Health care worker quarantine for Ebola: to eradicate the virus or alleviate fear?

The 2014 Ebola outbreak originating in West Africa is a public health emergency of international concern that has drawn worldwide media attention. Quarantine—an action that restricts movement of individuals, with the goal to protect the public health—is a historic public health action. Despite our global experience with emerging infectious diseases, politicians empowered with making health policy decisions and even some scientists have created confusion, fear, and stigmatization of health care workers by inconsistent use of quarantine. The paradoxic application of quarantine during the 2014 Ebola outbreak has led to confusion among health care workers and the public alike. Within the United States, conflicting policies have resulted in a nurse being placed in quarantine in a tent next to a hospital in New Jersey and later in her home in Maine after returning from treating Ebola patients in West Africa, yet at the same time other returning health care workers moved about freely, including a physician in New York City who later tested positive for Ebola. Asymptomatic health care workers returning from treating Ebola patients in West Africa even met with the President of the United States, a strong indication that they were of no threat to others. Furthermore, health care workers caring for patients with Ebola within the United States and other non-African countries have not had their movement restricted. Similarly, the US ambassador to the United Nations returned from an Ebolastricken country and was simply placed under public health monitoring, whereas the media concurrently reported that returning US military troops would be quarantined for 21 days. Physicians from West Africa were told they would be quarantined if they traveled to the United States to attend a professional meeting at the same time that physicians who returned from treating Ebola patients moved freely about at the annual American College of Emergency Physicians (ACEP) Scientific Assembly. So what is the truth about quarantine? Quarantine is an ancient term that is derived from the Italian quaranta, which refers to the 40-day sequestration imposed on arriving merchant ships during plague outbreaks of the 14th century. Although the terms are frequently used interchangeably, quarantine differs from isolation in important ways. According to the 2001 US Model State Emergency Health Powers Act, both quarantine and isolation are tools that “enforce physical separation