Ebola virus: General information for people working at ICHT
Introduction
To learn more about Ebola, how it is transmitted, signs and symptoms and what to do if you are worried
have a look at the fantastic information at the NHS Choices website
Please read the information below that supplements the Trust Ebola and Viral Haemorrhagic Fever clinical
guidelines. These guidance notes are based upon national OH guidance approved by Public Health England.
How occupational health contribute to patient and staff safety from Ebola
Occupational health provide expert advice, care and support to all our people exposed to potentially harmful
substances, infections or work processes whatever their role. Our specialist nurses and doctors have expertise
that crosses many essential technical clinical and non-clinical activities and roles including health and safety, risk
reduction and infection control. Our involvement with Ebola preparation and case management may vary
according to the local situation but will always be directed towards:
 Protection of health care staff and students from risks to which they may be exposed at work
 Assessment of fitness for work and of the health effects of work
 Protection of patients from risks related to health issues in staff.
Circumstances, related to Ebola, in which requests for OH advice from individuals or management are likely
include:
 Pre-deployment immunisation or advice for
o NHS staff who volunteer to assist with the crisis in West Africa
o Healthcare and other students on placements there or seeking UK electives from an affected
area
 Appropriate and safe resumption of NHS work when volunteers return to UK
 Longer term follow up and particularly psychological support for those who may have been affected
directly or indirectly by the disease
 Assessment for new starters/returning travellers (NHS employees or students) who arrive in the UK from
Ebola affected areas
 Pre-placement assessment of new NHS staff, e.g. nurses recruited from areas where Ebola patients
have been hospitalised (e.g. Spain).
What you need to know if travelling to an affected area
We no longer need travellers to affected areas to contacts us prior to travel unless contact with potentially
infected people such as family, friends or others can be foreseen. However those travelling to provide voluntary
humanitarian aid that is not coordinated by a recognised NGO must contact us and can report their travel plans
online via the infection reporting link on our website www.imperialhealthatwork.co.uk/infection. In all
circumstances, those travelling to affected countries must always have a full travel health assessment and
advice by a competent travel health service prior to departure so all health risks can be identified and
preventative care provided. Travel health insurance is essential.
Imperial Health at Work are proud to be a SEQOHS accredited service
Updated April 2014
Humanitarian aid volunteers: pre-travel
Public Health England (PHE) indicates that the majority of volunteers will be deployed under the banner of one
of the large Non Governmental Organisations (NGO), usually Save the Children. Their pre-deployment health
screening, immunisations and other advice plus a ‘mission support kit’ of necessary medication and supplies will
be organised via Interhealth who work with Save the Children, or the Liverpool School of Tropical Medicine.
The current plans are for NHS volunteers to organise treatment centres and laboratories rather than to provide
hands on care for Ebola patients. On return all NHS volunteers will be subject to the surveillance requirements
of PHE who are arranging post trip monitoring via their Health Protection Team (HPT) in Essex.
Humanitarian aid volunteers returning from affected countries
Latest PHE guidance for humanitarian aid workers working in Ebola affected countries in West Africa includes
categorisation of returning healthcare workers and of the level of post trip monitoring and surveillance required
for each group.
Category 1
 Has visited an Ebola affected area but had no direct contact with an Ebola patient or body fluids.
 No monitoring or reporting requirement and can return to usual activities.
 Can work as normal.
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Category 2
 Direct contact with Ebola patients (or body fluids), e.g. routine medical/nursing care but wore appropriate
protective clothing with no known breaches in PPE.
 Will be required to check temperature twice daily for 21 days after return and to report any raised
temperature or other suspicious symptoms to monitoring team at PHE. The monitoring team will provide
all necessary information, equipment and contact.
 Will be required to notify OH of their contact on return from their aid work placement by submitting an
infection contact report online at http://www.imperialhealthatwork.co.uk/infection. If a response is
not received within 1 working day please contact our call handlers on 020 3313 7010.
 Can return to work but only after occupational health assessment and written confirmation of clearance
by the OH nurse consultant (Paul D'Arcy) or an OH Physician (Consultant Dr Basil Assoufi or either Dr
Julia Rees or Dr Akbar Halim). A rapid access appointment will be offered when we call you back after
receiving your report
 Any category 2 contact from patients at Imperial premises will be followed up by occupational health in
addition to PHE and we will provide the necessary equipment
 Psychological support from CONTACT will be available for any returning humanitarian aid worker or
through occupational exposure at Imperial.
