Of all the ongoing revelations regarding the first domestically diagnosed case of Ebola in the US, the one that I find most problematic is the fact that the patient initially presented to the hospital, made his travel history known, and was discharged.
It has been reported that the nursing records indicated the travel history but this information was not communicated to others on the care team.
This is a real error.
As an infectious disease physician, travel history is something I always emphasize and not just for Ebola. MERS, chikungunya, dengue, and malaria are all other diseases in which the travel history can be key to the diagnosis. Even for those within the US, travel history is crucial. Diseases like hantavirus, plague, Rocky Mountain Spotted Fever, histoplasmosis, and coccioidiomycosis (and now dengue) have a geographic element to their domestic epidemiology.
No doubt this patient's drug allergies (or their absence) were plastered all over his chart and tethered to his wrist. Travel history is the lynchpin of our defense against emerging infectious diseases and it merits the same level of importance.