This document provides a checklist for screening and evaluating patients for potential Ebola virus disease (EVD). The checklist asks whether the patient has a fever, compatible EVD symptoms such as headache, weakness, or gastrointestinal issues, and if they have travelled to an Ebola-affected area within the last 21 days. If so, medical administrators should be notified and precautions like personal protective equipment should be used to prevent contact with the patient.

1. 0 Check list for evaluation of ebola virus (EVD).
SCREENING FORM
o Does the patient have fever?
o Does patient have compatible EVD symptoms headache
, weakness, muscle pain, vomiting, diarrhea, abdominal pain,
Hemorrhage?
* Has patient travelled to Ebola affected area/INTERNATION AL TRAVEL in 21 days before
illness onset?
Notify to medical administrator
Send patient to Naidu hospital
USE CAP GOWN MASK N95* Double gloves, disposable shoe cover

2. PREVENT CONTACT WITH PATIENT.*