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Medical Center Considers Reverse Quarantine as Possible Ebola Prevention

The Baylor College of Medicine in Houston is considering a reverse quarantine that would keep health staffers from patients for 21 days after they have traveled to countries affected by the Ebola outbreak.

Ebola virus virion. Created by CDC microbiologist Cynthia Goldsmith, this colorized transmission electron micrograph (TEM) revealed some of the ultrastructural morphology displayed by an Ebola virus virion.

When Dr. Tom Wheeler returned home to Houston from a wedding in Mexico in 2009, during the height of the H1N1, or "swine flu," epidemic there, the Baylor College of Medicine's pathology chief was told by his employer to stay home for a day before coming back to work at Texas Medical Center, home to more than 50 health care institutions and considered the world's largest medical district.

The idea was simple. The preventive measure, known as a reverse quarantine, would keep Wheeler from patients for a period of time to make sure he had no symptoms of swine flu. 

"I was just told to stay at home, no special precautions," said Wheeler, who never showed any symptoms of the virus. "I came to work the next day."

The reverse quarantine is now being considered at the Texas Medical Center on a much larger scale in the midst of the Ebola outbreak in northwestern Africa. Hospital executives are dusting off and updating emergency management plans usually used to guide the more than 100,000 employees located there during weather disasters like hurricanes and tropical storms. And they're using Wheeler's experience as a guide.

"This is not our first rodeo," said Dr. Kenneth Mattox, Ben Taub Hospital's chief of staff and a distinguished service professor at the Baylor College of Medicine, who is part of the team of professionals who have helped advise other hospitals in Southeast Texas and government officials during hurricanes.

During a hurricane, Texas Medical Center institutions are usually working to get patients out of harm's way. Now, hospital executives are looking for ways to keep Ebola's dangers out of their hospital. The medical center attracts medical talent from around the world, including those who work or have relatives in areas affected by the outbreak, which has so far killed more than 900 people.  

When he heard about Wheeler's experience, Mattox proposed that Baylor staff who have traveled to northwestern African countries such as Sierra Leone, Liberia, Guinea and Nigeria — which have experienced an Ebola outbreak — stay away from patients upon their return to Houston for 21 days. 

"I have recommended that there be strong consideration that this be done in the interest of public health," Mattox told The Texas Tribune on Monday. While Baylor is still considering the measure, if approved, it could be one of the stronger preventive tactics taken yet in Texas.

Glenna Picton, a spokeswoman for Baylor, said the school is still gathering information about what preventive measures should be taken. "We hope to craft a policy that will fit our own particular needs," she said. "The reverse quarantine Dr. Mattox mentioned is one option, but no policy has been put in place at Baylor College of Medicine at this time." 

The University of Texas Health Science Center, which is also located in the 1,345-acre Texas Medical Center campus, is identifying its international students and those coming back from areas affected by the Ebola outbreak. They plan to contact the school's health officer and to look for symptoms that can seem like flu. 

Symptoms include fever, headache, joint and muscle aches, weakness, vomiting and diarrhea. 

Robert Emery, UTHSC's vice president of safety, health, environment and risk management, said the school is also asking students who are traveling to affected areas to report the travel to the school's health officer and to monitor their own health for signs of symptoms. 

"Our primary concern was the notion that we have faculty or students who might have traveled to this area," he said. "If you have traveled, these are things we would like you to do."

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