Ann Intern Med. 2015 Aug 4;163(3):164-73. doi: 10.7326/M15-0968.
Following hospitalization of the first patient with Ebola virus disease diagnosed in the United States on 28 September 2014, contact tracing methods for Ebola were implemented.
To identify, risk-stratify, and monitor contacts of patients with Ebola.
Descriptive investigation.
Dallas County, Texas, September to November 2014.
Contacts of symptomatic patients with Ebola.
Contact identification, exposure risk classification, symptom development, and Ebola.
The investigation identified 179 contacts, 139 of whom were contacts of the index patient. Of 112 health care personnel (HCP) contacts of the index case, 22 (20%) had known unprotected exposures and 37 (30%) did not have known unprotected exposures but interacted with a patient or contaminated environment on multiple days. Transmission was confirmed in 2 HCP who had substantial interaction with the patient while wearing personal protective equipment. These HCP had 40 additional contacts. Of 20 community contacts of the index patient or the 2 HCP, 4 had high-risk exposures. Movement restrictions were extended to all 179 contacts; 7 contacts were quarantined. Seven percent (14 of 179) of contacts (1 community contact and 13 health care contacts) were evaluated for Ebola during the monitoring period.
Data cannot be used to infer whether in-person direct active monitoring is superior to active monitoring alone for early detection of symptomatic contacts.
Contact tracing and monitoring approaches for Ebola were adapted to account for the evolving understanding of risks for unrecognized HCP transmission. HCP contacts in the United States without known unprotected exposures should be considered as having a low (but not zero) risk for Ebola and should be actively monitored for symptoms. Core challenges of contact tracing for high-consequence communicable diseases included rapid comprehensive contact identification, large-scale direct active monitoring of contacts, large-scale application of movement restrictions, and necessity of humanitarian support services to meet nonclinical needs of contacts.
None.
2014 年 9 月 28 日，美国首例埃博拉病毒病患者住院后，实施了埃博拉接触者追踪方法。
确定、风险分层和监测埃博拉患者的接触者。
描述性调查。
德克萨斯州达拉斯县，2014 年 9 月至 11 月。
埃博拉症状患者的接触者。
接触者识别、暴露风险分类、症状发展和埃博拉。
调查共确定 179 名接触者，其中 139 名接触者是索引患者的接触者。在 112 名与索引病例相关的卫生保健人员（HCP）接触者中，22 名（20%）有已知无保护接触，37 名（30%）没有已知无保护接触，但与患者或污染环境有多次接触。在穿戴个人防护设备与患者有大量接触的 2 名 HCP 中确认发生了传播。这些 HCP 还有 40 名其他接触者。在索引患者或 2 名 HCP 的 20 名社区接触者中，有 4 名接触者有高风险暴露。所有 179 名接触者都延长了行动限制；7 名接触者被隔离。在监测期间，对 179 名接触者中的 7 名（1 名社区接触者和 13 名卫生保健接触者）进行了埃博拉评估。
数据不能用于推断直接主动监测是否优于主动监测，以早期发现有症状的接触者。
美国的埃博拉接触者追踪和监测方法已进行调整，以考虑到对医护人员未被识别的传播风险的不断认识。美国没有已知无保护接触的 HCP 接触者应被视为埃博拉风险较低（但并非为零），应积极监测其症状。高后果传染病接触者追踪的核心挑战包括快速全面的接触者识别、大规模的直接主动接触者监测、大规模的行动限制应用，以及满足接触者非临床需求的人道主义支持服务的必要性。
无。
