unexplained illness. We recognise that it is extremely unlikely that you will encounter a
patient with suspected VHF, but have been asked to provide advice for optometrists just in case this happens.
Key points
People with Ebola only become contagious after they begin to have symptoms, such as fever.
A patient who contacts the practice who has a fever or a history of fever within the past 24 hours should be asked
if they have recently visited the affected areas (Guinea, Liberia and Sierra Leone), or been caring for someone or
come into contact with body fluids or clinical specimens from a person who is alive or dead or an animal known or
strongly suspected to have VHF.
If a patient falls into this category and contacts the practice advise them:
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not to visit the practice or their GP surgery or walk-in centre
to contact their GP by telephone for advice.
If a patient falls into this category and attends the practice, you should:
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isolate the patient, by putting them into a side room (ideally removable items should be removed from this
room to reduce the need for cleaning should Ebola be confirmed later)
ring NHS Direct Wales or 999 and mention that you have a patient with suspected Ebola
ring the local health protection team.1
Background
Public Health Wales advises2 that Ebola can only be transmitted from one person to another through direct
contact (through broken skin or mucous membrane) with blood or bodily fluids of an infected person, or indirect
contact with environments contaminated with splashes or droplets or blood or body fluids.3 The incubation period
of Ebola virus ranges from 2 to 21 days (typically 5-7 days).4
The most infectious body fluids are blood, faeces and vomit. Saliva and tears may also carry some risk. However,
the studies implicating these additional bodily fluids were extremely limited in sample size and the science is
inconclusive. In studies of saliva, the virus was found most frequently in patients at a severe stage of illness. The
whole live virus has never been isolated from sweat. 5 The Ebola virus can also be transmitted through contact
with surfaces and objects that have been previously contaminated by infected blood or body fluids. The risk of
transmission via this route is low, and can be reduced even further by appropriate cleaning and disinfection
procedures.5
Good infection control procedures, such as regular and careful hand hygiene (with soap and water, or alcohol
hand rub if soap isn’t available) are important in minimising the spread of disease.
The College of Optometrists issues guidance on infection control. Please see chapter A3 of the College’s Code of
Ethics and Guidelines for Professional Conduct: www.college-optometrists.org/InfectionControl
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.1.
Telephone number
Mid & West Wales
01792 607387
Swansea
Local Authority/Local Health Board area
Bridgend, Neath Port Talbot, Swansea
Carmarthenshire, Ceredigion, Pembrokeshire, Powys
Cardiff
02920 402478
Cardiff, Merthyr Tydfil, Rhondda Cynon Taf, Vale of
Glamorgan
Gwent
01495 332219
Blaenau Gwent, Caerphilly, Monmouthshire, Newport,
Torfaen
North Wales
01352 803234
Anglesey, Conwy, Denbighshire, Flintshire, Gwynedd,
Wrexham
2
Public Health Wales: Information for Primary Care: Managing patients who require assessment for Ebola virus
disease pdf.
http://www.wales.nhs.uk/sitesplus/documents/888/PHW_Ebola_guidance_for_primary_care_v3_N
ovember21%20%282%29.pdf
3
Advisory Committee on Dangerous Pathogens: Management of Hazard Group 4 viral haemorrhagic fevers and
similar human infectious diseases of high consequence.
4
NHS Choices: Ebola virus disease.
5
World Health Organization: What we know about transmission of the Ebola virus among humans