The Mecklenburg County Health Department said Monday it has begun monitoring people in the Charlotte area who recently arrived in the United States from the west African countries impacted by the Ebola virus.
The daily monitoring is part of new federal government guidelines in which travelers from Guinea, Sierra Leone and Liberia not only have their temperatures checked upon arrival at the airport, but must check in with local health departments for three weeks.
The Centers for Disease Control has called the new guidelines “active post-arrival monitoring.”
Mecklenburg County Medical Director Stephen Keener said the monitoring is routine. He said Monday night the county is monitoring “less than 10” people and a county memo said there are two people under watch.
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Unlike New York and New Jersey, which last weekend established automatic quarantines for travelers returning from West Africa, North Carolina health officials are following a less restrictive policy.
Dr. Megan Davies, state epidemiologist, said travelers from West Africa will be monitored in three ways, depending upon their potential Ebola exposure. The protocol generally follows federal guidelines.
• Travelers with Ebola symptoms will be immediately isolated in a health care facility.
• Travelers with an Ebola exposure risk but no symptoms will receive immediate and daily assessments by a public health nurse. Their movements will be monitored and, if necessary, restricted for 21 days.
• Travelers with no identified risk will have an in-person assessment by a public health nurse, who will check in daily for 21 days.
Keener said the travelers are taking their own temperature twice a day and are being called by local health officials daily. They are being asked whether they have any Ebola symptoms, such as vomiting or fatigue. He said the people being monitored have all been reachable and no one has shown any signs of having the virus.
There are no direct flights between North Carolina and West African countries affected by Ebola. But the U.S. Centers for Disease Control and Prevention is notifying state health officials when travelers from those countries come to North Carolina from the five major airports with direct flights to that region.
Automatic quarantines for all travelers from West Africa were instituted by New York and New Jersey governors after Friday’s diagnosis of Ebola infection in Dr. Craig Spencer. He recently traveled to New York from Guinea, where he worked for Doctors Without Borders. Spencer, 33, is being treated at Bellevue Hospital.
On Friday, Spencer received a transfusion of blood plasma from Charlotte’s Nancy Writebol, one of the first U.S. citizens to develop Ebola infection while working in Liberia.
Transfusions of blood from survivors have been used to help treat Ebola patients, including Dr. Kent Brantly, a missionary with Boone-based Samaritan’s Purse. Brantly received a transfusion while in Liberia from a young survivor there. In turn, after he recovered at Emory University Hospital in Atlanta, Brantly donated plasma to Dr. Rick Sacra, a missionary with Charlotte-based SIM and NBC News freelance cameraman Ashoka Mukpo. Both Sacra and Mukpo recovered at Nebraska Medical Center.
This was Writebol’s first donation because it was the first time her blood type matched that of a U.S. Ebola patient, according to Bruce Johnson, president of SIM, which sponsored Writebol’s service. Like Brantly, Writebol was evacuated from Liberia to the Emory hospital, where she recovered in August.
Having observed closeup the return of Ebola patients and their family members to the United States, Johnson criticized “the rhetoric of the politicians … and some of the news media that is more reactionary.”
He said it started after Thomas Eric Duncan, a Liberian, was the first person to be diagnosed with Ebola while living in this country. Duncan died Oct. 8, and two nurses who cared for him were subsequently diagnosed with Ebola infection. Both have recovered.
Johnson said restrictions like those imposed by the New York and New Jersey governors will “dampen the ability” of other volunteers who want to go to West Africa to help. He said they won’t be able to take two or three weeks away from work to volunteer if they have to spend another three weeks in quarantine, away from their work and families.
About 20 SIM missionaries and family members returned to the United States this summer. Three were quarantined on the SIM campus, by order of the Mecklenburg County Health Department, but the others voluntarily monitored their temperatures and restricted their activities during the 21-day incubation period. None developed Ebola symptoms.
Like Johnson, Franklin Graham, head of Samaritan’s Purse, said automatic quarantines for returning travelers are misguided and confusing.
“You can’t put ’em in jail. You can’t lock ’em up,” Graham told the Greensboro New & Record. “…We need to treat them as heroes, not criminals.”
All Samaritan’s Purse staffers returning from West Africa are required to spend 21 days with “restricted public access,” which means they don’t use public transportation, avoid crowds and stay an arm’s length away from other people. They also are asked to take their temperatures four times a day.
Graham said he’d also like to see an “air bridge” using government-operated planes that would fly several times a week carrying supplies and health care workers between the United States and West Africa.