CLICK HERE for Ebola ‘HOW TO HANDLE AND DOCUMENT’ guidelines
CLICK HERE for Ebola ACTIVE MONITORING guidelines (updated 11/2015)
We have just received the first call concerning the question of how to handle a patient with fever who has arrived from an involved area. This is an effort to provide initial guidance:
1. Recent travel from Guinea ONLY. (LIBERIA and MALI has been declared Ebola outbreak free for weeks. As of Nov 7th, SIERRA LEONE has been 42 days free of any new EVD cases and will PASSIVELY monitor themselves.)
2. Determine level of exposure of the patient within the past 21 days to anyone with Ebola: prolonged contact with an Ebola victim or that person’s body fluids (“high risk of exposure”); limited contact (“low risk of exposure”); or no contact (“no risk of exposure”)
3. Determine presence of fever and any other symptoms
a. Fever is present in excess of 37.7 C ( > 100.0 F)
b. Headache, vomiting, diarrhea, malaise, bleeding
c. Lymphopenia, thrombocytopenia
4. Isolate the patient, in a room with filtration on exhausted air (“TB isolation”) if possible; use contact-droplet precautions with full face shield
5. Assess patient for other sources of illness, and specifically for malaria
6. Health care provider needs to talk with State Med Epi — LOOK AT THE WHITEBOARD to see who’s on-call for med EPI or CALL STEPHANIE DIRECTLY if it’s not posted.
7. Sample for testing needs to go to CDC in a plastic tube, purple or blue or yellow top collection tube, 4 mL minimum sample volume required, if directed to submit a sample by State Epi. CDC Emergency Operations Center needs to approve sample submission at 770-488-3100. If after usual hours, need to ask to talk with a “malaria branch clinician”. Need to submit both forms attached with sample (“cdc specimen submission form 50-34” and “ncezid specimen-submission”).
8. Exposed patients may need to have their travel restricted. If travel restrictions are imposed, this limits their transport in most ways, including by all ground vehicles and in public settings for 21 days after the last exposure. We will need to ascertain further how to handle these public health calls most efficiently if they become numerous.
- Case Definition for Ebola Virus Disease (EVD) _ Ebola Hemorrhagic Fever _ CDC
- CDC fever in returned travelers, as of 8-13-14
- National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Specimen-Submission
- Ebola Info for US Healthcare, CDC, as of 8-13-14
- Monitoring and movement of persons with ebola exposure, CDC, as of 8-8-14
- Ebola patient management within a US hospital, CDC, as of 8-6-14
- Ebola interim guidance specimen collection, CDC, as of 8-11-14