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Abstract

Ebola virus disease (EVD) patients treated in high-resource facilities are cared for by large numbers of healthcare staff. Monitoring these healthcare workers (HCWs) for any illness that may represent transmission of Ebola virus is important both for the individuals and to minimise the community risk. International policies for monitoring HCWs vary considerably and their effectiveness is unknown. Here we describe the United Kingdom (UK) experience of illness in HCWs who cared for three patients who acquired EVD in West Africa. Five of these 93 high-level isolation unit (HLIU) HCWs presented with fever within 21 days of working on the unit; one of these five presented outside of the UK. This article discusses different approaches to monitoring of HCW symptom reporting. The potential impact of these approaches on HLIU staff recruitment, including travel restrictions, is also considered. An international surveillance system enhancing collaboration between national public health authorities may assist HLIU HCW monitoring in case they travel.

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/content/10.2807/1560-7917.ES.2017.22.4.30449
2017-01-26
2018-09-26
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2017.22.4.30449
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References

  1. Kilmarx PH, Clarke KR, Dietz PM, Hamel MJ, Husain F, McFadden JD, et al. Centers for Disease Control and Prevention (CDC). Ebola virus disease in health care workers--Sierra Leone, 2014. MMWR Morb Mortal Wkly Rep. 2014;63(49):1168-71. PMID: 25503921 
  2. Uyeki TM, Mehta AK, Davey RT Jr, Liddell AM, Wolf T, Vetter P, et al. Working Group of the U.S.–European Clinical Network on Clinical Management of Ebola Virus Disease Patients in the U.S. and Europe. Clinical Management of Ebola Virus Disease in the United States and Europe. N Engl J Med. 2016;374(7):636-46.  https://doi.org/10.1056/NEJMoa1504874  PMID: 26886522 
  3. Parra JM, Salmerón OJ, Velasco M. The first case of Ebola virus disease acquired outside Africa. N Engl J Med. 2014;371(25):2439-40.  https://doi.org/10.1056/NEJMc1412662  PMID: 25409262 
  4. Liddell AM, Davey RT Jr, Mehta AK, Varkey JB, Kraft CS, Tseggay GK, et al. Characteristics and Clinical Management of a Cluster of 3 Patients With Ebola Virus Disease, Including the First Domestically Acquired Cases in the United States. Ann Intern Med. 2015;163(2):81-90.  https://doi.org/10.7326/M15-0530  PMID: 25961438 
  5. Bannister B, Puro V, Fusco FM, Heptonstall J, Ippolito GEUNID Working Group. Framework for the design and operation of high-level isolation units: consensus of the European Network of Infectious Diseases. Lancet Infect Dis. 2009;9(1):45-56.  https://doi.org/10.1016/S1473-3099(08)70304-9  PMID: 19095195 
  6. Public Health England (PHE) and Department of Health. Viral haemorrhagic fever: ACDP algorithm and guidance on management of patients. Last updated 19 Nov 2015. Available from: https://www.gov.uk/government/publications/viral-haemorrhagic-fever-algorithm-and-guidance-on-management-of-patients
  7. European Centre for Disease Prevention and Control (ECDC). Algorithm for Ebola virus disease contact management. Stockholm: ECDC. Last updated: 12 Nov 2014. Available from: http://ecdc.europa.eu/en/healthtopics/ebola_marburg_fevers/algorithm-evd-contact-management/Pages/default.aspx
  8. Hutchinson JG, Gray J, Flewett TH, Emond RT, Evans B, Trexler PC. The safety of the Trexler isolator as judged by some physical and biological criteria: a report of experimental work at two centres. J Hyg (Lond). 1978;81(2):311-9.  https://doi.org/10.1017/S0022172400025158  PMID: 701792 
  9. Health and Social Care Information Centre. NHS staff: average worker takes an estimated 9.5 working days off sick a year. 2013. [Accessed 14 Aug 2015]. Available from: http://www.hscic.gov.uk/staffsicknesspr
  10. Lado M, Walker NF, Baker P, Haroon S, Brown CS, Youkee D, et al. Clinical features of patients isolated for suspected Ebola virus disease at Connaught Hospital, Freetown, Sierra Leone: a retrospective cohort study. Lancet Infect Dis. 2015;15(9):1024-33.  https://doi.org/10.1016/S1473-3099(15)00137-1  PMID: 26213248 
  11. O’Shea MK, Clay KA, Craig DG, Matthews SW, Kao RLC, Fletcher TE, et al. Diagnosis of Febrile Illnesses Other Than Ebola Virus Disease at an Ebola Treatment Unit in Sierra Leone. Clin Infect Dis. 2015;61(5):795-8.  https://doi.org/10.1093/cid/civ399  PMID: 25991466 
  12. Robert Koch Institut (RKI). Recommended measures for medical and other staff who were involved in patient care or outbreak response during the Ebola outbreak in West Africa. Berlin: RKI. Available from: http://www.rki.de/EN/Content/infections/epidemiology/outbreaks/Ebola_virus_disease/Ebola_returning_HCW.html
