As travel continues between West Africa and the rest of the
world, the possibility increases that more individuals exposed to
Ebola will seek care at hospital emergency departments. It is
also possible that more medical and other volunteers caring for
Ebola patients will contract the disease and need treatment in
U.S. hospitals. The Centers for Disease Control and Prevention
(CDC) and the Office of the Assistant Secretary for Preparedness
and Response have been anticipating and preparing for Ebola in
the U.S. Both agencies aim to increase understanding of the Ebola
virus disease (EVD) and encourage widespread preparation for
managing EVD patients.
The Centers for Disease Control and Prevention (CDC) modified
protocols for travelers from Liberia to the United States,
stipulating that those currently under active or direct active
monitoring for Ebola Virus Disease (EVD) by local health
departments (LHDs) no longer need monitoring. For California, the
protocol for Liberian travelers is spelled out in the attached
updated guidance from the California Department of Public Health
(CDPHi).
The guidance provides LHDs with important elements of an Ebola
plan, changes in notifications and monitoring of Liberian
travelers, and outlines the responsibilities of CDPH and the
Emergency Medical Services Authority (EMSA) in assisting LHDs.
While travelers from Liberia are considered to have extremely low
risk of developing EVD, the CDC states there is not zero risk.
The CDC recommends that, as indicated by clinical judgment, no
EVD-specific precautions are needed, and travelers may be seen by
a regular health care provider. As with any patient presenting
with symptoms, health care providers should implement appropriate
infection control procedures depending on the travel history and
clinical presentation of travelers returning from Liberia.
Hospitals and health care providers should assess travel history
for any possible infectious disease exposures, including MERS-CoV
and malaria.
December 2014 - On the outskirts of Monrovia, the capital of
Liberia, on grassy land among palm trees and tropical hardwoods,
stands a cluster of one-story bungalows painted cheerful yellow
with blue trim. This is the campus of Eternal Love Winning
Africa, a nondenominational Christian mission, comprising a
school, a radio station and a hospital. It was here that Dr.
Jerry Brown, the hospital’s medical director, first heard in
March that the fearsome Ebola virus had gained a toehold in his
country.