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Thursday, October 30, 2014

CDC Issues Revised Interim U.S. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure

CDC Issues Revised Interim U.S. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure

The Centers for Disease Control and Prevention (CDC) issued today revised Interim U.S. Guidance for Monitoring and Movement of Persons with Ebola Virus Exposure. This guidance (hyperlink to the guidance here) provides new information public health authorities and other partners can use to determine appropriate public health actions based on Ebola exposure risk factors and clinical presentation. It also includes criteria for monitoring exposed people and for when movement restrictions may be needed.

In determining the right approach, we have put the health and safety of Americans first and foremost, and our deliberations have been informed by our most knowledgeable and experienced public health and homeland security professionals. As with everything we have done to respond to the threat of Ebola both at home and abroad, we have been guided by the best science available.

Coordinated public health actions are essential to stop and reverse the spread of Ebola virus. CDC announced last week that public health authorities will begin active post-arrival monitoring of travelers whose travel originates in Liberia, Sierra Leone, or Guinea and arrive at one of the five airports in the United States doing enhanced screening. The revised interim guidance released today is intended to guide state and local health officials with decisions about managing the movement of individuals being monitored, including travelers from the countries with widespread transmission and others who may have been exposed in the United States.

Active post-arrival monitoring means that travelers without febrile illness or symptoms consistent with Ebola will be contacted daily by state and local health departments for 21 days from the date of their departure from Liberia, Sierra Leone, or Guinea. Six states (New York, Pennsylvania, Maryland, Virginia, New Jersey, and Georgia), where approximately 70% of incoming travelers are headed, will start active monitoring today, with the remainder of the states starting in the days following.

This guidance also outlines appropriate public health actions for those individuals classified as “some risk.” These include health care workers who are providing direct care to Ebola patients in West Africa or others, such as observers, who enter an Ebola treatment area where Ebola patients are being cared for. Additional precautions, such as direct active monitoring, are recommended for those classified as “some risk.” In addition, the guidance recommends public health authorities determine on an individualized case-by-case basis whether additional restrictions, such as controlled movement, workplace exclusions, or restrictions on other activities, are appropriate. This daily health consultation will give additional confidence to the community that a returning health care worker is asymptomatic and therefore not contagious.

Returning health care workers should be treated with dignity and respect. They, along with our civilian and military personnel in the region, are working tirelessly on the frontlines against Ebola, and their success is what ultimately will enable us to eliminate the threat of additional domestic Ebola cases. We must not prevent or unduly discourage them from undertaking this indispensable and selfless work.

Guidance for returning health care workers from West Africa should be distinguished from health care workers providing care for Ebola patients in the United States. There are important differences between providing care or performing public health tasks in Africa versus in a U.S. hospital. A U.S. hospital provides a more controlled setting than a field hospital in West Africa. A U.S. healthcare worker would be able to anticipate most procedures that would put them at risk of exposure and wear additional personal protective equipment as recommended. In some places in Africa, the same may not be true and workers may not have the ability to prepare for potential exposures.

This guidance is interim guidance and could be updated or changed as new information becomes available.