TIME ebola

48 Come Off Ebola Watch List in Texas

First Ebola case diagnosed in the United States
An unidentified person opens the door for Dallas County Judge Clay Jenkins along with two women at the apartment where Thomas Eric Duncan was staying in Dallas, Texas, Oct. 2 2014. Larry W. Smith—EPA

“We are so happy this is coming to an end”

The first wave of people who had contact with the original Dallas Ebola patient were taken off a watch list early Monday, marking a moment of relief for the 48 individuals even as dozens more continue to be monitored by officials.

Midnight (1 a.m. ET) marked the end of 21 days since the diagnosis of Thomas Eric Duncan, who was treated and died at the Texas Health Presbyterian Hospital in Dallas. Ebola has a 21-day incubation period, and when a case is confirmed officials monitor anyone who had contact with that person for three weeks.

“We are so happy this is coming to an end…”

Read the rest of the story from our partners at NBC News

TIME ebola

Second U.S. Nurse With Ebola Was ‘in No Way Careless’ by Flying, Family Says

Texas nurse Amber Vinson (L) steps from an ambulance at Emory University Hospital in Atlanta
Texas nurse Amber Vinson, left, steps from an ambulance at Emory University Hospital in Atlanta, Ga., on Oct. 15, 2014. Stringer—Reuters

The Centers for Disease Control and Prevention had given the green light for Amber Vinson to travel, claims her family

The family of the second nurse to contract Ebola in the U.S. says she was “in no way” careless in making the decision to fly to Dallas after her exposure to the disease.

Amber Vinson, 29, apparently decided to fly back to Dallas from Cleveland as a precaution, after she heard her colleague Nina Pham had been diagnosed with Ebola.

Both Vinson and Pham had cared for Thomas Eric Duncan, who died of the disease on Oct. 8.

“To be clear, in no way was Amber careless prior to or after her exposure to Mr. Thomas Eric Duncan. She has not and would not knowingly expose herself or anyone else,” Vinson’s family wrote in the statement.

According to the statement, the Centers for Disease Control and Prevention (CDC) had given the green light for Vinson to travel. Her family says she had even asked to stay at the Texas Health Presbyterian Hospital for the remainder of her 21-day monitoring period.

“Suggestions that she ignored any of the physician and government-provided protocols recommended to her are patently untrue and hurtful,” says the statement.

The family insists she followed CDC self-monitoring guidelines correctly and reported her temperature three times before boarding her flight, and each time the CDC cleared her to travel.

TIME ebola

Nigeria Is Ebola-Free: Here’s What They Did Right

A school official takes a pupil's temperature using an infrared digital laser thermometer in front of the school premises, at the resumption of private schools, in Lagos
A school official takes a pupil's temperature using an infrared digital laser thermometer in front of the school premises, at the resumption of private schools, in Lagos, Sept. 22, 2014. Akintunde Akinleye—Reuters

It's been 42 days since the last new case

The World Health Organization declared Nigeria free of Ebola on Monday, a containment victory in an outbreak that has stymied other countries’ response efforts.

The milestone came at about 11 a.m. local time, or 6 a.m., E.T. The outbreak has killed more than 4,500 in West Africa is remains unchecked in Liberia, Sierra Leone and Guinea, so Nigeria is by no means immune to another outbreak.

“It’s possible to control Ebola. It’s possible to defeat Ebola. We’ve seen it here in Nigeria,” Nigerian Minister of Health Onyebuchi Chukwu told TIME. “If any cases emerge in the future, it will be considered—by international standards—a separate outbreak. If that happens, Nigeria will be ready and able to confront it exactly as we have done with this outbreak.”

For the WHO to declare Nigeria as Ebola-free, the country had to make it 42 days with no new cases (double the incubation period), verify that it actively sought out all possible contacts, and show negative test results for any suspected cases.

Nigeria had 20 cases of Ebola after a Liberian-American man named Patrick Sawyer flew into Lagos and collapsed at the airport. Health care workers treating Sawyer were infected, and as it spread it ultimately killed eight people, a low number next to the thousands of cases and deaths in other countries. Nigeria’s health system is considered more robust, but there was significant concern from experts that a case would pop up in one of the country’s dense-populated slums and catch fire.

So what did Nigeria do right? Chukwu and Dr. Faisal Shuaib of the country’s Ebola Emergency Operation Center, broke it down for TIME.

