It is important that health professionals phone their local public health unit for advice for any person whose history and symptoms raise concern, even if the person does not meet the formal case definition.
Given the lack of specificity of initial symptoms, a person will be defined as a suspected case only after a clinical assessment by an Infectious Diseases physician.
A person with a clinical illness compatible with Ebola
Fever (temperature 38°C or above)1 with or without additional symptoms such as intense weakness, severe headache, myalgia, abdominal pain, sore throat, marked vomiting, marked diarrhoea or unexplained haemorrhage. Initial symptoms are usually not specific, but onset is sudden and intense with symptoms worsening over a few days, often with prostration, rash, evidence of capillary leak, bleeding/haemorrhage, shock and impaired consciousness.
AND, within 21 days before onset of illness, a history of travel to the affected areas or a contact with an identified potential source of Ebola virus elsewhere,
- direct contact with a probable or confirmed case2 OR
- exposure to Ebola-infected blood or other body fluids or tissues3 OR
- direct handling of bats, rodents or primates, from Ebola-affected countries OR
- preparation or consumption of ‘bushmeat’4 from Ebola-affected countries.
A suspected case with no possibility of laboratory confirmation for Ebola either because the patient or samples are not available for testing.
A suspected case with laboratory confirmation (positive serology or PCR).
1 Fever may be absent at presentation if the person is taking antipyretic medication.
2 Direct contact includes:
- direct physical contact with the case during the illness (without the appropriate infection prevention and control measures)
- direct physical contact with the case post mortem (without the appropriate infection prevention and control measures)
- having touched case’s blood or body fluids during the illness (without the appropriate infection prevention and control measures)
- having touched case’s clothes or linens during the illness (without the appropriate infection prevention and control measures)
- having been breastfed by the case.
3 This includes the semen of a recovered male patient. The presence of virus has previously been demonstrated in semen for up to three months after recovery.
4 Bushmeat is the meat of African wild animals used as food.