Active Monitoring of Persons at Risk of Ebola Virus Exposure in the United States

Key Objectives:
Share experiences and lessons learned from the local, state, and federal perspective on active monitoring of persons at risk of Ebola virus exposure Identify useful techniques for conducting monitoring activities

Brief Summary:
The 2014 outbreak of Ebola virus disease (EVD) in West Africa involved widespread transmission in both healthcare and community settings. This resulted in a potential for exposure among both residents and responders from other countries. To provide early detection and treatment of EVD in persons arriving in the United States from countries with widespread Ebola virus transmission, CDC released guidance on monitoring persons at risk for Ebola virus exposure. Guidance called for all jurisdictions to establish monitoring programs by early November. All travelers entering the United States from countries with widespread Ebola virus transmission (Guinea, Liberia, Sierra Leone) and later Mali were screened on arrival and classified in one of three risk categories: Low (but not zero), Some, High. State, local, and territorial health departments were notified of travelers entering their jurisdictions so that appropriate monitoring could begin. Persons in the Low-risk category were placed under active monitoring; persons in the Some-risk category were placed under direct active monitoring. Any persons assessed at High risk were handled specially, but also subject to direct active monitoring. Active monitoring included daily notification of health status to the state health department; direct active monitoring included daily visual confirmation and discussion of health status. Healthcare workers providing care for EVD patients in the United States were also classified at Low risk, but direct active monitoring was recommended. Discussion may cover 1) notification of health departments about arriving travelers, 2) procedures for contacting and maintaining contact with persons under monitoring, 3) techniques for direct active monitoring, 4) state-to-state notification and transfer protocols for persons traveling across jurisdictions, and 5) cost/benefit of monitoring for public health. Participants are encouraged to share obstacles encountered and solutions developed for monitoring in their jurisdictions.