{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:23:15Z","timestamp":1777681395336,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T00:00:00Z","timestamp":1590969600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Security"],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:p>In August 2014, the World Health Organization declared the Ebola virus disease epidemic in West Africa a public health emergency of international concern. After 2 imported cases of the disease were identified in the United States in autumn 2014, the Centers for Disease Control and Prevention recommended that all jurisdictions begin active monitoring of travelers at risk of developing Ebola virus disease for 21 days from the last day of a potential exposure to minimize the risk of disease transmission. Here we describe the infrastructure development, monitoring processes, total planned expenditures, and effects on the public health system in Georgia associated with active monitoring and illness response of all travelers from Ebola-affected West African countries from October 2014 to March 2016. We conducted qualitative interviews with Georgia Department of Public Health (GDPH) staff. We identified state active monitoring and illness response infrastructure investments and monitoring activities and state and federal funds spent in both areas. And, we evaluated whether active monitoring and illness response enhanced Georgia's ability to respond to future infectious disease outbreaks. Developing the infrastructure to support the monitoring and response required investment in information technology, training of public health and medical personnel, increasing laboratory capacity, and securing personal protective equipment. Estimated total expenditures were $8.25 million, with 76% spent on infrastructure and 17% on daily monitoring. The GDPH leveraged internal resources and partnerships to implement active monitoring and illness response. Infrastructure investment increased surveillance capacity, strengthened relationships between the GDPH and medical providers, and led to the creation of infectious disease transport and hospital networks. Active monitoring and illness response increased outbreak preparedness, but it warrants comparison with other possible responses to determine its overall value.<\/jats:p>","DOI":"10.1089\/hs.2019.0127","type":"journal-article","created":{"date-parts":[[2020,6,19]],"date-time":"2020-06-19T15:58:21Z","timestamp":1592582301000},"page":"164-176","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["The Cost and Public Health System Effects of Active Monitoring and Illness Response for Ebola Virus Disease: A Case Evaluation of Georgia"],"prefix":"10.1177","volume":"18","author":[{"given":"Victoria","family":"Phillips","sequence":"first","affiliation":[{"name":"Victoria Phillips, DPhil, is an Associate Professor, Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, and a consultant to the Division of Global Migration and Quarantine, Quarantine and Border Health Services Branch, Centers for Disease Control and Prevention, Atlanta, GA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph D.","family":"Njau","sequence":"additional","affiliation":[{"name":"Joseph D. Njau, PhD, is a Staff Fellow, Food and Drug Administration, White Oak Campus Federal Research Center, Silver Spring, MD."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Edison","sequence":"additional","affiliation":[{"name":"Laura Edison, DVM, is in the Career Epidemiology Field Officer Program, Division of State and Local Readiness, Center for Preparedness Response; and Clive Brown, MD, is Chief, Division of Global Migration and Quarantine, Quarantine and Border Health Services Branch; both at the Centers for Disease Control and Prevention, Atlanta, GA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clive","family":"Brown","sequence":"additional","affiliation":[{"name":"Laura Edison, DVM, is in the Career Epidemiology Field Officer Program, Division of State and Local Readiness, Center for Preparedness Response; and Clive Brown, MD, is Chief, Division of Global Migration and Quarantine, Quarantine and Border Health Services Branch; both at the Centers for Disease Control and Prevention, Atlanta, GA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,6,17]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"World Health Organization (WHO). Statement on the 1st meeting of the IHR Emergency Committee on the 2014 Ebola outbreak in West Africa. WHO website. Published August 8 2014. Accessed May28 2020. http:\/\/who.int\/mediacentre\/news\/statements\/2014\/ebola-20140808\/en\/"},{"issue":"46","key":"e_1_3_2_3_2","first-page":"1087","article-title":"Ebola virus disease cluster in the United States\u2014Dallas County, Texas, 2014","volume":"63","author":"Chevalier MS","year":"2014","unstructured":"Chevalier MS, , Chung W, , Smith J, et al. Ebola virus disease cluster in the United States\u2014Dallas County, Texas, 2014. MMWR Morb Mortal Wkly Rep. 2014; 63(46):1087-1088.