Story highlights Ebola survivor donates plasma to Dr. Craig Spencer

Doctors Without Borders says there is a ''notable lack of clarity'' in new guidelines

Health care worker arrived at Newark Liberty International Airport on Friday

Officials said she developed high temperature after arrival, result from Ebola test came back negative

A mandatory 21-day quarantine imposed by New York and New Jersey on health care workers returning from West Africa after treating Ebola patients caught local and federal officials by surprise and spurred a heated debate on handling the spread of the virus.

The policy of isolating medical personnel and others arriving from Ebola-affected countries zones was abruptly implemented Friday by the governors of New York and New Jersey, Andrew Cuomo and Chris Christie. The announcement came one day after a New York doctor who treated patients in Guinea became the first Ebola case diagnosed in the city and the fourth in the United States.

The mandate came as a surprise to the federal Centers for Disease and Control and Prevention in Atlanta, according to a federal official familiar with the situation.

"They're not happy," the official said of the CDC. "These two governors said, 'Take this, federal government.' They're very worried we won't be able to get physicians or nurses to go (to countries affected by the Ebola outbreak)."

A New York City official called more stringent screening "a real stunner."

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Photos: The Ebola epidemic Photos: The Ebola epidemic An Ebola survivor participates in a study in Monrovia, Liberia, on June 17, 2015. The country launched a five-year study to unravel the mystery of the long-term health effects that plague survivors of the viral disease. Since the epidemic started more than a year ago in a remote village in Guinea, more than 11,000 people have died, the vast majority in three West African nations, according to the latest numbers from the World Health Organization . And that number is believed to be low, since there was widespread under-reporting of cases, according to WHO. Hide Caption 1 of 45 Photos: The Ebola epidemic Women in Monrovia celebrate after the World Health Organization declared Liberia Ebola-free on May 9, 2015. Other cases have recurred since, however. Two people in Liberia have died of the disease since the end of June, just weeks after the WHO declared the nation free of the disease. Hide Caption 2 of 45 Photos: The Ebola epidemic A man walks past an Ebola awareness painting in Monrovia on March 22, 2015. Hide Caption 3 of 45 Photos: The Ebola epidemic Soldiers from the U.S. Army's 101st Airborne Division walk across the tarmac at Campbell Army Airfield before reuniting with their families at a homecoming ceremony March 21, 2015 in Fort Campbell, Kentucky. The 162 soldiers were deployed in Liberia, where they helped fight the spread of Ebola. Hide Caption 4 of 45 Photos: The Ebola epidemic Relatives weep for a loved one who it was believed died from Ebola, at a graveyard on the outskirts of Monrovia on March 11, 2015. Hide Caption 5 of 45 Photos: The Ebola epidemic Doctors Without Borders staffer Alex Eilert Paulsen watches as mattresses and bed frames burn at the Ebola Treatment Unit in Paynesville, Liberia, on January 31, 2015. The organization reduced its number of beds from 250 to 30 as gains were made in battling the virus. Hide Caption 6 of 45 Photos: The Ebola epidemic Pauline Cafferkey, a Scottish woman diagnosed with Ebola, is put on a plane in Glasgow, Scotland, on December 30, 2014. Cafferkey, a 39-year-old nurse who volunteered in Sierra Leone, was being transported to London for treatment. Hide Caption 7 of 45 Photos: The Ebola epidemic A child who survived the Ebola virus is fed by another survivor at a treatment center on the outskirts of Freetown, Sierra Leone, on November 11, 2014. Hide Caption 8 of 45 Photos: The Ebola epidemic Health workers in Monrovia cover the body of a man suspected of dying from the Ebola virus on October 31, 2014. Hide Caption 9 of 45 Photos: The Ebola epidemic Kaci Hickox leaves her home in Fort Kent, Maine, to take a bike ride with her boyfriend on October 30, 2014. Hickox, a nurse, recently returned to the United States from West Africa, where she treated Ebola victims. State authorities wanted her to avoid public places for 21 days -- the virus' incubation period. But Hickox, who twice tested negative for Ebola, said she would defy efforts to keep her quarantined at home. Hide Caption 10 of 45 Photos: The Ebola epidemic Health officials in Nairobi, Kenya, prepare to screen passengers arriving at the Jomo Kenyatta International Airport on October 28, 2014. Hide Caption 11 of 45 Photos: The Ebola epidemic U.S. President Barack Obama hugs Ebola survivor Nina Pham in the Oval Office of the White House on October 24, 2014. Pham, one of two Dallas nurses diagnosed with the virus, was declared Ebola-free after being treated at a hospital in Bethesda, Maryland. The other nurse, Amber Vinson (not pictured), was treated in Atlanta and also declared Ebola-free. Hide Caption 12 of 45 Photos: The Ebola epidemic Health workers in Port Loko, Sierra Leone, transport the body of a person who is suspected to have died of Ebola on October 21, 2014. Hide Caption 13 of 45 Photos: The Ebola epidemic Health workers bury a body on the outskirts of Monrovia on October 20, 2014. Hide Caption 14 of 45 Photos: The Ebola epidemic Garteh Korkoryah, center, is comforted during a memorial service for her son, Thomas Eric Duncan, on October 18, 2014, in Salisbury, North Carolina. Duncan, a 42-year-old Liberian citizen, died October 8 in a Dallas hospital. He was in the country to visit his son and his son's mother, and he was the first person in the United States to be diagnosed with Ebola. Hide Caption 15 of 45 Photos: The Ebola epidemic Boys run from blowing dust as a U.S. military aircraft leaves the construction site of an Ebola treatment center in Tubmanburg, Liberia, on October 15, 2014. Hide Caption 16 of 45 Photos: The Ebola epidemic Aid workers from the Liberian Medical Renaissance League stage an Ebola awareness event October 15, 2014, in Monrovia. The group performs street dramas throughout Monrovia to educate the public on Ebola symptoms and how to handle people who are infected with the virus. Hide Caption 17 