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.

Alere, Orlando, FL), and blood smear examination for malaria parasites were routinely performed. Laboratory testing was performed in the routine clinical laboratory of EHC when suspicion of EVD was low (after consideration of presenting symptoms and epidemiologic risk level). However, for PUI with increased concern for EVD (including all patients where Ebola testing was indicated), testing was performed at a specialized isolation laboratory located in the ETU [18] until EVD was determined to be extremely unlikely based on a negative Ebola virus test and other epidemiologic and clinical features of the case. In these situations, some tests were limited because routine microbiologic cultures could not be performed in the ETU laboratory [18] . The decision to perform Ebola virus testing was made by the infectious diseases physician and public health authorities with consideration of clinical and epidemiologic risk factors for EVD. When Ebola testing was performed, a multiplex reversetranscriptase assay for multiple pathogens that included Ebola virus was performed (FilmArray Biothreat Panel; Biofire, Salt Lake City, UT), and a specimen was sent to the Georgia Department of Public Health for confirmatory testing in some cases. Patients who recovered from their illness were considered to be ruled out for EVD, even when Ebola testing was not performed.