symptoms include acute onset of fever, maculopapular rash, arthralgia and conjunctivitis
Dengue and chikungunya circulate in the same areas as Zika, and should be tested for commercially if Zika is suspected All persons with travel to an area with known Zika virus transmission (regardless of pregnancy status) reporting two or more of the following symptoms: acute onset of fever, maculopapular rash, arthralgia, or conjunctivitis, during or within two weeks of travel. Obtain specimens during the first week of illness if possible
Pregnant women with travel to an area with known Zika virus transmission (at any trimester). o With clinical illness consistent with Zika virus disease—Testing recommended during the first week of illness if possible.
o Asymptomatic —Testing can be offered two to 12 weeks after pregnant women return from travel.
o Babies born to women with a history of travel during pregnancy to an area with known Zika virus transmission, with evidence of maternal infection or fetal infection.
If testing, collect 2 mL serum, separate, refrigerate and transport cold to the Washington Public Health Laboratories. Be sure to also collect serum for commercial dengue and chikungunya testing, if indicated.
MultiCare employees - see the MHSnet webpage for links to MERS-CoV and ebola updates and preparedness website for current hospital guidelines!
Tacoma Pierce County Health Department: 253-798-6410
South King County Health Department: 206-296-4774
MHS Infection Prevention: 253-403-4677 – after hours call the hospital operator to reach the on call infection preventionist.
MERS is a respiratory illness caused by a virus called Middle East Respiratory Syndrome Coronavirus, or MERS-CoV. Most people confirmed to have MERS-CoV infection have had severe acute respiratory illness with symptoms of fever, cough and shortness of breath.
The virus is thought to be spread via respiratory secretions such as coughing, but the exact ways are not yet well understood. Look for travel outside the U.S.
Symptoms to look for:
1. Fever AND pneumonia or acute respiratory distress syndrome AND one of the following: recent history of travel in/near Arabian Peninsula OR close contact with a symptomatic traveler OR history of being in a health care facility in Republic of Korea within 14 days of symptom onset
2. Fever AND symptoms of respiratory illness (not necessarily pneumonia) AND being in a health care facility within 14 days before symptom onset in a country or territory in or near the Arabian Peninsula
3. Fever OR symptoms of respiratory illness (not necessarily pneumonia) AND close contact with a confirmed MERS case while the case was ill
To help identify possible cases of MERS, we plan to:
• Implement a MERS-CoV Screen Questionnaire that includes information about travel history and symptoms of MERS.
• Deploy a screening tool in Epic that will provide questions to ask patients and appropriate actions to take if you encounter potential cases. The tool will be live Sept. 9.
If you do suspect a case, follow these steps:
• Immediately contact your local health department and the Infection Preventionist by calling the hospital operator at 253-403-1000.
o Tacoma Pierce County Health Department: 253-798-6410
o South King County Health Department: 206-296-4774
• Place a mask on patient
• Bring patient to negative airflow room
• Place patient into Airborne Respiratory and Contact Precautions (negative airflow room, gowns, gloves and PAPR respirator)
Urgent Care Centers, Clinics
• Place a mask on patient
• Bring patient to a private room and keep door closed
• Staff wear gloves, gown and mask with eye protection
• Maintain a log of all individuals entering the room
Screening will remain in effect until the CDC and local health officials recommend otherwise. Please also continue to screen for Ebola until you hear otherwise. More information about MERS will be available on MHSnet on the MERS-CoV website. Marketing is arranging to print flyers that will be posted at the front desks of all of our locations. Details and form number will be available soon.
CDC "What's New"
CDC Ebola Treatment Recommendations
CDC: Identify, Isolate, Inform: Emergency Department Evaluation and Management for Patients Who Present with Possible Ebola Virus Disease
Interim Guidance for Emergency Medical Services (EMS) Systems and 9-1-1 Public Safety Answering Points (PSAPs) for Management of Patients with Known or Suspected Ebola Virus Disease in the United States
Case Map as of Oct 24th, 2014 [CDC online]