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Ebola virus disease in West Africa--South African perspectives.

The number of Ebola virus disease (EVD) cases and deaths continues to rise in Guinea, Liberia and Sierra Leone, and a co-ordinated intensive international response is required.  The exportation of EVD is of concern given the recent cases in the USA, Nigeria and Senegal. South Africa is well prepared for the possibility of imported EVD, given extensive experience in managing Crimean-Congo haemorrhagic fever. The response includes traveller health screening at entry points and training of port health staff. There are 11 designated public sector health facilities (at least one in each province), with staff trained and provided with personal protective equipment, but realistically we must understand that patients may arrive at any hospital or clinic. The most important factor is early recognition of potential cases and especially protection of front-line health workers, who are the most vulnerable. In patients with unexplained acute febrile illness, a history of travel involving the three affected countries, together with the likelihood of exposure to blood and body fluids of ill persons, should raise the suspicion of EVD.  Malaria remains the commonest cause of febrile illness in travellers for whom Ebola virus testing has been requested of the National Institute for Communicable Diseases.