Thursday, October 9, 2014

Ebola UK: everything you need to know about the crisis - Telegraph.co.uk


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. Latest information is available from WHO.


The virus has killed more than 3,400 people and infected more than 7,200.


Are people in the UK at risk from Ebola?


Ebola can only be transmitted through contact with the blood or other bodily fluids of an infected person or animal.


As such, the risk to the general UK population remains very low.


The risk to UK travellers of contracting Ebola is very low and can be mitigated by simple precautions such as maintaining good hygiene and keeping away from infected areas and people. There is a higher risk for humanitarian healthcare workers exposed to patients.


Specific advice has been prepared for humanitarian and health care workers


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


As the crisis continues it is looking increasingly likely that we will see cases of Ebola imported into Britan. The World Health Organisation has said new cases in Europe are 'unavoidable' and the Foreign Secretry Philip Hammond has warned that the disease 'knows no borders.' Public Health England this week admitted there was a 'reak risk' the disease could enter the country.


Doctors have been told to take a detailed travel history of any patients with a fever.


The Deparment of Health has written to clinicians warning: "It is unlikely but not impossible that people infected in Sierra Leone, Guinea and Liberia could arrive in the UK while incubating the disease, and then develop symptoms after their return."


However the Government has said that Britain has robust, well developed and well tested NHS systems for managing unusual infectious diseases.


Four major NHS hospitals in England have now been identified as units to take patients with Ebola if the need arises.


Currently, just one unit has been established, in the Royal Free Hospital in north London, which treated William Pooley, a British nurse who contracted the virus in Sierra Leone in August.


Royal Liverpool University Hospital NHS foundation trust, Newcastle Upon Tyne Hospitals Foundation trust and Sheffield Teaching Hospitals foundation trust have now been identified as hospitals which could take Ebola patients if the virus reaches the UK.


British nurse Will Pooley


What steps are UK airports taking to stop Ebola?


Advice has been issued to the 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.


America has started to screen the temperature of passengers but Public Health England claim that increased checks are unlikely to pick up the disease.


Experts say screening would throw up many false positives, including people who were hot from running to catch a flight or make a connection.


What information has been given to Border Force?


The UK Border Force has been given information and advice for arriving passengers. Immigration officials have been advised to look out for passengers suffering fever, fever, nausea, vomiting, diarrhoeah or a rash. Patients suspected of infection would be isolated and then taken to hospital isolation units.


However Immigration Service Union (ISU) general secretary Lucy Moreton has said her members are unprepared for the threat and has warned there are inadequate facilities at airports to deal with an infected traveller.


"There is no health facility at the border, there is no containment facility, and until extremely recently there has been no guidance issued to staff at all as to what they should do," she has said.


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 froman 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. That would be huge numbers of low risk people.


Public Health England has provided UK Border Force with advice on the assessment of an unwell patient on entry to UK.


What do the experts say about screening?


Most virologists agree that screening would do little to stop the virus entering the country.


Dr Ben Neuman, a virologist at the University of Reading said; “I think the present UK policy of not screening incoming airline passengers is sensible. The sorts of tests that can be done on large numbers by non-doctors would not be likely to stop an infected person from entering the UK.


“The screening that is being proposed in the US would not have caught Thomas Eric Duncan as he arrived in Dallas - he had only recently caught the virus and did not have any visible symptoms yet. Blood tests over several days are the only surefire way to detect Ebola, and I do not think turning airports into isolation wards would make us much safer or happier.”


Prof Jonathan Ball, Professor of Molecular Virology at the University of Nottingham said: “I am not convinced (secreening) it is necessary yet.


“Also, might give false comfort /sense of security which could lead us potentially to not considering missed cases who are incubating but not showing symptoms at time of screening. Possibly focussing on flights from high risk areas would help, but again doesn’t pick up all possibility like those transiting through high risk areas.”


What do the politicians say?


Jeremy Hunt, the Health Secretary, has warned that it is possible that someone with Ebola could enter Britain but added the health service was prepared.


"Well this is clearly one of the most serious global health emergencies of recent years. Our first priority as the Government is to make sure the British people are safe,” he said.


"It is now entirely possible that someone with Ebola will come to the UK by one route or another but we have very, very good plans in place.


Michael Fallon, the Defence Secretary has said that screening is unnecessary and the Government would continue to follow the advice of the World Health Orgainisation.


"The World Health Organisation advice is that it is better to screen on exit from a country to make sure that people who are leaving are not infected, rather than trying to screen people who arrive," he said.


"At the moment there are no direct flights from Sierra Leone to the United Kingdom. It is very hard to be able to track people who are changing planes and arriving by different means in the United Kingdom.


"It is particularly difficult because the symptoms may not be obvious for a number of weeks after you actually catch the disease. It is not straightforward."


Philip Hammond the Foreign Secreatry, has warned that the disease ‘knows no borders.’


“We now need, as the secretary has said, the wider international community to step up to the plate and deliver that additional resource, not just money, but trained medical and clinical personnel to lead that effort on the ground.


“We all have to do more if we are going to prevent what is currently a crisis from becoming a catastrophe.


"The disease is an unprecedented threat that knows no borders. We have to get ahead of this disease, but if we get ahead of it, if we rise to the challenge, we can contain it and beat it. We know how to do this. It is not complicated to do. It just requires a large focus of resource and effort to deliver it.”


Keith Vaz, MP, the chair of the Home Affairs Select Committee has called for temperature screening at airports.


“What we need to ensure is that the public feel there is confidence at our borders and that means, we need to put in screening at our borders in order to give the public that confidence” he said.


“We don’t want to deal with this after the event just because we have the best health service in the world. We don’t want to test it to see if it can cope with Ebola.


“What we need to do is understand those who police our borders are not health experts, they are immigration officers.”


How is Britain helping the crisis in West Africa:


More than 750 British troops will be sent to Sierra Leone along with three helicopters and a medical support ship.


Troops will deploy to West Africa as early as next week, where British military engineers and medics are already overseeing the building of an Ebola hospital.


The troops will include soldiers of the Royal Scots Borderers (1 SCOTS) based in Co Down, Northern Ireland.


The government has committed £125 million to tackle the disease.


Medical leaders have appealed for NHS doctors, nurses and paramedics to volunteer to treat Ebola victims in Sierra Leone.


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


While the UK might see cases of imported Ebola, this is extremely unlikely to result in a large outbreak in the UK. England 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


Is there a treatment for Ebola?


There is 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.


Will Pooley was treated with Zmapp and survived, but others who have taken the drug have died. It could be that they were given the medication too late.


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









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