WASHINGTON -- Military Health System colleagues,

Members of the U.S. military have begun to deploy to the Ebola-stricken nation of Liberia. The medical and logistic capabilities of the Department, along with our infectious disease expertise, will provide a significant level of support to the heroic clinical and public health workforce in these nations as well as the many non-governmental organizations serving in the West African countries of Liberia, Guinea, and Sierra Leone.

Domestically, the U.S. has confirmed the Ebola Virus Disease (EVD) within our own borders, reminding all military medical professionals of our obligation to remain informed on the current state of medical knowledge regarding the prevention, identification, treatment, and ongoing surveillance of EVD regardless of where we work.  Every medical professional has a role to play within our military communities, as well as helping to educate and inform the American public and help allay unwarranted fears.

The Centers for Disease Control and Prevention (CDC) maintains comprehensive information and guidance for medical institutions on their website: http://www.cdc.gov/vhf/ebola/index.html. These CDC documents outline a number of important steps that every military medical commander must take in order to ensure the highest state of readiness within the military medical community.

While every member of our medical team should be familiar with the basic checklist for identifying a possible case of EVD, it is particularly important that our clinical personnel in primary care, specialty clinics, and emergency rooms are educated on the current screening procedures and identification of risk factors for EVD - particularly questioning whether individuals may have traveled to those locations where the disease is endemic. The clinical checklist should be followed for any patient who presents with the following symptoms:

*         Fever

*         Headache

*         Weakness

*         Muscle pain

*         Vomiting

*         Diarrhea

*         Abdominal pain

*         Hemorrhage


If EVD is considered a possible diagnosis, the MTF must isolate the patient immediately while completing further evaluation and testing.  Prompt notification to higher headquarters and to the CDC must follow the identification of these preliminary cases.  Facilities should ensure proper medical waste disposal guidelines are followed even prior to definitive tests confirming or ruling out the diagnosis of EVD. This extra level of precaution is prudent - and expected of all our medical professionals. 

As deployed members return from Liberia, or if other beneficiaries have traveled to West Africa, our responsibilities to protect the health of our force and our communities will grow. DoD leadership has created comprehensive pre- and post-deployment screening guidance, and every MTF needs to be prepared to support the requirements detailed in it. We've attached the policy guidance to this letter for your review - and we urge you to familiarize yourself, especially with the post-deployment monitoring. All of the troops coming home from affected areas will be screened twice a day, regardless of exposure - so MTFs will play a large role in supporting this task.   

We have the capability and expertise to identify potential cases of EVD, and mitigate any risks that would arise if a positive diagnosis is made. This infectious disease threat can be effectively managed with disciplined public health processes.

Please ensure that every medical professional within your area of responsibility remains attentive to the symptoms of EVD, and follows the CDC protocols to identify and treat individuals with this disease.  We urge all of you to continually check the CDC website for their updates of information and guidance, http://www.cdc.gov/vhf/ebola.


Sincerely,

Jonathan Woodson, M.D., Assistant Secretary of Defense (Health Affairs)                                           

Lt. Gen. Patricia D. Horoho, Surgeon General, United States Army

Vice Adm. Matthew Nathan, Surgeon General, United States Navy                        

Lt. Gen. Thomas W. Travis, Surgeon General, United States Air Force

Lt. Gen. Douglas J. Robb, Director, Defense Health Agency