Ebola risk low but we need high level protocols

Following the death of a patient in the US from the Ebola virus and the case of a Spanish nurse contracting the viral haemorrhagic fever from a patient she was treating, Irish people are naturally worried about the risks.

There are no direct flights connecting airports here with west Africa but someone could contract the virus in Liberia or Sierra Leone and travel indirectly to the Republic. Because of an incubation period of up to 21 days they could, theoretically, arrive in Ireland before showing any symptoms of Ebola.

But even in the event of that occurring, the risk to the public remains small. Unlike respiratory illnesses such as measles or influenza, which can be transmitted by virus particles that remain suspended in the air after an infected person coughs or sneezes, Ebola is transmitted by direct contact with body fluids of a person who has symptoms of Ebola disease. Therefore it is healthcare workers, who help treat and transport the patient, who could be exposed to the virus.

This is why the robustness of protocols for managing a suspected case is key. As long as they do not come in direct contact with the body fluids of an Ebola patient, healthcare workers will not be infected. This means wearing full protective clothing to prevent the patient’s blood, faeces, vomit, saliva, urine or semen coming in contact with the eyes, mucous membranes in the mouth and nose or contact with the broken skin of a health professional.

It has now emerged that the Spanish nurse rubbed her face with her gloved hand after leaving the Ebola patient's room. This is a breach of infection control protocols and is a reminder to the Health Service Executive to ensure that staff here are fully equipped, educated and trained in how to safely care for a person suspected of having Ebola.

The Minister for Health is correct to advise his Cabinet colleagues there are no preventive benefits in commencing airport screening for Ebola.

While exit screening at west African airports makes sense, entry screening here using temperature checks does not. Because of the 21-day incubation period, even a rare case of Ebola coming through an Irish airport is likely to be asymptomatic – meaning it wouldn’t be identified.

Instead there is likely to be a high number of false positive results; people with a high temperature travelling from Africa are far more likely to have flu, malaria or even tuberculosis, yet the screening process would falsely label them as Ebola cases.

The introduction of limited airport screening in the UK, US and Canada is a purely optical exercise designed to reassure a nervous public.

Early symptoms of Ebola include fever, headache, muscle pain and sore throat. In the event of someone who has returned from west Africa in the previous three weeks developing flu-like symptoms, they should contact a doctor for advice.