Status:
Resolved
Health alert:
140009
Date Issued:
18 Sep 2014 (Update from 31 July 2014)
Issued by:
Dr Rosemary Lester, Chief Health Officer, Victoria
Issued to:
Health professionals, health services and laboratories

Key messages

  • The Department of Health has released a plan providing guidance for general practitioners, frontline clinicians, health services and laboratories on actions to take for a suspected or confirmed case of Ebola Virus Disease (EVD). Health professionals should read more about the Victorian Ebola Virus Disease Response Plan.
  • Ebola is transmitted through direct contact with the blood or body fluids of an infected person or animal, and is not transmitted through the air. Contact and droplet precautions are sufficient to prevent transmission.
  • Consider the possibility of EVD in a patient with fever or illness within 21 days of return from countries in West Africa affected by EVD, which at 15 September 2014 are Liberia, Sierra Leone, Guinea and Nigeria. A separate outbreak of EVD is also occurring in the Democratic Republic of Congo.
  • In the event of a suspected case of EVD, immediately isolate the patient, don personal protective equipment (PPE) as described in the plan, and notify the Department by calling 1300 651 160, 24 hours a day.
  • Minimise staff contact, avoid undertaking a throat swab or aerosol generating procedure or venepuncture unless immediately essential for clinical care, and avoid processing of blood samples from a suspected case unless there has been advice to do so from the Department.

What is the issue?

  • An outbreak of Ebola virus disease (EVD) in West Africa is ongoing and transmission has been confirmed in Sierra Leone, Liberia, Guinea and Nigeria. A separate outbreak of EVD is also occurring in the Democratic Republic of Congo.
  • The current list of countries affected by the West African outbreak can be accessed at the Centres for Disease Control and Prevention .
  • EVD, previously known as Ebola Haemorrhagic Fever, is a severe and often deadly illness that can occur in humans and primates. It is caused by an Ebolavirus. Ebolaviruses are part of the family Filoviridae, which also includes Marburg virus. Fruit bats of the Pteropodidae family are considered to be a likely natural host.
  • There is a need for vigilance for illness in people returning to Victoria from affected countries in West Africa, and for strict infection prevention and control precautions in suspected cases during assessment.

Who is at risk?

Travellers who have visited affected countries in West Africa or the Democratic Republic of Congo in the previous 21 days. There is a risk of EVD infection if the individual has had:

  • contact with blood or bodily fluids of a person or deceased body infected with the Ebola virus
  • contact with or handling of wild animals (alive or dead) or their raw or undercooked meat
  • unprotected sex with a person who is sick with EVD or up to three months after they have recovered
  • contact with any object that has been contaminated with blood or bodily fluids of a person with Ebola virus.

Symptoms and transmission

Symptoms initially include a fever as well as headache and muscle pain. The illness then typically progresses to vomiting, diarrhoea and abdominal pain, and in some cases, internal and external bleeding or bruising.

In this outbreak, Ebola virus is spreading through person-to-person transmission via contact with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluid, including in healthcare settings, and through contact at burial ceremonies in West Africa. The risk of transmission in healthcare settings can be avoided through the appropriate use of infection control precautions and adequate barrier procedures. 

At a minimum, standard, contact and droplet precautions should be used in managing suspected or confirmed cases. Fluid-impermeable gowns, gloves, goggles or face shields and single use fluid resistant face masks should be used in the care of all cases.

Aerosol-generating procedures should not take place unless airborne precautions are in place, including P2 masks, gloves, and use of a negative-pressure room.

Prevention / treatment

There is no vaccine available or therapeutic option available for EVD, although experimental vaccines and treatments are under evaluation. Care is supportive.

Call the Department who will organise transfer by Ambulance Victoria to an appropriate hospital. Ambulance personnel and receiving facilities must be made aware of the possible diagnosis and will use appropriate PPE.

Diagnosis

Laboratory diagnosis is perfomed on venous blood and throat swab and may include virus isolation, PCR or serology. Do not take clinical specimens except under advice from the Department. Only the Department can authorise testing for EVD in patients in Victoria.

All specimens should be sent to the Victorian Infectious Diseases Reference Laboratory (VIDRL) at the Peter Doherty Institute.  After authorisation, contact VIDRL on 0438 599 437 to confirm arrangements.

Further information

Contact the Communicable Disease Prevention and Control Section at the Department of Health on 1300 651 160 (24/7).

Collection of specimens requires significant precautions as detailed in Laboratory Precautions for Samples Collected from Patients with Suspected Viral Haemorrhagic Fevers.

Further information on specimen collection and transport is available from the Commonwealth Department of Health