Ebola virus disease triage — DTM&H MCQ

Correct answer: A — Isolate the nurse and notify the outbreak response team

The correct answer is A, isolate the nurse and notify the outbreak response team. A percutaneous injury from an Ebola-suspected patient followed by fever, diarrhoea and weakness within the incubation period (2 to 21 days) constitutes a high-risk exposure with symptom onset, and Ebola treatment unit protocols mandate immediate isolation of the symptomatic worker plus urgent notification to the outbreak team so a formal risk assessment, safe sampling and contact tracing can begin. UK ACDP guidance for viral haemorrhagic fevers identifies direct inoculation with sharps and contact with blood or body fluids as the principal transmission routes, which is exactly the mechanism here, making containment the immediate priority. Isolation limits onward transmission to other patients and staff in a unit already short of isolation space, while notification triggers the outbreak response system that governs testing, PPE level and contact monitoring. Bed pressure elsewhere does not override infection prevention and control for a probable case of a Hazard Group 4 pathogen. Why the other options are wrong: E. Send the nurse home with oral fluids: this abandons isolation entirely, risking transmission to family and community contacts and losing the ability to monitor or treat a potentially fatal, highly transmissible infection. C. Start chloroquine while awaiting malaria film: malaria co-infection should be assessed in parallel and never delays infection control, but treating empirically instead of isolating ignores the needlestick exposure that defines this case as high risk for Ebola. B. Give yellow fever vaccine immediately: yellow fever vaccine has no role in established or suspected Ebola exposure or illness and would not address the acute risk. D. Continue normal duties using gloves: gloves alone are inadequate PPE for a symptomatic high-risk contact and continuing patient contact directly propagates nosocomial spread. Key point: a symptomatic high-risk exposure to Ebola always mandates immediate isolation and outbreak team notification before any other investigation or treatment.

Reference: UKHSA/ACDP, Viral haemorrhagic fever: algorithm and guidance on management of patients, GOV.UK (updated 2026), https://www.gov.uk/government/publications/viral-haemorrhagic-fever-algorithm-and-guidance-on-management-of-patients