Development and Implementation of the Ebola Traveler Monitoring Program and Clinical Outcomes of Monitored Travelers during October – May 2015, Minnesota

摘要: Background In October 2014, the United States began actively monitoring all persons who had traveled from Guinea, Liberia, and Sierra Leone in previous 21 days. State public health departments were responsible for travelers; Minnesota has largest Liberian population States. The MDH Ebola Clinical Team (ECT) was established to assess travelers with symptoms of concern virus disease (EVD), coordinate access healthcare at appropriate facilities including Assessment Treatment Units (EATU), provide guidance clinicians. Methods Minnesota Department Health (MDH) receiving traveler information collected by U.S. Customs Border Control Centers Disease Prevention staff on 21, 2014 via encrypted electronic communication. All returning Leone, Guinea during 10/21/14–5/15/15 monitored manner recommended CDC based traveler’s risk categorization as “low (but not zero)”, “some” “high” risk. When a reported or temperature ≥100.4° F any time their 21-day period, an ECT member would speak perform clinical assessment telephone video-chat. Based recommend 1) continued while home frequent follow-up member, 2) outpatient evaluation site agreed upon parties, 3) inpatient one four EATUs. members assessed approved testing infection MDH. Traveler data, calls outcomes logged secure server MDH. Results During 10/21/14–5/15/15, total 783 monitored; 729 (93%) 30 (4%) 24 (3%) Guinea. median number per week 59 (range 45–143). age 35 years; 136 (17%) aged <18 years. Thirteen 256 women reproductive (5%) pregnant. country passport issuance known 720 travelers. majority (478 [66%]) used non-U.S. 442 (61%) nationals. A 772 (99%) zero)” risk; 11 (1%) Among travelers, 43 experienced illness symptoms; 29 (67%) symptom consistent EVD. Two tested negative results. Most frequently fever (20/43, 47%) abdominal pain (12/43, 28%). During evaluation, 16 (37%) prior travel; chronic conditions tumors/cancer, pregnancy, orthopedic most common. Infectious causes 19 included upper respiratory infection, malaria, gastrointestinal infections. Discussion Prior no similar active program been performed Minnesota; management symptomatic new activity Ensuring safe entrance into particularly challenging children, pregnant women, well those without connection healthcare. Unnecessary evaluations successfully avoided close phone. Before programs are considered future, careful thought must be given necessary resources impact affected populations, health, system.