Health Update
STATUS OF EBOLA OUTBREAK IN WEST AFRICA AND REVISED EBOLA SCREENING GUIDELINES

On December 29, 2015, the World Health Organization (WHO) declared Guinea free of Ebola Virus Disease (Ebola). Similar declarations were made for Sierra Leone on November 7, 2015 and Liberia on May 9, 2015, respectively. This health advisory summarizes current screening recommendations and provides clinical reminders to health care providers regarding international travelers returning to Delaware.

Summary

• The World Health Organization has declared Guinea, Liberia, and Sierra Leone free of Ebola Virus Disease.
• Delaware Division of Public Health (DPH) no longer recommends screening of patients for travel to Guinea, Liberia, and Sierra Leone specifically, and is suspending monitoring activities of travelers returning from West Africa.
• Health care providers are encouraged to continue to screen patients for travel-associated and emerging illnesses by taking a good travel history and exposure history.
• Diagnostic testing in returning travelers should focus on conditions consistent with the patient’s signs and symptoms, with special consideration for Ebola, malaria, typhoid fever, and other tropical illnesses as well as other acute respiratory and gastrointestinal illnesses as appropriate

Background

Since October 2014, the Delaware Division of Public Health has been actively monitoring travelers returning from Ebola-affected countries, including travelers from Guinea, Liberia and Sierra Leone, for symptoms of Ebola. At this time, all Ebola-affected countries have been declared free of Ebola by WHO and DPH will suspend daily active monitoring of travelers returning from West Africa. DPH will continue to make contact with travelers returning from these countries to provide them with DPH contact information.

Recommendation

DPH no longer recommends that clinicians and health care providers screen patients specifically for travel from Liberia, Guinea, or Sierra Leone; however, travel history should remain a component of all health histories.

Given the constant risk for travel-associated diseases (such as dengue, malaria and vaccine-preventable diseases) and emerging pathogens (such as Middle East Respiratory Syndrome Coronavirus - MERS-CoV, Chikungunya, Zika virus), travel history should be remain a component of routine patient evaluation. Patients with a history of international travel should be thoroughly assessed using standard and transmission-based precautions appropriate for the clinical presentation. Diagnosis and treatment of these patients should not be delayed. The Division of Public Health can help facilitate diagnostic testing for several emerging pathogens through the Delaware Public Health Laboratory or the Centers for Disease Control and Prevention (CDC).

For febrile patients who report a travel history to Liberia, Guinea, Sierra Leone, along with symptoms such as fever, malaise, other constitutional symptoms; or other symptoms such as gastrointestinal or respiratory symptoms, evaluation should be conducted in a private room using infection control practices appropriate for the symptom presentation.

Additional Information and Reporting

Should you have any questions or report any suspected cases of an emerging infectious disease, contact Delaware DPH, Office of Infectious Disease Epidemiology at 888-295-5156 or after-hours at 302-744-4700 or email: reportdisease@delaware.gov.

To report a notifiable condition, visit http://www.dhss.delaware.gov/dhss/dph/dpc/rptdisease.html

For a list of currently circulating emerging infectious disease pathogens with by country, visit http://wwwnc.cdc.gov/travel/notices

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