New York, New Jersey announce Ebola quarantines

New York state and New Jersey announced mandatory quarantines of arriving passengers who had direct contact with Ebola patients in West Africa early Friday evening, and within three hours Gov. Christie reported that a health-care worker who flew through Newark Liberty International Airport had developed a fever and was in isolation at University Hospital Newark.

The developments came as state and local health departments were gearing up to carry out the latest federal directive for containing Ebola: monitoring for 21 days all travelers from Liberia, Guinea, or Sierra Leone who fly into the United States. Bucks County was already following four people; Camden County, two.

"None of these people are symptomatic or contagious to the general population," Martin Raniowski, the deputy secretary overseeing emergency preparedness for the Pennsylvania Department of Health, said Friday afternoon.

The health-care worker in Newark was a potentially different story - as was the 33-year-old physician who returned to New York City a week ago from treating Ebola patients in Guinea and was found to have the virus on Thursday. He was listed in stable condition Friday night at a special isolation unit at Bellevue Hospital Center.

It was that case that prompted Christie and New York Gov. Andrew Cuomo to announce the mandatory quarantine for medical workers and other passengers arriving at Newark and John F. Kennedy airports, both major international portals, who have had direct contact with people infected with Ebola.

A quarantine, to be coordinated with local health departments, is more rigorous than the monitoring recommended by the U.S. Centers for Disease Control and Prevention.

Christie had already announced, consistent with the new policy, that the health-care worker who came through Newark would be quarantined even though she showed no symptoms. The fever developed later. Ebola had not been confirmed.

Although the governors' guidelines are stricter than the CDC's, both call for isolating anyone flying from West Africa who is found to have symptoms during screening at the five airports around the country that are designated to receive all travelers from the three affected countries.

Names and contact information are collected and transmitted to state health departments in the six states that are the final destinations for 70 percent of visitors from West Africa: Pennsylvania, New Jersey, New York, Maryland, Virginia, and Georgia. The "post-arrival" screenings are to begin Monday.

The vast majority of new arrivals who are to be monitored locally would have had no direct contact with the disease.

David C. Damsker, a physician and director of the Bucks County Health Department, said he began receiving names of people to monitor within minutes after the CDC announced the new guidelines Wednesday. By Friday night, he had four.

All have been contacted, given lists of symptoms to watch for, and told to take their temperatures twice a day: "If they don't have a thermometer, we'll get them one," Damsker said.

They are to report their temperature to the county at least daily - other jurisdictions are requiring twice-daily reporting, which Damsker said he believed was unnecessary - and will be tracked down by public health nurses if they do not.

Initial symptoms of Ebola are similar to the flu. Damsker and others said that anyone experiencing symptoms who has not been in West Africa or in direct contact with a patient who showed symptoms within 21 days is virtually sure not to have Ebola.

If a traveler who is being monitored develops symptoms or a fever, Damsker saidthat he would call 911 to arrange transport to a local hospital. Damsker's second call would be to the hospital, "to the emergency room, and let them know so they can all be gowned, gloved," and perhaps a separate entrance opened "so anyone in the waiting room wouldn't be affected."

Then doctors would begin ruling out other causes. "We won't know what they have initially. They could have had a bad hamburger for dinner," he said. "Someone who says, 'Yeah, I have a little headache, I came from Liberia, but I didn't touch anyone,' we might bring them in and isolate them until we find another cause for fever or get negative result and they are improving."

The Pennsylvania health department said its lab in Chester County could turn around a test in six to eight hours.

State and local officials said arrivals from West Africa would be asked to keep a detailed daily diary of how they are feeling. Those who might have been exposed to Ebola will be instructed not to use commercial travel.

Beginning Monday, the state will post weekly updates on the number of people being monitored at www.health.state.pa.us.

Caroline Johnson, disease control director for the Philadelphia Health Department, said the city had "already launched" its monitoring program.

Gloucester County said it had not received any names, but was prepared to follow procedures like those described by officials in Pennsylvania.

Camden County, which got two names of people to monitor on Friday, had held a training session for first responders the day before. "They will be making the assessments. They will be the first on the scene," said county spokesman Dan Keashen, explaining the attendance of 300 - triple the expected number.

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