May 2013 - MERS Cov & Influenza A(H7N9)

Please beware of severe respiratory and/or fever symptoms in recently returned travellers from the Arabian Peninsula and neighbouring countries or from China.

These persons may have novel coronavirus (MERS-CoV) or influenza A(H7N9) which are infectious and maybe highly virulent. Patients are usually quite ill.


  • Fever > 38°C and clinical signs of pneumonia or SIRS after travel to above areas
  • Immunocompromised are at particular risk

Management of suspected cases

  • Infection control measures! (in an unfit for purpose ED?) as published
  • Try to protect other patients and staff
  • Hand hygiene, surgical mask, ± eye protection
  • "Place patient at least 1 metre from other patients." !
  • "Single room"
  • "Avoid contact with people who are immunosuppressed and/or have chronic medical conditions"
  • Particular precautions (yourself) if intubation or NIV used

Ebola Alert 7/7/2014

VHF - Viral Haemorrhagic Fever

Recent extensive outbreak of Ebola virus disease (EVD), a form of Viral Haemorrhagic Fever (VHF), in West Africa.

Please take a travel history from all those with flu-like illness and fever >38°C. Any traveller returning from a trip to (or travel through) the affected areas (Guinea, Liberia, Sierra leone and Mali) who develops a fever >38°C within 21 days of their return, should seek urgent medical attention.

If such a person should present to you:

  1. You should call and discuss the case immediately with your local Emergency Medicine Consultant, alerting him/her that you are referring a patent with suggestive history. The hospital may wish to make arrangements to have the person assessed away from the ED
  2. While awaiting transfer, use standard precautions with the patient, and if the person has any bleeding, bruising, vomiting, diarrhoea or cough, use standard, contact and droplet precautions, pending transfer to ED for assessment. Details of these precautions can be found in the HPSC Guidance document and Management of Viral Haemorrhagic Fevers in Ireland (2012). There are as number of risk assessment documents for use in assessing possible cases of VHF on the HPSC website. In addition, the Mater Hospital operates the National Isolation Unit, which is responsible for caring for patients referred from throughout Ireland, who have both hazardous and highly infectious diseases (such as Ebola)

Content by Dr Íomhar O' Sullivan. Last review Dr ÍOS 11/04/23.