Ebola algorithm for the evaluation of the returned traveler
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [3]
Overview
The CDC has developed an algorithm for the evaluation of the returned traveler that can be used to stratify patients according to their risk of exposure and triage them urgently to the appropriate level of care.[1]
Algorithm
Is there a FEVER (subjective or ≥101.5°F or 38.6°C) or compatible EVD symptoms (headache, weakness, muscle pain, vomiting, diarrhea, abdominal pain or hemorrhage) in a patient who has traveled to an Ebola-affected area in the 21 days before illness onset? | |||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||
1. Isolate patient in single room with a private bathroom and with the door to hallway closed 2. Implement standard, contact, and droplet precautions (gown, facemask, eye protection, and gloves) | Report asymptomatic patients with high- or low-risk exposures in the past 21 days to the health department | ||||||||||||||||||||||||
Determine the risk of exposure | |||||||||||||||||||||||||
HIGH-RISK EXPOSURE | LOW-RISK EXPOSURE | NO KNOWN EXPOSURE | |||||||||||||||||||||||
Percutaneous (e.g., needle stick) or mucous membrane contact with blood or body fluids from an EVD patient OR | Household members of an EVD patient and others who had brief direct contact (e.g., shaking hands) with an EVD patient without appropriate PPE OR | Residence in or travel to affected areas without HIGH- or LOW-risk exposure | |||||||||||||||||||||||
Review case with Health Department including: • Severity of illness | |||||||||||||||||||||||||
Is EVD suspected? | |||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||
TESTING IS INDICATED • The health department will arrange specimen transport and testing at a Public Health Laboratory and CDC. | TESTING IS NOT INDICATED If patient requires in-hospital management: | ||||||||||||||||||||||||