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CDC Investigating Potential Exposures of American Citizens to Ebola in West Africa

Infected patient admitted to NIH clinical center

On March 13, an American volunteer health care worker in Sierra Leone who tested positive for Ebola virus returned to the U.S. by medevac and was admitted to the National Institutes of Health (NIH) Clinical Center in Bethesda, Maryland, for care and treatment.

As a result of this case, the Centers for Disease Control and Prevention (CDC) is conducting an investigation of individuals in Sierra Leone, including several other American citizens, who may have been exposed to this index patient or have had exposures similar to those that resulted in the infection of the index patient. At this time, none of these individuals has tested positive for Ebola, the agency says. The individuals are volunteers in the Ebola response and are currently being monitored in Sierra Leone.

The CDC and the State Department are developing contingency plans for returning those Americans with potential Ebola exposure to the U.S. by noncommercial air transport. One of these American citizens had potential exposure to the individual being treated at the NIH and is currently being transported via charter flight to the Atlanta area to be close to Emory University Hospital. The individual has not shown symptoms of Ebola and has not been diagnosed with Ebola. Upon arrival in Atlanta, the individual will voluntarily self-isolate and will be monitored for the 21-day incubation period.

As a result of the CDC’s ongoing investigation, the agency and the State Department are facilitating the return of additional American citizens who had potential exposure to the index patient or exposures similar to those that resulted in the infection of the index patient. Currently, none of these individuals have been identified as having Ebola virus disease.

The individuals will be transported to the U.S. by noncommercial air transport and will be near the NIH, the University of Nebraska Medical Center, or Emory University Hospital.

The individuals will follow the CDC’s recommended monitoring and movement guidelines, including direct active monitoring and, as appropriate, voluntary self-isolation during the 21-day incubation period. In the event that an individual shows symptoms of Ebola virus infection, he or she will be transported to an Ebola treatment center for evaluation and care.

Ebola is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. Five Ebola virus species have been identified, four of which are known to cause disease in humans: Ebola virus (Zaire ebolavirus); Sudan virus (Sudan ebolavirus); Taï Forest virus (Taï Forest ebolavirus, formerly Côte d’Ivoire ebolavirus); and Bundibugyo virus (Bundibugyo ebolavirus). The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates, but not in humans.

Ebola viruses are found in several African countries. Ebola was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Since then, outbreaks have appeared sporadically in Africa.

The natural reservoir host of Ebola virus remains unknown. However, on the basis of evidence and the nature of similar viruses, researchers believe that the virus is animal-borne and that bats are the most likely reservoir. Four of the five virus strains occur in an animal host native to Africa.

Sources: CDC; March 14, 2015; CDC; March 13, 2015; and Ebola Virus Disease; December 8, 2014.


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