States, cities examine best practices for stopping spread of Ebola in US

As a fifth American diagnosed with the Ebola virus returned to the United States from Africa on Monday, health officials around the country began to reexamine their protocols for treating the disease and locating those who may have been exposed to the virus abroad. 

Cameras closely followed the jet carrying Ashoka Mukpo, an American freelance journalist who was diagnosed with Ebola while on the job in Liberia last week, as it made its way to the Nebraska Medical Center in Omaha, which is specially equipped to quarantine and treat infectious diseases.

The Nebraska center, which is the largest of four biocontainment units in the US, treated the American missionary doctor Richard Sacra last month after the Massachusetts native contracted Ebola while on a humanitarian mission to Liberia. 

But after a Texas hospital initially bungled the diagnosis of Liberian-born Thomas Eric Duncan, who recently returned from a visit to his home country, health officials in a number of states have been reexamining procedures for treatment and prevention.  

Texas Gov. Rick Perry (R) said on Monday that his state would set up an infectious disease task force after the mistakes made at the Dallas hospital, where Mr. Duncan is being treated. 

“Over the past several days, we have learned a lot about the unique challenges of situations like this, and it's important that we continue to adapt our responses to these realities,” Governor Perry told a news conference at the State Capitol.

In New York, officials have been trying to locate anyone who may have unknowingly been exposed to Ebola. Operators for the 911 emergency system are asking all who call to report Ebola-like symptoms whether they have traveled to West Africa in the past few weeks. City officials also have begun to reach out to the West African community, encouraging city residents to go to the hospital if they are experiencing symptoms of the virus that the World Health Organization has said has been responsible for more than 3,400 deaths in Africa.

Health officials in south Florida, another well-traveled area with a diverse population from around the globe, also responded to the Duncan case by assuring citizens that the region has been ramping up preparations for Ebola cases, should they be found in Florida.

Such preparations, including the dissemination of the federal document “Detailed Hospital Checklist for Ebola Preparedness,” are “tying us all together throughout South Florida to be aware and know what to look for,” said Timothy O’Connor, spokesman for the Florida Department of Health, according to the Sun-Sentinel.  

According to current protocols, health officials monitor anyone who may have been exposed to the virus through a process called “contact tracing.” They try to identify all persons known to have had contact with anyone diagnosed with Ebola and then monitor those persons for 21 days. In addition to Duncan, the lone US diagnosis to date, five Americans have been flown home for treatment. 

Anyone who develops Ebola-like symptoms is then isolated and tested for the virus. If positive, that person would be isolated and treated, and the contact tracing process would begin again.

But more and more, public officials are turning their attention to the nation’s ports of entry. On Sunday, New York Sen. Charles Schumer (D) called for the Transportation Security Administration to screen passengers from Ebola-afflicted countries when entering the US and to have passengers fill out health surveys before being admitted into the country.

On Monday, a high-ranking government health official said that, in fact, an additional layer of screening is being considered.

"The discussion that is under way right now, and all options are going to be looked at, is what kind of screening do you do on the entry end, namely, when people come in here right now," Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN. "And that's something that's on the table now, and the discussion is, is that extra added layer of screening going to be worth the resources that are put into doing it? That hasn't been decided right now." 

Senator Schumer also wrote a letter to Customs and Border Commissioner Gil Kerlikowske and Centers for Disease Control and Prevention Director Tom Frieden, urging them to work with the Department of Homeland Security to create a database, available to local hospitals nationwide, of passengers flying to and from West Africa.

“This database would allow hospitals to confirm whether patients exhibiting symptoms have been to one of the source countries and would ensure that physicians have the most truthful information of a patient’s travel itinerary,” Schumer wrote.

On Friday, Louisiana Gov. Bobby Jindal (R), a likely 2016 presidential aspirant, called for the Obama administration to impose a complete travel ban on flights from those countries with Ebola outbreaks.

“President Obama said it was ‘unlikely’ that Ebola would reach the U.S,” the Louisiana Republican said in statement. “Well, it has, and we need to protect our people. But the Obama administration keeps saying they won’t shut down flights. They instead say we should listen to ‘the experts.’ In fact, they said it would be counterproductive to stop these flights. That statement defies logic.”

But administration officials spoke out against such a travel ban.

"When you close off a country, you create such stress and fear and amplify the problem,” said Dr. Fauci on "Fox News Sunday." “I think any health-care person will agree with me that that's not a good idea to completely block off the country.”