  13. Centers for Disease Control and Prevention (CDC). Interim US. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure. Atlanta: CDC. [Accessed 23 Nov 2015]. Available from: http://www.cdc.gov/vhf/ebola/exposure/monitoring-and-movement-of-persons-with-exposure.html#mm-table
  14. Interim US. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure Atlanta: CDC. [Accessed 27 Jul 2015]. Available from: http://www.cdc.gov/vhf/ebola/exposure/monitoring-and-movement-of-persons-with-exposure.html#table-monitoring-movement
  15. Public Health England (PHE). Public health recommendations for asymptomatic contacts of an Ebola case in the UK. London: PHE. [Accessed 14 Aug 2015]. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/402483/Public_health_recommendations_for_asymptomatic_contacts_of_an_Ebola_case.pdf
  16. Chevalier MS, Chung W, Smith J, Weil LM, Hughes SM, Joyner SN, et al. Centers for Disease Control and Prevention (CDC). Ebola virus disease cluster in the United States--Dallas County, Texas, 2014. MMWR Morb Mortal Wkly Rep. 2014;63(46):1087-8. PMID: 25412069 
  17. National Health Service (NHS). NHS staff survey national briefing; 2013. [Accessed 14 Aug 2015]. Available from: http://www.nhsstaffsurveys.com/Caches/Files/NHS%20staff%20survey_nationalbriefing_2013_FINAL.pdf
  18. Nichol K, Bigelow P, O’Brien-Pallas L, McGeer A, Manno M, Holness DL. The individual, environmental, and organizational factors that influence nurses’ use of facial protection to prevent occupational transmission of communicable respiratory illness in acute care hospitals. Am J Infect Control. 2008;36(7):481-7.  https://doi.org/10.1016/j.ajic.2007.12.004  PMID: 18786451 
  19. Stein AD, Makarawo TP, Ahmad MFR. A survey of doctors’ and nurses’ knowledge, attitudes and compliance with infection control guidelines in Birmingham teaching hospitals. J Hosp Infect. 2003;54(1):68-73.  https://doi.org/10.1016/S0195-6701(03)00074-4  PMID: 12767850 
  20. McCarty CL, Basler C, Karwowski M, Erme M, Nixon G, Kippes C, et al. Centers for Disease Control and Prevention (CDC). Response to importation of a case of Ebola virus disease--Ohio, October 2014. MMWR Morb Mortal Wkly Rep. 2014;63(46):1089-91. PMID: 25412070 
  21. Heymann DL. SARS and emerging infectious diseases: a challenge to place global solidarity above national sovereignty. Ann Acad Med Singapore. 2006;35(5):350-3. PMID: 16830003 
  22. Aghaizu A, Elam G, Ncube F, Thomson G, Szilágyi E, Eckmanns T, et al. Preventing the next ‘SARS’ - European healthcare workers’ attitudes towards monitoring their health for the surveillance of newly emerging infections: qualitative study. BMC Public Health. 2011;11(1):541.  https://doi.org/10.1186/1471-2458-11-541  PMID: 21740552 
  23. McDougall CW, Upshur REG, Wilson K. Emerging norms for the control of emerging epidemics. Bull World Health Organ. 2008;86(8):643-5. [Accessed 25 May 2016]. Available from: http://www.who.int/bulletin/volumes/86/8/08-051771/en/
  24. European Commission. Ebola: Germany provides additional medical evacuation capacity. European Commission. [Accessed 10 May 2016]. Available from: http://ec.europa.eu/echo/news/ebola-germany-provides-additional-medical-evacuation-capacity_en
  25. Drazen JM, Kanapathipillai R, Campion EW, Rubin EJ, Hammer SM, Morrissey S, et al. Ebola and quarantine. N Engl J Med. 2014;371(21):2029-30.  https://doi.org/10.1056/NEJMe1413139  PMID: 25347231 
  26. Tracey LE, Regan AK, Armstrong PK, Dowse GK, Effler PV. EbolaTracks: an automated SMS system for monitoring persons potentially exposed to Ebola virus disease. Euro Surveill. 2015;20(1):20999.  https://doi.org/10.2807/1560-7917.ES2015.20.1.20999  PMID: 25613652 
Febrile illness in healthcare workers caring for Ebola virus disease patients in a high-resource setting
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Douglas+Fink&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fink Douglas</a>, <a href="/search?value1=Ian+Cropley&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cropley Ian</a>, <a href="/search?value1=Michael+Jacobs&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jacobs Michael</a>, <a href="/search?value1=Stephen+Mepham&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mepham Stephen</a></span>. Febrile illness in healthcare workers caring for Ebola virus disease patients in a high-resource setting. <a href="/content/ecdc">Euro Surveill.</a> 2017;22(4):pii=30449. <a href="https://doi.org/10.2807/1560-7917.ES.2017.22.4.30449" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2017.22.4.30449</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 08 Feb 2016;&nbsp;&nbsp; <span class="generated">Accepted</span>: 21 Jul 2016 </span> </p>
/content/10.2807/1560-7917.ES.2017.22.4.30449
/content/10.2807/1560-7917.ES.2017.22.4.30449
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