{"id":10305,"date":"2025-03-01T14:07:33","date_gmt":"2025-03-01T19:07:33","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan332\/"},"modified":"2025-03-02T00:52:24","modified_gmt":"2025-03-02T05:52:24","slug":"dhan332","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan332\/","title":{"rendered":"php\/alerts\/dhan332 ~  Division of Public Health &#8212; Health Alert  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n  <br>\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n    <!-- BEGIN readspeaker div -->\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan332.html\" title=\"Listen to this page using ReadSpeaker\">\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n      <\/a>\n\n    <\/div>\n\n    <!-- END readspeaker div -->\n\n\n\n    \n\n    <header class=\"pull-left\">\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->332 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->August 5, 2014 2:01 pm <!--[END]--> <\/h2>\n\n    <\/header>\n\n  <\/div><br>\n\n \n\n  <div class=\"container\">\n\n    <div class=\"row\">\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n          <div class=\"panel sectionmenu_panel\">\n\n            <div class=\"panel-heading\">\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n            <\/div>\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; 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To date, no cases have been reported\n\n\n  in the United States. The purpose of this health update is 1) to provide updated guidance to healthcare providers and state and local\n\n\n  health departments regarding who should be suspected of having EVD, 2) to clarify which specimens should be obtained and how to submit\n\n\n  for diagnostic testing, and 3) to provide hospital infection control guidelines.\n\n\n<\/p>\n\n\n<p>\n\n\n  U.S. hospitals can safely manage a patient with EVD by following recommended isolation and infection control procedures. Please\n\n\n  disseminate this information to infectious disease specialists, intensive care physicians, primary care physicians, hospital\n\n\n  epidemiologists, infection control professionals, and hospital administration, as well as to emergency departments and microbiology\n\n\n  laboratories.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Background\n\n\n<\/h3>\n\n\n<p>\n\n\n  CDC is working with the World Health Organization (WHO), the ministries of health of Guinea, Liberia, and Sierra Leone, and other\n\n\n  international organizations in response to an outbreak of EVD in West Africa, which was first reported in late March 2014. As of July 27,\n\n\n  2014, according to WHO, a total of 1,323 cases and 729 deaths (case fatality 55-60%) had been reported across the three affected\n\n\n  countries. This is the largest outbreak of EVD ever documented and the first recorded in West Africa.\n\n\n<\/p>\n\n\n<p>\n\n\n  EVD is characterized by sudden onset of fever and malaise, accompanied by other nonspecific signs and symptoms, such as myalgia,\n\n\n  headache, vomiting, and diarrhea. Patients with severe forms of the disease may develop hemorrhagic symptoms and multi-organ dysfunction,\n\n\n  including hepatic damage, renal failure, and central nervous system involvement, leading to shock and death. The fatality rate can vary\n\n\n  from 40-90%.\n\n\n<\/p>\n\n\n<p>\n\n\n  In outbreak settings, Ebola virus is typically first spread to humans after contact with infected wildlife and is then spread\n\n\n  person-to-person through direct contact with bodily fluids such as, but not limited to, blood, urine, sweat, semen, and breast milk. The\n\n\n  incubation period is usually 8\u201310 days (ranges from 2\u201321 days). Patients can transmit the virus while febrile and through\n\n\n  later stages of disease, as well as postmortem, when persons touch the body during funeral preparations.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Patient Evaluation Recommendations to Healthcare Providers\n\n\n<\/h3>\n\n\n<p>\n\n\n  Healthcare providers should be alert for and evaluate suspected patients for Ebola virus infection who have both consistent symptoms and\n\n\n  risk factors as follows: 1) Clinical criteria, which includes fever of greater than 38.6 degrees Celsius or 101.5 degrees Fahrenheit, and\n\n\n  additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage; AND 2)\n\n\n  Epidemiologic risk factors within the past 3 weeks before the onset of symptoms, such as contact with blood or other body fluids of a\n\n\n  patient known to have or suspected to have EVD; residence in\u2014or travel to\u2014an area where EVD transmission is active; or direct\n\n\n  handling of bats, rodents, or primates from disease-endemic areas. Malaria diagnostics should also be a part of initial testing because\n\n\n  it is a common cause of febrile illness in persons with a travel history to the affected countries.