The College of Optometrists

The College and Association of Optometrists issue advice for optometrists on Ebola virus disease

Ebola virusEbola virus is one cause of viral haemorrhagic fever (VHF).  Although the likelihood of imported cases is low, health care providers, including optometrists, should remain vigilant for those who have visited areas affected by Ebola and who develop unexplained illness.  We recognise that it is extremely unlikely that you will encounter a patient with suspected VHF, but have been asked to provide advice for optometrists just in case this happens.

Key points

People with Ebola only become contagious after they begin to have symptoms, such as fever.  

A patient who contacts the practice who has a fever or a history of fever within the past 24 hours should be asked if they have recently visited the affected areas (Guinea, Liberia and Sierra Leone), or been caring for someone or come into contact with body fluids or clinical specimens from a person who is alive or dead or an animal known or strongly suspected to have VHF.

If a patient falls into this category and contacts the practice advise them:

  • not to visit the practice or their GP surgery or walk-in centre
  • to contact their GP by telephone for advice.  

If a patient falls into this category and attends the practice, you should: 

  • isolate the patient, by putting them into a side room (ideally removable items should be removed from this room to reduce the need for cleaning should Ebola be confirmed later)
  • ring 111 or 999 and mention that you have a patient with suspected Ebola
  • ring the local health protection team.1

Background

Public Health England advises2 that Ebola can only be transmitted from one person to another through direct contact (through broken skin or mucous membrane) with blood or bodily fluids of an infected person, or indirect contact with environments contaminated with splashes or droplets or blood or body fluids.3 The incubation period of Ebola virus ranges from 2 to 21 days (typically 5-7 days).4

The most infectious body fluids are blood, faeces and vomit.  Saliva and tears may also carry some risk.  However, the studies implicating these additional bodily fluids were extremely limited in sample size and the science is inconclusive. In studies of saliva, the virus was found most frequently in patients at a severe stage of illness. The whole live virus has never been isolated from sweat.5 The Ebola virus can also be transmitted through contact with surfaces and objects that have been previously contaminated by infected blood or body fluids.  The risk of transmission via this route is low, and can be reduced even further by appropriate cleaning and disinfection procedures.5

Good infection control procedures, such as regular and careful hand hygiene (with soap and water, or alcohol hand rub if soap isn’t available) are important in minimising the spread of disease.  

Please refer to the Guidance section on Infection control

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Public Health England: Postcode look-up for health protection teams

2 Public Health England: Information for Primary Care: Managing patients who require assessment for Ebola virus disease pdf

3   Advisory Committee on Dangerous Pathogens: Management of Hazard Group 4 viral haemorrhagic fevers and similar human infectious diseases of high consequence.

4  NHS Choices: Ebola virus disease.  

5 World Health Organization: What we know about transmission of the Ebola virus among humans

 

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