martes, 12 de agosto de 2014

Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease Exposure | Ebola Hemorrhagic Fever | CDC

Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease Exposure | Ebola Hemorrhagic Fever | CDC



Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease Exposure

This interim guidance is intended to provide public health authorities and other partners a framework for evaluating risk of exposure of persons to Ebola Virus Disease (EVD) and initiating appropriate public health actions based on exposure risk and clinical assessment. Refer to Case Definition for Ebola Virus Disease (EVD).
Exposure LevelClinical PresentationPublic Health Actions
High Risk
  • Percutaneous (e.g., needle stick) or mucous membrane exposure to body fluids of EVD patient
  • Direct care of an EVD patient or exposure to body fluids without appropriate personal protective equipment (PPE)
  • Laboratory worker processing body fluids of confirmed EVD patients without appropriate PPE or standard biosafety precautions
  • Participation in funeral rites which include direct exposure to human remains in the geographic area where outbreak is occurring without appropriate PPE
Fever1 or other symptoms2without fever
  • Medical evaluation using infection control precautions for suspected EVD, consultation6, and testing if indicated
  • If transport is clinically appropriate and indicated, air medical transport only (no public or commercial conveyances permitted)
  • If infection control precautions are determined not to be indicated: conditional release3 and controlled movement4 until 21 days after last known exposure
Asymptomatic
  • Conditional release3 and controlled movement4 until 21 days after last known exposure
Low Risk
  • Household member or other casual contact with an EVD patient
  • Providing patient care or casual contact without high-risk exposure with EVD patients in health care facilities in outbreak-affected countries*
Fever1 with or without other symptoms2
  • Medical evaluation using initial infection control precautions for suspected EVD, consultation6, and testing if indicated
  • If transport is clinically appropriate and indicated, air medical transport only (no public or commercial conveyances permitted)
  • If infection control precautions are determined not to be indicated: conditional release3 and controlled movement4 until 21 days after last known exposure
Asymptomatic
  • Conditional release3 and controlled movement4 until 21 days after last known exposure
No Known Exposure
  • In affected country
  • No low-risk or high-risk exposures
Fever1 with other symptoms2
  • Medical evaluation and optional consultation6 to determine if movement restrictions and infection control precautions are indicated
  • If movement restrictions and infection control precautions are determined not to be indicated: travel by commercial conveyance allowed; self-monitor5 until 21 days after leaving country
Asymptomatic
  • No movement restrictions
  • Travel by commercial conveyance allowed
  • Self-monitor5 until 21 days after leaving country


* Outbreak-affected countries include Guinea, Liberia, Nigeria and Sierra Leone as of August 4, 2014
1 Fever: measured temperature ≥ 38.6°C/ 101.5°F or subjective history of fever
2 Other symptoms: includes headache, joint and muscle aches, abdominal pain, weakness, diarrhea, vomiting, stomach pain, lack of appetite, rash, red eyes, hiccups, cough, chest pain, difficulty breathing, difficulty swallowing, bleeding inside and outside of the body. Laboratory abnormalities include thrombocytopenia (≤150,000 /µL) and elevated transaminases.
3 Conditional release: Monitoring by public health authority; twice-daily self-monitoring for fever; notify public health authority if fever or other symptoms develop
4 Controlled movement: Notification of public health authority; no travel by commercial conveyances (airplane, ship, and train), local travel for asymptomatic individuals (e.g. taxi, bus) should be assessed in consultation with local public health authorities; timely access to appropriate medical care if symptoms develop
5 Self-monitor: Check temperature and monitor for other symptoms
6 Consultation: Evaluation of patient's travel history, symptoms, and clinical signs in conjunction with public health authority

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