The 2014–2015 Ebola epidemic was the largest in history. As of March 2015, the epidemic had affected several countries in West Africa as well as health care workers from other areas of the world. On March 29, 2016, the World Health Organization (WHO) released a statement from the 9th meeting of the IHR (International Health Regulations) Emergency Committee regarding the Ebola outbreak in West Africa. According to this statement, Ebola transmission in West Africa no longer constitutes an extraordinary event, the risk of international spread is now low, and countries currently have the capacity to respond rapidly to new virus emergences.

2014–2015 Ebola Outbreak

On October 22, 2014, the U.S. Centers for Disease Control and Prevention (CDC) announced that public health authorities were to begin active Ebola virus monitoring of people coming to the United States from Liberia, Sierra Leone, or Guinea. These measures were designed to complement existing procedures in which people traveling from affected areas are screened for fever and other Ebola symptoms. The World Health Organization declared the end of Ebolavirus transmission in Sierra Leone in November 2015.

Along with the CDC, Customs and Border Protection conduct entry screenings on people arriving from these West African countries at one of 5 airports in the United States—in Georgia, Maryland, New Jersey, New York, Pennsylvania, and Virginia. Seventy percent of incoming travelers from this region arrive via these airports. Active post-arrival monitoring began on October 27, 2014, in these airports first. The procedures were then will be implemented in other airports.

Upon arriving at designated airports from an affected area, each traveler received a CARE (Check And Report Ebola) kit that contains the following:

  • Tracking log
  • Pictorial description of Ebola symptoms
  • Thermometer
  • Directions on how to monitor temperature correctly
  • Card that contains contact information, which they can use if they develop symptoms and/or present to health care providers
  • Infographic about monitoring health for 21 days (3 weeks)

Active Ebola Monitoring

Active post-arrival monitoring was performed by local and state health departments, with assistance from the CDC. Assistance may include providing information about travelers arriving in each state, as well as technical support, funding, and consultations.

Active Ebola virus post-arrival monitoring required travelers from the West African countries of Liberia, Sierra Leone, or Guinea to have daily contact with state and local health authorities for 21 days following their last possible date of Ebola virus exposure.

For 3 weeks, travelers from these areas were required to report their body temperature and inform state and local health authorities about the absence or presence of Ebola symptoms daily for 21 days after the last possible day of exposure to the virus. Symptoms that must be reported included:

  • Abnormal bleeding
  • Appetite loss
  • Diarrhea
  • Headache
  • Joint pain
  • Muscle aches
  • Vomiting
  • Weakness

Upon returning to the United States from an affected area, individuals also were required to notify authorities if they intended to travel—in-state or out-of-state—during this 21 day period.

The goals of active post-arrival Ebola monitoring were:

  • to establish daily contact between public health officials and all travelers returning from West African countries affected by the current outbreak of Ebola virus,
  • to allow health officials to implement isolation and evaluation measures faster and more effectively should an individual develop Ebola symptoms to help limit exposure to the virus, and
  • to improve treatment for infected individuals by directing them to a local hospital trained to receive potential Ebola patients more quickly.

Experimental Ebola Treatment

In February 2015, the National Institute of Allergy and Infectious Diseases (NIAID) launched a clinical trial in partnership with the government of Liberia. The goal of the trial was to study the safety and efficacy of the investigational drug cocktail ZMapp to treat Ebola. This drug, which is comprised of three proteins called monoclonal antibodies, targets the Ebola virus and is designed to prevent the progression of Ebola disease.

ZMapp has been used under emergency authorization in Africa, the United States, and Western Europe. It has been studied in non-human primates, but this is the first human clinical trial. The study included

  • adults and children of any age admitted for Ebola treatment in Liberia,
  • health care workers who contracted Ebola in West Africa and returned to the United States for treatment, and
  • adults and children of any age who may have contracted Ebola in the United States via secondary transmission.

Sources: U.S. Centers for Disease Control and Prevention (CDC); National Institute of Allergy and Infectious Diseases of the National Institutes of Health (NIH); World Health Organization (WHO)

Updated by Remedy Health Media

Publication Review By: the Editorial Staff at

Published: 26 Oct 2014

Last Modified: 30 Mar 2016