Ebola monitoring and movement of persons following exposure: Difference between revisions
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==Recommendations for Evaluating Exposure Risk to Determine Appropriate Public Health Actions== | ==Recommendations for Evaluating Exposure Risk to Determine Appropriate Public Health Actions== | ||
{| | |||
| '''Exposure Level''' || '''Clinical Criteria''' || '''Public Health Actions''' | {| style="cellpadding=0; cellspacing= 0; width: 1200px;" | ||
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| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF;" align=center | '''Exposure Level''' || style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF;" align=center |'''Clinical Criteria''' || style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF;" align=center |'''Public Health Actions''' | |||
|- | |- | ||
|rowspan=2 |High Risk <br> | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left rowspan=2 |High Risk <br> | ||
* Percutaneous (e.g., needle stick) or mucous membrane exposure to blood or body fluids of EVD patient | * Percutaneous (e.g., needle stick) or mucous membrane exposure to blood or body fluids of EVD patient | ||
* Direct skin contact with, or exposure to blood or body fluids of, an EVD patient without appropriate personal protective equipment (PPE) | * Direct skin contact with, or exposure to blood or body fluids of, an EVD patient without appropriate personal protective equipment (PPE) | ||
* Processing blood or body fluids of a confirmed EVD patient without appropriate PPE or standard biosafety precautions | * Processing blood or body fluids of a confirmed EVD patient without appropriate PPE or standard biosafety precautions | ||
* Direct contact with a dead body without appropriate PPE in a country where an EVD outbreak is occurring | * Direct contact with a dead body without appropriate PPE in a country where an EVD outbreak is occurring | ||
|Fever OR other symptoms consistent with EVD without fever | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |Fever OR other symptoms consistent with EVD without fever | ||
| | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left | | ||
* Consideration as a probable case | * Consideration as a probable case | ||
* Medical evaluation using infection control precautions for suspected Ebola, consultation with public health authorities, and testing if indicated | * Medical evaluation using infection control precautions for suspected Ebola, consultation with public health authorities, and testing if indicated | ||
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* If infection control precautions are determined not to be indicated: conditional release and controlled movement until 21 days after last known potential exposure | * If infection control precautions are determined not to be indicated: conditional release and controlled movement until 21 days after last known potential exposure | ||
|- | |- | ||
|Asymptomatic | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |Asymptomatic | ||
|Conditional release and controlled movement until 21 days after last known potential exposure | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |Conditional release and controlled movement until 21 days after last known potential exposure | ||
|- | |- | ||
|rowspan=2 |Some Risk of Exposure | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left rowspan=2 |Some Risk of Exposure | ||
* Household contact with an EVD patient | * Household contact with an EVD patient | ||
* Other close contact with an EVD patient in health care facilities or community settings | * Other close contact with an EVD patient in health care facilities or community settings | ||
|Fever WITH OR WITHOUT other symptoms consistent with EVD | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |Fever WITH OR WITHOUT other symptoms consistent with EVD | ||
| | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left | | ||
* Consideration as a probable case | * Consideration as a probable case | ||
* Medical evaluation using initial infection control precautions for suspected Ebola, consultation with public health authorities, and testing if indicated | * Medical evaluation using initial infection control precautions for suspected Ebola, consultation with public health authorities, and testing if indicated | ||
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* If infection control precautions are determined not to be indicated: Conditional release and controlled movement until 21 days after last known potential exposure | * If infection control precautions are determined not to be indicated: Conditional release and controlled movement until 21 days after last known potential exposure | ||
|- | |- | ||
|Asymptomatic or clinical criteria not met | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |Asymptomatic or clinical criteria not met | ||
| | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left | | ||
*Conditional release and controlled movement until 21 days after last known potential exposure | *Conditional release and controlled movement until 21 days after last known potential exposure | ||
|- | |- | ||
|rowspan=2 |No Known Exposure | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left rowspan=2 |No Known Exposure | ||
