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HICprevent

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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

U.S. Ebola patient isolated in Dallas hospital, frantic search for patient contacts underway

March 18th, 2015

The first Ebola case diagnosed in the U.S. is under isolation precautions in a Dallas hospital as public health investigators try to find and follow any contacts who may have been exposed while the patient was symptomatic.

The man returned from Liberia – one of the West African countries fighting the largest Ebola outbreak in history – on Sept. 20, the Centers for Disease Control and Prevention reported. The patient began developing symptoms four days later, meaning he was asymptomatic and considered non-contagious during air travel. He sought treatment on Sept 26 at Texas Health Presbyterian Hospital of Dallas, where he was subsequently admitted after developing symptoms consistent with Ebola on Sept. 28.

Based on the person's travel history and symptoms, the CDC recommended testing for Ebola. The medical facility isolated the patient and sent specimens for testing to a Texas lab in the CDC's Laboratory Response Network. After identifying the Ebola virus as the infecting agent, the CDC informed the hospital and dispatched a follow-up team to Dallas to try to identify any contacts of the patient and begin following them for symptoms. Ebola has an 8-10 day incubation period on average, but symptoms may appear as early as two days and as late as 21 days. Thus, contacts must be followed for the full three weeks before they are considered clear of infection risk.

"While it is not impossible that there could be additional cases associated with this patient in the coming weeks, I have no doubt that we will contain this," said CDC Director Tom Frieden, MD, MPH.

Again, the man did not have Ebola symptoms during the air travel and the CDC does not recommend that people on the same commercial airline flights undergo monitoring. The CDC reiterated prior warnings that U.S. hospitals may begin seeing cases linked to the expanding outbreak. People who return from West Africa with signs of fever, fatigue, vomiting and diarrhea should be considered suspect Ebola cases and placed in isolation under contact and droplet precautions until the virus can be ruled out.