E5. Have there been any members of the household who got sick during the Ebola outbreak but did not seek medical attention at a health facility?
[] 1. Yes
[] 2. No
[] 3. Don't know
If 1 complete the following table.
If 2 or 3, end the interview[Complete the following table for each person only if responded 'yes' above]
All:
Sex:
[] 1. Male
[] 2. Female
Age: ____
Women aged 10 - 54
Pregnancy Status
[] 1. Pregnant
[] 2. Not Pregnant
[] 3. Don't know