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 Dr. Thomas Frieden, director of the U.S. Centers for Disease Control
and Prevention (CDC), called for isolation of people at the highest
risk for Ebola infection but said most medical workers returning
from the three countries at the center of the epidemic would require
daily monitoring without isolation.
New York and New Jersey are among a handful of states to impose
mandatory quarantines on returning doctors and nurses amid fears of
the virus spreading outside of West Africa, where it has killed
nearly 5,000 people in the worst outbreak on record.
The Obama administration's new guidelines are not mandatory, and
states will have the right to put in place policies that are more
strict. Some state officials, grappling with an unfamiliar public
health threat, had called federal restrictions placed on people
traveling from Ebola-affected countries insufficient to protect
Americans and have imposed tougher measures.
With thousands already dead from Ebola in Liberia, Sierra Leone and
Guinea, concerns are high in the United States about stopping its
spread.
Late on Monday, the University of Maryland Medical Center in
Baltimore said it was assessing a potential Ebola patient, who was
in isolation. The hospital, one of three designated Ebola treatment
centers in the area, gave no further details.
Earlier in the day in New York City, a 5-year-old boy who arrived in
the United States from Guinea and was in hospital for screening for
fever, tested negative for Ebola.
The CDC's Frieden, on a conference call with reporters,
warned against turning doctors and nurses who are striving to tackle
Ebola in West Africa before it spreads more widely into "pariahs."
Under new CDC guidelines that spell out four risk categories, most
healthcare workers returning from West Africa's Ebola hot zone would
be considered to be at "some risk" for infection, while healthcare
workers tending to Ebola patients at U.S. facilities would be seen
as "low but non-zero" risk.
In other Ebola-related developments, the U.S. military said it was
isolating troops returning from their mission to help West African
countries curb Ebola even though they showed no sign of infection.
And a nurse who treated patients in Sierra Leone was released to go
to her home state of Maine after New Jersey had forced her into
quarantine. The nurse had been kept in quarantine for two days after
testing negative for the Ebola virus.
There has been a growing chorus of critics, including public health
experts, the United Nations, medical charities and even the White
House, denouncing mandatory quarantines as scientifically
unjustified and an obstacle to fighting the disease at its source in
West Africa.
"At CDC, we base our decisions on science and experience. We base
our decisions on what we know and what we learn. And as the science
and experience changes, we adopt and adapt our guidelines and
recommendations," Frieden said.
Medical professionals say Ebola is difficult to catch and is spread
through direct contact with bodily fluids from an infected person
and not transmitted by asymptomatic people. Ebola is not airborne.
Frieden said high-risk people include healthcare workers who suffer
a needle stick while caring for an Ebola patient or who tend to a
patient without protective gear.
He said returning health workers at “some risk” would have their
health monitored daily by a local health department official who
would check their temperature, look for signs of fatigue and review
their daily activity plans to determine what activity “makes sense
for that individual, at that time.”
President Barack Obama's spokesman, Josh Earnest, made clear Monday
that the White House was not thrilled that individual states had
implemented quarantines viewed as unfair to returning healthcare
workers, though he acknowledged the states' rights to set them.
"We want to make sure that whatever policies are put in place in
this country to protect the American public do not serve as a
disincentive to doctors and nurses from this country volunteering to
travel to West Africa to treat Ebola patients," Earnest said.
MAJOR GENERAL ISOLATED
The Pentagon move went well beyond previously established military
protocols. The U.S. Army has already isolated about a dozen soldiers
at part of a U.S. base in Vicenza, Italy, including Major General
Darryl Williams, who oversaw the initial response to the Ebola
outbreak, the worst on record with nearly 5,000 dead.
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Dozens more will be isolated in the coming days as they rotate out
of West Africa, where the military has been building infrastructure
to help health authorities treat Ebola victims, the Pentagon said.
"We are billeted in a separate area (on the base). There's no
contact with the general population or with family. No one will be
walking around Vicenza," Williams told Reuters in a telephone
interview.
"Nobody is symptomatic. No Army soldier came in contact with
Ebola-stricken patients," Williams said, calling the move
precautionary.
The case of nurse Kaci Hickox, put into quarantine on Friday under a
New Jersey policy that exceeded precautions adopted by the U.S.
government, underscored the dilemma that federal and state officials
are facing.
New Jersey Governor Chris Christie, who has defended his state's
policy of automatic quarantine for medical workers returning from
treating patients in Liberia, Sierra Leone and Guinea, told
reporters he did not reverse the policy in allowing her to be
discharged from the hospital and to return to Maine.
"We're very happy that she has been released from the hospital,"
said Christie, who Hickox had criticized for making comments about
her health that she said were untrue while calling her quarantine
unjust.
"She hadn’t had any symptoms for 24 hours and she tested negative
for Ebola so there’s no reason to keep her," said Christie, a
potential Republican Party 2016 U.S. presidential candidate known
for his combative style.
Christie said he sees no reason to talk to her and expressed
"goodwill" toward Hickox, who had worked with the medical charity
Doctors Without Borders in Sierra Leone. "But she needs to
understand that the obligation of elected officials is to protect
the public health of all the people," Christie said.
Christie said his state was providing transportation for her to
Maine, whose health officials "will take over her care and
monitoring from there" as she completes a 21-day quarantine at home.
The quarantine matches the incubation period of the virus.
U.N. Secretary-General Ban Ki-moon on Monday became the latest to
criticize quarantines, saying through his spokesman these create
difficulties for medical workers risking their lives in the battle
against the deadly disease.
"Returning health workers are exceptional people who are giving of
themselves for humanity," said Ban's spokesman, Stephane Dujarric.
"They should not be subjected to restrictions that are not based on
science. Those who develop infections should be supported, not
stigmatized."
Four people have been diagnosed with Ebola in the United States,
with one death - a Liberian man visiting Texas. The only patient now
being treated for Ebola in the country is a New York doctor, Craig
Spencer, who was diagnosed last Thursday. He had worked with Doctors
Without Borders treating Ebola patients in Guinea.
(Additional reporting by David Morgan, Jeff Mason, Steve Holland,
Phil Stewart, David Alexander, Roberta Ramptom and Susan Heavey in
Washington, Louis Charbonneau, Laila Kearney and Joseph Ax, Bill
Berkrot in New York, and Steve Scherer in Rome; Writing by Will
Dunham and Bill Rigby; Editing by Lisa Shumaker and Grant McCool)
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