Preparing early. Nigeria knew it was possible a case of Ebola would make it into the country, so officials got to work early by training health care workers on how to manage the disease, and disseminating information so the country knew what to expect.

Declaring an emergency—right away. When Nigeria had its first confirmed case of Ebola, the government declared a national public health emergency immediately. This allowed the Ministry of Health to form its Ebola Emergency Operations Center (EOC). The EOC is an assembly of public health experts within Nigeria as well as the WHO, Centers for Disease Control (CDC), and groups like Doctors Without Borders. “[We] used a war-room approach to coordinate the outbreak response,” Shuaib said. “So you have a situation whereby government and staff of international development agencies are co-located in a designated facility where they are able to agree on strategies, develop one plan and implement this plan together.”

The EOC was in charge of contact tracing (the process of identifying and monitoring people who may have had direct or indirect contact with Ebola patients), implementing strict procedures for handling and treating patients, screening all individuals arriving or departing the country by land, air and sea, and communicating with the community. Some workers went door-to-door to offer Ebola-related education, and others involved religious and professional leaders. Social media was a central part of the education response.

Training local doctors. Nigerian doctors were trained by Doctors Without Borders and WHO, and treated patients in shifts with their oversight.

Managing fear. “Expectedly, people were scared of contracting the disease,” Shuaib said. “In the beginning, there was also some misinformation about available cures, so fear and inaccurate rumors had to be actively managed.” Nigeria used social media to to ramp up awareness efforts, and publicized patients who were successfully treated and discharged. “People began to realize that contracting Ebola was not necessarily a death sentence,” Shuai said. “Emphasizing that reporting early to the hospital boosts survival gave comfort that [a person] has some level of control over the disease prognosis.”

Keeping borders open. Nigeria has not closed its borders to travelers from Guinea, Sierra Leone and Liberia, saying the move would be counterproductive. “Closing borders tends to reinforce panic and the notion of helplessness,” Shuaib said. “When you close the legal points of entry, then you potentially drive people to use illegal passages, thus compounding the problem.” Shuaib said that if public health strategies are implemented, outbreaks can be controlled, and that closing borders would only stifle commercial activities in the countries whose economies are already struggling due to Ebola.

Remaining prepared for more patients. Even though this outbreak was contained, Nigeria is not slowing down its training and preparations for the possibility of more cases. “Outbreak response preparedness is a continuous process that requires constant review of the level of the response mechanisms in place to ensure that the health system is ready to jump into action at all levels,” Shuaib said. “There is no alternative to preparedness.”

Advocating for more international response. “The global community needs to consistently come together, act as one in any public health emergency, whether it is Ebola or a natural disaster.” Shuaib said. “While a lot has been done, it still falls short of what is necessary to get ahead of the curve. We must act now, not tomorrow, not next week.”

TIME ebola

Spanish Nurse Tests Negative for Ebola After Contracting Disease

After she was diagnosed, the regional government euthanized her dog

The Spanish nurse who became the first known person to contract the disease outside of West Africa in this current outbreak has tested negative for the disease, her family announced to Spanish media.

Teresa Romero’s doctors said the results are preliminary and that more tests would be needed to confirm she no longer has Ebola, according to the BBC. (Her name has also been reported as Teresa Romero Ramos.)

The 44-year-old contracted the virus while caring for two missionaries who had been in West Africa. Both missionaries ultimately died from the disease.

Romero has said she may have contracted the disease while removing her protective gear. As a precautionary measure, the regional government euthanized her dog, Excalibur, though to date there is not a single case of dogs transmitting Ebola to people or people to dogs.

[BBC]

TIME ebola

Friends, Family of Ebola Patient Reach Milestone

Relatives of the first patient diagnosed with Ebola on U.S. soil, attend a news conference in Dallas
From Left: The nephew of Thomas Eric Duncan, the first patient diagnosed with Ebola on U.S. soil, and Nowai Korkoyah Duncan's mother attend a news conference in Dallas on Oct. 7, 2014. Jim Young—Reuters

(FORT WORTH, Texas) — As her boyfriend Thomas Eric Duncan lay dying of Ebola in a Dallas hospital bed, Louise Troh battled loneliness and fear that she too had contracted the disease while confined to a stranger’s home under armed guard.

Troh’s confinement was ending Sunday night, along with several friends, family and others who had contact with Duncan after he first became infectious. Ebola has a 21-day incubation period, and the people who interacted with Duncan after he first arrived in Dallas from Liberia will be in the clear.

