Ebola algorithm for the evaluation of the returned traveler

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]

Overview

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 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)
3.Notify the hospital Infection Control Program and other appropriate staff
4. Evaluate for any risk exposures for EVD

5. IMMEDIATELY report to the health department
 
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
Direct skin contact with, or exposure to blood or body fluids of, an EVD patient
OR
Processing blood or body fluids from an EVD patient without appropriate personal protective equipment (PPE) or biosafety precautions
OR

Direct contact with a dead body (including during funeral rites) in an Ebola affected area without appropriate PPE
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

References

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