Doctors Without Borders has warned some mandatory Ebola quarantine measures in the US are having a “chilling effect” on its work.
The charity group has said it may shorten some assignments to West Africa as a result of recent state restrictions.
One of the charity’s volunteers, nurse Kaci Hickox, has defied orders by the state of Maine that she remain quarantined in her house after being in Sierra Leone.
There have been nearly 14,000 cases worldwide, but only nine in the US.
Doctors Without Borders – also known as Medecins Sans Frontieres (MSF) – has 270 international and 3,000 locally hired staff in Guinea, Liberia, and Sierra Leone.
But the foreign workers now have additional concerns when heading home, said executive director Sophie Delaunay.
“There is rising anxiety and confusion among staff members in the field over what they may face when they return home upon completion of their assignments in West Africa,” she told Reuters news agency.
Some health workers are delaying returning to the US and staying in Europe for 21 days, she added, “in order to avoid facing rising stigmatization at home and possible quarantine”.
Some people are being discouraged by their families from returning to the field, she added.
Doctors Without Borders has 270 international and 3,000 locally hired staff in Guinea, Liberia, and Sierra Leone
Lawyers for Kaci Hickox, a nurse recently returned to the US from treating Ebola patients in Africa, have vowed to fight a court order that would enforce a 21-day quarantine.
Maine Governor Paul LePage said the state was willing to agree to arrangements that would have allowed Hickox to go for walks, runs and bicycle rides, but not allow her to go to public places.
The governor said discussions with Kaci Hickox, 33, had failed.
She says her freedom should not be limited when she is perfectly healthy.
People are not infectious until they show symptoms, usually a fever.
Another worker, Dr. Craig Spencer, travelled around New York City before he fell ill. He is currently in isolation in hospital.
After his case was announced, New York, New Jersey and other states ordered the mandatory quarantine of healthcare workers who had been exposed to Ebola patients.
President Barack Obama has warned that overly restrictive measures could discourage volunteering in West Africa.
UN Secretary-General Ban Ki-moon has condemned the actions of US states ordering medics to be isolated.
Nurse Kaci Hickox, who was quarantined on her return to the US from treating Ebola patients in Sierra Leone, has criticized the way she was dealt with at Newark airport.
Kaci Hickox, 33, said the experience was frightening and could deter other health workers from travelling to West Africa to help tackle the Ebola virus.
Illinois has become the third state after New York and New Jersey to impose stricter quarantine rules.
Meanwhile US Ambassador to the UN Samantha Power is to visit West Africa.
Samantha Power will travel to Guinea on October 26, continuing later to Liberia and Sierra Leone – the three worst-hit countries.
“For me the benefits of having first hand knowledge of what is happening in these countries gravely outweighs the almost nonexistent risk of actually travelling to these countries, provided I take the proper precautions,” she said on Saturday.
She said she hoped her trip would “draw attention to the need for increased support for the international response”.
The White House has expressed concern that strict quarantine restrictions such as those imposed in New York, New Jersey and Illinois could put off aid workers and others travelling to West Africa to help mitigate the crisis at its source.
More than 10,000 people have contracted the Ebola virus, with 4,922 deaths, according to the WHO’s latest report.
Only 27 of the cases have occurred outside Sierra Leone, Liberia and Guinea.
Kaci Hickox, of medical charity Doctors Without Borders, described seeing a “frenzy of disorganization, fear and most frightening, quarantine” on her return from Sierra Leone on October 24.
Writing for The Dallas Morning News, Kaci Hickox asked whether fellow health workers would “face the same ordeal”.
Nurse Kaci Hickox was quarantined on her return to the US from treating Ebola patients in Sierra Leone (photo My Space)
“Will they be made to feel like criminals and prisoners?” she questioned.
Kaci Hickox said she was kept in isolation at the airport terminal for seven hours and given only a cereal bar to eat.
She also denied that she had had a fever, saying she was merely flushed because of the upset caused by her treatment at the airport.
Though Kaci Hickox tested negative in a preliminary test for the virus, she will remain under quarantine for three weeks and continue to be monitored by health officials.
Stricter quarantine measures were put in place in New York and New Jersey after a doctor, Craig Spencer, tested positive for the virus on his return from Guinea last week.
Dr. Craig Spencer is currently being treated at New York’s Bellevue Hospital in isolation.
The new measures mean that anyone who has had contact with Ebola victims in West Africa now faces a mandatory 21-day quarantine period.
