Sir, – Further to Dr Ruairi Hanley’s letter of August 13th and his proposal for a mobile unit to assess people at risk of being infected with Ebola in their own homes it would be timely to make a few observations.
Most people returning from affected countries who develop symptoms will not have had any exposures that put them at risk of Ebola. Most will have common illnesses that we all encounter, such as pneumonia, urinary tract infections or common travel-related illnesses such as malaria, shigella or typhoid.
GPs have been provided with information and fact sheets to assess returning travellers and quickly identify whether Ebola could be considered as a possibility, and the appropriate infection control precautions to prevent any risk of infection. Details on how and where to refer such persons for specialist care if needed form part of the information provided. These guidelines have been developed in conjunction with general practitioners, and are similar to those used throughout Europe and the United States.
Although there have been several previous outbreaks of Ebola, export of the virus from an infected area to a non-endemic country is an extremely rare event and has never occurred in Europe. It is true that the current outbreak surpasses all previous ones, both in size and complexity, and represents a major challenge for control in the affected countries.
Transmission of Ebola requires direct contact with blood, secretions, organs or other bodily fluids of dead, or living infected, persons. While there is a low risk that people infected with Ebola may travel to Ireland from the affected countries, the risk of secondary transmission in healthcare settings or to direct close contacts (family or relatives) is still considered very low if basic infection control precautions are strictly followed.
Protocols are in place to protect against further spread of the disease, including transfer to the National Isolation Unit in the Mater and contact tracing of those with unprotected exposure to bodily fluids. – Yours, etc,
DARINA O’FLANAGAN
MB, FRCPI, FFPHMI, MPH
Director ,
Health Protection
Surveillance Centre,
Middle Gardiner Street,
Dublin 1