October 19th, 2014
As of 10/19/14 in the United States:
Confirmed Cases: 3
Contacts*: 11 (4***)
Possible Contacts**:155 (13***)
Total: 166 (17***)
*Contacts – Definite exposure
**Possible Contacts – Possible exposure
***Completed active surveillance
Note: The number of possible contacts increased significantly Oct. 14 to account for a group of healthcare workers who were previously self-monitoring and are now being actively monitored following a healthcare worker’s Ebola diagnosis over the weekend. Another case was diagnosed Oct. 15, which also impacted the numbers. Contacts are defined as people who had recognized exposure to an Ebola patient, blood, bodily fluids, specimens of an Ebola patient or potentially contaminated surfaces. Possible contacts are defined as people who had possible exposure to an Ebola patient, blood, body fluids, specimens of an Ebola patient or potentially contaminated surfaces.
When Caring for Suspect or Confirmed Patients with Ebola
1.Activate the hospital preparedness plan for Ebola, which should include:
- Initiate the notification plan for suspect or confirmed Ebola patient immediately.
- Ensure hospital infection control is notified.
- Create a clinical care team led by a senior level experienced clinician that includes at a minimum a hospital infection control specialist, a senior nurse, an infectious disease specialist, and critical care consultants.
- Assign a senior staff member from the clinical care team to coordinate testing and reporting of results from the hospital laboratory, state health department laboratory, CDC, and local and state public health. For a list of state and local health department phone numbers, see http://www.cdc.gov/vhf/ebola/outbreaks/state-local-health-department-contacts.html.
- Isolate the patient in a separate room with a private bathroom.
- Ensure a standardized protocol is in place for how and where to remove and dispose of personal protective equipment (PPE) properly and that this information is posted in the patient care area.
- When interviewing the patient, collect data on:
- Earliest date of symptom onset and the sequence of sign/symptom development preceding presentation to an emergency department.
- Detailed and precise travel history (e.g., dates, times, locations).
- Names of any persons with whom the patient may have had contact during and any time after the earliest date of symptom onset.
- Consider and evaluate for all potential alternative diagnoses (e.g. malaria, typhoid fever).
- Reassure patient and family that appropriate care will be provided.
- Ensure patient has the ability to communicate with family.
What SHOULD NOT be done for a patient under investigation for Ebola virus disease
- Don’t have any physical contact with the patient (e.g., perform examination, collect clinical samples, position for x-rays) without first putting on appropriate PPE and using recommended infection control practices necessary to prevent Ebola virus transmission.
- Don’t neglect the patient’s medical needs; assess and treat patient’s other medical conditions as indicated (e.g., diabetes, hypertension).
- Don’t forget to evaluate for all potential alternative diagnoses (e.g. malaria, typhoid fever).
- Don’t perform elective tests or procedures; minimize sample collection, laboratory testing, and diagnostic imaging (e.g., blood draws, X-rays) to those procedures necessary to provide acute care.
- Don’t allow family members to visit without putting on appropriate PPE; provide a telephone for family to communicate with patient.
Questions call Deb McMahan, MD