It’s an important milestone in the nation’s efforts to contain the outbreak and a cause for celebration for Troh. After three long weeks, she will be able to have a clean bill of health, leave the house and be done with twice-daily temperature readings by government health care workers. She likened the period to being a prisoner.

“I want to breathe, I want to really grieve, I want privacy with my family,” Troh told The Associated Press on Friday, lamenting that she was missing Duncan’s memorial service at his mother’s church in North Carolina because of the quarantine. Troh says she and Duncan planned to get married later in the week.

Duncan arrived in Dallas from Liberia in late September and went to the hospital complaining of headache and stomach pain. He was sent home with a prescription for antibiotics to treat a misdiagnosed sinus infection. He returned two days later, was diagnosed with Ebola and died Oct. 8.

The day Duncan tested positive for Ebola, Troh, her 13-year-old son, Duncan’s nephew and a family friend were ordered by a Dallas court to stay inside the apartment among Duncan’s used linens and any lingering virus. The unusual confinement order was imposed after the family failed to comply with a request not to leave the apartment, Dallas County Judge Clay Jenkins said. The four were later taken to an undisclosed gated community.

Jenkins and Troh’s pastor George Mason delivered the news of Duncan’s death to her during the confinement period.

The other people who will have their quarantine period end at midnight include Youngor Jallah, Troh’s daughter, a nurse’s assistant who checked Duncan’s vital signs before calling for an ambulance.

For nearly three weeks, Jallah has not left the cramped, second-story apartment she shares with her partner, Aaron Yah, their three children, ages 2, 4 and 6, and Yah’s 10-year-old son.

Unlike Troh, Jallah is not prevented from leaving by an armed guard, but Centers for Disease Control and Prevention officials have come by daily to check everyone’s temperature.

“I’m telling you, just to step outside will be so great. To hug my mom and grieve for Eric, not over the phone like we’ve been doing but in the flesh,” Jallah said.

Mason said he is coordinating efforts with the city, county and philanthropic community to help Troh and the family recover. Because of the Ebola infection risk, crews stripped Troh’s apartment down to the carpeting, saving only a few personal documents, photographs and a Bible.

“They were left with nothing. They are completely devastated by this, so there’s need to have their lives rebuilt,” Mason said.

Troh plans to partially recover financially with a book written about her life, from growing up in Liberia, meeting Duncan in a refugee camp in Ivory Coast, Duncan’s years-long quest to come to America to be reunited with his girlfriend and their 19-year-old son, and his death in an isolation ward.

“It will be a love story,” she said.

At Wilshire Baptist Church in Dallas on Sunday, associate pastor Mark Wingfield said the congregation was eager to welcome Troh back.

“We look forward to welcoming Louise and her family members back to church after the quarantine is lifted and we want you to know that when that happens we will be glad to receive each one of them,” he said.

TIME ebola

Texas Hospital Apologizes for ‘Mistakes’ Made in Ebola Care

"...many of the theories and allegations being presented in the media do not align with facts stated in the medial record and accounts of caregivers who were present on the scene"

The hospital where two nurses contracted Ebola after helping care for Ebola victim Thomas Eric Duncan has apologized for “mistakes” in a full-page ad running in two newspapers on Sunday.

A letter from Barclay Berdan, CEO of Texas Health Resources, which owns Texas Health Presbyterian Hospital, ran in both the Dallas Morning News and the Fort Worth Star-Telegram, NBC News reports. The ad admitted that “training and education programs had not been fully deployed before the virus struck” and that the hospital “made mistakes handling this very challenge.”

“The fact the Mr. Duncan had traveled to Africa was not communicated effectively,” the ad’s letter read. “For that we are deeply sorry.” Duncan died Oct. 8.

The letter also said that the hospital was still trying to figure out why nurses Nina Pham and Amber Vinson contracted Ebola but noted that “Texas Health Presbyterian Hospital Dallas is a safe place for employees and patients.”

“Based on what we already know, I can tell you that many of the theories and allegations being presented in the media do not align with facts stated in the medial record and accounts of caregivers who were present on the scene,” the statement says. “We have remained committed to complying with CDC guidelines from the start.”

TIME ebola

Military Prepares 30-Person Ebola Team For U.S.

