You are an on-duty physician in a major academic teaching hospital. A young medical resident from your hospital calls at midnight from the Ivory Coast in Africa. While doing missionary work at a small local hospital in that country, he is caring for a group of patients who have recently exhibited a febrile illness with a severe bleeding diathesis, and two have died. Healthcare providers have been using full barrier precautions with eye and respiratory protection because of a history of ebola infection in the past in this region. Yesterday they received word from the CDC that ebola had been confirmed. Today while cutting off tape covering the sleeves of his gown and his gloves, the young doctor accidentally pierced the skin of his wrist with a pair of bandage scissors. There was blood on the outside of the gown sleeve, and minimal blood at the site of the wound. He asks you for advice on what he should do. Though small, the local hospital where he is working has modern ICU capabilities with unused beds and sufficient staff.

You correctly advise him to:

   A  . Remain in place for 21 days under close medical observation for evidence of VHF symptomology.
   B  . Begin post-exposure prophylaxis with oral ribavirin immediately
   C  . Arrange for immediate transport within 48 hours to the closest major medical center in Europe with isolation and intensive care capabilities.
   D  . Wait to see if symptoms occur, and then arrange transport out of the area.
   E  .  Either A or C are correct.