Re Ebola virus disease again

CDC has published the risk factor guide line for Ebola virus disease quoted below in this post.

We should avoid any contacts with symptomatic patients without appropriate protection. At the front of medical services, it could be difficult for the staff to observe these instructions once there is an epidemic occurring in the community. Quarantine is of limited power as well.

At present, the biggest issue is that China could be the source of the outbreak world wide. There is a close relationship between China and African countries including the epidemic area. There is heavy traffic of people between these two areas. It means EVD could be transmitted by them into China. The secretive politics as well as undeveloped medical system in China might reinforce the possible outbreak there. In such an epidemic world wide, it could be quite tough to do with it since the infrastructure of medical system could be destroyed at first anywhere.

We still should be careful about what goes on with this outbreak. Much more support should be given to the Western Africa in the outbreak now.

From CDC web site;

The following epidemiologic risk factors should be considered when evaluating a person for Ebola virus disease (Ebola), classifying contacts, or considering public health actions such as monitoring and movement restrictions(http://www.cdc.gov/vhf/ebola/exposure/monitoring-and-movement-of-persons-with-exposure.html) based on exposure.

1. High risk includes any of the following:
   • Percutaneous (e.g., needle stick) or mucous membrane exposure to blood or body fluids of a person with Ebola while the person was symptomatic,
   • Exposure to the blood or body fluids (including but not limited to feces, saliva, sweat, urine, vomit, and semen) of a person with Ebola while the person was symptomatic without appropriate personal protective equipment (PPE)(http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html),
   • Processing blood or body fluids of a person with Ebola while the person was symptomatic without appropriate PPE or standard biosafety precautions,
   • Direct contact with a dead body without appropriate PPE in a country with widespread Ebola virus transmission(http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/distribution-map.html),
   • Having lived in the immediate household and provided direct care to a person with Ebola while the person was symptomatic
2. Some risk includes any of the following:
   • In countries with widespread Ebola virus transmission(http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/distribution-map.html): direct contact while using appropriate PPE with a person with Ebola while the person was symptomatic
   • Close contact in households, health care facilities, or community settings with a person with Ebola while the person was symptomatic
     • Close contact is defined as being for a prolonged period of time while not wearing appropriate PPE within approximately 3 feet (1 meter) of a person with Ebola while the person was symptomatic
3. Low (but not zero) risk includes any of the following:
   • Having been in a country with widespread Ebola virus transmission(http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/distribution-map.html) within the past 21 days and having had no known exposures
   • Having brief direct contact (e.g., shaking hands) while not wearing appropriate PPE, with a person with Ebola while the person was in the early stage of disease
   • Brief proximity, such as being in the same room for a brief period of time, with a person with Ebola while the person was symptomatic
   • In countries without widespread Ebola virus transmission: direct contact while using appropriate PPE with a person with Ebola while the person was symptomatic
   • Traveled on an aircraft with a person with Ebola while the person was symptomatic.
4. No identifiable risk includes:
   • Contact with an asymptomatic person who had contact with person with Ebola
   • Contact with a person with Ebola before the person developed symptoms
   • Having been more than 21 days previously in a country with widespread Ebola virus transmission(http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/distribution-map.html)
   • Having been in a country without widespread Ebola virus transmission and not having any other exposures as defined above