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Concerns for HCW slowed response in pediatric patients with suspected Ebola
A recent report in MMWR, outlining the CDC’s response to suspected Ebola virus in pediatric patients during the 2014-2015 outbreak, revealed that appropriate clinical care was delayed for at least five children due to concerns regarding staff exposure to the disease.
“Pediatric clinical care presents unique challenges during an Ebola assessment, and routine pediatric care for common pediatric illnesses (eg, bacterial and viral infections, or malaria, a disease that is endemic in West Africa) was sometimes delayed because of concerns about Ebola,” Alyson B. Goodman, MD, of the CDC’s 2014-2015 Ebola response team, and colleagues wrote. “No child evaluated for Ebola had any known contact with an Ebola patient or their body fluids, or with a deceased patient, and to date, no pediatric Ebola case has been identified or managed in the United States.”
Investigators identified 89 children from 27 states and the District of Columbia with clinical inquiries into suspected Ebola contamination. Thirty-three patients had an epidemiologic risk factor, with 32 meeting the criteria for a person under investigation. All of those patients had traveled to an Ebola-affected country, while none had any known contact with an Ebola-infected patient. Each patient under investigation also had one or more symptoms associated with Ebola.
Of these 32 patients, only 15 were tested for Ebola; all tested negative. Ebola infection was ruled out for the other patients by confirmation of an alternative diagnosis or clearing of symptoms.
The investigators said at least 15 of the pediatric patients were placed in some type of isolation. Difficulty finding a hospital and hesitancy to treat persons under investigation for fear of contamination in health care workers (HCW) led to delayed treatment in at least five patients.
“While maintaining a high level of vigilance for Ebola among ill pediatric patients who have recently traveled from affected countries, US public health officials and health care providers should provide child-focused care that includes timely diagnosis and appropriate treatment of common pediatric illnesses, as well as Ebola, and reflects overall best practices in supporting children’s psychosocial needs,” Goodman and colleagues wrote. – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
