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Ebola virus disease (EVD)

see also:

    • if suspect a case (see below for criteria):
      • under law must notify the Department (DH) immediately by calling 1300 651 160 in order to enable an assessment by the Chief Health Officer (CHO) or delegate and in order to trigger other immediate public health actions.
      • isolate the patient in a single room immediately (negative pressure room if possible) and minimise unnecessary staff and family contact (ie. NO visitors)
      • ensure standard, contact and droplet precautions are taken by all staff (and by parent(s) of a child case if it is essential for them to remain with the patient) who are providing care in the same room, which means PPE composed of a minimum :
        • a fluid-resistant submicron single use face mask AND
        • eye goggles AND
        • a fluid-impermeable gown AND
        • gloves
        • check hospital policy as many are advocating full PPE protection with multiple gloves, face mask, full head to ankle PPE suit, etc.
      • AVOID:
        • taking a throat swab or undertaking any aerosol generating procedure or venepuncture unless immediately essential for clinical care
        • arranging ambulance transfer - DH will liaise with this
          • designated quarantine hospital is RMH (or RCH)
      • READ the above PLAN (pdf) carefully


  • the Ebola viruses are part of the family Filoviridae which also includes Marburg virus.
  • the likely natural host are fruit bats of the Pteropodidae family.
  • first emerged in the Democratic Republic of Congo and the Sudan in 1976.
  • it mainly occurs in rainforest areas of central Africa including Sudan, Congo, Uganda, Ivory Coast, Sierra Leone, Liberia, Guinea.
  • EVD is a severe, highly infectious disease of humans and primates which is fatal in ~90% of cases
  • outbreaks are usually contained within a few months, but social stigma and fear means many infected individuals do not seek medical help, if it is available, thereby spreading infection

Ebola outbreaks as at July 31, 2014, courtesy of Bloomberg

suspected case definition in Victoria, 2014

  • a suspected case of EVD is a case with clinical evidence AND epidemiological evidence

clinical evidence means:

  • a history of fever ≥38°C in the last 24 hours OR subjective history of fever in the last 24 hours
    • additional symptoms such as severe headache, muscle pain, vomiting, diarrhoea, abdominal pain, unexplained haemorrhage.

epidemiological evidence means

  • within 21 days prior to onset of symptoms there was:
    • residence in or travel to an area where EVD transmission is active OR
    • one or more high risk exposures (see below) OR
    • one or more low risk exposures (see below)

areas where EVD transmission is active (Sept 2014)

  • Sierra Leone
  • Guinea
  • Liberia
  • Nigeria
  • +/- Democratic Republic of Congo (DRC)

high risk exposures

  • percutaneous or mucous membrane exposure to blood or body fluid of an EVD patient
  • direct skin contact with or exposure to blood or body fluids of an EVD patient without appropriate PPE
  • processing blood or body fluids of a confirmed EVD patient without appropriate PPE or standard biosafety precautions
  • direct contact with a dead body without appropriate PPE in a country where EVD transmission is active

low risk exposure

  • household contact with a confirmed case of EVD;
  • persons who had direct contact with bats or primates in States with active EVD transmission;
  • other close contact with a confirmed case of EVD in health care facilities or community settings.
    • close contact is defined as:
      • being within the same room of a patient with active vomiting or diarrhoea or coughing or the patient having an aerosol generating procedure, while not wearing appropriate personal protective equipment (i.e. as per standard, contact and droplet precautions);
      • having direct brief contact (e.g. shaking hands) with an EVD patient while not wearing appropriate personal protective equipment.

casual exposure

  • being in the near vicinity of a case with possible contact with a shared surface without appropriate PPE.


  • spread is via contact with secretions, blood or bodily fluids of infected wild animals, persons or corpses
  • includes contact with heavily contaminated fomites, sexual transmission, needles, and handling of raw or undercooked infected meat
  • burial ceremenonies are a known high risk activity for transmission
  • no documented cases of aerosol transmission


  • quarantine processes
  • standard contact and droplet precautions using gowns, gloves, face shields and masks
  • avoid high risk activities including sexual intercourse during infective period and eating wild animals
  • avoid aerosol-generating procedures unless adequate airborne precautions including negative pressure room, P2 masks, gowns, gloves are used.
  • in Victoria, suspected cases requiring ambulance transfer must have PRIOR notification to the Communicable Disease Prevention and Control Section of Department of Health on 1300 651 160 and ambulance personnel and receiving facilities must be made aware of the possible diagnosis


  • infected individuals are an infectious risk from onset of symptoms until at least 7 weeks after clinical recovery

clinical features

  • viral haemorrhagic fever
  • incubation period with current strain is 4-6 days (but may be up 21 days)
  • sudden onset fever, muscle & joint aches
  • usually progresses rapidly to vomiting, diarrhoea, and sometimes haemorrhage from eyes, ears, mouth, and rectum with purpura and death


  • viral PCR or serology on blood samples - these require significant precautions see documentation 1)
    • in Victoria, must notify VIDRL first on (03) 8344 5689


  • supportive care
  • infection control
ebola.txt · Last modified: 2014/12/12 06:02 by

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