EVD
PH importance: quarantinable disease and nationally notifiable
Case Mx
Isolate and institute appropriate infection control
Ebola virus disease: is a viral haemorrhagic disease.
Incubation period: 2 to 21 days
Transmission: bodily fluids, SI, objects contaminated with blood. Intro to human population through direct contact with infected animals
Infectivity increases with worsening symptoms
Clinical: gastrointestinal (vomiting, diarrhea), neurological, vascular, cutaneous, respiratory. Can progress to MOF and high CFR with haemorrhagic complications.
Suspected, probable and confirmed cases require notification
Reservoir: fruit bats, but also chimpanzees, gorillas, monkeys, forest antelopes
Routine prevention: travellers should avoid countries where OBs are occurring, should avoid exposure to bodily fluids of cases, avoid consumption of bushmeat. safe sex practices.
Confirmed = lab def evidence
At reference lab: isolation of EBV virus (blood), detection of virus by NAT, or IGG seroconversion
Appropriate precautions must be taken when testing blood, as blood is highly infectious.
Case Ix: likely source
Infection control measures at a minimum: single room nursing with private bathroom, HCW with P2/N95 mask, cover all skin, fluid resistant gown, gloves and eye protection, leg and shoe covering.
Environmental disinfection and treatment
Contact management
Contact definition: from onset of symptoms of case
Casual
Low-risk
High-risk
household contact, HCWs/community setting within 1 m of patient for prolonged period
Direct contact with the patient and their bodily fluids e.g. needle stick, contact with bodily fluids without PPe, lab personal, contact with dead body without PPE
Twice daily self-monitoring for temperature for 21 days, daily monitoring by PHU, fact sheet. For HCWs consider exclusion from work.
Twice daily self moniting of temperature, notify PH of symptoms
Special circumstances
Returned aid workers: must not work in clinical care for 21 day monitoring period.
Confirmed, probable or suspectetd case travelling by plane: risk assessment. Contact tracing my be indicated, focusisng on those who reported direct contact, sat +/- 1 seat