So far, so good for Minnesota's new Ebola monitoring system.
Five weeks after Minnesota health officials began tracking travelers arriving from Ebola-affected countries, each of the 120 people screened has been deemed low-risk and none has developed Ebola symptoms.
Public health workers say the effort remains time-consuming and, occasionally, complicated by language barriers or bad contact information. Officials, though, say they've worked through many of the program's early kinks.
Most people have not balked at being monitored, said David Johnson, supervisor of epidemiology in Hennepin County, home to the biggest share of Minnesota's Liberian-American population.
"They're there at the phone waiting for our call and so we really appreciate it," said Johnson, whose public health office has monitored about 70 percent of the travelers. "That's made our jobs just that much easier because of that cooperation."
The program was created to make it easier to trace and quickly contain possible Ebola cases in the U.S. When it launched this fall, travelers arriving from Ebola-affected West African countries were asked to provide whatever contact information they had so they could be monitored at their destination for 21 days — the longest time that Ebola could incubate within a person.
A lot of that information, however, was wrong or inadequate.
About 40 percent of travelers to Minnesota were hard to reach, said Kris Ehresmann, the state health department's infectious diseases director.
"Sometimes you'd just get an email address or you'd just get an international phone number," she said. "The level of detective work and sleuthing to try and find these individuals was really challenging."
Disease investigators mined every shred of information they had. They would visit the person's address. If the traveler wasn't there or didn't answer, health department employees would consult with property managers and scan license plates in parking lots to try to locate the person.
The need for those measures has faded since the CDC started collecting more contact information. The federal agency also supplies travelers with prepaid cell phones. Ehresmann said her team has been able to reach more than 90 percent of travelers, in most cases, without a lot of work.
Some people still require extra time and attention. In one recent case, epidemiologists went through multiple interpreters before finding one that could speak a traveler's uncommon dialect.
Ehresmann's staff also had to figure out how to do Ebola monitoring for a traveler who didn't read or write, and had never used a thermometer before.
"They figured out a color-coding system that if the thermometer read like this, it was red, green or yellow, then that person would be able to tell us what was happening," she said.
After the health department establishes contact with a traveler, the agency usually hands off the case to a local public health department, if possible, for the remainder of the monitoring period.
In Hennepin County, eight employees work on the monitoring program. The calls tend to be pretty quick, taking and around five minutes to collect a traveler's temperature and discuss symptoms, Johnson said.
There's no break, however, from the daily screening requirements and that's been a challenge to manage with his small staff, he added. "We're calling on holidays. We're calling on the weekend. We've been putting in a lot of hard work on this."
Johnson set up a rotation for his employees and has asked them to use flex time to accommodate the changes in their schedules. For now, he says he's working within his existing budget.
So is the Minnesota Department of Health.
The agency is trying to come up with a way to sustain its efforts with current resources, Ehresmann said, adding that Ebola could be a threat for a year or longer, and in the meantime there are many other health priorities that can't be ignored.
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