Keeping Ebola in Check: Advice From the CDC

Centers for Disease Control and Prevention


August 08, 2014

Editorial Collaboration

Medscape &

Medscape: How is the CDC monitoring this outbreak, and are there strategies to prevent potentially infected persons from entering the United States?

CDC: We are working closely with global health partners, including the World Health Organization and the Ministries of Health of affected countries, to monitor and control the outbreak.

CDC advises all travelers arriving from Guinea, Liberia, Nigeria, and Sierra Leone to monitor their health for 21 days and watch for fever (temperature of 101.5° F/38.6° C or higher), chills, muscle aches, rash, and other symptoms consistent with Ebola. If symptoms occur, they should call ahead to the hospital or healthcare provider and report recent travel so that appropriate precautions can be taken.

At this time, the World Health Organization does not recommend screening of passengers at arrival or departure points of entry, travel restrictions, or closure of borders. However, CDC is working with international public health organizations, other federal agencies, and the travel industry to identify sick travelers arriving in the United States and to take public health actions to prevent the spread of contagious diseases.

If CDC is informed about travelers with a serious contagious disease before they travel, we can take steps to prevent them from traveling. Airlines are required to report to CDC any deaths onboard or ill travelers meeting certain criteria before arriving in the United States.

CDC also continues to use routine processes to detect ill travelers by working with our partners at US ports of entry, including Customs and Border Protection, who conduct the passport review for all arriving travelers, and emergency medical service units at airports. CDC and partners determine whether any public health action is needed if an ill traveler is identified.

If a confirmed case of a communicable disease that posts a public health risk is confirmed on a flight, CDC will conduct an investigation of exposed travelers and work with the airline, federal partners, and state and local health departments to notify them and take any necessary public health action.

We also provide guidance to airlines for managing ill passengers/crew and cleaning aircraft. Guidance specific to Ebola is available here.

Medscape: Can you speak to the treatment of the infected American healthcare workers? What is the mechanism of action of this new serum, and should it be needed, is there sufficient production capacity to treat larger numbers of patients?

CDC: We are not involved in the reported administration of the new experimental drug given to the 2 American healthcare workers infected with Ebola virus. The drug is still experimental, having not yet been tested in humans. It is not considered a viable tool for widespread use at this time. Inquiries about the investigational product should be directed to the company or to the US Food and Drug Administration. More information is available here.

Medscape: What are CDC's key messages for healthcare professionals?

CDC: Ebola poses a very low risk to the United States, but healthcare providers should remain alert to the evolving situation in West Africa and remain vigilant for travel-associated cases. CDC has issued updated interim guidance for healthcare workers providing care to suspected Ebola patients in the United States.

Healthcare workers should take good travel histories from patients and, if the patient has traveled within the past 3 weeks to affected parts of Africa, ask about fever and symptoms consistent with Ebola virus infection. Patients who show signs and have symptoms consistent with Ebola should be promptly isolated, and state and local health authorities should be notified.

There have already been a handful of travelers returning from the region who had fever and sought care. This is to be expected. Several were diagnosed as having malaria, and one with influenza B.

Any suspected case needs to be isolated until diagnosis is confirmed or ruled out. Healthcare providers working with the isolated patient should wear gloves, gown (fluid resistant), eye protection (goggles or face shield), and a facemask. Depending on the situation, additional personal protective equipment may be necessary. Healthcare providers need to follow strict hand hygiene procedures and diligently clean and disinfect surfaces.

Patients should be placed in a single-patient room (containing a private bathroom) with the door closed. Medical equipment should be dedicated to the individual patient, and facilities should maintain a log of all persons entering the patient's room. Visitors should be avoided or limited.

The standard, rigorous infection-control procedures used in major hospitals in the United States will prevent spread of Ebola.

For more information, see CDC's updated infection control guidance for US hospitals on handling patients with known or suspected Ebola.

Medscape: What are the messages that healthcare professionals should be sharing with patients?

CDC: There is currently no significant risk for exposure to Ebola virus within the United States. The American healthcare workers being returned to the United States for care are being cared for in strict isolation, and we remain vigilant for potential travel-acquired cases.

The best way to protect Americans is to control the outbreak at its source, in Africa. According to CDC Director Dr. Tom Frieden, "We do know how to stop Ebola. It's old-fashioned, plain and simple public health: Find the patients, make sure they get treated, find their contacts, track them, educate people, do infection control at the them really well and Ebola goes away."

CDC is providing surge capacity for the African response by sending 50 staff over the next month. By working with international partners, we can and will control this outbreak.