\n\n\n<\/p>\n\n\n<p>\n\n\n  Testing of patients with suspected EVD should be guided by the risk level of exposure, as described below:\n\n\n<\/p>\n\n\n<p>\n\n\n  CDC recommends testing for all persons with onset of fever within 21 days of having a high-risk exposure. A high-risk exposure includes\n\n\n  any of the following:\n\n\n<\/p>\n\n\n<ul>\n\n\n  <li>percutaneous or mucous membrane exposure or direct skin contact with body fluids of a person with a confirmed or suspected case of\n\n\n  EVD without appropriate personal protective equipment (PPE),\n\n\n  <\/li>\n\n\n  <li>laboratory processing of body fluids of suspected or confirmed EVD cases without appropriate PPE or standard biosafety precautions,\n\n\n  or\n\n\n  <\/li>\n\n\n  <li>participation in funeral rites or other direct exposure to human remains in the geographic area where the outbreak is occurring\n\n\n  without appropriate PPE.\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<p>\n\n\n  For persons with a high-risk exposure but without a fever, testing is recommended only if there are other compatible clinical symptoms\n\n\n  present and blood work findings are abnormal (i.e., thrombocytopenia <150,000 cells\/\u00b5L and\/or elevated transaminases) or\n\n\n  unknown.\n\n\n<\/p>\n\n\n<p>\n\n\n  Persons considered to have a low-risk exposure include persons who spent time in a healthcare facility where EVD patients are being\n\n\n  treated (encompassing healthcare workers who used appropriate PPE, employees not involved in direct patient care, or other hospital\n\n\n  patients who did not have EVD and their family caretakers), or household members of an EVD patient without high-risk exposures as defined\n\n\n  above. Persons who had direct unprotected contact with bats or primates from EVD-affected countries would also be considered to have a\n\n\n  low-risk exposure. Testing is recommended for persons with a low-risk exposure who develop fever with other symptoms and have unknown or\n\n\n  abnormal blood work findings. Persons with a low-risk exposure and with fever and abnormal blood work findings in absence of other\n\n\n  symptoms are also recommended for testing. Asymptomatic persons with high- or low-risk exposures should be monitored daily for fever and\n\n\n  symptoms for 21 days from the last known exposure and evaluated medically at the first indication of illness.\n\n\n<\/p>\n\n\n<p>\n\n\n  Persons with no known exposures listed above but who have fever with other symptoms and abnormal bloodwork within 21 days of visiting\n\n\n  EVD-affected countries should be considered for testing if no other diagnosis is found. Testing may be indicated in the same patients if\n\n\n  fever is present with other symptoms and blood work is abnormal or unknown. Consultation with local and state health departments is\n\n\n  recommended.\n\n\n<\/p>\n\n\n<p>\n\n\n  If testing is indicated, the local or state health department should be immediately notified. Healthcare providers should collect serum,\n\n\n  plasma, or whole blood. A minimum sample volume of 4 mL should be shipped refrigerated or frozen on ice pack or dry ice (no glass tubes),\n\n\n  in accordance with IATA guidelines as a Category B diagnostic specimen. Please refer to <a href=\"http:\/\/www.cdc.gov\/ncezid\/dhcpp\/vspb\/specimens.html\">http:\/\/www.cdc.gov\/ncezid\/dhcpp\/vspb\/specimens.html<\/a> for detailed instructions\n\n\n  and a link to the specimen submission form for CDC laboratory testing.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Recommended Infection Control Measures\n\n\n<\/h3>\n\n\n<p>\n\n\n  U.S. hospitals can safely manage a patient with EVD by following recommended isolation and infection control procedures, including\n\n\n  standard, contact, and droplet precautions. Early recognition and identification of patients with potential EVD is critical. Any U.S.\n\n\n  hospital with suspected patients should follow CDC\u2019s Infection Prevention and Control Recommendations for Hospitalized Patients\n\n\n  with Known or Suspected Ebola Hemorrhagic Fever in U.S. Hospitals (<a href=\"http:\/\/www.cdc.gov\/vhf\/ebola\/hcp\/infection-prevention-and-control-recommendations.html\">http:\/\/www.cdc.gov\/vhf\/ebola\/hcp\/infection-prevention-and-control-recommendations.html<\/a>).\n\n\n  These recommendations include the following:\n\n\n<\/p>\n\n\n<ul>\n\n\n  <li>\n\n\n    <strong>Patient placement:<\/strong> Patients should be placed in a single patient room (containing a private bathroom) with the door\n\n\n    closed.