On alert for Ebola: public health risk assessment of travellers from Uganda to the USA during the 2022 outbreak
Author:
Fowler Jennifer J1, Preston Leigh Ellyn12, Gearhart Shannon L1, Figueroa Argelia1, L Christensen Deborah12, Mitchell Colby13, Hernandez Estephania14, Grills Ardath W1, Morrison Stephanie M1, Wilkinson Melanie1, Talib Tahab1, Marie Lavilla Kayla1, Watson Tureka1, Mitcham Dionne13, Nash Ronnae15, Veguilla Maria A Colón15, Hansen Sabrina1, Cohen Nicole J1, Nu Clarke Seseni A1, Smithson Ar'reil1, Shearer Emma16, Pella Danielle Gilliard12, Morris Joseph D13, Meehan Sarah12, Aboukheir Mahmoud1, Adams Kara1, Sunavala Zenia1, Conley Jake1, Abouattier Maeva1, Palo Matthew12, Pimentel Linda Capewell12, Berro Andre1, Mainzer Hugh7, Byrkit Ramona7, Kim Daniel13, Katebi Volha1, Alvarado-Ramy Francisco12, Roohi Shahrokh1, Wojno Abbey E1, , Brown Clive M1, Gertz Alida M1
Affiliation:
1. National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention Division of Global Migration Health, , Atlanta, Georgia, USA 2. U.S. Public Health Service Commissioned Corps , Washington, District of Columbia, USA 3. Oak Ridge Institute for Science and Education , Research Participation Program, Oak Ridge, Tennessee, USA 4. Deloitte Consulting , LLP, New York, New York, USA 5. Caduceus Healthcare , Inc, Jersey City, New Jersey, USA 6. Council of State and Territorial Epidemiologists , Applied Epidemiology Fellowship Program, Atlanta, Georgia, USA 7. Office of Readiness and Response, Immediate Office of the Director, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Division of State and Local Readiness,
Abstract
Abstract
Background
On 20 September 2022, the Ugandan Ministry of Health declared an outbreak of Ebola disease caused by Sudan ebolavirus.
Methods
From 6 October 2022 to 10 January 2023, Centers for Disease Control and Prevention (CDC) staff conducted public health assessments at five US ports of entry for travellers identified as having been in Uganda in the past 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
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.
Conclusion
Entry risk assessment and post-arrival monitoring of travellers are resource-intensive activities that 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.
Funder
Research Participation Program at the Centers for Disease Control and Prevention Oak Ridge Institute for Science and Education U.S. Department of Energy Centers for Disease Control and Prevention Inter Agency Applied Epidemiology Fellowship Program Council of State and Territorial Epidemiologists
Publisher
Oxford University Press (OUP)
Reference21 articles.
1. Disease Outbreak News: Ebola Disease Caused by Sudan Virus – Uganda;World Health Organization,2022 2. Arrival Restrictions Applicable to Flights Carrying Persons who have Recently Traveled From or Were Otherwise Present Within Uganda;U.S. Customs and Border Protection,2022 3. Atlanta, GA. Ebola Outbreak Over in Uganda;Centers for Disease Control and Prevention,2023 4. Disease Outbreak News: Ebola Disease Caused by Sudan virus – Uganda;World Health Organization,2023 5. Recommendations for Organizations Sending U.S.-Based Healthcare or Emergency Response Personnel to Areas with Viral Hemorrhagic Fever (VHF) Outbreaks;Centers for Disease Control and Prevention,2024
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