An emergency department patient presents with sudden fever and headache after potential exposure to Ebola virus disease (EVD) while volunteering in West Africa. Based on exposure history and timing, what is the level of risk for developing EVD?

• A. High risk
• B. Moderate risk
• C. Low risk
• D. No risk

Answer: (D)

The key idea is that Ebola virus disease risk depends on the type of exposure and where you are in the incubation period. Ebola incubation is 2 to 21 days, and early symptoms like fever and headache are nonspecific, so the amount of risk hinges on what kind of contact occurred and whether it happened within that 21-day window.

If there was direct exposure to infected blood or body fluids, or unprotected contact with an EVD patient, the risk is high. If the exposure was more indirect or with proper PPE, the risk is lower, but not zero. In this scenario, volunteering in West Africa suggests potential exposure, and the patient now has fever and headache within the incubation period. That means there is at least some nonzero risk of developing EVD, and such a presentation would prompt evaluation and appropriate infection-control precautions.

No risk would be reserved for a situation with truly no exposure and no symptoms within the incubation window. Here, the history implies at least some risk, so labeling it as no risk isn’t consistent with the exposure history and timing.