CDC releases new Ebola monitoring guidelines amid continuing controversy over quarantines

The U.S. Centers for Disease Control and Prevention (CDC) has created four risk categories and new guidelines for the monitoring of people who may have been exposed to the Ebola virus. The new guidelines are stricter than previous rules, says Tom Frieden, MD, MPH, director of the CDC. The rules apply to healthcare workers returning from fighting the outbreak in West Africa and to anyone in contact with Ebola patients in the United States.

The CDC guidelines create four categories of relative risk. The highest-risk group includes people with possible direct exposure to the virus, either through direct contact with a patient or with someone else who had contact with an infected person. These individuals will be isolated in their homes for 21 days. They will be told to stay at home, away from public places and transportation.

People who have cared for Ebola patients in an outbreak area and who are not known to have been exposed are considered at some risk. These individuals will be “intensively monitored,” and contacted daily for 21 days after their arrival by state and local health, Frieden says. Their travel may also be restricted on a case-by-case basis.

Healthcare workers taking care of Ebola patients in the U.S. are considered to be at low risk. People who have never traveled to an Ebola outbreak area, or who have not done so for 21 days, are considered to be at no risk.

In recent days, controversy has erupted over more stringent protocols that have been promulgated by individual states—most notably, New Jersey’s mandatory 21-day quarantine on people returning from Ebola-stricken areas of West Africa. Nurse Kaci Hickox was detained under this protocol against her will, before being returned to her native Maine, where as of this writing she is under home quarantine.

This morning Hickox told a national TV audience, “I am not going to sit around and be bullied by politicians and forced to stay in my home when I am not a risk to the American public.” The prospect of the federal government having to enforce the quarantine of an unwilling individual adds another troubling dimension to the ongoing Ebola story. Read the CDC guidelines.