Ebola Risk Remains Low in UK For UK Postal Workers

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LTB515/14 Ebola Risk Remains Low in UK For The Public and UK Postal Workers - Surveillance and Support Continues



No. 515/14

Ref E1/14

Date: 11 August 2014

To: All Branches

Dear Colleagues,

Ebola Risk Remains Low in UK For The Public and UK Postal Workers - Surveillance and Support Continues:

Introduction

Ebola is a form of viral haemorrhagic fever and currently 1000 deaths have been reported in Guinea, Liberia, Nigeria and Sierra Leone. CWU Branches and members will have been watching developments through the news media and will be aware that the World Health Organisation (WHO) has declared the current Ebola virus outbreak in West Africa an international health emergency. The Geneva-based United Nations health agency has said the possible consequences of further international spread of the outbreak, which has killed almost 1,000 people in four West African countries, are "particularly serious" in view of the virulence of the disease. A coordinated international response under the guidance of the WHO is being organised in order to stop and reverse the spread of the virus. British Airways is among a number of European and US Airlines suspending flights to those West African nations struggling to contain an outbreak of the deadly Ebola virus.

With concerns amongst CWU members growing, particularly in those working at the international mail and parcels processing centres, Heathrow World Distribution Centre (HWDC) and Parcelforce Coventry International Hub, the Health, Safety and

Environment Department has been in contact and discussions with Royal Mail Group's Head of Health and Consultant Medical Adviser as well as UK Government Agencies, the Department of Health, the HSE and Public Health England (PHE).

PHE is monitoring the Ebola Virus Disease (EVD, Ebola) outbreak in West Africa and advise us that the risk to the UK remains very low. No cases of imported Ebola have ever been reported in the UK. Within the UK, PHE has informed medical practitioners about the situation in West Africa and requested they remain vigilant for unexplained illness in those who have visited the affected area, and actions to take in the event of a possible case. PHE has also provided advice for humanitarian workers planning to work in areas affected, and advice has already been issued to Immigration Removal Centres on carrying out health assessments for people who may have previously been in Ebola outbreak areas within the preceding 21 days. In light of the ongoing outbreak, PHE will continue to liaise with the Border Agency and Port Health, to update guidance for staff working in airports and ports. Airline Cabin crew identifying a sick passenger with suspicion of infectious disease on board, as well as ground staff receiving the passenger at the destination, have been advised to follow the International Air Transport Association (IATA) guidelines for suspected communicable diseases.

PHE state that the risk to UK travellers and people working in these countries of contracting Ebola is very low but UK medical practitioners have been alerted about the situation in West Africa and requested they remain vigilant for unexplained illness in those who have visited the affected area. People who have returned from affected areas who have a sudden onset of symptoms such as fever, headache, sore throat and general malaise within three weeks of their return should immediately seek medical assistance. PHE state that it is important to stress that no cases of imported Ebola have ever been reported in the UK and the risk of any traveller to West Africa contracting Ebola is very low without direct contact with the blood or body fluids of an infected person.

The UK government Minister has recently stated that this is not an issue that affects the UK directly. The UK has experienced scientists and doctors at the Royal Free Infectious Disease Unit, the Liverpool School of Tropical Medicine and the London School of Hygiene and Tropical Medicine and a lot of experience of dealing with dangerous diseases. The risk of this disease spreading fast in the UK is much lower because of that. The UK government is taking precautionary measures and looking at capability but is confident that the UK has experienced people who are ready to deal with anything if it were to arrive here.

The UK Border Force has been working closely with Public Health England and other agencies to ensure staff are prepared to deal with the threat of the Ebola virus. If a person is identified at the border as being a potential carrier of Ebola they will be immediately referred by a Border Force officer to a specialist medical care provider and reported to Public Health England.

Travellers to Sierra Leone, Liberia and Guinea are advised to follow the health advice issued by the National Travel Health Network and Centre.

