UKHSA urges GPs to be alert to signs of Ebola

Healthcare professionals have been warned to be alert to signs of Ebola in anyone acutely unwell with history of recent travel to the Democratic Republic of the Congo (DRC) or Uganda.

The urgent public health alert from the UK Health Security Agency (UKHSA) comes amidst rapid spread of the Bundibugyo strain of Ebola in the DRC with more than 1,000 suspected cases reported and 246 deaths.

World Health Organisation officials have said the risk within the country is very high and the outbreak is proving difficult to contain after late detection in the region which faces conflict and limited healthcare facilities.

It is one of the largest ever outbreaks, but the international risk is rated as low and cases of Ebola disease in the UK are ‘extremely rare’, UKHSA noted.

Ebola is transmitted through direct contact with body fluids or indirect contact with contaminated materials, with an incubation period of between two to 21 days post-exposure.

It can present with a wide range of symptoms, the onset of which can be sudden, and may initially include fever, malaise, muscle pain, and headaches. Some patients may not have a fever when they present.

Under the UKHSA guidance, if Ebola is suspected in a primary care setting, staff are advised to isolate the patient immediately in a room away from others, minimise contact, seek local infection specialist advice and arrange transfer, UKHSA said.

Clinicians should consider Ebola disease in any patient who is acutely unwell with a history of fever and who has left the DRC or Uganda in the previous 21 days.

But common alternative diagnoses such as malaria should also be urgently investigated, following the ACDP viral haemorrhagic fever (VHF) risk assessment algorithm.

Patients with no fever but have an acute severe illness such as unexplained haemorrhage, multi-organ failure, or reduced score on the Glasgow Coma Scale, who have travelled to these areas, should be discussed with the infection control team.

Clinical services should make sure they have pathways in place for assessment and management of Ebola disease within their setting.

And staff should be aware of how to access local infection specialist advice.

UKHSA should be informed of Ebola and other VHF disease as these are notifiable diseases, it added.

As yet there is no approved vaccine for the Bundibugyo strain but three are in development including one by the Oxford Vaccine Group using the same technology they deployed for the Covid-19 vaccine.