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"12","key":"e_1_3_2_4_2","first-page":"321","article-title":"Ebola virus disease in a humanitarian aid worker\u2014New York City, October 2014","volume":"64","author":"Yacisin K","year":"2015","unstructured":"Yacisin K, , Balter S, , Fine A, et al. Ebola virus disease in a humanitarian aid worker\u2014New York City, October 2014. MMWR Morb Mortal Wkly Rep. 2015; 64(12):321-323.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_2_5_2","unstructured":"Centers for Disease Control and Prevention (CDC). CDC announces active post-arrival monitoring for travelers from impacted countries. CDC website. Published October 22 2014. Accessed May28 2020. http:\/\/www.cdc.gov\/media\/releases\/2014\/p1022-post-arrival-monitoring.html"},{"key":"e_1_3_2_6_2","unstructured":"Centers for Disease Control and Prevention (CDC). Enhanced Ebola screening to start at five U.S. airports and new tracking program for all people entering U.S. from Ebola-affected countries. CDC website. Published October 8 2014. Accessed May28 2020. http:\/\/www.cdc.gov\/media\/releases\/2014\/p1008-ebola-screening.html"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6549a4"},{"issue":"13","key":"e_1_3_2_8_2","first-page":"347","article-title":"Ebola active monitoring system for travellers returning from West Africa\u2014Georgia, 2014-2015","volume":"64","author":"Parham M","year":"2015","unstructured":"Parham M, , Edison L, , Soetebier K, et al. Ebola active monitoring system for travellers returning from West Africa\u2014Georgia, 2014-2015. MMWR Morb Mortal Wkly Rep. 2015; 64(13):347-350.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/hpm.2122"},{"issue":"49","key":"e_1_3_2_10_2","first-page":"1163","article-title":"Airport exit and entry screening for Ebola\u2014August-November 10, 2014","volume":"63","author":"Brown CM","year":"2014","unstructured":"Brown CM, , Aranas AE, , Benenson GA, et al. Airport exit and entry screening for Ebola\u2014August-November 10, 2014. MMWR Morb Mortal Wkly Rep. 2014; 63(49):1163-1167.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"25","key":"e_1_3_2_11_2","first-page":"685","article-title":"Monitoring of persons with risk for exposure to Ebola virus disease\u2014United States, November 3, 2014-March 8, 2015","volume":"64","author":"Stehling-Ariza T","year":"2015","unstructured":"Stehling-Ariza T, , Fisher E, , Vagi S, et al. Monitoring of persons with risk for exposure to Ebola virus disease\u2014United States, November 3, 2014-March 8, 2015. MMWR Morb Mortal Wkly Rep. 2015; 64(25):685-689.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.su6503a9"},{"key":"e_1_3_2_13_2","unstructured":"Centers for Disease Control and Prevention (CDC). Epidemic Information Exchange (Epi-X). CDC website. Last reviewed April 4 2018. Accessed May28 2020. https:\/\/www.cdc.gov\/mmwr\/epix\/epix.html"},{"key":"e_1_3_2_14_2","unstructured":"Centers for Disease Control and Prevention (CDC). Hospital Preparedness Program (HPP) and Public Health Emergency Preparedness (PHEP) cooperative agreements\/PHEP supplemental for Ebola preparedness and response activities. Attachment 2: Funding Table. CDC website. Accessed May28 2020. www.cdc.gov\/cpr\/documents\/PHEP-Amendment-II-Funding-Table.pdf"},{"key":"e_1_3_2_15_2","unstructured":"Centers for Disease Control and Prevention (CDC). Hospital Preparedness Program (HPP) and Public Health Emergency Preparedess (PHEP) Cooperative Agreements. CDC website. Published January 20 2015. Accessed May28 2020. www.cdc.gov\/cpr\/documents\/PHEP-Ebola-Guidance.pdf"},{"key":"e_1_3_2_16_2","unstructured":"Centers for Disease Control and Prevention (CDC). National Center for Emerging and Zoonotic Infectious Diseases. Domestic Ebola Supplement to Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) - Building and Strengthening Epidemiology Laboratory and Health Information Systems Capacity in State and Local Health Departments. CDC website. Published January 20 2015. Accessed June7 2020. https:\/\/govtribe.com\/opportunity\/federal-grant-opportunity\/domestic-ebola-supplement-to-epidemiology-and-laboratory-capacity-for-infectious-diseases-elc-building-and-strengthening-epidemiology-laboratory-and-health-information-systems-capacity-in-state-and-local-health-departments-ck141401pphfsupp15"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6503a3"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6440a4"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.su6503a11"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0166797"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.21.6.15"},{"issue":"13","key":"e_1_3_2_22_2","first-page":"1","article-title":"Updated