Symptoms of bleeding

Jennifer works at the Center for Disease Control as a resource provider for the malaria hotline. Most calls that Jennifer receives come from within the United States—either from healthcare providers seeking recommendations for managing an imported malaria case or from people planning travel to malaria-prone areas and requesting information on how to prevent malaria. But on Sunday night, Jennifer received a call from a college student named Lauren, who is two weeks into a summer-long internship in Sierra Leone with a non-profit agency that digs wells in remote villages of West Africa. Lauren complains of a high fever, severe body aches, and nausea. She’s concerned that she might be suffering from malaria, and worried that if she needs to immediately see a doctor, there isn’t one available in the village where she’s staying. The nearest town is a three-hour drive, and Lauren is unsure if there are even qualified healthcare providers there. Mobile phone coverage in the village is spotty, so despite being so ill, Lauren had to hike to the top of a hill in order to find a spot with enough cell reception to call the hotline. Jennifer tries to calm and reassure Lauren, and then gathers a patient history. Lauren came to Africa with enough antimalaria (preventive) medication for her entire stay, but she forgot to take it for the past four days, due to work being so demanding. She doesn’t sleep in a mosquito bed net, but applies insect repellant each morning before going to work. Over the past day Lauren developed a faint pink rash on her torso. The fever and aches are persistent, rather than intermittent. She feels “awful all over,” but doesn’t report any joint pain. Lauren started feeling ill yesterday and got progressively worse throughout today. She says she hasn’t had any bleeding from the nose or mouth during the illness. Jennifer then asked if over the past week Lauren had contacted anyone who was bleeding or if any of her coworkers were ill. Lauren reported that none of her team members were sick, but that a man died in the village this week, after a long illness. Lauren paid her respects to the family members of the deceased man, but did not have any contact with the man himself, enter his house, or attend the funeral. Jennifer does a computer search to help Lauren locate the nearest reliable medical clinic. The town Lauren mentioned as being three hours away does have a clinic. Jennifer asks Lauren to find a way to get to the clinic as soon as possible, and to call back if the clinic tries to prescribe any medication. She also re-quests that Lauren let her know what treatment is offered, if any. Lauren would need a blood test to make final confirmation of the disease Jennifer suspects.

Questions:

1. What disease was Jennifer trying to ascertain risk of when she asked Lauren about contact with ill people showing symptoms of bleeding? What factor(s) in Lauren’s situation makes asking about this particular disease important?

2. Based on her history and symptoms, what disease(s) does Lauren have the greatest probability of contracting? Explain your answer.

3. Is there any danger of Lauren infecting her coworkers? Why or why not?