Illinois governor Pat Quinn announced on October 25 that his state would start imposing the same measures, without providing further details.
Meanwhile, New York City Mayor Bill de Blasio said he was not consulted over the new rules, which were ordered by the state governors of New York and New Jersey.
“The state has the right to make its decision, just like the CDC does, and we’re going to work with them,” he told reporters on October 25.
President Barack Obama said in his weekly radio and online address that Americans had “to be guided by the facts – not fear”, reiterating that people cannot contract Ebola unless they have come into direct contact with an infected patient’s bodily fluids.
Barack Obama’s comments follow the release of the WHO’s latest report, which warned that the number of Ebola cases in West Africa could be much higher than recorded, as many families were keeping relatives at home rather than taking them to treatment centers.
The CDC will issue new guidelines for healthcare workers handling Ebola patients, the Los Angeles Times reported.
The Centers for Disease Control and Prevention is “wrapping up the final details” about the new guidelines, which come in the wake of the first Ebola cases in the US, CDC spokeswoman Melissa Brower has said.
The CDC will issue new guidelines for healthcare workers handling Ebola patients
As of October 17, roughly 1,000 people were being watched for symptoms, asked to monitor themselves or urged to check with a counselor at the CDC. None has exhibited symptoms.
The group includes those who may have flown on a Frontier Airlines jetliner that carried Amber Vinson, the second of two nurses who contracted Ebola after caring for Thomas Eric Duncan at Texas Health Presbyterian Hospital.
Amber Vinson is the Texas nurse who flew on a plane with more than 130 people on board on the day before she came down with symptoms of Ebola.
Amber Vinson, 29, who is the second person infected in the US, fell ill on Tuesday, October 14.
Both she and nurse Nina Pham, 26, had treated Liberian Thomas Eric Duncan, who died a week ago in Dallas.
A nurses’ union has said those treating Thomas Eric Duncan were not given full protection and had parts of their skin exposed
More than 70 healthcare workers who may have come in contact with him at the hospital are being monitored for symptoms, the hospital’s director has said.
Meanwhile, the UN’s Ebola mission chief says the world is falling behind in the race to contain the virus, which has killed more than 4,000 in West Africa.
On October 15, the US Centers for Disease Control and Prevention (CDC) said it wanted to interview the passengers on Frontier Airlines flight 1143 from Cleveland, Ohio, to Dallas, Texas on October 13.
It said it was taking the measure “because of the proximity in time between the evening flight and first report of illness the following morning”.
Amber Vinson flew to Cleveland on October 10, even though she was being monitored for signs of Ebola
Both Amber Vinson and Nina Pham treated Thomas Eric Duncan early in his stay at Texas Health Presbyterian Hospital in Dallas when he had “extensive production of body fluids”, said CDC director Dr. Tom Frieden.
A national nurse union told reporters on October 15 the health workers treating Thomas Eric Duncan had not been properly protected and called for all health workers treating Ebola patients to receive full protective suits and training from hospitals.
Union director RoseAnn DeMoro said staff treated Thomas Eric Duncan for days without the necessary protective gear, and hazardous waste was allowed to pile up to the ceiling.
The CDC has appointed a “site manager” in Dallas to standardize the protective equipment and supervise the method of putting it off and on.
Amber Vinson flew to Cleveland on October 10, even though she was being monitored for signs of Ebola and therefore should not have flown on a commercial plane, Dr. Tom Frieden said.
When Amber Vinson returned from Ohio, she was not showing symptoms of the disease, the crew has told CDC investigators.
Health experts say people who are not showing symptoms are not contagious.
On the morning of October 14, Amber Vinson came down with a fever and was isolated within 90 minutes. Her diagnosis was announced early on October 15.
One of the ill women is to be transferred to Emory University hospital in Atlanta, which oversaw the recovery of two US aid workers who had caught the disease in Africa.
Thomas Eric Duncan, who was the first person to be diagnosed in the US with Ebola, started showing symptoms of the disease just days after he arrived in Texas from Liberia, where he contracted it.
An initial set of 48 people who were in contact with Thomas Eric Duncan before he was admitted to hospital are nearing the end of the window in which they could develop an Ebola infection.
Dr. Tom Frieden, head of the Centers for Disease Control and Prevention (CDC), has said a mistake was “clearly” made by staff treating Thomas Eric Duncan who died of Ebola in Texas, resulting in one being infected.