guidelines for evaluating public health surveillance systems: recommnedations from the Guidelines Working Group","volume":"50","author":"German RR","year":"2001","unstructured":"German RR, , Lee LM, , Horan JM, et al. Updated guidelines for evaluating public health surveillance systems: recommnedations from the Guidelines Working Group. MMWR Recomm Rep. 2001; 50(RR-13):1-35.","journal-title":"MMWR Recomm Rep"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780195138276.003.0008"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2004.03.006"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780198529446.001.0001"},{"key":"e_1_3_2_26_2","volume-title":"Tools for Evaluating the Metropolitan Medical Response System Program: Phase I Report","author":"Manning FJ","year":"2001","unstructured":"Manning FJ, , Goldfrank L, eds. Tools for Evaluating the Metropolitan Medical Response System Program: Phase I Report. Washington, DC: National Academies Press; 2001."},{"key":"e_1_3_2_27_2","unstructured":"Association of State and Territorial Health Officials (ASTHO). National Public Health Performance Standards. ASTHO website. Accessed May29 2020. https:\/\/www.astho.org\/Programs\/Accreditation-and-Performance\/National-Public-Health-Performance-Standards\/?terms=performance+standards+state+assessment+instrument"},{"key":"e_1_3_2_28_2","unstructured":"Center for Health Policy. Bioterrorism and Emergency Readiness: Competencies for All Public Health Workers. New York: Columbia University School of Nursing; 2002. Accessed May28 2020. https:\/\/training.fema.gov\/emiweb\/downloads\/bioterrorism%20and%20emergency%20readiness.pdf"},{"key":"e_1_3_2_29_2","unstructured":"Council of State and Territorial Epidemiologists (CSTE). 2013 National Assessment of Epidemiology Capacity. Atlanta GA: CSTE; 2014. Accessed May28 2020. www.cste2.org\/2013eca\/CSTEEpidemiologyCapacityAssessment2014-final2.pdf"},{"key":"e_1_3_2_30_2","unstructured":"English JF Cundiff MY Malone JD et al. Bioterrorism Readiness Plan: A Template for Healthcare Facilities. Atlanta GA: APIC Bioterrorism Task Force and CDC Hospital Infections Program Bioterrorism Working Group; 1999. Accessed May28 2020. https:\/\/emergency.cdc.gov\/bioterrorism\/pdf\/13apr99APIC-CDCBioterrorism.pdf"},{"key":"e_1_3_2_31_2","unstructured":"Federal Emergency Management Agency (FEMA). Logistics Capability Assessment Tool: FEMA's Self Assessment Tool to Determine State Logistics Readiness. FEMA website. Accessed January23 2018. https:\/\/www.fema.gov\/pdf\/media\/factsheets\/2009\/log_lcat.pdf"},{"key":"e_1_3_2_32_2","unstructured":"US Department of Health and Human Services (HHS). Emergency Preparedness Resource Inventory (EPRI) A Tool for Local Regional and State Planners. Part 2. Technical Manual. Rockville MD: HHS; 2005. Accessed May28 2020. https:\/\/archive.ahrq.gov\/research\/epri\/eprimanual.pdf"},{"key":"e_1_3_2_33_2","volume-title":"Prevention Effectiveness: A Guide to Decision Analysis and Economic Evaluation","author":"Haddix AC","year":"2003","unstructured":"Haddix AC, , Teutsch SM, , Corso PS. Prevention Effectiveness: A Guide to Decision Analysis and Economic Evaluation. 2nd ed. New York: Oxford University Press; 2003."},{"key":"e_1_3_2_34_2","unstructured":"State of Georgia. Download salary & travel data. Open Georgia website. Accessed May28 2020. http:\/\/www.open.georgia.gov\/download.html"},{"key":"e_1_3_2_35_2","unstructured":"US Bureau of Labor Statistics (BLS). Occupation employment statistics. BLS website. Accessed May28 2020. https:\/\/www.bls.gov\/oes\/current\/oes_12060.htm"},{"key":"e_1_3_2_36_2","unstructured":"Zillow. Historical Rental Data. 2015. Accessed October 4th 2017. https:\/\/www.zillow.com\/research\/data\/"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1506290"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2017.149"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1089\/hs.2017.0077"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-19406-x"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1089\/hs.2015.0016"}],"container-title":["Health Security"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/hs.2019.0127","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/hs.2019.0127","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/hs.2019.0127","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:39:47Z","timestamp":1777451987000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/hs.2019.0127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,1]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,6,1]]}},"alternative-id":["10.1089\/hs.2019.0127"],"URL":"https:\/\/doi.org\/10.1089\/hs.2019.0127","relation":{},"ISSN":["2326-5094","2326-5108"],"issn-type":[{"value":"2326-5094","type":"print"},{"value":"2326-5108","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,1]]}}}