McCarty Carolyn L, Basler Colin, Karwowski Mateusz, Erme Marguerite, Nixon Gene, Kippes Chris, Allan Terry, Parrilla Toinette, DiOrio Mary, de Fijter Sietske, Stone Nimalie D, Yost David A, Lippold Susan A, Regan Joanna J, Honein Margaret A, Knust Barbara, Braden Christopher
MMWR Morb Mortal Wkly Rep. 2014 Nov 21;63(46):1089-91.
On September 30, 2014, the Texas Department of State Health Services reported a case of Ebola virus disease (Ebola) diagnosed in Dallas, Texas, and confirmed by CDC, the first case of Ebola diagnosed in the United States. The patient (patient 1) had traveled from Liberia, a country which, along with Sierra Leone and Guinea, is currently experiencing the largest recorded Ebola outbreak. A nurse (patient 2) who provided hospital bedside care to patient 1 in Texas visited an emergency department (ED) with fever and was diagnosed with laboratory-confirmed Ebola on October 11, and a second nurse (patient 3) who also provided hospital bedside care visited an ED with fever and rash on October 14 and was diagnosed with laboratory-confirmed Ebola on October 15. Patient 3 visited Ohio during October 10-13, traveling by commercial airline between Dallas, Texas, and Cleveland, Ohio. Based on the medical history and clinical and laboratory findings on October 14, the date of illness onset was uncertain; therefore, CDC, in collaboration with state and local partners, included the period October 10-13 as being part of the potentially infectious period, out of an abundance of caution to ensure all potential contacts were monitored. On October 15, the Ohio Department of Health requested CDC assistance to identify and monitor contacts of patient 3, assess the risk for disease transmission, provide infection control recommendations, and assess and guide regional health care system preparedness. The description of this contact investigation and hospital assessment is provided to help other states in planning for similar events.
2014年9月30日,得克萨斯州州立卫生服务部报告了一例在得克萨斯州达拉斯市诊断出的埃博拉病毒病(埃博拉)病例,并经美国疾病控制与预防中心(CDC)确认,这是美国确诊的首例埃博拉病例。患者(患者1)来自利比里亚,该国与塞拉利昂和几内亚一样,目前正经历有记录以来最大规模的埃博拉疫情。在得克萨斯州为患者1提供医院床边护理的一名护士(患者2)因发烧前往急诊室就诊,并于10月11日被确诊为实验室确诊的埃博拉病例,另一名同样提供医院床边护理的护士(患者3)于10月14日因发烧和皮疹前往急诊室就诊,并于10月15日被确诊为实验室确诊的埃博拉病例。患者3在10月10日至13日期间前往俄亥俄州,乘坐商业航班往返于得克萨斯州达拉斯市和俄亥俄州克利夫兰市之间。根据10月14日的病史以及临床和实验室检查结果,发病日期不确定;因此,出于充分谨慎以确保对所有潜在接触者进行监测,CDC与州和地方合作伙伴合作,将10月10日至13日这一期间列为潜在感染期的一部分。10月15日,俄亥俄州卫生部请求CDC协助识别和监测患者3的接触者,评估疾病传播风险,提供感染控制建议,并评估和指导区域医疗保健系统的准备情况。提供此次接触者调查和医院评估的描述,以帮助其他州为类似事件制定计划。