Download Public Health Link - Update on Ebola outbreak in West Africa

Public Health Link
From the Chief Medical Officer for Wales
Distribution:
As Appendix 1
From:
Dr Ruth Hussey, Chief Medical Officer, Welsh
Government
Date:
1 August 2014
Reference:
Category:
CEM/CMO/2014/4b
Urgent (cascade within 24 hours)
Title:
What is this about:
Update on Ebola Outbreak in West Africa
General advice and guidance for NHS Wales;
including advice for staff who may be
engaging in humanitarian aid and healthcare
delivery in the affected areas
For information and distribution to colleagues at
Appendix 1.
Why has it been sent:
Dear Colleague
I am writing to provide an update following on from my last Public Health Link dated 10 July
and the Public Health Wales clinical brief circulated on the 4 July 2014. New cases and
deaths attributable to Ebola continue to be reported by the Ministries of Health in the four
West African countries of Guinea, Liberia, Nigeria and Sierra Leone.
Increasing case numbers and extended geographical spread may increase the risk for UK
citizens engaged in humanitarian aid and healthcare delivery in the affected areas. I attach
at the bottom of this letter links to specific guidance available to humanitarian aid
workers.
The risk for tourists, visitors or expatriate residents in affected areas, is still considered very
low if elementary precautions are followed (by way of example, the World Health
Organization does not recommend that any travel or trade restrictions be applied to countries
involved in the outbreak). People are not at risk of becoming infected unless they have direct
contact with blood/body fluids/tissues of dead or living infected persons or animals (nonhuman primates, other mammals and bats). Airborne transmission has never been
documented. The main mode of transmission as the outbreak continues is person-to-person
spread via direct contact with infected / deceased patients. The incubation period of Ebola
virus ranges from 2 to 21 days and people are not contagious during the incubation period.
Therefore it remains unlikely, but not impossible, that travellers infected in Guinea, Liberia or
Sierra Leone could arrive in the UK while incubating the disease and develop symptoms after
their return. Clinicians seeing patients returning from these countries should question them
about symptoms of fever, headache, sore throat and malaise, and confirm the travel history
and any possible exposures to Ebola virus cases. Any suspected cases should be discussed
with the local infectious diseases or microbiology consultant, and reported to the Health
Protection Team as soon as possible. As referred to in my previous Public Health Link,
the management of suspected cases is laid out in the recently updated risk
assessment algorithm and the Department of Health and Health & Safety Executive
document, both available here:
http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/ViralHaemorrhagicFever/Guideline
s/
Attached below are links to the latest WHO and ECDC risk assessments and to the guidance
available for humanitarian aid workers. Please check the WHO and ECDC websites for
regular updates
WHO risk assessment (24 June 2014):
http://www.who.int/csr/disease/ebola/EVD_WestAfrica_WHO_RiskAssessment_20140624.pdf
ECDC risk assessment (9 June 2014) which also includes information for healthcare
workers: http://www.ecdc.europa.eu/en/publications/Publications/ebola-risk-assessment-virusGuinea-Liberia-Sierra-Leone.pdf
WHO Travel and transport risk assessment: Recommendations for public health
authorities and transport sector: http://www.who.int/ith/updates/20140421/en/
PHE has produced information for humanitarian workers:
https://www.gov.uk/government/publications/ebola-virus-disease-information-for-humanitarianaid-workers
NaTHNaC updates include some additional advice for those going to be working in
healthcare (stricter precautions):
http://www.nathnac.org/pro/clinical_updates/ebola_030614.htm
WHO Interim Infection Control Recommendations for Care of Patients with Suspected
or Confirmed Filovirus (Ebola, Marburg) Haemorrhagic Fever Filoviruses:
http://www.who.int/csr/bioriskreduction/interim_recommendations_filovirus.pdf
Please circulate this letter to relevant clinical services and teams. Further information and
advice will be provided as and when it becomes available.
Yours sincerely
Dr Ruth Hussey
Chief Medical Officer for Wales
Appendix 1
Distribution is a follows:
To:
Local Health Boards and NHS Trusts:
Chief Executives
Directors of Public Health
Medical Directors
Nurse Directors
For onward distribution to:
Healthcare staff in Emergency / A&E Departments
Acute Medical Units
Infectious Diseases Departments
Medical Microbiologists
Medical Virologists
Infection Control Staff
Consultants in Health Protection
To:
Public Health Wales:
Chief Executive
Director of Public Health Services
Consultants in Pharmaceutical Public Health
Public Health Teams
To:
NHS Direct Wales