The female health worker infected is in an isolation ward in stable condition, awaiting confirmation of her diagnosis.
Tom Frieden said a full inquiry would be made into how the transmission occurred.
He said 48 other people who may also have had contact were being observed.
The health worker at Texas Health Presbyterian Hospital wore full protective gear while treating Ebola victim Thomas Eric Duncan, health officials in Dallas say.
Thomas Eric Duncan, who caught the virus in his native Liberia, died on October 8.
The current Ebola outbreak, concentrated in Liberia, Guinea and Sierra Leone, has resulted in more than 8,300 confirmed and suspected cases, and at least 4,033 deaths.
Dr. Thomas Frieden said a full investigation would be conducted into how the infection had occurred.
A female health worker at Texas Health Presbyterian Hospital has been infected with Ebola virus after treating Thomas Eric Duncan
“Clearly there was a breach in protocol,” he told CBS.
The CDC investigation, he told reporters, would focus on possible breaches made during two “high-risk procedures”, dialysis and respiratory intubation.
Education and training of health workers would be stepped up, he said, and efforts would be made to reduce the number of staff treating Ebola cases.
Dr. Daniel Varga, of the Texas Health Resource, said the health worker had worn a gown, gloves, mask and shield when providing care to Thomas Eric Duncan during his second and final hospital admission.
Following a positive preliminary test for Ebola, follow-up tests on the infected health worker are due to be completed on Sunday, October 12.
Police are guarding the apartment complex where the woman lives in Dallas as decontamination work is carried out.
No details of her identity or position at the hospital have been given, in accordance with family wishes.
Thomas Eric Duncan tested positive in Dallas on September 30, 10 days after arriving on a flight from Monrovia via Brussels.
He had become ill a few days after arriving in the US, and went to the hospital in Dallas with a high fever.
However, despite telling medical staff he had been in Liberia, Thomas Eric Duncan was sent home with painkillers and antibiotics.
Thomas Eric Duncan was later put into an isolation unit at the hospital but died despite being given an experimental drug.
Health officials have announced that passengers arriving in the US from Ebola-affected countries in West Africa could be subject to extra screening at airports.
Extra checks at entry is one of the options under consideration as the US tries to limit the spread of its first confirmed case, a Liberian in Dallas.
President Barack Obama is to be briefed on the Ebola crisis later on Monday, October 6.
The Ebola outbreak is the world’s deadliest, killing more than 3,400 people, mostly in Liberia, Sierra Leone and Guinea.
Celebrations in West Africa for the Muslim festival of Eid al-Adha have been badly affected, with public places used for prayers deserted.
One of the US president’s advisers on the issue, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said “discussion is underway right now” regarding all options to contain the virus.
Passengers arriving in the US from Ebola-affected countries in West Africa could be subject to extra screening at airports
On airport checks, Dr. Anthony Fauci told CNN the question was whether “the extra level of screening is going to be worth the resources you need to put into it”.
Passengers leaving affected countries already have their temperatures checked, but people do not become infectious until they display symptoms.
The infected Liberian in Dallas, Thomas Eric Duncan, was monitored for symptoms when he left Liberia but they did not develop until four days later, when he was in the US.
Thomas Eric Duncan is now in a critical condition in hospital.
Ten people who came into direct contact with him are being closely monitored but no-one has yet displayed any Ebola symptoms.
When asked about screening, Dr. Thomas Frieden of the Centers for Disease Control and Prevention (CDC) said: “We are looking at all options to protect Americans.”
However, he ruled out banning flights to the US because isolating these countries would only increase the outbreak within Africa and would deny them crucial aid, he said.
On the White House meeting later on Monday, Thomas Frieden said: “We’re going to be covering many aspects and figure out what we can do” to protect Americans and stop the outbreaks.”
But he repeated that he did not believe it would spread in the US.
“We can stop it in its tracks here, which we are doing,” he said.
A national survey by the Pew Research Center, suggests most Americans trust the government to prevent a major outbreak – 20% have a “great deal” of confidence, while another 38% said they have a “fair amount” of confidence.
A plane carrying American journalist Ashoka Mukpo, who contracted Ebola while working in Liberia, landed on Monday in Nebraska, where he will undergo treatment for the deadly disease.
Other US aid workers who have been flown home are now recovering after treatment.
A French nurse who contracted the virus in Liberia has recovered after having experimental medication in Paris.