Interim Guidance on Implementing Home Monitoring of People Being Evaluated for Ebola Virus Disease

Who this is for: State and local health department staff, infection prevention and control professionals, clinical healthcare providers, and healthcare workers who are coordinating the home care and monitoring of people who are being evaluated for possible Ebola virus disease (see Case Definitions).

Purpose and how to use this guidance: To advise how to assess and manage of people who have had a low (but not zero) risk exposure for Ebola and 

• Whose symptoms and diagnostic findings either do not meet criteria for required medical evaluation for possible Ebola (see Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease Exposure) (for example, a person who is afebrile and does not have constitutional or gastrointestinal symptoms) 
• Whose diagnosis is strongly consistent with an alternative diagnosis (for example, febrile respiratory illness without gastrointestinal symptoms, consistent with influenza or upper respiratory tract illness) 
• Who do not necessarily require hospitalization while being monitored to determine if symptoms progress or awaiting diagnostic test results (for example, tests for influenza, respiratory syncytial virus, rhinovirus).

Prior guidance: No prior guidance. This guidance builds on the Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease Exposure and on the Algorithm for Evaluation of the Returned Traveler [PDF – 1 page] and is based on what is currently known about Ebola virus transmission. CDC will update this guidance as needed.

Isolating people in hospital settings who have a low (but not zero) risk of exposure to Ebola virus and who are clinically well enough to be managed in residential settings can unnecessarily use health worker time, hospital space, and personal protective equipment. People who do not require hospitalization in a healthcare facility while awaiting results of diagnostic testing for Ebola virus and other conditions may be cared for and isolated in a residential setting after a healthcare professional determines that the setting is suitable and the patient is able to care for him- or herself or have help. In coordination with CDC, state or local health departments and healthcare professionals can recommend that the patient be isolated in a residential setting after the patient is assessed for risk of exposure  and clinical signs and symptoms, and the residence is determined to be suitable for isolating and monitoring the patient. See Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease Exposure for more information.

Assessing the Feasibility of the Residential Setting for Home Care

In consultation with state or local health department staff and CDC, a healthcare professional should

• Assess whether the residential setting is suitable and appropriate for home care.
• Assess whether the patient is capable of adhering to recommended precautions for isolating and monitoring in the home, including limiting contact with others.
• Assess whether the patient and other household members are comfortable with the plan for isolating and monitoring in the home.
• Provide CDC’s Guidance for When Caring for Patients Under Investigation or Confirmed Patients with Ebola to the person being evaluated for Ebola and to the caregiver and household members.
• Establish in advance the criteria for discontinuing home monitoring or admitting the patient for hospital isolation.