Time to think Ebola: a message from NHS England to frontline clinical staff.

Professor Sir Bruce Keogh, the national medical director, and Dr Bob Winter, the national clinical director for emergency preparedness, have released an important announcement on Ebola to frontline staff. 2 In line with the key messages from the guidance on Ebola from Public Health England and the guidelines from the College of Emergency Medicine, 4 it highlights the utmost importance of assessing the risk of Ebola in all clinical cases presenting to healthcare professionals in the UK. The guidance is targeted at all frontline clinical staff who might encounter such a patient seeking medical attention, including hospital junior doctors, general practitioners, nurses, and paramedical and pharmacy staff. It emphasises the importance of considering Ebola in all patients with a history of travel to west Africa in the previous 21 days with or without a history of fever. It emphasises the importance of avoiding physical contact with suspected cases and of urgently isolating the patient. In primary care, the patient needs to be urgently transported to hospital by ambulance. In hospital, the consultant for infection (a microbiologist, an infectious diseases physician, or a virologist, depending on local protocol) and the local Public Health England health protection team should additionally be informed. 5 At all points, when such a case is suspected, the receiving team must be informed of the clinical suspicion of Ebola in advance so that adequate precautions can be followed, which include wearing personal protective equipment when dealing with a suspected case. Personal protective equipment for Ebola includes hand hygiene, gloves, a water repellent gown and overshoes, a fluid repellent surgical facemask, and eye protection as stated in the guidance from the Advisory Committee on Dangerous Pathogens. For further advice and guidance, please see the Public Health England website.