Ebola-California-Preparedness
Doctors and staff participate in a preparadness exercise on diagnosing and treating patients with Ebola virus symptoms, at the Ronald Reagan UCLA Medical Center in Los Angeles. Reed Hutchinson—AP

"They will not be sent to West Africa or elsewhere overseas and will be called upon domestically only if deemed prudent by our public health professionals"

The U.S. military is forming a 30-person medical team to prepare to respond to additional cases of Ebola in the United States, the Pentagon announced Sunday.

The “expeditionary medical support team” will consist of 20 critical care nurses, five doctors trained in infectious disease, and five trainers in infectious disease protocols, Pentagon Press Secretary Rear Admiral John Kirby said in a statement.

“In response to a request from the Department of Health and Human Services—and as an added prudent measure to ensure our nation is ready to respond quickly, effectively, and safely in the event of additional Ebola cases in the United States—Secretary Hagel today ordered his Northern Command Commander, Gen. Chuck Jacoby, to prepare and train a 30-person expeditionary medical support team that could, if required, provide short-notice assistance to civilian medical professionals in the United States,” Kirby said.

The team will begin specialized training in infection control and the use of personal protective equipment within the next week, at Fort Sam Houston.

“Upon conclusion of training, team members will remain in a ‘prepare to deploy’ status for 30 days, available to be sent to other [contiguous United States] locations as required,” Kirby said. “They will not be sent to West Africa or elsewhere overseas and will be called upon domestically only if deemed prudent by our public health professionals.”

Up to 4,000 American troops are being deployed to assist in responding to the Ebola epidemic in West Africa, but they are not involved in direct patient care.

The Pentagon team formation follows last week’s Ebola diagnosis of a second health care professional in Dallas, the third confirmed case of the virus in the United States, causing public concern about the spread of the disease to reach new heights.

The virus is only spread through direct contact with the bodily fluids of those who are symptomatic with the disease.

U.S. officials say they are confident they can stop the spread of the disease in the U.S. In an appearance on Fox News Sunday, Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health reiterated that the risk of an outbreak in the U.S. is minimal.

“There aren’t absolutes. Nothing is completely risk-free,” he said. “But the relative risk of things, people need to understand, is very, very small.”

TIME Addiction

Gamblers Get Less Of a Buzz From Pleasure, Study Finds

gambling poker
Getty Images

New research presented at the European College of Neuropsychopharmacology Congress in Berlin sheds light on what happens in the brains of gamblers.

Pathological gambling is a difficult condition to classify. Though the Diagnostic and Statistical Manual of Mental Disorders (DSM) formerly classified it as an impulse control disorder, the most recent version, the DSM-5, made the switch to defining it as an addictive disorder because of the growing research finding that “gambling disorder is similar to substance-related disorders in clinical expression, brain origin, comorbidity, physiology, and treatment,” the DSM website says.

But this new small study shows that it might be unique in some neurologic ways, too. Researchers performed Positron Emission Tomography (PET) scans on 14 male pathological gamblers and 15 non-gambling volunteers to measure their levels of opioid receptors, the parts of the brain activated by pleasure-inducing endorphins. People with addictions like alcoholism or drug addiction have been found to have more opioid receptors. In problem gamblers, however, the researchers saw no difference from healthy volunteers, a finding that surprised them.

Then, participants took an amphetamine capsule, which unleashes endorphins with similar effects to the rush you get from exercise or alcohol, the study says. An additional PET scan revealed that pathological gamblers responded differently to the drug. They released fewer endorphins than those who didn’t gamble, and they also reported lower levels of euphoria on a questionnaire afterward. This might help explain the addictive part of pathological gambling: to get pleasure from the act, problem gamblers might need more of it or to work harder for it.

These findings suggest the involvement of the opioid system in pathological gambling and that it may differ from addiction to substances such as alcohol,” says lead researcher Dr. Inge Mick of the Imperial College London in a press release. “We hope that in the long run this can help us to develop new approaches to treat pathological gambling.”

TIME Diet/Nutrition

12 Superfoods That Warm You Up

Pot of chili
Getty Images

When the weather gets cold, turn to these hot and spicy comfort foods to stay snug as a fall sweater

As the temperature drops, don’t be tempted to warm your belly with rich macaroni and cheese and creamy soup. Instead, get that toasty feeling from superfoods: healthy eats that are loaded with nutrients, antioxidants, and immune-boosting powers that your body needs to power itself through cold weather. Read on to find the best hot foods to eat on chilly days and a few healthy tidbits to prepare them for ultimate nutrition.

