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Ebola virus disease

Action requested: Be aware of potential for Ebola Virus Disease in travelers returning from West Africa.

Background

According to the World Health Organization, as of July 23, 2014, a total of 1,201 cases and 672 deaths (case fatality 55-60%) due to Ebola Virus Disease had been reported in Guinea, Liberia, and Sierra Leone.  Nigerian health authorities have now confirmed a diagnosis of EVD in a patient who died on Friday in Lagos, Nigeria, after traveling from Liberia on July 20, 2014. The report marks the first Ebola case in Nigeria linked to the current outbreak. Health authorities also reported this weekend that two U.S. citizens working in a hospital in Monrovia, Liberia, have confirmed Ebola virus infection. These recent cases underscore the potential for travel-associated spread of the disease and the risks of EVD to healthcare workers.

EVD is characterized by sudden onset of fever and malaise, accompanied by other nonspecific signs and symptoms, such as myalgia, headache, vomiting, and diarrhea. Patients with severe forms of the disease may develop multi-organ dysfunction, including hepatic damage, renal failure, and central nervous system involvement, leading to shock and death.

Ebola virus is typically first spread to humans after contact with infected wildlife and is then spread person-to-person through direct contact with bodily fluids such as, but not limited to, blood, urine, sweat, semen, and breast milk. The incubation period is usually 8–10 days (rarely ranging from 2–21 days). Patients can transmit the virus while febrile and through later stages of disease, as well as postmortem, when persons contact the body during funeral preparations.

EVD poses little risk to the U.S. general population at this time.  Successful implementation of standard precautions has proved sufficient to limit transmission of imported Marlburg and other cases of viral hemorrhagic fever disease in the U.S.

Recommendation: Be alert for signs and symptoms of EVD in patients with compatible illness who have a recent (within 21 days) travel history to countries where the outbreak is occurring and consider isolating patients meeting these criteria, pending diagnostic testing.

For more information about EVD, see http://www.cdc.gov/ebola

Interim Guidance on EVD for healthcare workers can be found at: http://www.cdc.gov/vhf/abroad/healthcare-workers.html

Travel notices for each country can be found at:

Guinea: http://wwwnc.cdc.gov/travel/notices/alert/ebola-guinea

Liberia: http://wwwnc.cdc.gov/travel/notices/alert/ebola-liberia

Sierra Leone: http://wwwnc.cdc.gov/travel/notices/alert/ebola-sierra-leone

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