On March 29, 2016, the WHO ended the Public Health Emergency of International Concern for the EVD outbreak in West Africa. Since the beginning of the outbreak in 2014, a total of 28,610 cases were identified, with 11,308 deaths. New clusters continue to occur, though at decreasing frequency, and the 3 countries primarily involved (Guinea, Liberia, and Sierra Leone) have all completed a 42-day observation period and a 90-day enhanced surveillance period.65 The 2014 outbreak was the largest EVD outbreak to date, and though it has officially ended, there were a number of lessons learned.65,66
A total of 11 patients with EVD were cared for in the United States during this time period, with 9 survivors. Although most survivors recover completely without relapse, clinicians should be aware of potential complications, which range from fatigue and joint pain to blindness, memory loss, or mental illness.
Additionally, it is important for clinicians to understand the persistence of Ebola virus in various body fluids and tissues, as this may have implications for isolation precautions. Infectious virus has been detected in aqueous humor 98 days after illness onset and in cerebrospinal fluid 282 days after illness onset. In semen, viral detection by RT-PCR was reported 284 days after illness onset. Though standard precautions are recommended in the routine clinical care of EVD survivors, additional precautions may be necessary if contact with any of these body fluids is anticipated. In these cases, clinicians are urged to contact their state health department and/or the CDC to determine the best course of action.66
Marlie Dulaurier, MD;Katherine Moyer, DO;Rebecca Wallihan, MD
July 2, 2016
August 2, 2019
4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits. Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 0.5 Pharmacology CME credits