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Ebola or Not? Evaluating the Ill Traveler From Ebola-Affected Countries in West Africa.
Open Forum Infect Dis. 2016 Jan; 3(1):ofw005.OF

Abstract

Background.

The 2014-2015 Ebola epidemic in West Africa had global impact beyond the primarily affected countries of Guinea, Liberia, and Sierra Leone. Other countries, including the United States, encountered numerous patients who arrived from highly affected countries with fever or other signs or symptoms consistent with Ebola virus disease (EVD). Methods. We describe our experience evaluating 25 travelers who met the US Centers for Disease Control and Prevention case definition for a person under investigation (PUI) for EVD from July 20, 2014 to January 28, 2015. All patients were triaged and evaluated under the guidance of institutional protocols to the emergency department, outpatient tropical medicine clinic, or Emory's Ebola treatment unit. Strict attention to infection control and early involvement of public health authorities guided the safe evaluation of these patients.

Results.

None were diagnosed with EVD. Respiratory illnesses were common, and 8 (32%) PUI were confirmed to have influenza. Four patients (16%) were diagnosed with potentially life-threatening infections or conditions, including 3 with Plasmodium falciparum malaria and 1 with diabetic ketoacidosis.

Conclusions.

In addition to preparing for potential patients with EVD, Ebola assessment centers should consider other life-threatening conditions requiring urgent treatment, and travelers to affected countries should be strongly advised to seek pretravel counseling. Furthermore, attention to infection control in all aspects of PUI evaluation is paramount and has presented unique challenges. Lessons learned from our evaluation of potential patients with EVD can help inform preparations for future outbreaks of highly pathogenic communicable diseases.

Authors+Show Affiliations

Division of Infectious Diseases, Department of Medicine.Division of Infectious Diseases, Department of Medicine.Division of Infectious Diseases, Department of Medicine; Department of Pathology and Laboratory Medicine.Division of Infectious Diseases, Department of Medicine; Department of Pathology and Laboratory Medicine.Division of Infectious Diseases, Department of Medicine.Division of Infectious Diseases, Department of Medicine; Division of Pediatric Infectious Diseases, Department of Pediatrics.Division of Infectious Diseases, Department of Medicine.Department of Emergency Medicine , Emory University.Department of Emergency Medicine , Emory University.Department of Emergency Medicine , Emory University.Department of Emergency Medicine , Emory University.Emory Healthcare.Department of Quality and Safety: Infection Prevention and Control , Emory Healthcare , Atlanta, Georgia.Division of Infectious Diseases, Department of Medicine.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26925428

Citation

Fairley, Jessica K., et al. "Ebola or Not? Evaluating the Ill Traveler From Ebola-Affected Countries in West Africa." Open Forum Infectious Diseases, vol. 3, no. 1, 2016, pp. ofw005.
Fairley JK, Kozarsky PE, Kraft CS, et al. Ebola or Not? Evaluating the Ill Traveler From Ebola-Affected Countries in West Africa. Open forum infectious diseases. 2016;3(1):ofw005.
Fairley, J. K., Kozarsky, P. E., Kraft, C. S., Guarner, J., Steinberg, J. P., Anderson, E., Jacob, J. T., Meloy, P., Gillespie, D., Espinoza, T. R., Isakov, A., Vanairsdale, S., Baker, E., & Wu, H. M. (2016). Ebola or Not? Evaluating the Ill Traveler From Ebola-Affected Countries in West Africa. Open Forum Infectious Diseases, 3(1), ofw005. https://doi.org/10.1093/ofid/ofw005
Fairley JK, et al. Ebola or Not? Evaluating the Ill Traveler From Ebola-Affected Countries in West Africa. Open forum infectious diseases. 2016;3(1):ofw005. PubMed PMID: 26925428.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ebola or Not? Evaluating the Ill Traveler From Ebola-Affected Countries in West Africa. AU - Fairley,Jessica K, AU - Kozarsky,Phyllis E, AU - Kraft,Colleen S, AU - Guarner,Jeannette, AU - Steinberg,James P, AU - Anderson,Evan, AU - Jacob,Jesse T, AU - Meloy,Patrick, AU - Gillespie,Darria, AU - Espinoza,Tamara R, AU - Isakov,Alexander, AU - Vanairsdale,Sharon, AU - Baker,Esther, AU - Wu,Henry M, Y1 - 2016/01/18/ PY - 2015/10/02/received PY - 2016/01/12/accepted PY - 2016/3/1/entrez PY - 2016/3/1/pubmed PY - 2016/3/1/medline KW - Ebola virus disease KW - clinical screening KW - fever KW - travel medicine SP - ofw005 EP - ofw005 JF - Open forum infectious diseases VL - 3 IS - 1 N2 - Background. The 2014-2015 Ebola epidemic in West Africa had global impact beyond the primarily affected countries of Guinea, Liberia, and Sierra Leone. Other countries, including the United States, encountered numerous patients who arrived from highly affected countries with fever or other signs or symptoms consistent with Ebola virus disease (EVD). Methods. We describe our experience evaluating 25 travelers who met the US Centers for Disease Control and Prevention case definition for a person under investigation (PUI) for EVD from July 20, 2014 to January 28, 2015. All patients were triaged and evaluated under the guidance of institutional protocols to the emergency department, outpatient tropical medicine clinic, or Emory's Ebola treatment unit. Strict attention to infection control and early involvement of public health authorities guided the safe evaluation of these patients. Results. None were diagnosed with EVD. Respiratory illnesses were common, and 8 (32%) PUI were confirmed to have influenza. Four patients (16%) were diagnosed with potentially life-threatening infections or conditions, including 3 with Plasmodium falciparum malaria and 1 with diabetic ketoacidosis. Conclusions. In addition to preparing for potential patients with EVD, Ebola assessment centers should consider other life-threatening conditions requiring urgent treatment, and travelers to affected countries should be strongly advised to seek pretravel counseling. Furthermore, attention to infection control in all aspects of PUI evaluation is paramount and has presented unique challenges. Lessons learned from our evaluation of potential patients with EVD can help inform preparations for future outbreaks of highly pathogenic communicable diseases. SN - 2328-8957 UR - https://www.unboundmedicine.com/medline/citation/26925428/full_citation L2 - https://academic.oup.com/ofid/article-lookup/doi/10.1093/ofid/ofw005 DB - PRIME DP - Unbound Medicine ER -
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