03:40pm Sunday 17 December 2017

Ebola outbreak unlikely in Australia but no room for error, experts warn

Experts from the university’s Marie Bashir Institute for Infectious Diseases and Biosecurity and the NSW Health Department briefed media on the preparedness of hospitals, GPs and public health networks to detect and manage people entering the country who were infected by the deadly virus.

Immigration and health officials are working closely to assess, detect and monitor people entering Australia from Ebola-affected nations, according to Dr Vicky Sheppeard, Director of Communicable Diseases at NSW Health.

“We are ready, and we feel confident that we can monitor people and link them appropriately with our health services in New South Wales,” Dr Sheppeard told the forum.

“We have to plan for a patient with Ebola presenting in any kind of setting. That could be in general practice; they could be calling from their home, to an ambulance, to health direct services, or turning up at an emergency department in a hospital in New South Wales.”

The real number of people who are currently sick with Ebola is unknown but more than thirteen thousand cases, including forty-nine hundred deaths, have been reported so far, largely in the West African nations of Guinea, Liberia and Sierra Leone. A tiny fraction of these cases – 18 people – have been treated for Ebola infection in Europe and the United States.

There is currently no vaccine or cure for the disease caused by Ebola virus, which causes severe fever and muscle pain, vomiting, diarrhoea, and in some cases, organ failure and severe bleeding. Currently, the only way to stop it is to break the chains of infection.

Dr Sheppeard confirmed that 190 people from Ebola affected nations had entered New South Wales in the past six weeks and no Ebola-infected people had entered the country.

However, four returning health care workers and two humanitarian visa families are currently under surveillance in New South Wales.

Nationally, an average of 15 to 30 travelers is arriving from Ebola-affected countries each week. In the two months to late October, authorities had screened more than 900 passengers at ten Australian airports.

The Federal government this week announced that it had suspended its immigration programs from Ebola-affected countries, including its humanitarian program. This means no visas will be issued to people from those countries wishing to travel to Australia.

Responding to this announcement, Dr Adam Kamradt-Scott told the forum: “The Australian government is exercising a level of caution which is understandable, given the amount of public anxiety that exists about people returning to Australia as potential carriers of the virus.

“Having said that, Australia has got very good health care systems in place to deal with this and while mistakes can happen in a clinical setting, particularly where a health care worker might get exposed, as we have even seen in the United States, the systems are in place, and they work very effectively to prevent community transmission.

“I believe in that context the government is taking an overly cautious approach. From an international relations perspective, I think it’s starting to reflect negatively on Australia.

“The impression is the government is being unduly cautious and even mean spirited in its response to this humanitarian disaster,” he said.

The University of Sydney’s Professor Lyn Gilbert said the current outbreak of Ebola is unprecedented.

“We are faced now with a challenge that we have not yet faced previously.

“It’s not that Ebola is more transmissible or more infectious than other infectious diseases. In fact it’s less so than many of them.

“The difference is of course that it’s more serious if transmission occurs. There is a high rate of severe illness and mortality, although we don’t know what the mortality would be in western countries.

“And that means that we can’t afford any mistakes. We need to be absolutely sure that we contain it if a case is to arrive in Australia.”

Professor Gilbert emphasised that the situation in western countries is very different to that in West Africa.

“We have the diagnostic procedures, the isolation facilities, trained staff, and hospitals where we can look after these patients, and the risk to the rest of the community is negligible.”

However, infectious diseases physician, Professor Tania Sorrell AM noted that “many preventable health care associated infections continue to occur in hospitals because infection control procedures are not absolutely optimal.

She noted that Westmead Hospital in Sydney’s west had been designated as the sole treatment facility to treat any cases of Ebola that reach New South Wales

“We have the largest diagnostic and public health laboratory in New South Wales, and that includes a high security laboratory.

“It is able to handle any of the highly infectious disease and dangerous pathogens that we are ever likely to see in humans.”

Dr Grant Hill-Cawthorne, a medical virologist and lecturer in communicable disease at the University of Sydney, told the forum that West Africa was the worst area for Ebola to strike.

“The reason why this has been the biggest outbreak to date, why it has been larger than all previous outbreaks put together, is simply because of the circumstances of the country in which it originated,” he said.

“West Africa, particularly in Guinea and the Sierra Leone regions, has suffered from years of civil war, they have very underdeveloped health infrastructure, they have quite mobile populations that travel across borders, and close connections between urban and rural communities.

This has meant that the virus got into urban populations quite quickly, he added.

“The other key issue is diagnostics. Ebola wasn’t recognized in West Africa until March 2014 – a full four months after the original cased emerged.”

“This meant that affected communities had been constantly on the back foot.

“It got into urban populations and had traveled across international borders in the region. Combined with poor public health systems and the poor ability of governments to respond, low trust by individuals and communities in their government’s ability to respond – this was really the worst area for Ebola to strike.

“That means we have a long way to go.”

In order to control this outbreak, the WHO has set up the 70/70/60 Plan, Dr Grant said.

“The aim is to isolate 70 per cent of cases, ensure 70 per cent of bodies are buried in a timely manner, and to do this in the next 60 days.

“We are now 30 days into that 60 days and still a long way from meeting it.

“We currently have 22 per cent of the number of beds to isolate people in that region, we have a shortfall of nearly 1,000 health care workers in West Africa and we’ve only got two per cent of the community centres to actually educate people about this virus — so there is still a lot the international community can do,” he said.

Western nations had a duty of care and a global responsibility to aid West Africa to get health care workers on the ground, and to provide financial and logistics aid, he added.

The University of Sydney.

 


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