Background:

Public Health England provide regular updates on the risks from the Ebola Virus outbreak occurring in Guinea, Northern Liberia and more recently cases in Sierra Leone and Nigeria. Similar outbreaks occurred in 1994, 1996 and 2001-2. However, this outbreak seems more extensive than others. PHE advises that the risk for tourists, visitors or expatriate residents in affected areas, is still considered very low if elementary precautions are followed. Although there have been several previous outbreaks of Ebola, exportation of the virus from an outbreak to a non-endemic country has historically been an exceptionally rare event, and has never occurred in Europe.

Mode of transmission:

Ebola virus is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. Fruit bats are thought to be the reservoir. Once a person comes into contact with an animal that has Ebola and is infected by the virus, it can spread from human to human. Infection occurs from direct contact (through broken skin or mucous membranes) with the blood, or other bodily fluids or secretions (stool, urine, saliva, semen) of infected people. Infection can also occur if broken skin or mucous membranes of a healthy person come into contact with environments that have become contaminated with an Ebola patient's infectious fluids such as soiled clothing, bed linen, or used needles. Anyone who has close contact with a person infected with the virus, or someone who handles samples from patients is at risk. This includes hospital staff, family members and laboratory workers, all of whom are at risk if they do not use proper barrier nursing techniques.

Risk Assessment:

Overall the risk in the affected areas of contracting any viral haemorrhagic fever (VHF), including Ebola, is considered very low unless there has been direct contact with the blood or body fluids (e.g., saliva, urine) of symptomatic infected persons or animals, or objects that have been contaminated with body fluids. Such items would be expected to be present within the isolation units that have been established to treat patients with this condition. The cause of fever in persons who have travelled in areas where VHF is present is more likely to be a common infectious disease, but such persons should be evaluated by a health-care provider to be sure.

General Advice:

No additional specific measures are required. Someone who has travelled from an infected area to the UK who develops a fever should contact their GP. It is likely that such a person will be assessed by an infectious diseases specialist service. The relevant Public Health authorities in England, Scotland, Wales and Northern Ireland have action plans in the unlikely event of a case occurring in the United Kingdom.

Occupational Risk in Royal Mail:

Following discussion with Public Health England on the risk to postal workers from mail objects arriving in the UK from countries where the outbreak of Ebola is occurring, namely Guinea, Liberia, and Sierra Leone the following applies: No additional measures are required beyond those that are in place for handling leaking or blood stained mail items in general.

Attachments:

Royal Mail Group/PHE Briefing Note on Ebola Virus
PHE Fact Sheet on Ebola Virus
Travellers advice issued by the National Travel Health Network and Centre
Royal Mail Group Head of Health Statement/Guidance on Leaking and Blood Stained Parcels
Royal Mail Group "Be Aware" Suspect Package Managers Guide Booklet


Yours Sincerely

Dave Joyce
National Health, Safety & Environment Officer

[freelunch]

Since the above LTB was released it would appear the World Health Organisation (WHO) were correct to label the Ebola outbreak an International Health Emergency.

It has become clear in recent days Liberia, Guinea and Sierra Leone can't cope with the numbers of patients, the dead are not prevented from infecting relatives and basic precautions aren't being observed amongst medical workers.
Much of the population living in slums are very superstitious, lack basic education and protective of unhealthy customs and trade for economic reasons.
The relative high numbers of caregivers, volunteer aid and health workers dying has led to rumours and consequent panic to relatives removing patients from isolation.
The Nigerian caregivers who dealt with Dr Sawyer were well aware of all the caregiver deaths that had already occurred in their neighbour countries when they saw Dr Sawyer but they still got infected.

We're beginning to see reports that the true numbers of cases maybe far higher than official figures. Reports of people leaving Nigeria out of fear and potentially carrying the virus to Spain, India, Saudi and so on.
People with money in one of the world's poorest regions are flying to countries with the best medical facilities showing symptoms whilst local governments play down the size of the outbreak to prevent panic.
Next could be an exodus of oil-rig workers from Nigeria back to the UK particularly if they see the Lagos outbreak worsening.

We read that blood samples are routinely being sent to UK labs for analysis and there's currently no cure for Ebola, indeed a vaccine may be 2 years away.
Royal Mail Group (RMG) has a core interest and responsibility to it's employees and customers the preclusion of contamination with potentially lethal contaminants.
Maybe the time is now for RMG to become a little more pro-active and not wait for the risk to reclassified?