* Having been in a country in which an EVD outbreak occurred within the past 21 days and having had no exposures | * Having been in a country in which an EVD outbreak occurred within the past 21 days and having had no exposures | ||
|Fever WITH other symptoms consistent with EVD | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |Fever WITH other symptoms consistent with EVD | ||
| | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left | | ||
* Consideration as a person under investigation (PUI) | * Consideration as a person under investigation (PUI) | ||
* Medical evaluation and optional consultation with public health authorities to determine if movement restrictions and infection control precautions are indicated | * Medical evaluation and optional consultation with public health authorities 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 is allowed; self-monitor until 21 days after leaving country | * If movement restrictions and infection control precautions are determined not to be indicated: travel by commercial conveyance is allowed; self-monitor until 21 days after leaving country | ||
|- | |- | ||
|Asymptomatic or clinical criteria not met | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |Asymptomatic or clinical criteria not met | ||
| | |style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left | | ||
* No movement restrictions | * No movement restrictions | ||
* Travel by commercial conveyance allowed | * Travel by commercial conveyance allowed | ||
* Self-monitor until 21 days after leaving country | * Self-monitor until 21 days after leaving country | ||
|} | |} | ||
==References== | ==References== |
Revision as of 01:24, 1 October 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
Postexporure Management
Postexposure management among patients with close contact to Ebola may includes:
- Condition release
- Controlled movement
- Quarantine
- Self-monitoring
Close contact is defined as:
- Being within approximately 3 feet (1 meter) of an EVD patient or within the patient’s room or care area for a prolonged period of time (e.g., health care personnel, household members) while not wearing recommended personal protective equipment (i.e., standard, droplet, and contact precautions; see Infection Prevention and Control Recommendations); or
- having direct brief contact (e.g., shaking hands) with an EVD patient while not wearing recommended personal protective equipment.
- Brief interactions, such as walking by a person or moving through a hospital, do not constitute close contact.
Conditional Release
Conditional release means that people are monitored by a public health authority for 21 days after the last known potential Ebola virus exposure to ensure that immediate actions are taken if they develop symptoms consistent with EVD during this period. People conditionally released should self-monitor for fever twice daily and notify the public health authority if they develop fever or other symptoms.
Controlled Movement
Controlled movement requires people to notify the public health authority about their intended travel for 21 days after their last known potential Ebola virus exposure. These individuals should not travel by commercial conveyances (e.g. airplane, ship, long-distance bus, or train). Local use of public transportation (e.g. taxi, bus) by asymptomatic individuals should be discussed with the public health authority. If travel is approved, the exposed person must have timely access to appropriate medical care if symptoms develop during travel. Approved long-distance travel should be by chartered flight or private vehicle; if local public transportation is used, the individual must be able to exit quickly.
Quarantine
Quarantine is used to separate and restrict the movement of persons exposed to a communicable disease who don’t have symptoms of the disease for the purpose of monitoring. At this time, CDC is NOT recommending that asymptomatic contacts of EVD patients be quarantined, either in facilities or at home.
Self-Monitoring
Self-monitoring means that people check their own temperature twice daily and monitor themselves for other symptoms.
Early Recognition and Reporting of Suspected Ebola Virus Exposures
Early recognition is critical to controlling the spread of Ebola virus. Health care providers should be alert for and evaluate any patients with symptoms consistent with EVD and potential exposure history. Standard, contact, and droplet precautions should be immediately implemented if EVD is suspected. Both clinical presentation and level of exposure should be taken into account when determining appropriate public health actions, including the need for medical evaluation or monitoring and the application of movement restrictions when indicated.
Recommendations for Evaluating Exposure Risk to Determine Appropriate Public Health Actions
Exposure Level | Clinical Criteria | Public Health Actions |
High Risk
|
Fever OR other symptoms consistent with EVD without fever |
|
Asymptomatic | Conditional release and controlled movement until 21 days after last known potential exposure | |
Some Risk of Exposure
|
Fever WITH OR WITHOUT other symptoms consistent with EVD |
|
Asymptomatic or clinical criteria not met |
| |
No Known Exposure
|
Fever WITH other symptoms consistent with EVD |
|
Asymptomatic or clinical criteria not met |
|