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Ebola: Is "self-monitoring" good enough?

When Dr. Craig Spencer returned to New York from West Africa last week after doing volunteer work treating Ebola patients for Doctors Without Borders, he followed recommended guidelines to monitor his own health for any signs of illness.

But now that he's been diagnosed with Ebola, some are wondering if "self-monitoring" is good enough, or whether more restrictions should be placed on the movements and contacts of someone who may have been exposed to the disease. New York and New Jersey officials took action on Friday, announcing a new requirement for the quarantine of health care workers and others who had contact with victims in West Africa.

The World Health Organization says such a quarantine plan goes farther than necessary. "Health care workers are generally self-monitoring and are aware of the need to report any symptoms, as this patient did," said WHO spokeswoman Sona Bari.

Self-monitoring remains the standard for health care workers in other parts of the country. It involves the person checking their temperature twice a day, since a low-grade fever is usually the first sign of infection. Doctors Without Borders also warns its workers to watch out for symptoms such as headache, nausea, vomiting or diarrhea.

Health officials say Spencer followed the guidelines and notified them immediately when he detected a fever of 100.3 degrees on the morning of Oct. 23. Emergency responders in full protective gear transported him directly to the isolation ward at Bellevue Hospital.

"You are not infectious until you are symptomatic," Dr. Frank Esper, of University Hospitals Case Medical Center, told CBS News. "Once he felt that that's when he hunkered down and made sure he didn't expose any other people."

But in the days before he developed the fever, Spencer was out in several New York City neighborhoods, visiting the High Line park, a restaurant, and riding the subway to a bowling alley in Brooklyn. Doing so did not violate the guidelines he was given, and health officials say he would not have been contagious at that time.


According to the CDC, only people considered to be at high risk are put into quarantine - ordered to stay home and have no contact with people on the outside while they wait to see if illness develops. The fiancé of Dallas Ebola patient Thomas Eric Duncan and several others who lived with him were quarantined, but none got sick.

Still, some are questioning whether it was wise to allow Spencer to move about the city so freely given his potential exposure.

Dr. Anthony Fauci of the National Institute of Allergy and Infectious Diseases indicated wider change in policy could be on the way. "That is something that is right now under active discussion and you will be hearing shortly about what the guidelines will be," he said. He also noted that state officials -- like those in New York and New Jersey -- have a say in how such cases are handled in their communities.