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Maryland to monitor travelers from West Africa for Ebola symptoms as CDC increases surveillance

The CDC is ordering Maryland health officials to monitor all travelers entering the state from three West African countries for signs of Ebola as the federal agency is pressed to tighten border screening for the deadly virus.

Starting Monday, the travelers will be required to take their temperature daily and report to local health officials for three weeks, the longest it can take after exposure to Ebola for symptoms to appear. They also will be asked for contact information and may face travel restrictions, according to the Centers for Disease Control and Prevention.

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Maryland is among six states being asked to increase surveillance because about 70 percent of travelers from Guinea, Liberia and Sierra Leone are headed to those jurisdictions. The step is the latest by the Obama administration as it tries to both ease public concern and combat criticism that it was slow to respond to the virus.

"This is another step to protect families, communities and health care workers from Ebola," Dr. Thomas Frieden, director of the CDC, said Wednesday. "What we are doing is putting in multiple levels of checks."

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Maryland health officials said they are in talks with the CDC on how toconduct the monitoring. State health Secretary Joshua Sharfstein said his agency has already been performing similar surveillance, including on those who have returned from work with Ebola patients in African clinics.

"CDC is asking for further engagement, so we're working with them on the details," Sharfstein said.

Officials in Maryland as well as New York, Pennsylvania, Virginia, New Jersey, and Georgia "have already taken steps to plan and implement active post-arrival monitoring," the CDC said in a news release.

The practices are expected to expand beyond Maryland and the five other states soon.

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Federal officials are trying to screen the 150 or so people a day who come to the U.S. from the three West African countries, under travel screening procedures imposed earlier this month. At airports serving Atlanta, Chicago, Newark, New York and Washington, D.C., officials are taking the travelers' temperatures and looking for other possible Ebola symptoms, including vomiting, headaches, muscle aches and diarrhea.

The vast majority of travelers haven't shown symptoms, although several people have been taken to hospitals. Thus far, all have been determined to be Ebola-free, according to a CDC official.

Frieden said Wednesday this is expected to continue.

"With both airport screening and post-arrival monitoring, we expect there to be a steady stream of people with some symptoms who are found not to have Ebola. That's an example of the system working," he said.

Under the heightened travel surveillance, travelers from the three countries will be given kits at the airport where they arrive, including a thermometer, a log book for recording temperatures and information on identifying potential Ebola symptoms. If a traveler does not check in with the local health department, authorities will take immediate steps to find the person, according to the CDC.

Sharfstein said he thinks Maryland is among those states with more travelers from West Africa because of its diversity, noting that the state also has received the highest number per capita of children crossing the Mexican border in recent months.

Maryland ranks highly among states for its concentration of West African-born immigrants, according to U.S. Census data. A report released this month shows that 15 percent of Maryland's foreign-born population is from Africa, fourth-highest among states, and nearly half are from West Africa.

Dr. Georges C. Benjamin, head of the American Public Health Association, called the increased screening an "elegant solution," noting that public health departments are familiar with this kind of monitoring and shouldn't be overly burdened because the number of travelers is relatively low.

Even with the new step, Frieden and other public health officials stress that containing the Ebola outbreak in West Africa is the only way to ensure that there are no more cases in the U.S.

The U.N. World Health Organization's latest figures on Wednesday showed at least 4,877 people out of 9,936 cases have died in the outbreak, the worst on record. Guinea, Liberia and Sierra Leone account for all but about two dozen cases and nine deaths that have occurred, including three cases and one death in the United States.

Also Wednesday, the National Institutes of Health announced that human testing has begun on a second experimental Ebola vaccine, VSV-ZEBOV.

The vaccine, developed by the Public Health Agency of Canada, uses a genetically altered version of a virus that usually affects livestock and causes mild illness in humans. In tests with monkeys, the vaccine was shown to produce Ebola virus antibodies.

Last month, Phase 1 safety trials began on another vaccine candidate developed by the National Institute of Allergy and Infectious Diseases and drug maker GlaxoSmithKline, including one being conducted by University of Maryland School of Medicine researchers and a sister organization in Mali. University researchers also plan to conduct Ebola vaccine trials in Baltimore next month.

Initial safety and immune response results for the GlaxoSmithKline vaccine are expected by the end of the year.

Reuters and Los Angeles Times reporter Monte Morin contributed to this report.

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