Oatmeal

When it gets cooler, it’s the perfect time to break out the oatmeal. Oats are a whole grain, so you’ll get a dose of fiber and plant-based protein to stop hunger with just one bowl. Plus, oatmeal contains a powerful starch called beta-glucan. Research in Nutrition Reviews found that just 3 grams a day of the beta-glucan in oats may reduce your bad cholesterol levels by 5 to 10%, whether they start out normal or high. You can get extra nutrition if you choose the right toppings too. “To get some healthy fat mixed in, I add almond butter and chia seeds,” says Keri Gans, RD, a dietitian in New York City and author of The Small Change Diet.

Try this recipe: Chai Oatmeal

Hot chocolate

Curling up with a cup of hot cocoa is one way to feel snug—just nix the sugary powdered mix with marshmallow bits. “When I make it, I like to melt two squares of dark chocolate and stir it into regular or almond milk,” says Cynthia Sass, MPH, RD, Health‘s contributing nutrition editor. Adding a little dark chocolate to your diet is a great health booster too. The sweet contains flavonoids, a type of antioxidant thought to reduce the damage caused by free radicals, potential instigators of cancer and cardiovascular disease. A study in the Journal of Immunology Researchfound that red blood cells were less susceptible to free radicals after people consumed a drink with flavonoid-rich cocoa.

Try this recipe: Parisian Hot Chocolate

Black bean soup

There’s nothing like a soup with cumin and chili pepper to heat you up when things get cold. The nutrition star of this dish, though, is the beans. Black beans are a good source of iron and copper. So sipping on this soup will help your muscles use more oxygen and boost your immune system, Gans says. A typical serving of soup would include nearly a cup of black beans, which provides 15 grams each of protein and fiber. Unlike animal protein sources, black beans contain almost no saturated fat. Research from the American Chemical Society also shows their black skins contain higher levels of the disease-fighting antioxidants flavonoids than any other type of bean.

Try this recipe: Black Bean Soup

Brussels sprouts

Eating these mini cabbages may just help you fight a cold this fall. In addition to being packed with fiber and cancer-fighting phytonutrients, Brussels sprouts run high in vitamin C at 74.8 milligrams a cup. It won’t prevent the sniffles completely, but vitamin C has been shown to reduce the length of cold symptoms. Though the bitter taste of Brussels sprouts tends to scare some people away, heating them up can make a huge difference in flavor. “I would roast them with olive oil,” Gans says. That will help bring out the sweetness. (You can make these 12 other veggies taste better too.)

Try this recipe: Sautéed Brussels Sprouts with Parmesan and Pine Nuts

Pumpkin soup

If you’re lacking vitamin A, the nutrient critical for promoting vision, a dose of pumpkin will do you good, Gans says. Most adult women should be getting 700 micrograms a day, according to the National Institutes of Health. In a serving of soup, you would use a third to a half cup of pumpkin puree, Gans says. So you could be getting more than a day’s worth of this vitamin in most recipes. Be mindful of a recipe with cream, though, if you’re looking to cut back on calories. Pumpkin also has antioxidant properties thanks to beta-carotene, Gans says. It’s a pigment usually found in bright-colored produce, and it’s thought to have cancer-fighting powers. A study in Anticancer Research treated human breast cells using carotenoids, including beta-carotene and lycopene, and found they can prevent their growth.

Try this recipe: Curried Pumpkin Soup

Chili

The peppers in your stew contain a compound called capsaicin, which gives them their spicy kick. It’s also thought to boost metabolism and fight the buildup of fat. When paired with a high-fat diet, capsaicin was found to decrease body weight by 8%, according to an animal study conducted by Korean researchers. No matter the variety, the beans in chili also pack protein to help you build muscle. That’s not all. Tomato paste is rich in lycopene, and the onions provide unique antioxidants, Sass says. Think about cutting back on the meat in your chili from time to time though. A National Institutes of Health study found that men and women who consumed the most red meat were at increased risk for death from cancer and cardiovascular disease.

Try this recipe: All-American Chili

Avocado

There’s a way to enjoy this creamy fruit when it’s chilly. “Oven roasting avocado makes it even creamier,” Sass says. “Chop it up warm and put on top of another vegetable.” Bonus: about half of the fat of avocado comes from monounsaturated fat, which helps lower your bad cholesterol levels and provide nutrients for cells to function, according to the American Heart Association. They might also help you stay full. A study in Nutrition Journal found that eating a meal with avocado increased satisfaction by 23% over a five-hour period. Just watch your portion size: a serving is just one-fifth of an avocado.

