The Iowa Department of Public Health (IDPH) is updating the numbers of travelers who are currently being monitored for Ebola. As of November 6, 2014, 13 travelers, who were in the West African countries of Sierra Leone, Liberia or Guinea in the last 21 days, are now in Iowa. Twelve had low risk of having been exposed to Ebola in those countries, so they are being allowed to resume normal activities; however, IDPH has ordered them to self-monitor, meaning they are required to take their temperature
twice a day and report their health status to public health.

One person had some risk of being exposed to Ebola, and has been quarantined, meaning they have been directed to stay at home and take their temperature twice daily, including at least once with a public health official observing. At this time, there is no risk to public safety. None of these travelers have any symptoms consistent with Ebola – which include fever, vomiting and diarrhea. IDPH Medical Director and State Epidemiologist, Dr. Patricia Quinlisk stated, “These individuals are being monitored closely and pose no risk to the public’s health. All individuals are fully complying and are cooperating with health officials.”

Public health actions, such as “quarantines,” are used when a person is well, but may have been exposed to a serious disease, and so may become ill in the future. With the disease Ebola, the incubation period is up to 21 days, thus the person will stay at home or be “quarantined at home” for 21 days. “Isolation” is used when an individual is displaying symptoms of an illness; this has not been used yet in Iowa because none of these travelers have become ill or displayed symptoms.

As more non-ill travelers return from West Africa, it is likely that more people will be directed to either submit to self-monitoring or placed into quarantine. Iowans should be confident every step has been, and will continue to be taken to protect the public’s health. These public health actions are consistent with current national guidelines, are part of the standard practice of public health, and have been used in the past with outbreaks of SARS, measles, tuberculosis, and during the 2006 H1N1 influenza
pandemic.State law prevents the state from releasing certain health information that may identify individuals, but the following represents a “FAQ” (Frequently Asked Questions) regarding the situation:

• Are any of these individuals displaying signs or symptoms of Ebola? No individuals are displaying signs or symptoms of Ebola. These actions are being taken out of an abundance of caution.
• Is the public’s health, safety and well-being at risk? No, these individuals are not displaying symptoms. Ebola is only contagious when an individual is ill. Furthermore, all individuals are fully complying with the appropriate public health order.
• If there is no risk to the public’s health, why would the state release this information? The state believes in being transparent, especially when it pertains to the public’s health and wellbeing. We understand this is a public health issue of great interest to Iowans so we believe we need to be as forthcoming as possible. As such, the state believes the information needs to be released, even though there is not a risk to the public’s health at this time.

Case counts have been placed on IDPH’s web site since October 27 and are updated weekly. This will continue as has been done in the past with other outbreaks of serious diseases. You might find these updates at www.idph.state.ia.us/EHI/Issue.aspx?issue=Ebola%20Outbreak&pg=Status%20Updates

• Where are the individuals in Iowa? Because of the small number of travelers returning to Iowa from Ebola-affected counties in West Africa, the release of county-level data could lead to identification of an individual, in violation of Iowa law.
• Have monitored individuals been traveling around Iowa or been engaging in activities around members of the public? Those who are determined to be at low risk are allowed to travel by private car and to resume normal activities, but not to travel by airplane, train, long distance bus, or ship. Travelers who are determined to be at some risk are under orders to stay at home, but are allowed non-congregate outdoor activities (such as jogging in a park) as these types of activities do not put the public at any risk.
• Why weren’t these travelers stopped at the arrival airport? These individuals were flagged at the U.S. arrival airport after having traveled from one of the three West African countries, and were screened by Centers for Disease Control (CDC) officials. Travelers, who are well, are allowed to continue on to their destination, including Iowa. Meanwhile, public health officials in the destination state are alerted to the arrival of these travelers. In Iowa, public health officials contact these travelers and perform an in person interview to verify their risk of having been exposed to patients with Ebola, and are served an appropriate public health order based on that risk.
• What country did the individuals work in, who did they work with and what kind of work were they doing? Releasing information about an individual could identify them and violate state law, which protects an individual’s health information from becoming public.
• What can the public do to remain safe? The public is safe. These travelers are not having any symptoms at this time and are being monitored twice a day by public health officials.
• If the quarantined traveler were to become symptomatic, how would public health officials respond? Public health officials have been working with Iowa health care partners to have a system to safely transport a sick traveler to a prepared medical facility that could safely care for that patient.