ACDP guidelines are impractical

EDITOR —Klein and Millman describe 31 children with fever who had recently visited the tropics and presented to their department.1 Many of these children, including the 11 who had visited sub-Saharan Africa, would be likely to fall into the moderate risk category as defined by guidelines published in a document by the Advisory Committee on Dangerous Pathogens.2 This category includes febrile patients who have been in an endemic area during the 21 days before onset of illness. It would be interesting to know if the possibility of viral haemorrhagic fever was considered in any of these children, and if the guidelines were followed.

There are serious implications for the clinical management of patients falling into the moderate risk category. These people can be admitted only to isolation facilities, which have stringent specifications and are not available …