If the WHO declares that the current Ebola outbreak in DRC is a Public Health Emergency of International Concern, a number of procedures have been developed to protect our country.

Airport

Like for any other highly contagious diseases, early detection of (potential) cases is very important. Patients potentially contaminated by the Ebola virus are most likely to enter the country through the national airport. Additional precautionary measures can therefore be put in place if necessary:

• Imposing targeted temperature controls at the origin airport as well as at the arrival in Belgium
• Drawing up procedures for ill passengers on board who are suspected of being infected with Ebola
• Conducting field exercises

Fever control

• Passenger Locator Card
• Phase 1: Passenger Locator Card (in French)
• Step 2: Taking body temperature (in French)
• Step 3: Patient’s clinical history (taken by a nurse) (in French)
• Step 4: Airport doctor (in French)
• Questionnaire to be completed in case of positive results (in French)
• Transfer from airport to hospital (in French)

Sick passengers

• Questionnaire to be completed by the airport doctor (in French)

Hospitals and general practitioners

First- and second-line health providers are at very low risk of being exposed to Ebola. It is essential that (professional) care providers should be able to recognise Ebola symptoms and know who to contact, how to protect themselves and their environment, and where the patient must be treated.

In consultation with experts, the Risk Management Group has developed an operational procedure for health care providers in Belgium to manage Ebola. Following document must therefore be used as a guideline for all health workers in Belgium:

• Ebola control procedure for health professionals (in French)

The Superior Health Council has published an opinion on Ebola management in Belgium: Publication of the Superior Health Council No. 9188

General practitioners

If you are a general practitioner, there is a (very) small chance you’ll get into contact with a (potential) Ebola patient in your office. It’s therefore important you know what to do as a general practitioner.

Starting from the general guideline for Ebola risk management, we have summarised the most relevant information for you:

• Procedure in brief for general practitioners (in French)
• Ebola information poster for general practitioners (in French)
• Ebola in practice: how to be prepared in 10 steps (in French)

Emergency interventions

First-aid workers are likely to get into contact with patients (potentially) infected with Ebola. The risk is however very low and the precautionary measures that have been taken should not interfere with the smooth functioning of 112/100 emergency services. Therefore a procedure providing a clear task division for emergency services has been developed in dialogue with all the stakeholders. The transportation of patients suspected of being infected with Ebola has been organised to ensure a human and correct treatment for the patient, while considering the safety of emergency aid workers and preventing other patients’ lives from being put at risk.

• Intervention procedure (in French)
• Intervention flow chart (in French)
• Ebola Screening Questionnaire (in French)

Contact follow-up

When a patient is identified as (potentially) infected with Ebola, contact tracing is needed.This operation is conducted by the physician responsible for infectious disease control. Follow-up and necessary actions mainly depend on the exposure level.

• Contact tracing for patients with hemorrhagic fever (in French)

Remains of deceased patients

If a patient dies as a result of Ebola infection, it is important that health care providers, the funeral director and the family exactly know what is safe and what can be done with the remains. The corpse of an Ebola patient can be highly contagious.

Following procedure provides an overview of the agreements made with all the stakeholders:

• Recommendation on how to deal with remains of deceased VHF patients (in French)

Waste disposal

All medical and biological waste resulting from Ebola patient management is contagious. It must therefore be collected and disposed of in a specific and safe way. A multilateral agreement has been signed by Belgium and some other countries sharing the same approach.

• Multilateral Agreement M281 (in French)
• Waste disposal procedure for hospitals in case of patients (suspected of being) infected with VHF (in French)

Health workers getting back home

• Follow-up of humanitarian workers returning from ebola affected areas