Ebola outbreak in NZ unlikely

MICHAEL DALY
Last updated 15:58 11/08/2014
ebola
Reuters / World Health Organization

EPIDEMIC PREVENTION: Volunteers lower a corpse, prepared with safe burial practices to stop the chain of Ebola transmission, into a grave in Kailahun, Sierra Leone.

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The risk of anyone infected with Ebola arriving in this country is considered to be  "low".

Were it to happen, hospital infection control practices would protect healthcare workers and others, said Professor John Crump, the McKinlay professor of global health at the University of Otago.

The passenger arrival card completed by all people entering New Zealand would be the main way of detecting anyone who came to this country after being in areas affected with Ebola. The card included a question about the countries visited during the previous 30 days.

Fever was the most common initial symptom of Ebola virus disease (EVD), although it was also a feature of many more common infectious diseases.

"The screening approach would detect possible cases of EVD disease among travellers who accurately report their travel history and who have symptomatic infection," Crump said.

Symptoms could develop after arrival, as Ebola had an incubation period of up to three weeks, so information was also being provided to  apparently healthy travellers from affected areas.

"New Zealand's geographic isolation, lack of direct flights from West Africa, and limited travel volume from West Africa means that the risk of someone arriving in New Zealand with EVD is low, so the screening approach represents an abundance of caution."

The infection control methods that would be used for anyone with Ebola were used routinely for more common, although less deadly, infections. Also, health care facilities were prepared after dealing with other epidemic infectious diseases such as SARS and H1N1, Crump said.

Ebola was transmitted by close contact with living and dead patients, specifically contact with body fluids. Unlike potentially fatal virus infections such as measles and chicken pox, people could not become infected with Ebola by breathing the same air as a patient.

It was important to keep Ebola in perspective with other global infectious diseases. "Today 500 people will die of typhoid fever and 3000 from malaria worldwide and many more will be sickened," he said.

The concern with Ebola was that it was occurring in countries where conditions might facilitate the spread of the disease and make control more challenging.

"Our concern should first be for the citizens of those countries affected and for those trying to help. The risk to us is quite remote," Crump said.

The death rate from Ebola could be substantially lowered by managing patients' oxygen and breathing, fluids and electrolytes, and bacterial super-infections. The strain of virus was also important.

"Some patients clearly develop an immune response that ultimately clears the virus sometime during the second week of disease; supportive care aims to get people the best chance by getting them through to when an effective immune response develops," Crump said.

"While supportive care can improve survival, a large proportion of people with EVD will still die."

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