title: Clinical inquiries regarding Ebola virus disease received by CDC--United States, July 9-November 15, 2014.
abstract: Since early 2014, there have been more than 6,000 reported deaths from Ebola virus disease (Ebola), mostly in Guinea, Liberia, and Sierra Leone. On July 9, 2014, CDC activated its Emergency Operations Center for the Ebola outbreak response and formalized the consultation service it had been providing to assist state and local public health officials and health care providers evaluate persons in the United States thought to be at risk for Ebola. During July 9-November 15, CDC responded to clinical inquiries from public health officials and health care providers from 49 states and the District of Columbia regarding 650 persons thought to be at risk. Among these, 118 (18%) had initial signs or symptoms consistent with Ebola and epidemiologic risk factors placing them at risk for infection, thereby meeting the definition of persons under investigation (PUIs). Testing was not always performed for PUIs because alternative diagnoses were made or symptoms resolved. In total, 61 (9%) persons were tested for Ebola virus, and four, all of whom met PUI criteria, had laboratory-confirmed Ebola. Overall, 490 (75%) inquiries concerned persons who had neither traveled to an Ebola-affected country nor had contact with an Ebola patient. Appropriate medical evaluation and treatment for other conditions were noted in some instances to have been delayed while a person was undergoing evaluation for Ebola. Evaluating and managing persons who might have Ebola is one component of the overall approach to domestic surveillance, the goal of which is to rapidly identify and isolate Ebola patients so that they receive appropriate medical care and secondary transmission is prevented. Health care providers should remain vigilant and consult their local and state health departments and CDC when assessing ill travelers from Ebola-affected countries. Most of these persons do not have Ebola; prompt diagnostic assessments, laboratory testing, and provision of appropriate care for other conditions are essential for appropriate patient care and reflect hospital preparedness.
authors.forename: Mateusz P
authors.initials: MP
authors.lastname: Karwowski
authors.forename: Elissa
authors.initials: E
authors.lastname: Meites
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Fullerton
authors.forename: Ute
authors.initials: U
authors.lastname: Ströher
authors.forename: Luis
authors.initials: L
authors.lastname: Lowe
authors.forename: Mark
authors.initials: M
authors.lastname: Rayfield
authors.forename: Dianna M
authors.initials: DM
authors.lastname: Blau
authors.forename: Barbara
authors.initials: B
authors.lastname: Knust
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Gindler
authors.forename: Chris
authors.initials: C
authors.lastname: Van Beneden
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Bialek
authors.forename: Paul
authors.initials: P
authors.lastname: Mead
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Oster
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002487:Centers for Disease Control and Prevention, U.S. / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D029043:Ebolavirus / Q000302:isolation & purification; D005260:Female; D006268:Health Facilities; D006282:Health Personnel; D019142:Hemorrhagic Fever, Ebola / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019114:Remote Consultation / Q000706:statistics & numerical data*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult