CAPE ELIZABETH, Maine - A nurse who treated Ebola patients in Sierra Leone but has tested negative for the virus went for a bike ride on Thursday, defying Maine's order that she be quarantined in her home and setting up a legal collision with Governor Paul LePage.
Attorneys for Kaci Hickox, 33, said they had not yet been served with a court order to enforce the 21-day quarantine - matching the virus's maximum incubation period - but remained prepared to fight such an order if necessary.
LePage's office said negotiations with Hickox, who worked with Doctors Without Borders in Sierra Leone, "have failed despite repeated efforts by state officials" and that he would "exercise the full extent of his authority allowable by law."
The quarantine showdown between Hickox and Maine has become the focal point of a struggle between several US states opting for stringent measures to guard against Ebola and a federal government wary of discouraging potential medical volunteers.
Mandatory quarantines ordered by some US states on doctors and nurses returning from West Africa's Ebola outbreak are creating a "chilling effect" on Doctors Without Borders operations there, the humanitarian group said on Thursday.
Hickox left her home in the small Maine town of Fort Kent, along the Canadian border, and television news images showed her taking a morning bicycle ride with her boyfriend, Ted Wilbur.
Hickox has given the New England state a deadline of Thursday to lift an order that she remain at home until Nov. 10, or she will go to court.
"It's a beautiful day for a bike ride," said Hickox, wearing a helmet and other bike gear as she headed out for her 3-mile (5-km) ride while police stationed outside her house stood by without trying to stop her, according to local media.
LePage's office said he was open to an arrangement in which she could go for walks, runs or bike rides but not go into public places or come within 3 feet (1 meter) of other people.
"I was ready and willing - and remain ready and willing - to reasonably address the needs of healthcare workers meeting guidelines to assure the public health is protected," said LePage, a Republican locked in a tough three-way re-election battle.
President Barack Obama, who has criticised mandatory quarantine policies imposed by some states for returning medical workers like Hickox, flew to Maine on Thursday to campaign in the town of Cape Elizabeth for Democratic candidates, including Mike Michaud, who is trying to unseat LePage in Tuesday's midterm elections.
Asked for comment on Hickox's situation, White House spokesman Josh Earnest told reporters aboard Air Force One en route to Maine that US Centers for Disease Control and Prevention officials have been in regular touch with the health authorities in the state.
"Ultimately, it is their decision," said Earnest, adding that Obama had no plans to see Hickox while in Maine. Cape Elizabeth is at the opposite end of the state, on its southeastern coast.
Obama did not address the Ebola issue in public remarks at a voter rally.
One of Hickox's attorneys, Norman Siegel, defended his client's decision to go for a bike ride but noted that she avoided the centre of town so as not to "freak people out."
"Since there's no court order, she can be out in public," Siegel said. "Even if people disagree with her position, I would hope they respect the fact that she's taking into account the fear, which is based on misinformation about the way the disease is transmitted."
Medical professionals say Ebola is difficult to catch and is spread through direct contact with bodily fluids from an infected person and is not transmitted by asymptomatic people.