Evaluation of Persons Under Investigation or Patients with Confirmed Ebola

Patients under investigation (PUIs) or patients with confirmed EVD presenting to healthcare settings should be handled with appropriate precautions as soon as possible to prevent transmission of Ebola virus to others. See CDC’s infection control guidance

• Additional information on evaluating PUIs is available here
• Interim Guidance for Environmental Infection Control in Hospitals for Ebola Virus

Patients from countries with Ebola outbreaks who present with fever could have other potentially fatal infectious diseases that should be considered in the differential diagnosis, including but not limited to malaria, typhoid fever, and bacterial infections such as pneumonia. Evaluation of febrile illness in a recent traveler should include a thorough travel and exposure history.

See additional information about fever in travelers returning from affected countries.

For information about malaria please see CDC’s malaria website.

Health care providers needing assistance with diagnosis or management of suspected cases of malaria should call the CDC Malaria Hotline at:
770-488-7788 or 855-856-4713 toll-free (M-F, 9 a.m.-5 p.m., EST).

For emergency consultation after hours, call: 770-488-7100 and request to speak with a CDC Malaria Branch clinician.

Nonurgent questions can be emailed to: malaria@cdc.gov

Travelers from areas with Ebola outbreaks are advised to self-monitor their health for 21 days after departure and to seek health care if fever and symptoms develop. Travelers with possible exposure to Ebola virus, for example in a healthcare setting.

The current CDC definition of a PUI is available at Case Definition for Ebola Virus Disease (EVD).

Currently a PUI for EVD is defined as illness in a person who has both consistent symptoms and risk factors as follows: 1) Clinical criteria, which include elevated body temperature or subjective fever or additional symptoms such as severe headache, fatigue, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage; AND 2) epidemiologic risk factors within the past 21 days before the onset of symptoms, such as contact with blood or other body fluids of a PUI or patient with confirmed EVD; residence in—or travel to—a country with widespread transmission or cases in urban settings with uncertain control measures; participation in funeral and burial rituals, or direct handling of bats, rodents, or primates from disease-endemic areas.

Facilities evaluating a PUI should contact their local or state health department for testing. Health departments should contact the CDC Emergency Operations Center at 770-488-7100 for testing and consultation.

All laboratory testing should be performed using appropriate laboratory safety guidance. For information regarding guidance of specimen collection, transport, testing, and submission for PUIs, see CDC’s Guidance for Collection, Transport, Testing, and Submission of Specimens for Ebola Virus Testing, and the accompanying infographic pdf iconpdf icon[PDF – 1 page]. In general, laboratory testing should be kept to the minimum as required for patient care.