Try this recipe: Chilled Avocado Soup

Walnuts

Walnuts are good any time of year, but they make a lovely roasted snack in the fall. “Walnuts toast awesome on a cookie sheet at 350 degrees for 5 minutes,” Sass says. Lightly misting with oil and adding seasonings like pepper can up the flavor in a healthy way. Even better, walnuts are rich in alpha-linolenic acid (ALA), one omega-3 fat thought to boost heart health. In the Journal of the American College of Nutrition, a study found that people who ate a diet of walnuts, walnut oil, and flax oil had reduced resting blood pressure and blood flow resistance in their arteries than those who ate a diet lower in ALA.

Try this recipe: Walnut Coffee Cake

Apples

Baked apples make the perfect sweet treat for fall. The fruit packs soluble and insoluble fiber. One slows digestion and the other helps food pass through your system more smoothly. That means less hunger and tummy troubles. Just make sure you leave the skins on—they’re a more concentrated source of fiber than the flesh, says Melissa Rifkin, RD, a bariatric dietitian at Montefiore Medical Center in New York City. An unpeeled medium-sized apple contains 4.4 grams offiber. “If you sprinkle some cinnamon on top you get more antioxidants,” Rifkin says. Plus, apples are made up of nearly 86% water, so munching on the fruit will help you stay hydrated as you bundle up.

Try this recipe: Baked Apple Fritters

Sweet potatoes

Like pumpkin, sweet potatoes are particularly high in vitamin A. One baked, medium-sized spud contains 438% of your daily value. Plus, you’ll get nearly 4 grams of fiber—mostly found in the skin—to fill your tummy. Sweet potatoes are also rich in vitamin C, calcium, potassium, and a bit of iron. “If you bake the sweet potato by itself, it’s generally a low-calorie food,” Rifkin says. Just try to avoid slathering fatty butter or margarine on top. A better bet: rosemary. It has B vitamins and cancer-fighting phytochemicals, Rifkin says. The compounds are thought to block carcinogens from acting on your body’s tissues, according to the American Cancer Society. Bonus: a little rosemary will give your sweet potatoes amazing flavor.

Try this recipe: Twice-Baked Sweet Potatoes With Bacon and Sour Cream

Squash

In addition to having some calcium and vitamin C, most varieties of squash are high in potassium. A study in the Journal of the American College of Cardiology found a diet high in potassium (while also curbing sodium) could reduce risk of stroke by 21% and lower odds of developing heart disease. Squash is also rich in vitamin A and contains hunger-busting fiber. Take one of Rifkin’s favorites, butternut squash. A cup of baked cubes has 457% of your daily vitamin A, 7 grams of fiber, and just 82 calories. Even better, you can warm up all its parts. Bake the insides and season with garlic salt, pepper, even cumin or turmeric, Rifkin suggests. “You could also take out the seeds and bake them like pumpkin seeds,” Rifkin says.

Try this recipe: Gingery Butternut Squash and Tofu Curry

Ginger tea

If you’re thinking of reaching for a cup of tea, opt for a brew with ginger. “Ginger has thermogenic properties that can keep you warm,” Rifkin says. Because of its heating powers, ginger may also boost metabolism and promote blood flow. A study in Metabolism had one group of men consume 2 grams of ginger powder in a hot drink with their breakfast. Researchers found the men who drank the ginger beverage reported less hunger and greater fullness a few hours later than those who didn’t consume the ginger. Adding the spice to your tea could also help relieve body aches, like the ones you get after an intense workout. In a study for theInternational Journal of Preventative Medicine, one group of female athletes took three grams of ginger daily and reported less muscle soreness after six weeks than those who didn’t receive ginger.

Try this recipe: Honey-Ginger Tea

MORE FROM HEALTH.COM:

17 High-Protein Snacks You Can Eat On the Go

25 Surprising Ways to Lose Weight

31 Superfood Secrets to Extend Your Life

TIME ebola

Here’s How Suspected Ebola Patients Can Be Restricted

Ebola precautions in the Netherlands
A man tries on special Ebola gear in Berkel en Rodenrijs, The Netherlands, on Oct. 17, 2014. Remko De Waal—EPA

And other Ebola quarantine questions answered

About 100 Dallas healthcare workers who treated Thomas Eric Duncan, who died of Ebola Oct. 8, have been asked by the Texas state health agency not to go to public places or travel by plane or bus. The voluntary requirements are designed to halt the disease’s spread, which continue to concern Americans this weekend as a cruise ship quarantined a health worker and an airline attempts to contact passengers who flew with an infected Dallas nurse.