\n\n\n  <\/li>\n\n\n  <li>\n\n\n    <strong>Healthcare provider protection:<\/strong> Healthcare providers should wear: gloves, gown (fluid resistant or impermeable), shoe\n\n\n    covers, eye protection (goggles or face shield), and a facemask. Additional PPE might be required in certain situations (e.g., copious\n\n\n    amounts of blood, other body fluids, vomit, or feces present in the environment), including but not limited to double gloving,\n\n\n    disposable shoe covers, and leg coverings.\n\n\n  <\/li>\n\n\n  <li>\n\n\n    <strong>Aerosol-generating procedures:<\/strong> Avoid aerosol-generating procedures. If performing these procedures, PPE should include\n\n\n    respiratory protection (N95 filtering facepiece respirator or higher) and the procedure should be performed in an airborne isolation\n\n\n    room.\n\n\n  <\/li>\n\n\n  <li>\n\n\n    <strong>Environmental infection control:<\/strong> Diligent environmental cleaning and disinfection and safe handling of potentially\n\n\n    contaminated materials is paramount, as blood, sweat, emesis, feces and other body secretions represent potentially infectious\n\n\n    materials. Appropriate disinfectants for Ebola virus and other filoviruses include 10% sodium hypochlorite (bleach) solution, or\n\n\n    hospital-grade quaternary ammonium or phenolic products. Healthcare providers performing environmental cleaning and disinfection should\n\n\n    wear recommended PPE (described above) and consider use of additional barriers (e.g., shoe and leg coverings) if needed. Face\n\n\n    protection (face shield or facemask with goggles) should be worn when performing tasks such as liquid waste disposal that can generate\n\n\n    splashes. Follow standard procedures, per hospital policy and manufacturers\u2019 instructions, for cleaning and\/or disinfection of\n\n\n    environmental surfaces, equipment, textiles, laundry, food utensils and dishware.\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<h3>\n\n\n  For more information:\n\n\n<\/h3>\n\n\n<ul>\n\n\n  <li>For additional information regarding Ebola Virus Disease or to report a case of Ebola Virus Disease, call DPH, Office of Infectious\n\n\n  Disease Epidemiology: 1-888-295-5156 or 302-744-1033.\n\n\n  <\/li>\n\n\n  <li>Additional information on Ebola Virus Disease can be found at: <a href=\"http:\/\/www.cdc.gov\/ebola\">http:\/\/www.cdc.gov\/ebola<\/a>.\n\n\n  <\/li>\n\n\n  <li>Questions and Answers on Ebola can be found at: <a href=\"http:\/\/www.cdc.gov\/vhf\/ebola\/outbreaks\/guinea\/qa.html\">http:\/\/www.cdc.gov\/vhf\/ebola\/outbreaks\/guinea\/qa.html<\/a>.\n\n\n  <\/li>\n\n\n  <li>Ebola Guidance for Airlines can be found at: <a href=\"http:\/\/www.cdc.gov\/quarantine\/air\/managing-sick-travelers\/ebola-guidance-airlines.html\">http:\/\/www.cdc.gov\/quarantine\/air\/managing-sick-travelers\/ebola-guidance-airlines.html<\/a>.\n\n\n  <\/li>\n\n\n  <li>Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Hemorrhagic Fever in U.S.\n\n\n  Hospitals can be found at:\u00a0\u00a0 <a href=\"http:\/\/www.cdc.gov\/vhf\/ebola\/hcp\/infection-prevention-and-control-recommendations.html\">\n\n\n    http:\/\/www.cdc.gov\/vhf\/ebola\/hcp\/infection-prevention-and-control-recommendations.html<\/a>\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<p>\n\n\n  ************************************\n\n\n<\/p>\n\n\n<p>\n\n\n  You are receiving this email because you are a registered member of the Delaware Health Alert Network. If you are not a member and would\n\n\n  like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a>\n\n\n<\/p><!--[END]-->\n\n  \n\n        <div class=\"panel panel-danger\">\n\n          <div class=\"panel-heading\">    \n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n       <\/div>\n\n       <div class=\"panel-body\">\n\n      <ul>\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n            <\/ul>\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n          <\/div> \n\n        <\/div><br>  \n\n\n\n      <\/div>\n\n    <\/div>\n\n  <\/div><!-- \/container -->\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #332 August 5, 2014 2:01 pm Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10305","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10305","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10305"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10305\/revisions"}],"predecessor-version":[{"id":11481,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10305\/revisions\/11481"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10305"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}