With west and central African countries continuing to witness an outbreak of the deadly Ebola virus, India’s top health watchdog Integrated Disease Surveillance Program (IDSP), which looks out for disease outbreaks, has issued an advisory to state health intelligence officials and to the National Centre for Disease Control (NCDC) to “keep vigil” for the disease.
The advisory, issued by IDSP’s officiating national project officer Dr Pradip Khasnibis, describes Ebola as a “severe, often fatal illness with a fatality ratio of up to 90 per cent”.
On basic guidelines for response by first respondents, the advisory says, “Healthcare providers should consider the possibility of Ebola virus disease in person with a positive contact and travel history to affected areas and report to the Central Surveillance Unit (CSU), IDSP and NCDC. Suspected cases should be handled in isolation.” The CSU is the IDSP headquarters in Delhi, which coordinates between state surveillance units.
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Directing state surveillance officers to “maintain constant vigil and raise level of awareness and knowledge of surveillance officers and healthcare providers (first or early responders) on basic standard precautions” while treating suspected patients, the advisory says they should follow basic level of infection control — hand hygiene and use of personal protective equipment — to avoid direct contact with blood and bodily fluids and prevent needle stick injuries.
The advisory is expected to be sent to all international airports across the country this week. A level one “passive screening” of passengers returning from the affected African countries, where the disease has claimed more than 700 lives so far, will be started at the international airports, and passengers traveling to India will be advised to report symptoms to health officers at the airport.
The Health Ministry has so far not issued any travel advisory to the affected countries. Health Ministry officials are learnt to have carried out a “risk assessment” meeting for the virus on Friday, after which alerts were sent to Indians posted in the west African countries with the UN and other international agencies.
The IDSP advisory is similar to an an advisory issued by the Centre for Disease Control, the apex medical research and disease surveillance body in the US, last month. The CDC had issued advisories to US citizens to avoid “non essential travel” in Liberia, Guinea and Sierra Leone. The virus, which first broke in Guinea in February, has been circulating in these three countries and in Nigeria.
Facility to test samples have been made available at the National Institute of Virology in Pune. Cautioning that samples from patients are an “extreme biohazard risk”, the advisory says that “testing should be conducted under maximum biological containment conditions”.
The blood or serum samples collected for testing should be transported at 2-8 degrees within eight hours, and if there is any further delay, anticipated storage conditions should be at -70 degrees, with a “triple layer packing system”.
“There is no risk of transmission during the incubation period (2-21 days) and only low risk of transmission in the early phase of symptomatic patients,” it states. The advisory says that “even if a person has a history of visit to the affected area, the risk of developing the disease is very low. Casual contacts in public places with people that do not appear to be sick do not transmit Ebola,” it says.