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Wednesday, October 08, 2014

Medscape report- evaluating patients for Ebola virus

Although the risk of coming in contact with the Ebola virus in the US is far lower (nearly zero) when compared to the harm from domestic and gun violence incidents, it's nevertheless essential to learn how to keep the disease from spreading beyond those who are aready ill.  Medscape published this report:

Medscape Medical News

Evaluating Patients for Ebola: Centers for Disease Control

Recommendations for Clinicians
Centers for Disease Control and Prevention Health Advisory October 03, 2014

The first case of Ebola virus disease (Ebola) diagnosed in the United States was reported to the Centers for Disease Control and Prevention (CDC) by Dallas County Health and Human Services on September 28, 2014, and laboratory-confirmed by CDC and the Texas Laboratory Response Network (LRN) laboratory on September 30. 

The patient departed Monrovia, Liberia, on September 19, and arrived in Dallas, Texas, on September 20. The patient was asymptomatic during travel and upon his arrival in the United States; he fell ill on September 24 and sought medical care at Texas Health Presbyterian Hospital of Dallas on September 26. 

He was treated and released. 

On September 28, he returned to the same hospital and was admitted for treatment.

The purpose of this HAN Advisory is to remind healthcare personnel and health officials to:


1. Increase their vigilance in inquiring about a history of travel to Ebola-affected countries in the 21 days before illness onset for any patient presenting with fever or other symptoms consistent with Ebola;


2. Isolate patients who report a travel history to an Ebola-affected country (currently Liberia, Sierra Leone, Senegal, and Guinea) and who are exhibiting Ebola symptoms in a private room with a private bathroom and implement standard, contact, and droplet precautions (gowns, facemask, eye protection, and gloves); and

3. Immediately notify the local/state health department.


Background

The first known case of Ebola with illness onset and laboratory confirmation in the United States occurred in Dallas, Texas, on September 2014, in a traveler from Liberia. 

The West African countries of Liberia, Sierra Leone, and Guinea are experiencing the largest Ebola epidemic in history. 

From March 24, 2014, through September 23, 2014, there have been 6,574 total cases (3,626 were laboratory-confirmed) and 3,091 total deaths reported in Africa.

Ebola is a rare and deadly disease caused by infection with one of four viruses (Ebolavirus genus) that cause disease in humans. 


Ebola infection is associated with fever of greater than 38.6°C or 101.5°F, and additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage. 

Ebola is spread through direct contact (through broken skin or mucous membranes  which in my nurses opinion means sexual contact) with blood or body fluids (including but not limited to urine, saliva, feces, vomit, sweat, breast milk, and semen) of a person who is sick with Ebola or contact with objects (such as needles and syringes) that have been contaminated with these fluids. 

Ebola is not spread through the air or water (again in my nurses opinion, this statement is not 100 percent proven as the virus mutates).  (Nevertheless....) The main source for spread is human-to-human transmission.

Avoiding contact with infected persons (as well as potentially infected corpses) and their blood and body fluids is of paramount importance. Persons are not contagious before they are symptomatic. The incubation period (the time from exposure until onset of symptoms) is typically 8-10 days, but can range from 2-21 days. 


Additional information is available at http://www.cdc.gov/vhf/ebola/index.html.

Recommendations


Early recognition is critical to controlling the spread of Ebola virus. 

Consequently, healthcare personnel should elicit the patient's travel history and consider the possibility of Ebola in patients who present with fever, myalgia, severe headache, abdominal pain, vomiting, diarrhea, or unexplained bleeding or bruising. 

Should the patient report a history of recent travel to one of the affected West African countries (Liberia, Sierra Leone, and Guinea) and exhibit such symptoms, immediate action should be taken. The Ebola algorithm for the evaluation of a returned traveler and the checklist for evaluation of a patient being evaluated for Ebola are available at http://www.cdc.gov/vhf/ebola/pdf/ebola-algorithm.pdf andhttp://www.cdc.gov/vhf/ebola/pdf/checklist-patients-evaluated-us-evd.pdf.

1 Comments:

Blogger Linda jack said...

Thanks for the helpful information.

4:59 AM  

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