Identifying Suspected Cases

To: Hospital staff, employees, volunteers, and associated personnel

Date: October 2, 2014

Subject: Update about Ebola preparedness

With the CDC announcement on September 30 of the first case of Ebola virus disease diagnosed in the U.S. (in an individual who had traveled from Liberia), we wanted to take the opportunity to update you on preparedness activities at Boston Children’s Hospital and remind you about your role in identifying potential cases and the resources available to you in the event that Boston Children’s receives a patient with Ebola.

Preparedness Activities

Hospital has spent the last several months working to ensure that we can safely manage a suspect case of Ebola in the unlikely event that a patient should present here with the infection. Plans are in place for all aspects of care, including (but not limited to) patient placement, isolation precautions, personal protective equipment, staffing, handling of laboratory specimens, managing waste, cleaning and disinfection, transport, and education and guidance for patients and their families. We have robust supplies of all necessary items on hand, and we have conducted drills to practice critical steps in patient care activities. These drills and other preparedness activities will continue going forward.

Identifying Suspected Cases

We will depend on astute clinicians at points of entry—especially the Emergency Department, primary care offices and other ambulatory clinics—to consider the diagnosis early for patients with suggestive symptoms and the appropriate exposure history.

As a reminder,infection with Ebola causes a variety of symptoms from non-specific influenza-like illness (fever, malaise, muscle aches, headache) or vomiting and diarrhea to bleeding and rash.

All providers—particularly those who work in the Emergency Department or in outpatient settings—should be on the lookout for patients with fever and the symptoms described below. If you see a patient with these symptoms, you should rapidly obtain a travel history, specifically asking about travel from West Africa.

The most current case definition for identifying suspected cases of Ebola virus disease (EVD) can always be found at the following CDC website: http://www.cdc.gov/vhf/ebola/hcp/case-definition.html.

Here is a simple flow diagram to screen patients for the possibility of Ebola virus disease:

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