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VHF Differential and IPC — SCE Infectious Diseases MCQ

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HardTravel Medicine & VaccinationVHF Differential and IPCSCE Infectious Diseases

A 35-year-old man presents with a travel-related febrile illness. He returned from Liberia 5 days ago. He has high fever, jaundice, haemorrhagic manifestations (gum bleeding, petechiae), and elevated transaminases. Malaria films are negative. What critical diagnosis must be considered and what infection control measures are needed?

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Correct answer: D — Viral haemorrhagic fever (Ebola, Lassa, Marburg) — immediate isolation in a high-level isolation unit (HLIU); notify UKHSA/Imported Fever Service immediately; do NOT perform routine blood tests until VHF is excluded

A febrile traveller from West Africa with haemorrhagic manifestations and negative malaria films constitutes a potential VHF emergency. The differential includes Ebola (incubation 2–21 days), Lassa fever (endemic in West Africa), and Marburg. UKHSA's Advisory Committee on Dangerous Pathogens (ACDP) VHF algorithm must be followed: immediate patient isolation, notification to the Imported Fever Service (0844 778 8990), risk assessment, and deferral of routine blood sampling until VHF is excluded (to prevent laboratory exposure). If VHF is confirmed, transfer to an HLIU (Royal Free Hospital) is arranged.

Reference: UKHSA 2024 – VHF algorithm; ACDP guidelines; PHE 2019 – Ebola