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US State-Level Policy Responses to the Ebola Outbreak, 2014-2015

Sell, Tara Kirk MA; McGinty, Emma E. PhD, MS; Pollack, Keshia PhD, MPH; Smith, Katherine Clegg PhD, MA; Burke, Thomas A. PhD, MPH; Rutkow, Lainie JD, PhD, MPH

Journal of Public Health Management and Practice: January/February 2017 - Volume 23 - Issue 1 - p 11–19
doi: 10.1097/PHH.0000000000000384
Research Articles

Context: The 2014-2015 Ebola epidemic in West Africa raised concerns about the potential occurrence of an Ebola outbreak in the United States. The federal government and individual states developed guidance and policies to determine how to manage individuals within the United States who may have been exposed to Ebola.

Design: A total of 139 documents describing state policies for individuals considered at risk for Ebola and the requirements, as well as restrictions these individuals may be subject to, were systematically identified and analyzed.

Results: A wide range of policy responses and variations on quarantine, movement restrictions, exposure categories, and monitoring were found. While the majority of states reflected US Centers for Disease Control and Prevention guidance, some states enacted aggressive quarantine policies and movement restrictions, developed unique categorization strategies, and established more frequent monitoring procedures.

Conclusions: Findings may help public health practitioners and policymakers anticipate what policies could be implemented in response to future infectious disease threats. Furthermore, practitioners and policymakers should assume that some variation in response policies will occur at the state level.

Supplemental Digital Content is Available in the Text.

Departments of Health Policy and Management (Ms Sell and Drs McGinty, Pollack, and Rutkow) and Health, Behavior and Society (Dr Smith), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; UPMC Center for Health Security, Baltimore Maryland (Ms Sell); and United States Environmental Protection Agency, Washington, District of Columbia (Dr Burke).

Correspondence: Tara Kirk Sell, MA, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Room 513, 624 N. Broadway, Baltimore, MD 21205 (

Dr Burke contributed to this work while serving as Professor at Johns Hopkins. The views expressed are his own and do not necessarily reflect the policy positions of the EPA.

Support for this research was provided to TKS by the Johns Hopkins Sommer Scholars Program.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

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