BACKGROUND: In October 2014, the Centers for Disease Control and Prevention announced the start of enhanced monitoring for travelers arriving in the United States (US) from countries with widespread transmission of Ebola virus disease (EVD). Former Persons Under Monitoring (PUM) were asked to complete an anonymous survey to better understand the effectiveness of monitoring protocols from both the District of Columbia (DC) and the US Federal government, their personal experiences, and ways to improve future monitoring efforts.
METHODS: Former PUM were eligible to participate in the survey if they met the following: 1) were monitored by DC between October 2014 and September 2015, 2) were 18 years of age or older at the time of monitoring, and 3) classified as low (but not zero) risk for EVD. The survey was distributed using an email marketing service (MailChimp) and administered electronically (SurveyMonkey) October 10 through November 9, 2015, in English and French. Analyses were performed using Excel 2013 and SAS 9.3.
RESULTS: Over 34% (294/854) of eligible former PUM completed the survey; 9.9% (29/294) of which were completed in French. More than half of respondents were US citizens (158/294, 53.7%) and 28.2% (83/294) were citizens of Ebola-impacted countries (Guinea, Liberia, Sierra Leone, and Mali). Overall, 78.6% (231/294) of respondents rated using the DC active monitoring program as “very easy” or “easy.” The majority of respondents (235/294, 79.9%) indicated that having multiple options for reporting their temperatures (phone calls, emails, or text messages) made reporting easy. However, 17% (50/294) said the thermometer distributed during their airport screening produced inaccurate readings. Of the former PUM given a Check and Report Ebola (CARE) phone (257/293, 87.7%), 60.3% (155/257) reported using the phone during their initial risk assessment interview and 19.1% (49/257) reported it as their only means of communication. A total of 44/284 (15.5%) respondents reported a friend/family member would not spend time with them during their monitoring period. Approximately a third of respondents (102/284, 35.9%) strongly agreed that the US monitoring program helps recent travelers receive medical treatment faster when necessary.
CONCLUSIONS: Former PUM had an overall positive experience with both the DC and US monitoring systems. However, some respondents reported issues with materials distributed during airport screenings and experiencing stigma. Future monitoring programs would benefit from targeting telephone distributions to travelers with no other means of communication, developing educational materials to accurately convey risk to PUM’s personal contacts, and allowing flexibility in reporting methods.