For health professionals: Ebola virus disease
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What health professionals need to know about Ebola
Health professionals in Canada are advised to be vigilant in the recognition, reporting and prompt investigation of patients with symptoms of:
- similar diseases that can cause viral hemorrhagic fevers (VHFs)
Consult the national case definition for further information on symptoms, risk factors and testing.
Person-to-person transmission of Ebola is primarily associated with direct contact with blood and body fluids. Health care workers caring for patients with suspected or confirmed Ebola should apply strict infection control precautions.
Spectrum of illness
Clinical symptoms of Ebola include severe acute viral illness consisting of sudden onset of:
- severe headache
- conjunctival injection
- diarrhea that can be bloody
- impaired kidney and liver function
It is often accompanied by a maculopapular or petechial rash that may progress to purpura. In about 50% of patients, bleeding occurs from:
- the gums
- the nose
- injection sites
- the gastrointestinal tract
Dehydration and significant wasting occur as the disease progresses.
In severe cases, the hemorrhagic diathesis may be accompanied by:
- shock with multi-organ dysfunction
- hepatic, renal and central nervous system involvement
Patients under investigation for Ebola should be reported immediately to local public health authorities. This is a requirement as per jurisdictional protocols in the respective Canadian province or territory.
A patient's clinical history of illness should be reported to the Public Health Agency of Canada Health Portfolio Operations Centre (HPOC). Provinces and territories can contact HPOC at 1-800-545-7661. They should also fill out the Ebola Virus Disease Case Report Form at the time of the initial report.
Laboratories receiving specimens from patients under Ebola investigation should know that mishandled specimens are a serious risk to laboratory personnel. Before testing occurs, consult the Interim Biosafety Guidelines for Laboratories Handling Specimens from Patients Under Investigation for Ebola Virus Disease.
The decision for specimen collection and testing should be predicated on:
- the clinical status of the patient
- an on-going risk assessment
Virus cultures should not be attempted outside of the biosafety level 4 containment laboratories at the National Microbiology Laboratory (NML).
For diagnostic or confirmatory services for Ebola, liaise with the provincial public health laboratory of your jurisdiction. You should coordinate with the NML Operations Centre Director (OCD) at 1-866-262-8433. This number is staffed at all times.
The NML OCD will:
- work with the requesting provincial or territorial jurisdiction to activate the Emergency Response Assistance Plan
- connect you with the appropriate subject matter expert if you require assistance with:
- the shipping process
- sample requirements
- sample shipping conditions
Alongside laboratory service requests for Ebola or other VHFs, provinces and territories should report a patient's clinical history of illness to the HPOC. Contact the HPOC at 1-800-545-7661.
Clarification or further information may be requested from the patient's clinician to optimize delivery of requested laboratory services.
There is currently no licensed treatment or vaccine for Ebola.
Treatment is supportive and directed at maintaining:
- blood pressure
- electrolyte balance
- organ systems function
Consult the Ebola Clinical Care Guidelines: A Guide for Clinicians in Canada for more information.
For more information
Infection prevention and control
- Ebola virus: Pathogen safety data sheet - Infectious substances
- Infection Prevention and Control Expert Working Group: Advice on the Management of Ebola Virus Disease-Associated Waste in Canadian Healthcare Settings (May 06, 2015)
- Infection Prevention and Control Expert Working Group: Advice on Infection Prevention and Control Measures for Ebola Virus Disease in Healthcare Settings (June 25, 2015)
- Statement on infection prevention and control measures for Ebola virus disease (December 19, 2014)
- Environmental sanitation practices to control the spread of communicable disease in passenger conveyances and terminals (June 23, 2014)
- Interim Guidance for Airline Cabin Crews, Cleaning Personnel and Cargo Personnel: How to Protect Yourself and Others from Ebola Virus Disease (August 25, 2014)
- Guidance Document: Minimizing the Risk of Exposure to Ebola Virus Disease in Canada Through Strengthened Quarantine Measures
- Canada's experimental vaccine for Ebola
- Sole License Agreement for Recombinant Vesicular Stomatitis Virus Vaccines for Viral Hemorrhagic Fevers
- National Institutes of Health (NIH): "NIH Begins Early Human Clinical Trial of VSV Ebola Vaccine"
- Interim Biosafety Guidelines for Laboratories Handling Specimens from Patients Under Investigation for Ebola Virus Disease
Public health management
- Public Health Management of Cases and Contacts of Human Illness Associated with Ebola Virus Disease (EVD)
- World Health Organization: Ebola virus disease
- U.S. Centers for Disease Control and Prevention: Ebola
- European Centre for Disease Prevention and Control: Ebola and Marburg fevers
- Canadian Association of Emergency Physicians
- Association of Medical Microbiology and Infectious Disease Canada
- Canadian Critical Care Society
Articles of interest
- Canada Communicable Disease Report
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