Date Sent:06/15/2015 04:00 PM EDT
Sender:Michigan Health Alert Network
Subject:Update: Ebola Monitoring for Travelers from Liberia
On May 9, 2015, the World Health Organization declared Liberia free of Ebola transmission, following forty-two days (two incubation periods) without report of incident disease. Given this information, the CDC has revised assessment guidance and monitoring recommendations for individuals who are arriving in the United States with a recent history of travel that includes Liberia. (Note: recommendations have not changed for individuals traveling from Guinea and/or Sierra Leone.) On June 12, 2015, Dr. Daniel Jernigan, CDC 2014 Ebola Response Incident Manager, shared the new recommendations with State and Territorial Health Officials (attached). The changes for Michigan's healthcare and public health communities, summarized below, are effective June 17, 2015.
International Traveler Processing
While individuals with a 21 day travel history that includes Liberia will continue to be routed through the five identified United States ports of entry, the screening process has changed. Travelers from Liberia will still be assessed with a medical evaluation. Should they present with symptoms of illness, it will be addressed through the standard federal quarantine station protocol for all ill international travelers. If they are released from the assessment, they will be given a modified CARE Package that includes "self-observation" instructions, a thermometer and educational material. They will be advised to contact public health only if they suspect illness.
Public Health Monitoring
Travelers who have been in Liberia within 21 days of entering the United States no longer require Active or Direct Active Monitoring by local public health. Further, effective immediately, local public health should discontinue monitoring individuals with a travel history including Liberia; no additional travel referrals from Liberia will be sent from MDHHS.
To date, there are no changes to the recommendations for travelers who have been in Sierra Leone or Guinea within 21 days of entering the United States. Depending on the assessed epidemiologic risk, these travelers will continue to be subject to Active or Direct Active Monitoring, facilitated by local public health.
Healthcare providers should continue to gather travel history from all patients presenting at their facilities, but the inclusion of Liberia in a 21 day travel history will no longer warrant changes to standard patient infection control, isolation or notification practices. At this time, previous recommendations are still in place for those with a 21 day travel history to Sierra Leone or Guinea.