On their way home from West Africa on Wednesday, 30 US soldiers will make a detour in Italy, where they will be closely monitored following their service in the epicenter of the Ebola outbreak that has claimed nearly 5,000 lives since December.
While it appears to be very much like a quarantine, the US Army is calling the stopover in Italy "controlled monitoring" — something 10 other military personnel and Army Major General Darryl A. Williams are already undergoing in the European country. Both groups of soldiers will stay at the US military post in Vicenza, Italy for 21 days, which is the incubation period for the strain of the Ebola virus currently spreading in West Africa. According to an NBC report, the soldiers will not be allowed outside of the housing complex, dining hall, and gym.
"The Army Chief of Staff has directed a 21-day controlled monitoring period for all redeploying soldiers returning from Operation United Assistance," a press release from the Army read. "He has done this out of caution to ensure soldiers, family members, and their surrounding communities are confident that we are taking all steps necessary to protect their health."
While none of the soldiers are reported to have symptoms for the hemorrhagic fever, the first round of soldiers that arrived in Italy over the weekend were greeted by local authorities in protective suits and equipment, according to CNN. A total of 4,000 US troops are expected to be deployed in West Africa.
Despite the "controlled monitoring" period announced, during a press briefing on Monday, White House Press Secretary Josh Earnest said the Department of Defense (DOD), "has not issued a policy related to their workers that have spent time in West Africa." Earnest said this decision does not reflect a department-wide policy regarding the return of military personnel from the region, although a memo from earlier this month did say those who had been a high-risk of exposure could be quarantined for 21 days.
The CDC stressed that healthcare workers returning to the US after volunteering in West Africa should be treated with dignity and respect.
This comes as the US Centers for Disease Control & Prevention (CDC) issued updated interim guidelines for civilians returning from West Africa, with recommendations based on the level of risk an individual had for exposure to Ebola during their time in the region. These revisions relate specifically to exposure levels, and follow last week's announcement about the implementation of post-arrival monitoring for travelers originating from Liberia, Sierra Leone, or Guinea.
Based on the new guidelines, travelers without symptoms will be in daily contact with local health departments for the 21-day incubation period. However, for travelers with "some risk" of contacting Ebola — including healthcare workers and observers — the new guidelines recommend active monitoring and other precautions. The CDC said public health authorities can determine the necessity for controlled movement, workplace exclusion, or other restrictions on a case-by-base basis.
In a statement Monday, the CDC stressed that healthcare workers returning to the US after volunteering in West Africa should be treated with dignity and respect. Furthermore, the institute said they should not be prevented or discouraged from offering their "indispensable and selfless" services to the response.
"They, along with our civilian and military personnel in the region, are working tirelessly on the frontlines against Ebola," the statement read. "And their success is what ultimately will enable us to eliminate the threat of additional domestic Ebola cases."
Beyond manpower, the US military has also continued it's research efforts related to Ebola, both in the US and in West Africa. According to US Army Medical Research Institute of Infectious Diseases (USAMRIID), the institute has been conducting Ebola research for years, and is currently evaluating a number of vaccines and treatments. USAMRIID has seen headway recently with new diagnostics devices, in addition to the diagnostic laboratory in Liberia with a small staff that it supports.
USAMRIID said a real-time diagnostic assay for Ebola that it helped develop has received domestic emergency-use authorization from the FDA for clinical laboratories in the US. The military had received emergency-use authorization on August 5, and troops in West Africa were equipped with the device. The Department of Defense invested heavily in developing the scanner, which is called the FilmArray and is made by the company BioFire.
VICE News previously reported that the FilmArray scanner, capable of detecting Ebola in less than an hour, had been sitting on the shelf of the Dallas hospital where the first patient diagnosed in the US was treated. Even if the hospital had wanted to use it for this purpose, the previous FDA guidelines did not allow for it, something that has now changed with the emergency-use approval. According to BioFire, the device "is only authorized for the duration of the declaration that circumstances exist justifying the authorization of the emergency use."
USAMRIID stressed that diagnostics devices are important for response efforts.
"The assays typically are designed to pick up either proteins or nucleic acids from the virus, or in some cases the host, and the idea is to detect the presence of the virus in bodily fluids, typically of someone who is infected," Dr. David Norwood, chief of USAMRIID's diagnostics systems division, said in a press release on Monday. "Critical to a diagnostic test is the ability to detect the organism very early."
As Dr. Steven Morse, an epidemiologist at Columbia University's Mailman School of Public Health, told VICE News in a previous interview, early diagnostics are important for jumpstarting contact tracing efforts. Similarly, he said testing someone for Ebola is key in areas like west Africa where diseases like Malaria present similar symptoms. Thus it is imperative to differentiate and avoid delayed Ebola treatment or utilizing resources for a patient who in fact is not sick with Ebola.
On Monday, the DOD said USAMRIID was in the process of developing vaccines and treatments, but none have received approval for patient use.
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