Health Advisory
UPDATED GUIDANCE AND SCREENING TOOL FOR EMERGING AND TRAVEL ASSOCIATED INFECTIOUS DISEASES - OUTPATIENT PRACTICES
(UPDATED 9/22/2015)

Background

Although the Ebola virus disease outbreak in West Africa has reduced significantly in intensity since it first started in early 2014, the outbreak continues. In addition, other travel-associated emerging infectious diseases continue to pose a threat to public health. Some of these diseases [such as Middle East Respiratory Syndrome (MERS), and Ebola] can easily be spread from an infectious person, requiring early identification and containment measures to prevent a potential outbreak here in the US. Other travel associated diseases (such as Chikungunya and Dengue) are not spread by direct person to person contact, but do cause significant morbidity and/or mortality.

Summary

Early symptoms of many emerging infectious diseases can overlap with those of more common diseases, such as seasonal human influenza.  Therefore, in order to prevent an emerging infectious disease outbreak, it is important for health care providers to take a broad approach when screening patients.

Ebola Virus Disease, MERS, zoonotic (animal origin) influenza, and other emerging infectious diseases often have non-specific symptoms which may be difficult to differentiate from more common infections, and may include:

• Fever
• Severe headache or muscle pain
• Diarrhea, vomiting, abdominal pain
• Weakness, fatigue
• Difficulty breathing, shortness of breath
• Cough
• Sore throat or runny nose

Recommendations for Health Care Providers

• Develop a protocol to ensure that sick people visiting your facility are screened for travel to destinations outside of the continental U.S., and that they are also screened for unusual exposures (including exposure to sick animals).
• A sample screening protocol is available on the DPH website at http://www.dhss.delaware.gov/dhss/dph/php/files/emergingandtravelrelatedinfdiseasescreeningtool.pdf
• Ensure that your facility’s protocol allows for the immediate separation of suspect patients from common areas. Also ensure that you have at least a few sets of personal protective equipment on hand for staff completing examinations to use, should the need arise.
• Call DPH at 888-295-5156 immediately to report any suspected cases of an emerging infectious disease, particularly if you suspect a disease that is highly contagious.
• Encourage patients to get an annual influenza vaccination.

For More Information:

• National Center for Infectious Diseases (NCID) Infectious Disease Information at http://www.cdc.gov/ncidod/diseases/eid/  and http://www.cdc.gov/ncidod/diseases/eid/disease_sites.htm
• National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) at http://www.cdc.gov/ncezid/
• Ebola (Ebola Virus Disease) at http://www.cdc.gov/vhf/ebola/
• Middle East Respiratory Syndrome (MERS) at http://www.cdc.gov/coronavirus/mers/
• Information on Avian Influenza at http://www.cdc.gov/flu/avianflu/
• Influenza (Flu) at http://www.cdc.gov/flu/index.htm
• Delaware Public Health Seasonal Flu Clinics at http://dhss.delaware.gov/dhss/dph/fluclinics.html
• Delaware Reportable Diseases at http://dhss.delaware.gov/dhss/dph/dpc/rptdisease.html

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