of 45 Photos: The Ebola epidemic Ebola survivors prepare to leave a Doctors Without Borders treatment center after recovering from the virus in Paynesville, Liberia, on October 12, 2014. Hide Caption 18 of 45 Photos: The Ebola epidemic A man dressed in protective clothing treats the front porch of a Dallas apartment on October 12, 2014. The apartment is home to one of the two nurses who were diagnosed with Ebola after treating Thomas Eric Duncan, a Liberian national who traveled to Dallas and later died from the virus. Hide Caption 19 of 45 Photos: The Ebola epidemic A woman crawls toward the body of her sister as a burial team takes her away for cremation October 10, 2014, in Monrovia. The sister had died from Ebola earlier in the morning while trying to walk to a treatment center, according to her relatives. Hide Caption 20 of 45 Photos: The Ebola epidemic A man digs a grave on October 7, 2014, outside an Ebola treatment center near Gbarnga, Liberia. Hide Caption 21 of 45 Photos: The Ebola epidemic A person peeks out from the Dallas apartment where Thomas Eric Duncan, the first person diagnosed with the Ebola virus in the United States, was staying on October 3, 2014. Hide Caption 22 of 45 Photos: The Ebola epidemic A girl cries as community activists approach her outside her Monrovia home on October 2, 2014, a day after her mother was taken to an Ebola ward. Hide Caption 23 of 45 Photos: The Ebola epidemic A health official uses a thermometer September 29, 2014, to screen a Ukrainian crew member on the deck of a cargo ship at the Apapa port in Lagos, Nigeria. Hide Caption 24 of 45 Photos: The Ebola epidemic Workers move a building into place as part of a new Ebola treatment center in Monrovia on September 28, 2014. Hide Caption 25 of 45 Photos: The Ebola epidemic Medics load an Ebola patient onto a plane at Sierra Leone's Freetown-Lungi International Airport on September 22, 2014. Hide Caption 26 of 45 Photos: The Ebola epidemic A few people are seen in Freetown during a three-day nationwide lockdown on September 21, 2014. In an attempt to curb the spread of the Ebola virus, people in Sierra Leone were told to stay in their homes. Hide Caption 27 of 45 Photos: The Ebola epidemic Supplies wait to be loaded onto an aircraft at New York's John F. Kennedy International Airport on September 20, 2014. It was the largest single shipment of aid to the Ebola zone to date, and it was coordinated by the Clinton Global Initiative and other U.S. aid organizations. Hide Caption 28 of 45 Photos: The Ebola epidemic A child stops on a Monrovia street September 12, 2014, to look at a man who is suspected of suffering from Ebola. Hide Caption 29 of 45 Photos: The Ebola epidemic After an Ebola case was confirmed in Senegal, people load cars with household items as they prepare to cross into Guinea from the border town of Diaobe, Senegal, on September 3, 2014. Hide Caption 30 of 45 Photos: The Ebola epidemic A health worker wearing a protective suit conducts an Ebola prevention drill at the port in Monrovia on August 29, 2014. Hide Caption 31 of 45 Photos: The Ebola epidemic A burial team from the Liberian Ministry of Health unloads bodies of Ebola victims onto a funeral pyre at a crematorium in Marshall, Liberia, on August 22, 2014. Hide Caption 32 of 45 Photos: The Ebola epidemic Dr. Kent Brantly leaves Emory University Hospital on August 21, 2014, after being declared no longer infectious from the Ebola virus. Brantly was one of two American missionaries brought to Emory for treatment of the deadly virus. Hide Caption 33 of 45 Photos: The Ebola epidemic An Ebola Task Force soldier beats a local resident while enforcing a quarantine on the West Point slum on August 20, 2014. Hide Caption 34 of 45 Photos: The Ebola epidemic Local residents gather around a very sick Saah Exco, 10, in a back alley of the West Point slum on August 19, 2014. The boy was one of the patients that was pulled out of a holding center for suspected Ebola patients after the facility was overrun and closed by a mob on August 16. A local clinic then refused to treat Saah, according to residents, because of the danger of infection. Although he was never tested for Ebola, Saah's mother and brother died in the holding center. Hide Caption 35 of 45 Photos: The Ebola epidemic Workers prepare the new Ebola treatment center on August 17, 2014. Hide Caption 36 of 45 Photos: The Ebola epidemic Liberian police depart after firing shots in the air while trying to protect an Ebola burial team in the West Point slum of Monrovia on August 16, 2014. A crowd of several hundred local residents reportedly drove away the burial team and their police escort. The mob then forced open an Ebola isolation ward and took patients out, saying the Ebola epidemic is a hoax. Hide Caption 37 of 45 Photos: The Ebola epidemic A health worker disinfects a corpse after a man died in a classroom being used as an Ebola isolation ward August 15, 2014, in Monrovia. Hide Caption 38 of 45 Photos: The Ebola epidemic Aid worker Nancy Writebol, wearing a protective suit, gets wheeled on a gurney into Emory University Hospital in Atlanta on August 5, 2014. A medical plane flew Writebol from Liberia to the United States after she and her colleague Dr. Kent Brantly were infected with the Ebola virus in the West African country. Hide Caption 39 of 45 Photos: The Ebola epidemic Members of Doctors Without Borders adjust tents in the isolation area in Kailahun on July 20, 2014. Hide Caption 40 of 45 Photos: The Ebola epidemic Boots dry in the Ebola treatment center in Kailahun on July 20, 2014. Hide Caption 41 of 45 Photos: The Ebola epidemic Dr. Jose Rovira of the World Health Organization takes a swab from a suspected Ebola victim in Pendembu, Sierra Leone, on July 18, 2014. Hide Caption 42 of 45 Photos: The Ebola epidemic Red Cross volunteers disinfect each other with chlorine after removing the body of an Ebola victim from a house in Pendembu on July 18, 2014. Hide Caption 43 of 45 Photos: The Ebola epidemic A scientist separates blood cells from plasma cells to isolate any Ebola RNA and test for the virus April 3, 2014, at the European Mobile Laboratory in Gueckedou, Guinea. Hide Caption 44 of 45 Photos: The Ebola epidemic Health specialists work March 31, 2014, at an isolation ward for patients at the facility in southern Guinea. Hide Caption 45 of 45

