With the recently confirmed outbreak of Ebola Virus Disease (EVD) in Uganda, the Centers for Disease Control are asking emergency physicians to consider the virus in presenting patients who are residents or travelers with relevant exposure.
This week, the CDC and the Department of Homeland Security began routing travelers from Uganda into five United States airports - New York (JFK), Chicago (ORD), Newark (EWR), Atlanta (ATL), and Washington D.C. Dulles (IAD) - where they will undergo health screening.
Emergency physicians should consider EVD in their differential diagnosis for any patient who
- Has signs and symptoms consistent with Ebola virus infection AND
- Has traveled to affected areas of Uganda within 21 days before the onset of symptoms.
EVD symptoms include fever, headache, abdominal pain, nausea, vomiting, diarrhea, muscle aches, and unexplained bleeding.
Emergency physicians are also asked to follow precautions in accordance with CDC’s Identify, Isolate, Inform guidance:
- Immediate isolation of the patient in a private room with an in-room bathroom or covered bedside commode.
- Inform the hospital infection control team and the Epidemiology Unit.
- Contact with the patient should be limited to providing essential patient care.
- Any persons having contact with the patient should practice appropriate precautions and use appropriate Personal Protective Equipment (PPE).
- Procedures that could create splashes or increase environmental contamination with infectious material or create aerosols should be minimized.
- If aerosol-generating procedures are needed, they should be conducted in an Airborne Infection Isolation Room (AIIR) when feasible.
- All healthcare professional contacts should be documented.