Ebola Virus Disease (EVD) Information for School Health Clinicians October 8, 2014 Background The first case of Ebola Virus Disease (Ebola) with illness onset and laboratory confirmation in the United States occurred in Dallas, Texas in September 2014, in a traveler from Liberia. With significant international travel, immigration, and educational foreign exchange programs, there is a possibility that students, faculty, or staff who travel from areas where Ebola is present could arrive in the United States. Symptoms of EVD include: • Abrupt onset of fever and malaise • Additional symptoms such as severe headache, myalgia, vomiting, diarrhea, abdominal pain or unexplained hemorrhage. Ebola spreads through human-to-human transmission through direct contact with blood or body fluids (e.g., urine, saliva, feces, vomit, sweat, breast milk and semen) of a person who is ill with EVD or contact with objects that have been contaminated with these fluids. Ebola is not spread through the air, water or food. Persons are not contagious before they are symptomatic. The incubation period is typically about a week, but can range from 2–21 days. Recommendations The New Hampshire Department of Health and Human Services, Division of Public Health Services recommends the following interventions for school health clinicians: • • • • • Maintain a heightened awareness in students, faculty, or staff who present with symptoms consistent with EVD and who report a recent (within the past month) travel history to countries affected by Ebola or who have had contact with a person with Ebola Place symptomatic individuals in a private room with its own bathroom Implement standard, contact, and droplet precautions as outlined in CDC guidance. See links below. Wear the correct personal protective equipment (PPE), including masks, gloves, gowns (fluidresistant or impermeable), facemask and eye protection when entering the patient care area (http://www.cdc.gov/vhf/ebola/pdf/ppe-poster.pdf) o Before leaving the patient area, carefully remove PPE and ensure that you do not contaminate your skin and clothing o Dispose of PPE as biohazard waste o After removing PPE, wash your hands using soap and water (preferred) or an alcoholbased hand sanitizer containing at least 60 % alcohol Identify students, faculty, and staff who have been in countries where Ebola outbreaks are occurring or who have had contact with a person with Ebola within the past month. o School health clinicians should conduct a risk assessment to determine the level of risk exposure (http://www.cdc.gov/vhf/ebola/hcp/case-definition.html) NH Department of Health and Human Services Division of Public Health Services 1 Ebola Information for School Clinicians October 2014 All students, faculty, and staff who have been in the affected countries within the past month should be given instructions for health monitoring for EVD symptoms o The NH Division of Public Health Services does not recommend isolating or quarantining students, faculty or staff based on travel history alone o If the individuals have not had symptoms of EVD for 21 days since potentially being exposed, they do not have Ebola. No additional assessment is needed. If you suspect EVD, notify your local health department or the NH Division of Public Health Services at 603-271-4496 immediately. o • Additional Information and Resources NH Department of Health and Human Services, Division of Public Health Services: 603-271-4496 http://www.dhhs.nh.gov/dphs/cdcs/ebola.htm CDC Case Definition for Ebola Virus Disease (EVD): http://www.cdc.gov/vhf/ebola/hcp/casedefinition.html CDC Ebola information for healthcare workers: www.cdc.gov/vhf/ebola/hcp/index.html CDC Personal Protective Equipment poster: http://www.cdc.gov/vhf/ebola/pdf/ppe-poster.pdf CDC Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Virus Disease in U.S. Hospitals: http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html CDC Ebola information for colleges, universities, and students: http://wwwnc.cdc.gov/travel/page/advice-for-colleges-universities-and-students-about-ebola-inwest-africa CDC Ebola Virus Disease Information for Clinicians in U.S. HealthCare Settings: http://www.cdc.gov/vhf/ebola/hcp/clinician-information-us-healthcare-settings.html Source: Centers for Disease Control and Prevention, 2014 NH Department of Health and Human Services Division of Public Health Services 2 Ebola Information for School Clinicians October 2014