The Centers for Disease Control and Prevention has issued interim guidance for U.S. health care providers to safely care for survivors of Ebola virus disease (EVD).
The guidance includes information about sequelae of EVD as well as data on Ebola virus persistence in EVD survivors, and infection prevention and control recommendations for U.S. health care providers when evaluating a patient who is an EVD survivor. Of the eleven patients with Ebola virus disease who were managed in U.S. health care facilities during 2014-2015, nine survived. The CDC notes in the guidance that it is also possible that some EVD survivors from West Africa could seek medical care in the United States.
In most cases, the CDC notes, persons who have completely recovered from EVD do not experience a relapse of Ebola virus associated with systemic illness, although survivors can experience complications after surviving acute EVD. Reported complications among EVD survivors include nonspecific fatigue, joint pain, muscle aches, headaches, suppurative parotitis, pericarditis, orchitis, sexual dysfunction, hair loss, vision loss (including uveitis and permanent blindness), hearing loss, tinnitus, paresthesia or dysesthesia, memory loss, insomnia, depression, anxiety, and posttraumatic stress disorder.
The risk of infectivity from patients with persistent infection is unknown, the CDC guidance states, but “appears to be low and is likely to decrease over time.” The guidance includes infection control practices that should be used to “ensure that health care personnel do not contract infections from patients, whether or not they are known to be infectious,” and that personnel do not spread infectious material to other patients during routine medical care.
Medical professionals can view the complete care guidance on the CDC website. The CDC has also published additional resources to supplement the guidance. These include:
Messages for the Care of Survivors of Ebola Virus Disease. Topics in this resource include health problems EVD survivors may experience, guidance to use standard precautions for all patient care, and recommendations for when extra precautions may be needed.
FAQ on Screening for Ebola Virus Disease for Providers, Healthcare Facilities, and Health Departments. FAQs include information on adjusting screening practices for acutely ill patients while reiterating that a thorough travel history for all patients should be obtained to ensure proper infection control measures are in place. Additionally, information on hospital management recommendations for evaluating ill travelers from West Africa are included.
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