Joining other states, N.H. announces monitoring plans for travel from Ebola-affected countries

Last modified: 10/29/2014 12:15:16 AM
New Hampshire plans to monitor the health of anyone returning from an Ebola-affected country – at home, if that person had direct contact with Ebola patients – for 21 days upon their arrival back to the state, Gov. Maggie Hassan announced yesterday afternoon.

The state outlines two potential scenarios in its new protocol: one for people who had direct contact with Ebola patients, and one for people who simply traveled from Guinea, Liberia or Sierra Leone. Those who work directly with patients are being asked to stay at home during the three-week monitoring period upon arrival back in New Hampshire, while those who did not work with patients are allowed leave but are being asked to avoid “large public gatherings and public transit.”

New Hampshire is following suit with several other states that have announced their own Ebola monitoring guidelines. Here, the policy is proactive, as no patients are being monitored at this time.

The state’s approach to allow someone to stay at home, Division of Public Health Director José Montero said, seemed preferable to one in which residents would need to be isolated in “some secure facility.”

Those who did not have direct contact with patients will be subject to twice-daily temperature monitoring to check for fever – one symptom of Ebola – possibly done on a self-reported basis, Montero said. That same group of people will generally be allowed to travel freely in the community, Montero said, but to “limit it as much as you can.”

New Hampshire has previously asked patients to self-monitor in cases involving tuberculosis, Montero said.

Two New Hampshire residents assisting with Ebola relief efforts – Brig. Gen. Peter Corey, the deputy commanding general for U.S. Army Africa, and Dr. Elizabeth Talbot, one of the state’s leading epidemiologists, who also works as an infectious disease doctor with Dartmouth-Hitchcock Medical Center – have elected to “self-quarantine” upon returning to the state, the governor’s office announced. Corey is in Liberia, and Talbot is expected to travel there later this week to train clinical teams with International Medical Corps.

Should someone object to being quarantined, New Hampshire officials would have the authority to mandate isolation, quarantine and treatment under state law. As outlined in RSA:141-C, the Department of Health and Human Services commissioner can mandate isolation or quarantine procedures “whenever it is necessary to prevent the introduction or spread of communicable diseases within this state or from another state, or to restrict such diseases if introduced, and when such communicable diseases pose a substantial threat to the health and life of the citizenry.”

“Such isolation or quarantine shall be by the least restrictive means necessary to protect the citizenry which, in the case of an individual, shall be at a place of his or her choosing unless the commissioner determines such place to be impractical or unlikely to adequately protect the public health,” the law states. “The commissioner shall adopt such rules regarding the establishment, maintenance and lifting of isolation and quarantine as the commissioner may deem best for protecting the health of the public.”

Neither the governor’s office nor Montero referred to the protocol as a “mandatory” quarantine. Montero said he is hesitant to invoke the state’s legal authority and instead wants to foster a more cooperative approach with returning residents.

“We want to engage with everybody and explain and get them to work with us,” Montero said of the protocols. “We have the capacity, the legal authority, but this is not about legal 

To aid in the state’s ability to monitor returning residents, Montero said the Centers for Disease Control and Prevention will provide information about those traveling back to New Hampshire from Ebola-affected countries. Previously, Montero said, the state was relying on keeping track of travelers through local contacts.

Montero said the state, in its Ebola protocols, is trying to balance the science surrounding the spread of Ebola and the public’s fears about the disease.

“We want to be careful in how we reassure the community without creating problems with that,” he said, adding that the protocols are subject to change. “If this situation evolves, we just want to be sure we are not increasing anxiety and panic in the community as we educate them.”

Ebola spreads through direct contact with bodily fluids – including blood, saliva and sweat – and not through the air or by water, according to the CDC. It can take as long as 21 days for symptoms to begin showing.

A large-scale outbreak as severe as the one that has been afflicting West African nations since March remains unlikely in New Hampshire, Montero said. At this point, no one in the state is being monitored for Ebola, the Department of Health and Human Services confirmed yesterday.

And while some politicians have called for a travel ban as one possible means of stemming the threat of an Ebola outbreak in the United States, Montero and other health officials have said such an approach would likely do less help than harm. It would likely make it more difficult to track travel in and out of Ebola-affected nations, he said, and it could prevent aid from reaching the countries that need it most.

“We certainly don’t want it here,” Montero said, “but that means we need to help them there.”

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