Oct 24, 2014 8:16 PM

NY, NJ order Ebola quarantine for doctors, others

The Associated Press

NEW YORK (AP) Alarmed by the case of an Ebola-infected New York doctor, the governors of New Jersey and New York on Friday ordered a mandatory, 21-day quarantine of all medical workers and other arriving airline passengers who have had contact with victims of the deadly disease in West Africa.

The first person to fall under the order was a health care worker returning Friday from treating Ebola patients in West Africa. By Friday evening, she had developed a fever and was being evaluated, New Jersey officials said.

The move came after a physician who returned to New York City a week ago from treating Ebola patients in Guinea fell ill with the virus. Many New Yorkers were dismayed to learn that in the days after he came home, Dr. Craig Spencer rode the subway, took a cab, went bowling, visited a coffee shop and ate at a restaurant in the city of 8 million.

New Jersey Gov. Chris Christie and New York Gov. Andrew Cuomo said the case led them to conclude that the two states need precautions more rigorous than those of the U.S. Centers for Disease Control and Prevention, which recommends monitoring of exposed people for 21 days but doesn't require quarantine, in which they are kept away from others.

"It's too serious a situation to leave it to the honor system of compliance," Cuomo said.

Those who are forcibly quarantined will be confined either to their homes or, if they live in other states, to some other place, most likely a medical facility, the governors said. Those quarantined at home will receive house calls from health officials. Twenty-one days is the incubation period for the Ebola virus.

The woman who was quarantined arrived at Newark Liberty International Airport. The New Jersey Department of Health said she had no symptoms upon arrival. She was in isolation at University Hospital in Newark.

Dr. Howard Zucker, acting New York state health commissioner, said any medical personnel who have treated Ebola patients in the three Ebola-ravaged West African countries Sierra Leone, Guinea and Liberia will be automatically quarantined.

Cuomo said anyone arriving from the three countries will be questioned at the airport about their contact with Ebola sufferers.

The governors gave no estimate of how many travelers would be subject to quarantine, but Cuomo said "we're not talking about a tremendous volume of people coming in from these areas," and added that there are no plans to hire more screeners at airports.

The two states are home to Kennedy Airport and Newark Liberty in New Jersey, both major international portals.

Officials said they would track flight connections and screen passengers upon disembarking. However, they offered few details on how the quarantine would be enforced and what the consequences would be for people who violated the restrictions by going out in public.

A spokesman for New York City Mayor Bill de Blasio said the city's Department of Health was not consulted before the quarantine order came down, but said de Blasio and Cuomo have since spoken.

The de Blasio administration expressed some concern with the policy change.

"The mayor wants to work closely with our state partners, but he wants to make sure that there will not be any sort of chilling effect on medical workers who might want to go over to help," said spokesman Phil Walzak.

The White House did not have an immediate reaction to Cuomo and Christie's directives. Officials said Friday the administration was regularly reviewing its policies but indicated they were satisfied with the measures it has put in place, including steps that call on recent arrivals from West Africa to monitor their health and notify state and local authorities of their presence in their communities.

An administration official said federal officials have been considering similar quarantine requirements for some time. But the official, who spoke on the condition of anonymity because he was not authorized to discuss deliberations by name, said the Obama administration was not yet ready to take that step at the federal level.

The measures were discussed as recently as Friday morning but are still under review.

White House officials have said states are entitled to impose additional requirements beyond those set by the CDC.

The CDC said it sets baseline recommended standards, "but state and local officials have the prerogative to tighten the regimen as they see fit."

The agency also said, "When it comes to the federal standards set by the CDC, we will consider any measures that we believe have the potential to make the American people safer."

Spencer, a 33-year-old emergency room doctor, returned to the U.S. on Oct. 17 and sought treatment Thursday after suffering diarrhea and a 100.3-degree fever. He was listed in stable condition at a special isolation unit at Bellevue Hospital Center, and a decontamination company was sent to his Harlem home. His fiancee, who was not showing symptoms, was being watched in a quarantine ward at Bellevue.

Spencer's illness led lawmakers on Capitol Hill, scientists and ordinary New Yorkers to wonder why he was out on the town after his return and why stronger steps weren't being taken to quarantine medical workers.

Health officials said he followed U.S. and international guidelines in checking his temperature every day and watching for symptoms, and that he put no one at risk. But others said he should have been quarantined, either voluntarily or by the government, during the incubation period.

An automatic three-week quarantine makes sense for anyone "with a clear exposure" to Ebola, said Dr. Richard Wenzel, a Virginia Commonwealth University scientist who formerly led the International Society for Infectious Diseases.

Aid organizations such as Doctors Without Borders, the group Spencer was working for, have argued that mandatory quarantines are unnecessary because people with Ebola aren't contagious until symptoms begin, and even then it requires close contact with body fluids.

Also, aid groups have warned that many health care volunteers wouldn't go to Ebola hot zones if they knew they would be confined to their homes for three weeks after they got back.

"A three-week complete quarantine would eliminate two-thirds to three-quarters of the volunteers from the U.S." going to West Africa, said Dr. Rick Sacra, a Massachusetts physician who was recently infected in Liberia but recovered. "They wouldn't be able to spare the time."

On the streets of New York, Michael Anderson was critical of the U.S. government and Spencer.

"He's stupid, a complete idiot" for moving about in public, the longtime Manhattan resident said at Grand Central Station. "It's his responsibility when you come back from Africa" not to put people at risk, he said.

Nearly 4,900 people have died in the Ebola outbreak, most of them in Guinea, Liberia and Sierra Leone.

The World Health Organization is not recommending the quarantine of returning aid workers without symptoms, spokeswoman Sona Bari said.

"Health care workers are generally self-monitoring and are aware of the need to report any symptoms, as this patient did," she wrote in an email.

In other developments:

One of the two Dallas nurses who caught Ebola from a patient was declared virus-free and released from a hospital in Bethesda, Maryland. Nina Pham, 26, said she felt "fortunate and blessed to be standing here today." She later got a hug from President Barack Obama at the White House. The other nurse, Amber Vinson, is in an Atlanta hospital, where she was said to be "making good progress" and tests no longer detected virus in her blood.

Millions of doses of two experimental Ebola vaccines could be ready for use in 2015, and five more experimental vaccines will start being tested in March, WHO said.

In Mali, which reported its first case this week, authorities warned that many people are in danger because the toddler who brought the disease to the country was bleeding from her nose as she traveled on a bus from Guinea. The 2-year-old girl died at a hospital on Friday.


Medical writer Maria Cheng in London; Science writer Malcolm Ritter in New York; AP writers Erica Werner, Matthew Daly and Jim Kuhnhenn in Washington; Edith M. Lederer at the United Nations; Jonathan Lemire, Karen Matthews and Cameron Young in New York; Sarah DiLorenzo in Dakar, Senegal; Boubacar Diallo in Conakry, Guinea; Jonathan Paye-Layleh in Monrovia, Liberia, and John Heilprin in Geneva contributed to this report. Marchione reported from Milwaukee.


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