But as health officials try to contain the spread of the disease, the restrictions by federal and state agencies as well as private businesses like cruise lines are increasingly bumping up against civil liberties, raising a number of questions about who can officially order a quarantine and whether someone can be kicked off a plane for having Ebola-like symptoms.

Who can order a quarantine?

State, local and federal authorities can all issue quarantines, which separate and restrict the movement of people who were exposed to a communicable disease. But it’s often state authorities that order them. Those health agencies often have significant powers to issue a quarantine if they suspect someone has come into contact with a disease like Ebola, says Wendy Parmet, a Northeastern University law professor. Texas, for instance, has strong policing powers in the case of a public health emergency to quarantine those the state believes to have come in contact with the disease. For example, the state can destroy property it believes may have come into contact with a contagious disease.

The Centers for Disease Control and Prevention (CDC) also issues quarantines, with its powers deriving from the Public Health Service Act and the Commerce Clause of the U.S. Constitution. But the CDC is generally focused on issues at the border: flights and passenger ships coming into the U.S., for example. But it has jurisdiction over interstate flights as well.

Who can order someone to be isolated?

Local, state and federal agencies can issue an isolation order, which separates people with a contagious disease from those who are not infected.

What do those agencies have to prove to order a quarantine or an isolation?

Health agencies have an epidemiological checklist that helps them determine if someone showing symptoms of a disease is actually carrying it, says Indiana University law professor David Fidler. Those health agencies are generally required to be as unrestrictive as possible when issuing those orders. For example, the CDC can’t order a quarantine for longer than the general incubation period for Ebola, which is normally 21 days. If it does, an individual could theoretically take the health agency to court over the matter.

What happens if someone suspected of Ebola resists a state or federal order?

Because of the substantial powers given to the CDC and state and local health agencies, someone resisting a quarantine or isolation could be made to comply involuntarily. In Texas, it’s a criminal offense to resist a quarantine order.

“Most health agencies would certainly have the authority to send police in moon [hazmat] suits to physically put them somewhere in isolation or back in their house,” says Robert Field, a Drexel University professor of law and health policy.

What if you resist voluntary compliance, like the kind being asked of Dallas’s healthcare workers?

If healthcare workers resist signing the voluntary quarantine or defy its recommendations after agreeing to it, Emory University law professor Polly Price says that it’s likely an official quarantine would be ordered. “They could go and get a court order to formalize it, possibly even after the fact,” Price says. “But they would likely seek a formal quarantine.”

Can the CDC force a state health agency to quarantine someone?

The CDC does not have enforcement over state agencies, but Drexel’s Field says federal authority in those instances is rarely used. “It would be an unusual situation in which the federal government wanted to quarantine someone and a state did not,” he says.

Can you be kicked off a plane for being suspected of having Ebola?

Planes kick people off for all sorts of reasons, including joking about Ebola. So it doesn’t seem terribly far off that airlines could also kick someone off for having Ebola, considering they’re a private business and it wouldn’t be considered a discriminatory practice.

“The Americans With Disabilities Act says you can’t discriminate because of a disability,” says Drexel University’s Field. “But there are exceptions for someone who presents direct threats involving something like an infectious disease. An airline could use that exception to deny someone access to a plane.”

But it’s more likely that the CDC would get involved. Indiana University’s Fidler says that airlines are required to notify the CDC if there’s a sick passenger aboard who may have a contagious disease.

How about a cruise ship?

Cruise ships also appear to be able to temporarily quarantine or isolate a sick passenger or even remove them from a ship, but they would be required to immediately notify the CDC of such an event. Indiana University’s Fidler says it’s likely that a cruise ship would call the CDC for guidance on what to do.

But Peter Jacobson, a University of Michigan professor of health law and policy, says it’s likely that cruise ship passengers sign a contract that gives the captain wide discretion to take action to avoid harm to others on board.

Your browser, Internet Explorer 8 or below, is out of date. It has known security flaws and may not display all features of this and other websites.

Learn how to update your browser