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Category 3
 May have had unprotected exposure of skin or mucous membranes to potentially infectious blood or
body fluids, including on clothing or bedding. This includes:
o unprotected handling of clinical/lab specimens
o mucosal exposure to splashes
o needlestick injury
o kissing and/or sexual contact
Imperial Health at Work are proud to be a SEQOHS accredited service
Updated April 2014
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Will be required to check temperature twice daily for 21 days after return and REPORT DAILY to
monitoring team at PHE even if temperature normal and no suspicious symptoms.
If the contact was overseas, they will be required to notify OH of their contact on return from their aid
work placement by submitting an infection contact report online at
http://www.imperialhealthatwork.co.uk/infection. If the contact was during care for a probable or
confirmed case at Imperial, the report will be made directly by the incident team. Please also contact
Paul D'Arcy paul.darcy@imperial.nhs.uk (OH Nurse Consultant) and Dr Basil Assoufi
basil.assoufi@imperial.nhs.uk (OH Medical Consultant) so we can organise any follow-up directly.
Can not return to work on Trust premises unless written confirmation of clearance and restrictions on
practice and location of work has been given by the OH nurse consultant (Paul D'Arcy) or an OH
Physician (Consultant Dr Basil Assoufi or either Dr Julia Rees or Dr Akbar Halim)
Psychological support from CONTACT will be available for any category 3 contact at work or via
humanitarian aid work
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Needlestick injuries and other accidental exposures
Expert occupational health assessment and care supported by colleagues in virology, infectious diseases and
psychological support services will be required. In all cases an online report must be made at
http://www.imperialhealthatwork.co.uk/exposure In office hours (Monday to Friday 09:00 to 17:00) these
exposures will be managed by the OH nurse consultant or the OH duty doctor and they should be notified by
telephone immediately after the online form has been completed and the relevant person can be located by our
call handlers on 020 3313 7010. Out of hours, the duty infectious diseases doctor must be contacted via
switchboard and they will give clear advice about the necessary action to take. In all cases, Ebola risk must be
considered alongside the risk from other blood borne infections.
Other considerations that may require additional OH support
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Pregnant, breastfeeding or immunosuppressed staff should not, where practicable, assess or provide
direct patient care to patients who are deemed to be at high possibility of Ebola or other VHF. Also,
workers who have significant underlying health issue or disabilities that may cause difficulties in donning,
wearing and removing of PPE must not be allocated to assess or provide direct patient care.
Healthcare staff with significant underlying psychological conditions including anxiety or panic disorders
or claustrophobia should not be allocated to care for high possibility patients without having been
cleared by OH to do so.
A range of common and less common conditions may affect the ability of a HCW to provide care that
can be done in a way that meets the needs of both the patient and their own health and safety
needs. Conditions that make safe donning and removal of PPE difficult are incompatible with care for
high-possibility cases as any error with removing contaminated PPE has a high risk of infection for the
HCW or may put others at risk. Conditions that affect mobility, communication, ability to stand for
prolonged periods or perform highly dexterous tasks whilst wearing PPE may also be incompatible with
care for these patients as these factors can also increase safety risk. Examples include, hyper/
hypotension, musculoskeletal injury or conditions, diabetes, epilepsy, conditions causing pain, asthma,
cardiac conditions and so on.
Getting specialist OH support or advice
Imperial Health at Work are proud to be a SEQOHS accredited service
Updated April 2014
Routine advice including self or manager referrals can be made online via
www.imperialhealthatwork.co.uk. Rapid access advice can be obtained via the OH nurse consultant or duty
doctor using the details given above.
Guidance Documents October 2014
1. Click this for detailed general public health information about Ebola updated October 2014
2. This guidance note give useful information for friends and families of humanitarian aid workers but has
information that will be relevant for any other friends or family of possible contacts from work at Imperial
3. https://www.gov.uk/government/collections/ebola-virus-disease-clinical-management-and-guidance
4. https://www.gov.uk/.../PHE_Factsheet_on_Ebola_for_humanitarian_aid_ workers.pdf
5. https://www.gov.uk/.../Ebola_advice_for_further_educational_establishments
Imperial Health at Work are proud to be a SEQOHS accredited service
Updated April 2014