Presentation on theme: "Viral Haemorrhagic Fever: The West African Zaire Ebola Virus outbreak"— Presentation transcript:
1 Viral Haemorrhagic Fever: The West African Zaire Ebola Virus outbreak Dr Eleri Wilson-DaviesConsultant Medical VirologistWest of Scotland Specialist Virology Centre
2 VHF are of particular public health importance because they: Can spread readily within a hospital settingHave a high case-fatality rateAre difficult to recognise and detect rapidlyThere is no evidence based treatment
4 1976Yambuku, Democratic Republic of Congo (previously Zaire) – near Ebola riverNzara, Sudan318 cases280 deaths38 serologically confirmed survivors88% mortality rateSerum specimens were collected from persons in villages in the epidemic area if they had acute febrile illness during the epidemic period and were in contact with probable cases
7 Primary transmissionContact with the blood, secretions, organs or other bodily fluids of infected animalsFruit batsChimpanzeesGorillasMonkeysForest antelopePorcupines
8 Secondary transmission NO AEROSOL TRANSMISSIONMucous membrane protection prevents ALL transmissionAll VHFs enveloped virusesEasily inactivatedIn the UK the greatest risk to health care staff occurs BEFORE the diagnosis
9 West Africa Outbreak 17/11/14 CASES DEATHSSpain 1GuineaSierra LeoneSenegal 1MaliLiberiaNigeriaUnited StatesTOTAL 14,413 5,177CURRENT REPORTED MORTALITY 36%
10 Why? Poverty Travel for work Civil war Lack health infrastructure Doctors 1-2 per 100,000 of population in urban areasNo/insufficient PPEHCW fail to be paid
11 Culture Fear Hide symptomatic family members Long-standing funeral practices that involve close contact with highly infectious corpsesDistrust of government - corruptionTwo Nigerians have died after drinking salt water, which was rumoured to be protective
18 Publications: BBV laboratory infections Most recent references are fromThese are not representative of current health and safety practiceGrist NR, Emslie JAN. Infections in British clinical laboratories, 1988–1989. J Clin Pathol 1991; 44:667–9. Extract from the abstract:"Hepatitis was not reported. The sustained low level of hepatitis is encouraging and suggests a low risk to staff of bloodborne infections such as human immunodeficiency virus."
19 Walker D, Campbell D. A survey of infections in United Kingdom laboratories, 1994–1995. J Clin Pathol 1999; 52:415–8. The single bloodborne virus infection reported (HCV) details in table 6, the possible laboratory infection was potentially acquired by an ancillary staff member who 'may have' cut themselves on glass, as they worked in the wash up area.
20 Take home message:If you protect yourself from blood-borne viruses (HIV/HBV/HCV) you are protecting yourself against VHF viruses
21 www.hps.scot.nhs.uk Dr Eleri Wilson-Davies firstname.lastname@example.org Consultant Medical VirologistWest of Scotland Specialist Virology Centre