Local Health Districts (LHD) must ensure that each hospital has in place a contingency plan for the assessment and management of patients with an increased possibility for a VHF infection who present to their facility.
Detailed guidance is provided in the NSW Health Guideline (GL2016_002) NSW Contingency Plan for Viral Haemorrhagic Fevers and the accompanying Hospital EVD preparedness checklist.
Confirmed cases of Ebola virus disease in NSW will be cared for in a high-security isolation unit in one of the two hospitals designated for the treatment of patients with a viral haemorrhagic fever - Westmead Hospital (for adults) and Westmead Children’s Hospital (for children). Patients presenting to other hospitals and classified as being at increased risk of EVD will be safely transferred to one of these facilities as soon as possible.
Hospitals must be prepared to detect and isolate patients with fever or other symptoms suggestive of Ebola AND a history of travel in one of the affected countries in the 21 days prior to onset OR having had contact with a known or highly suspected EVD cases in the 21 days prior to onset. The hospital where the patient is being managed must provide as near as possible complete containment, as described in the VHF Contingency Plan.
In some circumstances, the clinical severity of the illness may make it inappropriate to immediately transfer a patient assessed as having an Increased Possibility of EVD to one of the designated VHF treatment hospitals. In this rare scenario, affected hospitals will be supported to manage the patient until transfer is possible or until EVD is excluded.
The Institute for Clinical Pathology and Medical Research (ICPMR) at Westmead has a high containment (PC4) laboratory equipped to test for the Ebola virus in patients categorised as Increased Possibility of EVD. This PCR test for Ebola takes about four hours once the specimen has been received at ICPMR.
National Public Health Laboratory Network guidelines are available to advise on the conduct of testing in standard laboratory conditions if required, particularly for patients categorised as Low Possibility of EVD . Point of care tests are also available in many hospitals to undertake basic testing for malaria and essential patient assessments.
- All emergency departments (EDs) need to be prepared to manage a patient who requires assessment for Ebola.
- To support this readiness, staff should be well practiced in putting on and removing (donning and doffing) personal protective equipment (PPE), and have trained observer to monitor these procedures.
- The key resource to assist ED staff on how to assess patients for Ebola is the NSW Health EVD - patient risk assessment algorithm .
Personal Protective Equipment (PPE) and Infection Control Resources
- Refer to the Clinical Excellence Commission (CEC) Healthcare Associated Infections Program for a range of EVD infection control training videos, posters and other resources related to PPE and clinical waste disposal.