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Ebola virus disease (EVD) is a viral haemorrhagic fever, with a case fatality rate of 50% (25–90%). The current outbreak in West Africa (Guinea, Sierra Leone and Liberia) is the largest and most complex since the Ebola virus was discovered. Ebola spreads via direct contact with bodily fluids of infected people, and materials contaminated with these fluids. Healthcare workers have frequently been infected while treating patients with EVD. This has occurred through close contact with patients when infection control precautions were not strictly practised.
One year into the current epidemic of EVD, there have been more than 15 000 confirmed cases and 5400 deaths (584 cases in health workers, of whom 329 have died).1 In previous Ebola virus outbreaks, children have been under-represented, perhaps because they have less contact with infected patients,2 and there is little published data on presentation, management or prognosis of EVD in children. In this outbreak, children have been hit hard both directly through EVD and indirectly through failure of the normal healthcare systems, displacement and thousands being orphaned.3 However, there are few systematic descriptions of clinical features in children, although mortality is said to be higher in younger children than in young adults and clinical presentations may differ from adults.4
No child with confirmed viral haemorrhagic fever has ever been cared for in the UK. A new paediatric pathway has been developed for the UK National Health Service (NHS) care of a child with EVD, which balances access to paediatric specialist care and staff safety. A child in the UK with confirmed Ebola infection will be transferred to and cared for in a national specialised centre—a high-level isolation unit (HLIU). These units have high-level infection prevention and control (IPC) features, including in some cases a bed isolator (Trexler) tent, and are staffed …
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