Ebola outbreak in West Africa
West Africa is currently experiencing an Ebola virus disease (EVD) outbreak in Guinea, Liberia and Sierra Leone. Nigeria and Senegal have reported imported cases from countries with ongoing EVD transmission. As of September 14 there were 5335 probable, confirmed and suspected cases (including 2622 deaths) and there continues to be widespread transmission in the affected countries. There have been no cases in Canada to date.
The potential risk in Canada is low
The risk of EVD in Canada is low. Canadians at potentially risk for EVD are those who have recently participated or are participating in response efforts in EVD-affected regions.
Although the risk of EVD presenting to Canadian healthcare facilities is low, preparation is ongoing to ensure that facilities have the capability to detect and manage suspected EVD cases. In addition, procedures are established at points of entry across Canada to identify symptomatic travellers. These preparations are an important preventive measure as well as a means to ensure that returning travellers from Africa with fever, the vast majority of whom will have other common causes of fever (malaria, influenza) receive high quality of care.
Symptoms
EVD is a severe, acute viral infection characterized by the sudden onset of:
- fever
- malaise
- muscle aches
- and severe headaches.
Symptoms such as pharyngitis, vomiting, diarrhea and rash may follow. In the late stages, hemorrhagic symptoms may occur.
Transmission
Transmission of Ebola virus occurs through direct contact (e.g. through mucous membranes or broken skin) with infected animals; blood, body fluids or tissues of infected persons; or contaminated medical equipment.
The incubation period ranges from two to 21 days (on average eight to 10 days).
Unlike many infectious diseases, EVD cases are only communicable when they begin to show symptoms.
Early detection and adherence to infection prevention practices will minimize the risk of transmission.
VCH preparations
Acute care facilities within VCH have implemented assessment, laboratory testing, environmental disinfection and infection prevention protocols for patients with suspected viral hemorrhagic fever, including EVD. These plans are consistent with recommendations by Public Health Agency of Canada and the US Centers for Disease Control and Prevention (CDC). Appropriate training and resources (including personal protective equipment) will be available to all healthcare workers caring for suspect cases.
Assessment of febrile illness in returning travelers
EVD should be considered in the differential diagnosis of travelers returning from EVD-affected areas who present with severe febrile illness, in particular those who had contact with a suspected or confirmed case of Ebola, or had worked in a lab handling the Ebola virus.
If you have a suspect case
Contact the on-call medical health officer (604-527-4893) for direction regarding the investigation and management of all suspect cases of EVD. In consultation with the medical health officer, a risk assessment will be carried out to determine the likelihood of EVD in the patient. Since the vast majority of patients with a febrile illness who have traveled to affected countries will have a different diagnosis, this risk assessment will make sure that these patients receive appropriate care for their presenting condition. Until EVD is ruled out, strict infection control practices should be implemented for any suspect case. If the suspect patient is in a public area, place a procedure mask on the patient and direct them to a private room.
Healthcare workers providing care for the patient should wear personal protective equipment (gloves, gowns, surgical or procedure mask, and eye protection).
Ebola resources
Public Health Agency of Canada
Centers for Disease Control and Prevention
For more information contact Dr. Titus Wong (titus.wong@vch.ca) or Dr Réka Gustafson (reka.gustafson@vch.ca).