"They did this without consulting the city, and that's not a good thing," the official said of Cuomo and Christie. "They didn't let anyone know in advance."

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Both officials spoke on condition of anonymity.

Illinois will require "high-risk individuals who have had direct contact with an individual infected with the Ebola virus while in Liberia, Sierra Leone or Guinea" to undergo a mandatory 21-day home quarantine, according to a press release from Governor Pat Quinn's office released on Friday.

On Saturday, the CDC said that it sets the baseline recommended standards, but state and local officials have the prerogative to set tighter policies.

"When it comes to the federal standards set by the CDC, we will consider any measures that we believe have the potential to make the American people safer," the CDC said in a statement.

Nurse worried about mandatory quarantines

The two-state policy was implemented the same day that nurse Kaci Hickox landed at Newark Liberty International Airport in New Jersey after working with Doctors Without Borders in treating Ebola patients in Sierra Leone.

Hickox, in an Op-Ed piece in The Dallas Morning News , wrote that she was ordered placed in quarantine at a hospital, where she tested negative in a preliminary test for Ebola. Still, hospital officials told her she must remain under mandatory quarantine for 21 days.

Hickox wrote that she was held at the airport and questioned by various health workers after her flight landed about 1 p.m. At first, her temperature -- taken with forehead scanner -- was 98 degrees.

Hours later, her cheeks flushed with anger over being held without explanation, another scanner check recorded her temperature as 101 degrees, she wrote.

Hickox eventually got a police escort, sirens blaring, to a hospital, when her temperature was again checked in an outdoor tent. On the oral thermometer, her temperature was recorded as 98.6. And she tested negative for Ebola, she wrote in the Dallas newspaper. A second test by the CDC confirmed the finding.

