A diagnosis of VHF should be considered for any patient with a fever who has recently arrived in this country from an endemic area.
Triage / assessment form for ALL patients returning from endemic areas.
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Has the patient been to an endemic country for VHF in the last month?
Endemic countries are: Guinea (-Conakry), Sierra Leone, Liberia, Cote d'Ivoire, Ghana, Togo, Benin, Nigeria, Mali, Burkina Faso, Niger, Central African Republic, Cameroon, Gabon, Democratic Republic of Congo, Sudan, Uganda, Chad, Congo, Equatorial Guinea
Does the patient have an illness with fever of less than 21 days' duration that started either while s/he was in the endemic country, or within 21 days of leaving an endemic country?
Has the patient:
- Travelled outside major cities
- Had contact with sick people or been to health care facilities
- Been in contact with rats or their excreta
- Been in direct contact with wild animals
If the answer to any part of question 3 is YES, or there is another reason to suspect VHF, then take a THIN FILM ONLY for malaria screen. DO NOT take any other specimens from the patient.. Discuss with the on-call Microbiologist. This does NOT necessarily mean that the patient is at risk of VHF, simply that further assessment is required.
If the answer to all parts of question 3 are NO, then document 'minimal risk of VHF' and continue with triage as normal.