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Key messages for primary care:
• All suspected Ebola cases that present to primary care should be discussed by the primary care clinician with the on call consultant microbiologist, at RCHT on 01872 254900 and at Derriford on 08451 558155 who will lead the risk assessment and arrange clinical review.
• Also contact the local PHE Health Protection Cornwall Team on 03442 253557
• Individuals that telephone the surgery or walk-in centre and report that they are unwell and have visited an affected area in the past 21 days AND report a fever of >38°C or fever within the past 24 hours must be told not to visit the surgery or walk-in centre. The patient should be called back as soon as possible by the GP or duty doctor to risk assess prior to discussion with the local infection specialist
• Surgeries, out of hours centres and walk in centres should clearly display information requesting patients to tell the receptionist on arrival if they are unwell and have returned from an Ebola-affected area within the last 21 days. Any patients identifying themselves to reception staff should not sit in the general waiting room once Ebola is considered a possibility. These patients should be isolated in a single side room immediately to limit contact, and urgent clinical advice sought from the local infection specialist.
• If at the time of a consultation it becomes apparent that Ebola may be a possibility then the attending primary care clinician should take immediate steps to isolate the patient to limit further contact and seek advice from the local infection specialist. Hand hygiene is an important infection control measure; the Ebola virus is not a robust virus, and is readily inactivated, for example, by soap and water or by alcohol. It is important to remember that transmission of Ebola from person to person is only through direct contact with the blood or body fluids of a symptomatic infected person. There is no evidence of Ebola transmission through intact skin or through small droplet spread, such as coughing or sneezing.
• If a patient is being transferred to hospital, it is essential to alert the ambulance service and the hospital to the possibility of Ebola, as they will need to put special precautions in place to ensure the vehicle and Personal Protective Equipment (PPE) are appropriate to the condition of the patient.
• Cleaning and decontamination of any rooms in which a suspected or confirmed Ebola patient has been isolated or any facilities used by the patient should be discussed with the local Health Protection Team. In the event of a case being confirmed identification and follow up of contacts will be undertaken by the local Health Protection Team