Ebola virus disease
WHO has declared that the Ebola Virus Disease (EVD) outbreak in West Africa fits the criteria under International Health Regulations (IHR) of a Public Health Emergency of International Concern (PHEIC). This declaration will trigger a WHO internationally coordinated response to countries with cases in order to assist them to take measures to contain and control the outbreak.
Cases have been identified in four countries in West Africa - Guinea, Sierra Leone, Liberia and Nigeria. To date there have been no reported cases in the UK.
Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a rare but severe disease caused by the Ebola virus.
The present outbreak of EVD in West Africa has highlighted the need for travellers to infected countries to ensure that they have taken all the necessary travel health precautions.
The Ebola virus is transmitted to people through direct contact with blood or body fluids of symptomatic people or animals, or infected objects. Ebola virus does not transmit through the air as influenza does.
The incubation period for EVD, i.e. the time interval from infection with the virus to onset of symptoms, varies from two to 21 days.
Symptoms include fever, weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, and in some cases, bleeding. There is no licensed vaccine.
Implications for Northern Ireland
There is no change to the current risk assessment, in that the risk to the public in Northern Ireland is very low. The likelihood of an individual contracting EVD is extremely low unless they have been exposed directly to blood or body fluids of symptomatic people or animals, or infected objects.
There is a potential risk for volunteers and healthcare staff working in affected countries, especially if involved in caring for EVD patients. However, if the basic precautions that would apply in all humanitarian situations are applied and the general principles of infection control are adhered to, the risk can be minimised.
The PHA is working with partner HSC organisations to ensure we have appropriate systems in place in the unlikely event that a case presents in Northern Ireland.
Advice to travellers
Several hundred cases of EVD in humans have been identified in recent months in West Africa and the outbreak is still evolving. There have been no reported cases in the UK. For the latest information, please see Public Health England's updates here.
Please note that the UK government has updated its travel advice for travel to Liberia. The advice reads: “The Foreign and Commonwealth Office (FCO) advise against non-essential travel to everywhere in Liberia except Monrovia and the Roberts International Airport.” The full text can be found at www.gov.uk/foreign-travel-advice/liberia.
The likelihood of contracting EVD is extremely low unless you have been exposed directly to blood or body fluids of symptomatic people or animals, or infected objects. Therefore the risk to the public in Northern Ireland is low.
If you have travelled and stayed in the areas where EVD cases have been recently reported, and you become ill within 21 days of returning home (fever, headache, achiness, sore throat, diarrhoea, vomiting, stomach pain, rash, or red eyes), seek medical attention as soon as possible and mention your travel history.
The risk of infection for travellers visiting the affected countries is considered low. However, the Public Health Agency (PHA) advises that travellers to affected countries need to be familiar with how EVD virus is transmitted. Travellers are advised to avoid all types of contact which could put them at risk of contracting the virus. The World Health Organization’s (WHO) travel and transport risk assessment on EVD is available here: www.who.int/ith/updates/20140421/en
The latest European Centre for Disease Prevention and Control epidemiological updates, which include EVD, are available here:www.ecdc.europa.eu/en/press/epidemiological_updates/Pages/epidemiological_updates.aspx
Healthcare workers and volunteers
There is a risk for healthcare workers and volunteers working in affected countries, especially if involved in caring for EVD patients. However, if the recommended level of precaution for such settings is implemented, transmission of the disease should be prevented. The risk level can be considered very low to low unless these precautions are not followed, e.g. no personal protective equipment, needle stick injury, etc. Avoid all contact with blood and body fluids of infected people or animals. Do not handle items that may have come in contact with an infected person’s blood or body fluids.
Public Health England’s Information for humanitarian aid workers for is available here: www.gov.uk/government/uploads/system/uploads/attachment_data/file/325796/PHE_Factsheet_Ebola_for_humanitarian_workers.pdf
General travel advice
In general, the PHA advises all travellers to make themselves aware of the health risks associated with the countries they plan to visit. All travellers need to prepare for their trip well in advance by understanding the risks, getting any recommended vaccinations and adhering to other country-specific precautions that are advised. In this way their health will be better protected and the risk of acquiring disease minimised. WHO international travel advice and health general precautions are available here: www.who.int/ith/precautions/en
Although the medical profession and the travel industry can provide extensive help and sound advice, it remains the traveller’s responsibility to seek information, understand any risks involved and take necessary precautions to protect their health while travelling.
Information for health professionals on the guidance of viral haemorrhagic fevers
Specialist guidance on the management (including infection control) of patients with viral haemorrhagic fever (VHF) is available here: https://www.gov.uk/government/publications/viral-haemorrhagic-fever-algorithm-and-guidance-on-management-of-patients