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Missionaries who had contact with Ebola to be quarantined in Charlotte

By Elisabeth Arriero
earriero@charlotteobserver.com

Missionaries returning from Liberia who have been in direct contact with the Ebola virus but who are not sick are heading to Charlotte and will be quarantined once they arrive, health officials said Sunday.

Dr. Stephen Keener, medical director of the Mecklenburg County Health Department, declined to specify how many missionaries will be quarantined, when they’ll arrive or how they’ll travel from Africa, citing the need for privacy. He also did not specify whether the missionaries are from Charlotte.

“It’s very important to hear and understand that … none of the returning missionaries are ill, none of them have the Ebola virus disease,” Keener said at a press conference. Those affected with Ebola are not infectious until they are symptomatic, health officials have said.

In a statement Sunday, Charlotte Douglas International Airport officials said they are “fully cooperating with state and local officials on the return of volunteers, staff and their families from West African countries currently affected by an Ebola outbreak.”

“The arrival will occur in an undisclosed, nonpublic area in order to ensure the safe return and privacy of the passengers,” the statement said. “The arrival is expected to have no impact (on) airport operations.”

SIM USA, based in Charlotte, is an international mission group that spreads the Gospel and helps the needy in Africa, Asia, the Americas and Europe.

One of its missionaries, Nancy Writebol of Charlotte, became the second American stricken with Ebola while serving in Liberia. She was transferred to Emory University Hospital last Tuesday while her husband, David, remains in Liberia until his health condition is cleared.

Two other missionaries, along with their six children, arrived in Charlotte from Liberia on Aug. 3, SIM said. They remain on the SIM campus in an area that is separate from ongoing operations.

Keener said the missionaries returning differ from those eight who returned last week because last week’s group didn’t have any defined contact with people affected by the Ebola virus.

Those missionaries who returned last week were asked to remain available to go the full 21 days of incubation in the interest of public safety. “They were not put under an official quarantine,” Bruce Johnson, SIM USA’s president, said.

Using extra caution

Quarantine is a tool used to protect the public from the possible spread of a disease. During a quarantine, persons who have been exposed to a communicable disease, but who are not themselves ill, are limited in their movement and contact with others.

“They’re kept at home or in another situation that is controlled so they do not contact other people,” Keener said.

In the case of Ebola, exposure would mean contact with blood, saliva, vomit or other bodily fluids as well as contact with instruments that may be used, such as needles.

Those missionaries who have not been exposed by that definition, however, are “free to travel wherever they want,” Keener said.

“The definition we’re using is a very broad one, just to ensure out of a sense of overcaution that we wouldn’t be letting anything slip through the cracks,” Keener said.

He said because these missionaries are not sick or an immediate threat to public health, the organization is not disclosing any more information about them.

“What’s important, I think, is No. 1, the individuals aren’t sick. So if you’re not sick, then there’s no reason to get on the media and talk about you personally and what you’re doing and not doing because it doesn’t matter,” he said.

He added that the local and state health departments are going above what’s required of them to ensure the public’s safety and “to ensure that these folks are going to remain well and that there’s no opportunity for anybody else to become exposed or sick.”

When pressed for a ballpark figure on how many missionaries are returning from Liberia, Palmer Holt – the president of InChrist Communications who was speaking on behalf of SIM USA – said the organization is not releasing additional information. He said more may be announced in the coming days.

Quarantines used before

Keener said the county has used quarantines in the past, including for SARS in 2003 and the measles in recent years.

The quarantine period depends on the longest known incubation period of the disease in question. For Ebola, that’s 21 days.

“(When the) possibility of them developing the disease has passed, quarantine is lifted,” said Keener, noting that the quarantine for the missionaries began in Liberia with their last contact with the Ebola virus.

Should one of the patients start showing symptoms of the virus, health officials plan to consult with experts to determine whether further evaluation is needed, said Keener.

He added that symptoms of the virus can mimic what one would see in the flu or other types of viral diseases.

In the event that someone shows signs of Ebola, “all the necessary precautions will be taken at (a) hospital. The hospital will use the normal isolation procedures to ensure the safety of the staff and public.”

Keener did not specify the hospital. In late July, Carolinas Medical Center emergency room staffers had an Ebola scare when they realized one of their patients had recently traveled in Africa.

In response, the hospital took precautions by roping off a portion of the ER and placing the patient in isolation for about seven hours. Soon after, doctors and public health officials ruled out the risk of Ebola.

In the wake of that incident, Dr. Katie Passaretti, medical director for infection prevention at Carolinas Medical Center, said medical personnel held meetings to go over emergency protocols. “We were prepared before that, but that definitely kicked things up even higher,” she said. “We are ready if it happens.”

Arriero: 704-358-5945; Twitter: @earriero
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