Ebola or Not? Evaluating the Ill Traveler From Ebola-Affected Countries in West Africa

Fairley, Jessica K.; Kozarsky, Phyllis E.; Kraft, Colleen S.; Guarner, Jeannette; Steinberg, James P.; Anderson, Evan; Jacob, Jesse T.; Meloy, Patrick; Gillespie, Darria; Espinoza, Tamara R.; Isakov, Alexander; Vanairsdale, Sharon; Baker, Esther; Wu, Henry M.

After identification of individuals meeting PUI criteria, timely triage, evaluation, and clinical management pose secondary challenges, given the need to simultaneously prioritize healthcare worker safety. Although PUI outside of endemic areas by definition may have EVD, the vast majority of them have alternative diagnoses [9, 10] . Surveillance of ill travelers from West Africa before this outbreak found that febrile and gastrointestinal illnesses are common, and Plasmodium falciparum malaria was the most frequent diagnosis [11, 12] . Similar non-EVD diagnoses have been reported in patients without EVD evaluated at Ebola treatment units in Sierra Leone [13] . Therefore, healthcare facilities must balance the need for appropriate infection control precautions while providing timely diagnosis and management of other common or potentially life-threatening travel-related illnesses that may be present. Unfortunately, delays in the diagnosis of non-EVD conditions due to infection control and prevention concerns have been reported in the United States [9, 10] .