Intended for healthcare professionals

Rapid response to:


Ebola and other viral haemorrhagic fevers

BMJ 2014; 349 doi: (Published 11 August 2014) Cite this as: BMJ 2014;349:g5079

Rapid Response:

We thank Fletcher et al for their editorial(1) highlighting the recently updated UK guidance on management of viral haemorrhagic fever(2), and suggesting that NHS staff are trained in both risk assessment and use of personal protective equipment. However, we feel that an important additional recommendation is missing from this editorial.

In order to control the current epidemic, the largest recorded with over 1500 deaths to date, it has been recognised that a global response is required in terms of finance, equipment, and skilled personnel(3,4). The most effective way to protect the UK from the Ebola virus is to address, contain and control the epidemic at its source. The UK government have shown commitment to the global response through the Department for International Development (DFID), who are convening national experts from a variety of fields. Further, the World Health Organisation, Medecins Sans Frontiers, the International Federation of Red Cross, and The King’s Fund have made national and international calls for health-care workers to accept temporary contracts and travel to the affected region on targeted ‘missions’. We believe that in order to support the UK’s response, the NHS must allow staff temporary leave of absence from their post to contribute to the global response. Consultant physicians, specialty trainees and specialist nurses in specialties including infectious diseases, microbiology, virology, public health, intensive care and infection control are well placed to offer assistance and should be supported. Part of the preparedness will require adequate training to reduce personal risk and ensure the best possible clinical care in the circumstances. Their experience and new skills would enhance the NHS pool of expertise for similar events in the future. We have anecdotal reports of physicians and nurses being denied leave for these activities, possibly due to lack of peer support or financial/resource pressures. If NHS trust financial pressures are a barrier to release of staff, would not central funding through DFID to NHS trusts for releasing staff be an option?

According to the WHO, the Ebola epidemic in West Africa is now an international public health emergency. The NHS trusts and deaneries must approve and fast-track requests from NHS staff who are willing to contribute their time and skills to deal with this crisis.

1. Fletcher, T. E., Brooks, T. J. G. & Beeching, N. J. Ebola and other viral haemorrhagic fevers. BMJ 5079, 10–11 (2014).
2. Advisory Committee on Dangerous Pathogens. Management of hazard group 4 viral haemorrhagic fevers and similar human infectious diseases of high consequence. Department of Health, 2012.
3. Ansumana, R., Bonwitt, J., Stenger, D. a & Jacobsen, K. H. Ebola in Sierra Leone: a call for action. Lancet 6736, 61119 (2014).

Competing interests: No competing interests

02 September 2014
Catherine F Houlihan
Clinical Research Fellow
Dr Ron Behrens, Professor David Moore
London School of Hygiene and Tropical Medicine, Hospital for Tropical Diseases.
London School of Hygiene and Tropical Medicine