Ebola: Q&A What you need to know

The Disasters Emergency Committee (DEC) launches an appeal for the Ebola Crisis in West Africa. Pic: Julie Bull

The Disasters Emergency Committee (DEC) launches an appeal for the Ebola Crisis in West Africa. Pic: Julie Bull

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HEALTH Protection Scotland has produced a Q&A on Ebola and the risk in the UK.

It is printed below and also available at www.hps.scot.nhs.uk.

What is Ebola?

Ebola virus disease (previously known as Ebola haemorrhagic fever) is a rare but severe disease which is caused by the Ebola virus. It can result in uncontrolled bleeding, causing damage to the patient’s vital organs. It was first recognised in 1976 and has caused sporadic outbreaks since then in

several African countries.

The virus is initially transmitted to people from wild animals and spreads in the human population through human-to-human transmission through contact with blood and body fluids.

Are people in Scotland at risk of Ebola?

For Ebola to be transmitted from one person to another, contact with blood or other body fluids is needed. As such, the risk to the general Scottish population remains very low. The risk to Scottish travellers of contracting Ebola is very low and can be mitigated by simple precautions. There is a higher risk for humanitarian healthcare workers exposed to patients unless appropriate protective equipment is used. Specific advice has been prepared for humanitarian and healthcare workers.

Is there a public health risk from a person with Ebola coming into the country?

We have alerted medical practitioners across NHSScotland about the situation in West Africa and requested they remain vigilant for unexplained illness in those who have visited the affected area.

Even if cases were identified, we have robust, well-developed and well-tested NHS systems for managing unusual infectious diseases when they arise, supported by a wide range of experts. Ebola causes most harm in countries with less developed healthcare facilities and public health capacity.

There are other illnesses which are much more common than Ebola (such as flu, typhoid fever and malaria) that have similar symptoms in the early stages, so proper medical assessment is really important to ensure you get the right diagnosis and treatment.

It is also really important that medical services are expecting your arrival and calling NHS24 on 111 or the Scottish Ambulance Service on 999 will ensure that this happens.

What if I think I might have Ebola?

Unless you’ve come into contact with the blood or bodily fluid of an infected person (for example by providing healthcare for a person with Ebola or handling the dead body of someone who died from Ebola), there is little chance of you being infected. If you feel unwell with symptoms such as fever, chills, muscle aches, headache, nausea, vomiting, diarrhoea, sore throat or rash within 21 days of coming back from Guinea, Liberia or Sierra Leone, you should stay at home and immediately telephone 111 or 999 and explain that you have recently visited West Africa. These services will provide advice and arrange for you to be seen in a hospital if necessary so that the cause of your illness can be determined.

There are other illnesses which are much more common than Ebola (such as flu, typhoid fever and malaria) that have similar symptoms in the early stages, so proper medical assessment is really important to ensure you get the right diagnosis and treatment.

It is also really important that medical services are expecting your arrival and calling NHS24 on 111 or the Scottish Ambulance Service on 999 will ensure that this happens.

Where is the current outbreak?

Since March 2014, there has been a large, widespread outbreak affecting Guinea, Liberia and Sierra Leone. Nigeria and Senegal are also affected by imported cases but latest information suggests that Ebola is no longer spreading in these two countries. Further information about the latest Ebola situation is available from the World Health Organisation (WHO).

What support is the UK providing in West Africa?

In addition to our work here in this country, staff from the UK have also been on the frontline as part of the international effort to tackle Ebola in West Africa. They have been supporting the Sierra Leone Ministry of Health by providing expert guidance on managing the outbreak and preventing the spread of the virus in health care facilities and in the community. Earlier this year a team member also worked on the ground in Sierra Leone, as part of the WHO global response. As well as providing support in Sierra Leone, a number of scientists from the UK have provided expert virological support with the EU Mobile Lab in Guinea. Discussions are ongoing regarding further deployment of staff from the UK to Africa.

What steps are Scottish airports taking to stop Ebola?

Advice has been issued to the UK Border Force to identify possible cases of Ebola and there are procedures in place to provide care to the patient and to minimise public health risk to others.

If you’re on a flight with someone with Ebola what is the risk to you? You cannot catch Ebola through social contact or by travelling on a plane with someone who is infected, without direct contact with the blood or body fluids of an infected person.

Cabin crew identifying a sick passenger with suspicion of infectious disease on board, as well as ground staff receiving the passenger at the destination, would follow the International Air Transport Association guidelines for suspected communicable diseases.

If there is someone unwell on board a flight, the pilot of the aircraft is legally required to inform air traffic control. Arrangements will be made for medical assessments for the person on arrival. The exact arrangements will depend on the airport involved. The local Public Health Team would be alerted if there was a possibility that the individual was suffering from an infectious disease so that appropriate public health action could be initiated.

Why don’t we use body temperature scanners at airports?

Entry screening in the UK is not recommended by WHO. Entry screening would require the UK to screen every returning traveller, as people could return to the UK from an affected country through any port of entry. This would be huge numbers of low risk people. Public Health Agencies in the UK have provided UK Border Force with advice on the assessment of an unwell patient on entry to the UK.

If we get a case of Ebola in Scotland, would we see an outbreak similar to West Africa?

While Scotland might see cases of imported Ebola, this is extremely unlikely to result in a large outbreak in the UK. Scotland has a world class health care system with robust infection control systems and processes and disease control systems which have a proven record of dealing with imported infectious diseases.

A case of Crimean Congo Viral Haemorrhagic Fever (which belongs to the same group of illness as Ebola) was diagnosed in Glasgow in 2012 in a traveller and that case was managed without any further spread to anyone else in Scotland.

Is there a treatment for Ebola?

It is important to note that no specific vaccine or medicine has yet been proven to be effective against Ebola. There is no cure for this disease, and antibiotics are not effective. In some instances, clinicians treating individuals with Ebola may source and decide to use an experimental drug, such

as Zmapp. Severely ill patients require intensive supportive care, which may include rehydration with intravenous fluids.

Source: Health Protection Scotland