Be Alert for Ebola, CDC Says

While there are no suspected U.S. cases of Ebola, the country needs to be ready for early identification and testing for patients who present with symptoms and have recently traveled to Uganda, where there is an ongoing outbreak, the CDC said on Thursday.

In a Health Alert Network advisory, the agency recommended that clinicians be prepared to consider Ebola virus disease as a differential diagnosis if a patient presents with the symptoms of the disease or viral hemorrhagic fever. Symptoms can include fever, headache, muscle and joint pain, fatigue, loss of appetite, gastrointestinal symptoms, and unexplained bleeding.

If a patient presents with those symptoms, the CDC recommended that clinicians immediately take a travel history and move the patient to a private room for any further clinical evaluation. Clinicians should also contact their local or state health department if a patient is suspected to have the disease, the CDC said.

The agency noted that early recognition and identification of a patient suspected to have Ebola virus disease is critical. This is in part because there is not an FDA-approved vaccine or treatment for the strain of Ebola virus causing the outbreak in Uganda, which is known as the Sudan strain. Ervebo, the only Ebola vaccine approved in the U.S., is indicated for the Zaire strain and is not expected to offer protection from the Sudan strain, according to the CDC.

Clinicians need to be aware of how the disease is transmitted, the agency said. For example, a person is not contagious until symptoms appear. The Sudan virus is not spread through airborne transmission but spreads through direct contact with the body fluids of a person who is sick with or has died from the disease.

Since 2000, there have been five Ebola outbreaks involving the Sudan strain in Uganda, including the current outbreak.

Uganda’s latest outbreak was officially declared by its Ministry of Health on September 20. The first confirmed case was in a 25-year-old man who was diagnosed with viral hemorrhagic fever and died the day prior — his blood tested positive for the Sudan strain of the Ebola virus.

The patient’s death prompted an investigation that revealed “a cluster of unexplained deaths” over the previous month in the nearby community. So far, the CDC said, there are 44 confirmed cases of Ebola in total in Uganda, and 10 confirmed deaths along with 20 probable deaths.

As of October 6, no suspected cases of Ebola related to this outbreak have occurred outside of Uganda, where the outbreak is limited to regions away from Kampala, Uganda’s capital, and the travel hub of Entebbe.

The CDC noted that Thursday’s alert and recommendations were issued as a precaution, and that the agency is communicating with U.S. public health departments, laboratories, and healthcare workers to raise awareness of this outbreak.

Even though there are not direct flights between the two countries, the U.S. embassy in Uganda announced that all U.S.-bound travelers who have been to Uganda in the previous 3 weeks would be redirected for enhanced screening to one of five designated U.S. airports: John F. Kennedy International Airport in New York City; Newark Liberty International Airport in New Jersey; Hartsfield-Jackson Atlanta International Airport; Chicago O’Hare International Airport; or Dulles International Airport in Washington, D.C.