Division of Infectious Diseases, Department of Medicine.
Division of Infectious Diseases, Department of Medicine; Department of Pathology and Laboratory Medicine.
Open Forum Infect Dis. 2016 Jan 18;3(1):ofw005. doi: 10.1093/ofid/ofw005. eCollection 2016 Jan.
Background. The 2014-2015 Ebola epidemic in West Africa had global impact beyond the primarily affected countries of Guinea, Liberia, and Sierra Leone. Other countries, including the United States, encountered numerous patients who arrived from highly affected countries with fever or other signs or symptoms consistent with Ebola virus disease (EVD). Methods. We describe our experience evaluating 25 travelers who met the US Centers for Disease Control and Prevention case definition for a person under investigation (PUI) for EVD from July 20, 2014 to January 28, 2015. All patients were triaged and evaluated under the guidance of institutional protocols to the emergency department, outpatient tropical medicine clinic, or Emory's Ebola treatment unit. Strict attention to infection control and early involvement of public health authorities guided the safe evaluation of these patients. Results. None were diagnosed with EVD. Respiratory illnesses were common, and 8 (32%) PUI were confirmed to have influenza. Four patients (16%) were diagnosed with potentially life-threatening infections or conditions, including 3 with Plasmodium falciparum malaria and 1 with diabetic ketoacidosis. Conclusions. In addition to preparing for potential patients with EVD, Ebola assessment centers should consider other life-threatening conditions requiring urgent treatment, and travelers to affected countries should be strongly advised to seek pretravel counseling. Furthermore, attention to infection control in all aspects of PUI evaluation is paramount and has presented unique challenges. Lessons learned from our evaluation of potential patients with EVD can help inform preparations for future outbreaks of highly pathogenic communicable diseases.
2014-2015 年西非埃博拉疫情对除几内亚、利比里亚和塞拉利昂这三个主要受影响国家之外的其他国家产生了全球性影响。包括美国在内的其他国家遇到了许多从受影响严重的国家来的发热或其他具有埃博拉病毒病（EVD）特征的病人。方法：我们描述了对 25 名旅行者的评估经验，这些旅行者符合美国疾病控制与预防中心对 2014 年 7 月 20 日至 2015 年 1 月 28 日期间埃博拉病毒病疑似病人（PUI）的病例定义。所有患者都根据机构协议分诊和评估，进入急诊室、门诊热带医学诊所或埃默里埃博拉治疗病房。严格遵守感染控制措施和早期公共卫生部门的参与指导了这些患者的安全评估。结果：没有诊断出埃博拉病毒病。呼吸道疾病很常见，8 名（32%）PUI 被确诊为流感。4 名患者（16%）被诊断为有潜在生命危险的感染或疾病，包括 3 名恶性疟原虫疟疾和 1 名糖尿病酮症酸中毒。结论：除了为可能的埃博拉病毒病患者做准备外，埃博拉评估中心还应考虑其他需要紧急治疗的危及生命的疾病，并且应强烈建议前往受影响国家的旅行者进行旅行前咨询。此外，在 PUI 评估的所有方面都要注意感染控制，这是至关重要的，并且提出了独特的挑战。从我们对埃博拉病毒病疑似病人的评估中吸取的经验教训可以为未来高致病性传染病的爆发做好准备。
