Nurses, doctors and other health-care workers who return to Ohio after tending to Ebola patients will face a mandatory 21-day home quarantine under Ohio Department of Health rules issued yesterday. The state's new protocol is stricter than federal recommendations and adds Ohio to a handful of states, including New York and New Jersey, that have taken a step that some public-health experts have said is overkill.

Nurses, doctors and other health-care workers who return to Ohio after tending to Ebola patients will face a mandatory 21-day home quarantine under Ohio Department of Health rules issued yesterday.

The state�s new protocol is stricter than federal recommendations and adds Ohio to a handful of states, including New York and New Jersey, that have taken a step that some public-health experts have said is overkill.

The new protocol released yesterday also calls for more-stringent monitoring of any travelers coming from the three most-affected countries in western Africa. Those travelers are to be monitored twice daily for fever and other symptoms related to Ebola. Local public-health officials also could institute more restrictions on those people, based on their evaluation of an individual.

Ohio�s plan does allow for exceptions for quarantined health-care workers, based on individual assessments.

That could mean an asymptomatic health worker would be allowed to go for bike rides, for instance, as long as that person stayed at least 3 feet away from others.

The new state guidance also calls for daily public-health monitoring of people at risk of Ebola if they fit at least one of these criteria: They traveled to an affected country; cared for a person with Ebola; or were within 3 feet of an infected person.

The Ohio guideline further says that a health-care worker who had direct contact with someone with Ebola and didn�t have protective equipment is to be under a full quarantine, without exceptions, and have direct daily public-health monitoring.

There currently are no Ohio health-care workers under surveillance for Ebola because of work overseas, said Dr. Mary Applegate, interim medical director for the Ohio Department of Health.

The monitoring could include home visits to take a person�s temperature and evaluate for symptoms, or it could include remote monitoring, through Skype for instance.

Guidance from the Centers for Disease Control and Prevention in Atlanta has created some confusion among public-health leaders and is subject to interpretation. Ohio�s aim was to have a more clearly defined plan, Applegate said.

Restricting movement of health-care workers � even those who report consistent use of personal protective equipment � makes sense at this point because some of those sickened with the disease were taking precautions during their exposures, Applegate said.

�We are extra cautious, understanding the total disruption of daily life that may be created."

Applegate said the hope would be that health-care workers, travelers and others exposed to those with Ebola would comply with public-health officials willingly. If they don�t, law officers could be called upon to enforce quarantines.

Applegate said the science on Ebola continues to evolve and so will Ohio�s protocol, if it makes good sense.

�I would say this is an abundance of caution,� said Columbus Health Commissioner Dr. Teresa Long, adding that she�s prepared to follow whatever guidance she gets from state leaders.

Susan Tilgner, Franklin County�s health commissioner, also said she�ll adopt the protocol but thinks the less-strict guidance from the CDC is sufficient.

�A person isn�t contagious unless they�re symptomatic,� Tilgner said.

She said it�s prudent to ask health-care workers who have treated someone with Ebola to stay off of airplanes, limit activity and submit to daily monitoring of symptoms.

�But I don�t know that it has to be a mandatory quarantine in a house,� she said.

Ohio�s plan �does give some latitude. It�s not a 100 percent quarantine as you might interpret the definition of quarantine,� Tilgner said. �There is a little bit of flexibility.�



mcrane@dispatch.com

@MistiCrane