On alert for Ebola: public health risk assessment of travellers from Uganda to the U.S. during the 2022 outbreak.

Border health Ebola outbreak Emergency response Entry screening Traveller monitoring

Journal

Journal of travel medicine
ISSN: 1708-8305
Titre abrégé: J Travel Med
Pays: England
ID NLM: 9434456

Informations de publication

Date de publication:
11 Jun 2024
Historique:
received: 16 04 2024
revised: 04 06 2024
medline: 11 6 2024
pubmed: 11 6 2024
entrez: 11 6 2024
Statut: aheadofprint

Résumé

On September 20, 2022, the Ugandan Ministry of Health declared an outbreak of Ebola disease caused by Sudan ebolavirus. From October 6, 2022, through January 10, 2023, CDC staff conducted public health assessments at five U.S. ports of entry for travellers identified as having been in Uganda in the previous 21 days. CDC also recommended that state, local and territorial health departments ('health departments') conduct post-arrival monitoring of these travellers. CDC provided traveller contact information daily to 58 health departments and collected health department data regarding monitoring outcomes. Among 11 583 travellers screened, 132 (1%) required additional assessment due to potential exposures or symptoms of concern. Fifty-three (91%) health departments reported receiving traveller data from CDC for 10 114 (87%) travellers, of whom 8499 (84%) were contacted for monitoring, 1547 (15%) could not be contacted, and 68 (1%) had no reported outcomes. No travellers with high-risk exposures or Ebola disease were identified. Entry risk assessment and post-arrival monitoring of travellers are resource-intensive activities which had low demonstrated yield during this and previous outbreaks. The efficiency of future responses could be improved by incorporating an assessment of risk of importation of disease, accounting for individual travellers' potential for exposure, and expanded use of methods that reduce burden to federal agencies, health departments, and travellers.

Sections du résumé

BACKGROUND BACKGROUND
On September 20, 2022, the Ugandan Ministry of Health declared an outbreak of Ebola disease caused by Sudan ebolavirus.
METHODS METHODS
From October 6, 2022, through January 10, 2023, CDC staff conducted public health assessments at five U.S. ports of entry for travellers identified as having been in Uganda in the previous 21 days. CDC also recommended that state, local and territorial health departments ('health departments') conduct post-arrival monitoring of these travellers. CDC provided traveller contact information daily to 58 health departments and collected health department data regarding monitoring outcomes.
RESULTS RESULTS
Among 11 583 travellers screened, 132 (1%) required additional assessment due to potential exposures or symptoms of concern. Fifty-three (91%) health departments reported receiving traveller data from CDC for 10 114 (87%) travellers, of whom 8499 (84%) were contacted for monitoring, 1547 (15%) could not be contacted, and 68 (1%) had no reported outcomes. No travellers with high-risk exposures or Ebola disease were identified.
CONCLUSIONS CONCLUSIONS
Entry risk assessment and post-arrival monitoring of travellers are resource-intensive activities which had low demonstrated yield during this and previous outbreaks. The efficiency of future responses could be improved by incorporating an assessment of risk of importation of disease, accounting for individual travellers' potential for exposure, and expanded use of methods that reduce burden to federal agencies, health departments, and travellers.

Identifiants

pubmed: 38861425
pii: 7691187
doi: 10.1093/jtm/taae079
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Published by Oxford University Press on behalf of International Society of Travel Medicine 2024.

Auteurs

Jennifer J Fowler (JJ)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Leigh Ellyn Preston (LE)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
U.S. Public Health Service Commissioned Corps.

Shannon Gearhart (S)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Argelia Figueroa (A)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Deborah Christensen (D)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
U.S. Public Health Service Commissioned Corps.

Colby Mitchell (C)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
Oak Ridge Institute for Science and Education§.

Estephania Hernandez (E)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
Deloitte Consulting, LLP.

Ardath W Grills (AW)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Stephanie M Morrison (SM)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Melanie Wilkinson (M)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Tahab Talib (T)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Kayla Lavilla (K)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Tureka Watson (T)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Dionne Mitcham (D)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
Oak Ridge Institute for Science and Education§.

Ronnae Nash (R)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
Caduceus Healthcare, Inc.

Maria Colon Veguilla (MC)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
Caduceus Healthcare, Inc.

Sabrina Hansen (S)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Nicole J Cohen (NJ)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Seseni A Nu Clarke (SA)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Ar'Reil Smithson (A)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Emma Shearer (E)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
Council of State and Territorial Epidemiologists†.

Danielle Gilliard Pella (DG)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
U.S. Public Health Service Commissioned Corps.

Joseph D Morris (JD)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
Oak Ridge Institute for Science and Education§.

Sarah Meehan (S)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
U.S. Public Health Service Commissioned Corps.

Mahmoud Aboukheir (M)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Kara Adams (K)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Zenia Sunavala (Z)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Jake Conley (J)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Maeva Abouattier (M)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Matthew Palo (M)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
U.S. Public Health Service Commissioned Corps.

Linda Capewell Pimentel (LC)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
U.S. Public Health Service Commissioned Corps.

Andre Berro (A)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Hugh Mainzer (H)

Division of State and Local Readiness, Office of Readiness and Response, CDC.

Ramona Byrkit (R)

Division of State and Local Readiness, Office of Readiness and Response, CDC.

Daniel Kim (D)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
Oak Ridge Institute for Science and Education§.

Volha Katebi (V)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Francisco Alvarado-Ramy (F)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
U.S. Public Health Service Commissioned Corps.

Shahrokh Roohi (S)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Abbey E Wojno (AE)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Clive M Brown (CM)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Alida M Gertz (AM)

Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

Classifications MeSH