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Ebola: what nursing staff need to know

Updated: 12 March 2015

Ebola virus disease (EVD) is a type of viral haemorrhagic fever that first appeared in 1976 near the Ebola River in the Democratic Republic of Congo. Sporadic outbreaks have occurred in Africa regularly since that time. EVD is a severe illness in human beings and the current strain has a case fatality rate of 70.8% (95% confidence interval, 69%-73%) with clinical symptoms of disease.

How is EVD spread?

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. Ebola virus is known to remain viable for several days on solid surfaces.

Current situation

An outbreak of EVD is ongoing in West Africa. As at March 8th 2015, 24,247 cases had been reported in nine affected countries (Guinea, LIberia, Mali, Sierra Leone, Spain, the United Kingdom, and the United States and two previously affected contries (Nigeria and Senegal). Nigeria and Senegal have now been declared Ebola-free.

The small number of cases that have occurred outside of Africa, included incidents involving a nurse in Spain and two nurses in America all of whom were in contact with known Ebola patients. Health care providers are at greatest risk of contracting Ebola due to their close contact with patients. A total of 840 health care workers had contracted Ebola as at 11th March 2015. 491 of these people died.

Risk in NZ: low 

NZNO supports the current assessment by the New Zealand Ministry of Health that the current risk of Ebola in NZ is low.

However, we recognise that nursing staff may be anxious or want to access more information, particularly those currently working with patients who may have travelled to West Africa or other affected areas or those who may work with these patients in the future.

What NZNO is doing

NZNO will continue to:

  • work with agencies including the Ministry of Health to ensure that systems and processes are in place to support and protect NZNO members and other health care workers
  • support agencies including local District Health Boards in preparation for any cases of Ebola entering New Zealand
  • provide NZNO members with access to the latest information

We won’t be publishing independent guidance on Ebola or other viral haemorrhagic fevers. This information is available on the Ministry of Health website.

NZNO does provide guidance for members on their obligations in a pandemic or disaster. These guidelines are available here.

The International Council of Nurses

NZNO supports the ICN call for governments to create safe workplaces for the care of Ebola patients. The ICN statement is available here.

Being prepared for Ebola Virus Disease (EVD)

Patients with suspected EVD may present in many settings, so we’re advising all nurses to keep up to date with developments and seek advice if required, in particular the following groups:

  • Public health nurses
  • Flight nurses
  • Practice nurses
  • Nurses working in assessment or emergency departments
  • Infection prevention and control nurses
  • Nurses in voluntary roles either working overseas or recently returned from overseas eg roles associated with non-governmental organisations

Ebola Virus Disease information for health professionals

Download the most recently updated documents on Ebola Virus Disease for health professionals from the Ministry of Health below. The updated documents were released in February 2015.

2015-02-04 Ebola virus disease - updated information for health professionals (PDF, 692KB)

Changes to this document include minor updates throughout the document to clarify intent or improve readability, and further clarification of 'Occupational health and blood and body fluid exposure' section (pg 18).

2015-02-04 Ebola virus disease - patient management guideline for primary care (PDF, 289KB)

Changes to this document include minor updates throughout the document to clarify intent or improve readability.

Action organisations can take 

Being prepared for suspected cases of infectious disease is not new and all health care organisations have a responsibility to have policies and procedures in place. However, the uncertainty and anxiety generated by the unknown is good reason to become informed and support others in seeking information.

NZNO is encouraging all health care organisations to take this opportunity to review their preparedness arrangements. This includes ambulance services and other organisations that may be contact points for patients outside of hospitals.

Organisations may wish to consider:

  • Staff knowledge and awareness of existing local infection prevention and control policies for the management of infectious disease and key contact points within and out of hours
  • Availability of protective clothing to effectively and efficiently manage presenting patients – consider the use of a ‘high risk infection grab bag’ or similar in a dedicated place containing all necessary equipment and available 24 hours a day (Note: such a resource supports the management of a number of high risk infections, not just EVD)
  • Ensure staff that are to be involved in the care of any patient presenting with Ebola-like symptoms have been trained in how to put on and take off relevant Personal Protective Equipment (PPE). WHO guidance on PPE is available here.
  • Hand hygiene is essential. See the Health Quality and Safety Commission website for further information on hand hygiene.
  • Consider whether refresher training is required for some staff groups
  • Availability of suitable isolation facilities should they be required

There may be other appropriate action to take, depending on the role and function of your organisation.

Find out more

NZNO Obligations in a Pandemic or Disaster: Summary Guidelines

Ministry of Health web page and associated guidelines

Ministry of Health guidance for people considering travel to Ebola-infected countries

American Nurses Association: Ebola is here - Knowledge, identification, and appropriate infection control are key

World Health Organisation Ebola information and Frequently Asked Questions

Information on Travel Safety


Acknowledgements: Royal College of Nurses UK, World Health Organization, New Zealand Ministry of Health, American Nurses Association.