Those under “low, but nonzero risk,” would undergo active monitoring for the 21-day period, while people with no identified risk may call in to a local provider concerned they have Ebola.
Frieden made it clear that returning healthcare workers could be subject to additional, more stringent requirements issued by state and local health officials.
He expressed concern over controversial policies being issued in states like New York and New Jersey that led to the mandatory quarantine of a nurse in New Jersey upon her return to the U.S. after treating Ebola patients in Sierra Leone. Such efforts, he said, create a stigma of those coming from affected countries and could discourage others healthcare professionals from volunteering to help in affected areas. New Jersey officials Monday announced Kaci Hickox was allowed to leave the hospital and travel to Maine.
“We are concerned about some policies that we have seen in various places that might have the effect of increasing stigma or creating false impressions,” Frieden said. “We have to tailor our approach to the science of Ebola.”
Other states, including Illinois and Georgia, have announced plans to impose mandatory quarantines on healthcare workers returning from the West African countries of Guinea, Liberia and Sierra Leone, where there have been more than 10,000 Ebola cases resulting in more than 4,900 deaths from the virus as of Oct. 25, according to the World Health Organization.
Other states, such as Florida, have announced they will impose their own mandatory 21-day health monitoring of all travelers from the region.
A number of medical organizations have spoken out against such policies, arguing that such measures would have the unintended consequence of discouraging healthcare workers from providing much-needed assistance to the region.
“When thousands of people in West African countries are suffering from this terrible virus, and when there are not enough clinicians available to take care of them, the last thing governments should do is to impose additional barriers to healthcare professionals who are willing to safely provide the care that is so desperately needed,” according to a statement released Monday by the American College of Physicians. “Mandatory quarantines threaten to stigmatize health professionals working in West Africa and potentially exacerbate existing health professional shortages in the region by discouraging clinicians from traveling to the affected regions, and by doing so, may contribute to more preventable deaths and undermine global efforts to stop the spread of the disease.”
Frieden Monday also provided an update on the case of a 5-year-old boy who was being tested for Ebola at a New York City hospital after traveling to West Africa.
The patient was transferred to Bellevue Hospital Center Sunday night after exhibiting symptoms consistent with the disease, according to the New York City Department of Health and Mental Hygiene.
Health officials said the child developed a fever while under observation at the hospital on Monday morning around 7 a.m., and was subsequently tested for the virus.
Though he deferred questions about the results of the child's test to local health officials, Frieden did say the illness would be “unusual as a presentation of Ebola” based on the current information he has seen about his case.
According to Frieden, an average of nearly 100 people travel to the U.S. daily from countries affected by the outbreak. Monday marks the start of a program announced last week to conduct screenings of airport arrivals in six states where some 70% of passengers from the affected countries within the region arrive in the U.S.
The new CDC guidelines come on the heels of updated recommendations the agency issued last week for healthcare workers in the U.S. The guidelines outlined treatment protocols to reduce the chance of infection, such as happened to two nurses at a Dallas hospital who contracted the disease while providing care for an Ebola patient who later died.
Follow Steven Ross Johnson on Twitter: @MHsjohnson