CDC issues guidelines for health care providers and patients on Ebola

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First U.S. Ebola case has health officials taking every precaution

The first person with Ebola virus disease (EVD) has been confirmed in the United States. CDC has deployed 10 experts to Texas, where the patient is in isolation, to investigate and assist with the case.

“We recognize that it is essential that appropriate measures are taken to prevent the virus from spreading,” said CDC Director Thomas Frieden, MD, MPH, in a statement. “CDC is working closely with partners to implement those measures.”

But questions are being raised as to how the Texas hospital the patient went to handled the case originally. A Liberian man entered a Dallas emergency department last week and presented with low-grade fever and abdominal pain. The hospital did not admit him based on his symptoms but acknowledged that they would have if his travel history had been communicated properly. The man told a nurse he had been in Africa but the information was not fully communicated to the medical team at Texas Health Presbyterian Hospital Dallas. He returned 3 days later, tested positive for EBV, and has been in isolation since.

The case is a lesson for all health care providers, including pharmacists, who may be the first to encounter a patient with symptoms consistent with the disease.

CDC said health care providers should take a travel history from any person who has symptoms of viral infection and should consider EBV in patients with a fever greater than 101.5° Fahrenheit, severe headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding 21 days after traveling from Guinea, Liberia, Nigeria, or Sierra Leone. Health care providers should immediately take infection control precautions and contact their state or local health department if they have questions.

The CDC guidelines are also meant to help health care providers, including pharmacists, try to assist patients and families from over-reacting.

According to CDC, patients who have recently traveled from Guinea, Liberia, Nigeria, or Sierra Leone should similarly monitor their health for symptoms. If they develop a fever greater than 101.5° Fahrenheit with severe headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding 21 days after traveling from these countries, they should go see a health care provider immediately. 

Although patients with Ebola cannot spread the infection before having symptoms, CDC is taking every precaution and wants the public to know they are controlling the isolated case.

CDC experts working in Texas are not only making sure the EVD patient is isolated and receiving proper treatment, but they are also interviewing and monitoring people the patient may have come in close contact with, including family members and health care providers who cared for the patient. These people are at the highest risk of getting sick because they may have been exposed to infected blood or body fluids from the patient—which is how the disease is transmitted.

The Texas patient began to show signs of EVD on September 24 and was not admitted to Texas Health Presbyterian until September 28. 

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