Doctors working in Emergency Departments (EDs) have queried whether Ireland would be able to cope with an Ebola threat given the high rate of overcrowding in the country's hospitals.

According to the Irish Association for Emergency Medicine (IAEM), ongoing plans by the Department of Health and the HSE to deal with the disease are to be welcomed. However, it queried whether a potential case could be managed safely.

"We have serious safety concerns including the continued crowding of EDs with admitted inpatients on trolleys, insufficient isolation facilities and the HSE's national dependence on locum staff who are less likely to be aware of procedures and to have undergone specific training," the association said.

It pointed out that infectious diseases spread among patients and staff in overcrowded EDs - this has occurred with illnesses such as norovirus (winter vomiting bug) and SARS. As a result, the association said it is ‘not reassured' by HSE and Department of Health claims that Ireland is prepared for Ebola.

"Particularly significant is the fact that hospitals serving our major national airports, namely Beaumont Hospital, University Hospital Limerick and Cork University Hospital, are most at risk as they have particularly high rates of crowding," it noted.

The association said that it is widely recognised that when EDs are crowded with inpatients, the mortality rate for these and other patients increases.

"Put simply, the very immediate and daily reality is that ED crowding is resulting in more deaths and greater morbidity right now than the risk Ebola presents in this country. Ebola will simply add to this reality," it insisted.

The association is calling on the HSE to implement the ‘full capacity protocol', which relieves ED overcrowding by sharing the inpatient load with an entire hospital.

In relation to Ebola specifically, the association is also calling on the HSE and all hospitals to:
-Identify areas where potential Ebola patients can be received and treated, which is away from the crowded ED
-Introduce mandatory training for all frontline staff in the use of personal protective equipment and other infection control measures.

Ebola virus disease is a severe and often fatal illness. It is initially transmitted to humans from wild animals, but human-to-human transmission can then occur as a result of direct contact with the blood, secretions, organs or other bodily fluids of infected people, or indirect contact with environments that have been contaminated with these fluids.

Symptoms include the sudden onset of fever, headache, sore throat, muscle pain and weakness. This is then followed by diarrhoea, vomiting, rash and impaired liver and kidney function. Internal and external bleeding, including bleeding from the eyes, can also occur.

Those affected require intensive care and there is currently no treatment or vaccine available. Where an outbreak occurs, the case fatality rate can reach 90%.

Some 4,500 people have already died during the current outbreak of the disease, which began earlier this year. Most of the deaths have occurred in west Africa.

Earlier this week, the HSE confirmed that a patient taken to the Mater Hospital in Dublin did not have the virus.