In a statement released Saturday, Doctors Without Borders, or Medecins Sans Frontieres (MSF), said there was a "notable lack of clarity" about the guidelines released by New York and New Jersey.

"We are attempting to clarify the details of the protocols with each state's departments of health to gain a full understanding of their requirements and implications," MSF said.

"While measures to protect public health are of paramount importance, they must be balanced against the rights of health workers returning from fighting the Ebola outbreak in West Africa to fair and reasonable treatment and the full disclosure of information to them, along with information about intended courses of action from local and state health authorities."

New York City Health Commissioner Dr. Mary Bassett is concerned that the mandatory quarantine will discourage doctors and nurses from volunteering to take care of Ebola patients in West Africa, according to her spokeswoman.

"We just want to make sure we don't inadvertently discourage volunteers who are going to West Africa to help control this epidemic,"said health department spokeswoman Jean Weinberg.

The new airport screening procedures require anyone who had direct contact with Ebola patients to remain in quarantine for up to three weeks.

In addition, people with a travel history to the affected regions but with no direct contact with Ebola patients will be "actively monitored ... and, if necessary, quarantined," according to the new policy.

"This is not the time to take chances," Cuomo said Friday. "This adjustment in increasing the screening procedures is necessary. ... I think public safety and public health have to be balanced and I think this policy does that."

New federal policy starts Monday

The new guidelines add to the federal policy requiring all travelers coming to the United States from Ebola-affected areas to be actively monitored for 21 days, starting Monday.

Already, such travelers landing at five U.S. airports -- New York's Kennedy, Dulles International, New Jersey's Newark Liberty International, Chicago's O'Hare International and Hartsfield-Jackson International in Atlanta -- must go through enhanced screening

Ebola has killed nearly 5,000 people, mostly in Liberia, Sierra Leone and Guinea, in what health officials call the worst outbreak of the disease in history.

On Friday, the National Institutes of Health said Nina Pham, a Dallas nurse , had been declared free of the Ebola virus.

Public health experts say there's plenty of scientific evidence indicating that there's very little chance that a random person will get Ebola, unless he or she is in very close contact -- close enough to share bodily fluids -- with someone who has it.

New York Ebola patient's fiancee cleared

On Thursday, a New York doctor who had traveled on a humanitarian mission to Guinea, where he had treated Ebola patients, developed symptoms and has been hospitalized in Manhattan.

Dr. Craig Spencer, 33, is in isolation at Bellevue Hospital in New York City. He arrived back from Guinea on October 17 and had limited his public interactions but did not eliminate them, according to officials.

On the same day Cuomo and Christie announced the new guidelines, Ebola survivor Nancy Writebol donated plasma to Spencer, said the charity SIM.

Writebol was one of the first two Americans diagnosed with the Ebola virus. She was successfully treated at Emory University Hospital in Atlanta in August.

Spencer's fiancee, Morgan Dixon, had been under quarantine at Bellevue, but was cleared and has no symptoms, according to Jean Weinberg, a city health department spokeswoman.

On Saturday night, Dixon returned home to the hazmat-cleaned apartment she shares with Spencer in Manhattan.

Dixon's family members have not been in physical contact with her or Spencer since his return from West Africa, according to a family statement.

Two friends of Spencer are under quarantine outside the hospital and are being monitored, though they feel healthy.

Dr. Jay Varma, deputy commissioner for disease control at the city health department, held a news conference outside said the woman would be under quarantine for 21 days and that she is healthy. She is not allowed visitors and groceries will be delivered to her apartment.

On Saturday, one of the places visited by the Spencer, The Gutter bowling alley in Brooklyn, reopened after extensive decontamination work. And New York Mayor Bill de Blasio dined on meatballs at a Manhattan restaurant visited by the doctor.

Should the focus of American policy be to do everything to prevent anyone who has visited the most ravaged regions from entering the United States, even if it discourages health care workers from going there?

Some U.S. lawmakers, such as Rep. Andy Harris, favor a strict three-week quarantine. (That duration is significant because it takes anywhere from two to 21 days from the time a person is exposed to Ebola to when he or she shows symptoms of it; if more time than that passes without symptoms, a person is considered Ebola-free.)

"In return from being allowed to come back into the country from a place where a deadly disease is endemic, you'd have to enter a quarantine facility and be supervised for 21 days," the Maryland Republican told CNN.

But other officials say while that policy could prevent some cases of Ebola in the United States over the short term, it could backfire if highly trained American doctors have less incentive to travel to Africa to fight the disease.

"These individuals who are going there to serve are the people who will end this crisis," de Blasio said. "We can't have the illusion that we can turn away from it and some day it may end. If we took that attitude, this would be a truly devastating global crisis."