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Guidance for the Evaluation of Employees with Suspected Infection with
Ebola Virus Disease
Early recognition is critical for infection control. Health care providers should be alert for and evaluate any patients
suspected of having Ebola Virus Disease (EVD).
Person Under Investigation (PUI)
A person who has both consistent symptoms and risk factors as follows:

Clinical criteria, which includes fever of greater than 38.6 degrees Celsius or 101.5 degrees Fahrenheit, and
additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or
unexplained hemorrhage; AND

Epidemiologic risk factors within the past 21 days before the onset of symptoms, such as contact with
blood or other body fluids or human remains of a patient known to have or suspected to have EVD;
residence in—or travel to—an area where EVD transmission is active*; or direct handling of bats or nonhuman primates from disease-endemic areas.
Ebola Testing
Ebola virus is detected in blood only after the onset of symptoms, usually fever. It may take up to 3 days after
symptoms appear for the virus to reach detectable levels. Virus is generally detectable by real-time RT-PCR from 310 days after symptoms appear.
Ideally, specimens should be taken when a symptomatic patient reports to a healthcare facility and is suspected of
having an Ebola exposure. However, if the onset of symptoms is <3 days, a later specimen may be needed to
completely rule-out Ebola virus, if the first specimen tests negative.
Evaluation
Employees presenting to Employee Health will be evaluated for signs and symptoms of EVD.
Guidance for the Evaluation of Employees with Suspected Infection with
Ebola Virus Disease
Upon arrival to Employee Health
Does employee have fever (subjective or ≥101.5°F)?
Oral temp:
Does patient have compatible EVD symptoms such as headache, weakness, muscle pain,
vomiting, diarrhea, abdominal pain or hemorrhage?
Has the patient traveled to an Ebola-affected area in the 21 days before illness onset?
 Yes
 No
 Yes
 No
If fever greater than ≥ 101.5° or EE responds “Yes” :

Immediately close Employee Health office

Don PPE (surgical mask and shield or goggles, gloves, and gown)

Place a surgical mask on the employee


Call ED to transfer employee.
Notify Employee Health Manager, Infection Preventionist and Medical Director of Infection Control
Conduct a risk assessment for exposure (asymptomatic):

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


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Percutaneous (e.g., needle stick) or mucous membrane exposure to blood or body
fluids from an EVD patient
Direct skin contact with skin, blood or body fluids from an EVD patient
Processing blood or body fluids from an EVD patient without appropriate PPE
Direct contact with a dead body in an Ebola-affected area without appropriate PPE
 Yes
 No
Household members of an EVD patient or others who had brief direct contact (e.g.,
shaking hands) with an EVD patient without appropriate PPE
Healthcare personnel in facilities with EVD patients who have been in care areas of
EVD patients without recommended PPE
 Yes
 No
If “Yes” :
 Provide support and offer EAP
 Notify Employee Health Manager, Infection Preventionist and Medical Director of Infection Control
 Work in concert with CDC 1 (770) 488-7100 and Office of Public Health 1(800) 256-2748
 Follow Blood and Body Fluid Policy/Protocol
Upon employee exiting Employee Health
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PPE should be carefully removed without contaminating one’s eyes, mucous membranes, or clothing with
potentially infectious materials
Discard disposable PPE
Re-useable PPE should be cleaned and disinfected per the manufacturer’s reprocessing instructions
Hand hygiene should be performed immediately after removal of PPE
 Wear PPE (detailed in center box) during environmental cleaning and use an EPA-registered hospital
disinfectant with a label claim for non-enveloped viruses
Ebola EH Eval KB/mgb 10/04/14