UKHSA issues ‘urgent’ public health notice for nurses on Ebola outbreak
Nurses and other healthcare professionals in the UK have been urged to consider Ebola in any acutely unwell patient with a history of fever who has left Democratic Republic of the Congo (DRC) or Uganda in the previous 21 days.
The warning from the UK Health Security Agency (UKHA) comes amid an outbreak of the disease in DRC and Uganda, in which a spread of the Bundibugyo strain has seen more than 1,000 suspected cases and 246 deaths reported.
The ‘urgent’ public health notice from the UKHSA includes that infection prevention and control teams must ensure ‘adequate stocks of personal protective equipment’ (PPE) and that relevant staff are trained in its use for the assessment and treatment of suspected Ebola cases.
The World Health Organization (WHO) designated the current outbreak a Public Health Emergency of International Concern on 17 May.
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In the UK, Ebola disease is considered a high consequence infectious disease (HCID), but the UKHSA has assessed the risk to the public as low.
In an alert last week, the UKHSA urged nurses and staff in primary care settings to isolate any patients suspected of having EBOD ‘immediately’ in a room away from other to minimise contact and seek urgent local infection specialist advice.
After moving the patient immediately to an empty room, staff in contact with the patient should be restricted and relatives and visitors must not enter the room.
Ebola is a notifiable disease meaning suspected cases must be reported immediately the UKHSA health protection team.
Staff also need be aware of how to access local infection specialist advice (infectious diseases, microbiology or virology) as well as ensuring clinical services have pathways in place for assessment and management of any suspected cases.
Alongside patients with a fever, patients with no fever but who have an acute severe illness such as unexplained haemorrhage, multi-organ failure, or reduced GCS, who have travelled to these areas, should also be assessed.
Ebola disease is transmitted through direct contact with blood, secretions or other body fluids of an infected person, or indirect contact with contaminated environments or materials. There is no evidence for natural airborne transmission.
Recently, the International Council of Nurses (ICN) sounded the alarm over a shortage of PPE and screening supplies for nurses working amid the Ebola outbreak in the DRC and Uganda.
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The organisation, which is in direct contact with national nursing associations in DRC, Uganda and neighbouring countries, says nurses are reporting feeling ‘scared for their safety because they do not have the equipment to protect themselves’.
Symptoms of Ebola disease
Ebola disease presents with a wide range of symptoms, with an incubation period of between two to 21 days post-exposure (average four to 10 days).
The onset of symptoms can be sudden and may initially include fever, malaise, myalgia, and headaches.
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Some patients may not have a fever when they present.
Symptoms may progress to include:
- Rash
- Nausea
- Vomiting
- Diarrhoea
- Abdominal pain and subsequent multi-organ failure, neurological sequelae and death.
- Internal and/or external bleeding may occur late in the illness course of a minority of cases; this should not be used as the sole indicator for suspicion of Ebola disease
As of yet there is no approved vaccine for the Bundibugyo strain but three are currently in development.
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