Man in U.S. With Ebola Had Been Screened to Fly, but System Is Spotty

[cali]

As he was preparing to leave Liberia for Dallas two weeks ago, Thomas E. Duncan, the man confirmed to be the first Ebola case in the United States, was checked at the airport for signs of the disease. He was determined to have no fever and allowed to board his flight, American officials say.

Since the deadly Ebola virus began spreading rapidly through West Africa, the Centers for Disease Control and Prevention has been pushing the authorities in the worst-hit countries, including Liberia, Sierra Leone and Guinea, to implement just that type of screening for departing passengers.

In early August, the C.D.C. sent medical workers to the region to train local government officials and airport workers in Ebola screening, according to Dr. Nicole Cohen, an infectious disease specialist with the agency’s Division of Migration and Quarantine. As part of that process, the agency advises that airport workers ask travelers if they have been exposed to Ebola in the last 21 days, have had a fever, and have had any symptoms including severe headache, muscle ache, abdominal pain, unusual bruising or bleeding, vomiting and diarrhea. The screener is expected to use a hand-held non-contact temperature monitor, a few inches from the travelers’ forehead, to check for fever.

But the system has its limits, relying on the traveler to reveal whether he or she has been exposed. And it leaves it to local officials to conduct the screening as they see fit, Dr. Cohen said. It is unclear how consistently or effectively those screenings are conducted across West Africa, and Dr. Cohen said she did not know how many potential travelers had been caught by screeners — if any.

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http://www.nytimes.com/2014/10/02/us/man-in-us-with-ebola-had-been-screened-to-fly-but-system-is-spotty.html?_r=0

[FLPanhandle]

1. "the system has its limits, relying on the traveler to reveal whether he or she has been exposed"

No traveler will do that. Someone made travel plans, purchased a ticket, has gone to the airport and is ready to go, then is going to say something they know will cancel their trip?

Being honest here, I wouldn't.

[MineralMan]

2. The reality is that there are no measures to prevent someone

exposed to Ebola and not exhibiting symptoms from traveling. All such measures rely on the person to say whether they have been exposed and a simple symptom check. As long as a disease is endemic or epidemic in the area, there is a risk of someone leaving and taking that disease with them.

The only real measure that might work would be a ban on travel from such places. And that ban would have to be international in scope, since people may not travel directly to the US. It's doubtful that any such quarantine measure will be implemented internationally, so we must remain watchful for people who develop symptoms after arriving in the US.

Still, there is no reason for panic. There is only reason for caution at this point. Some people will develop symptomatic Ebola after arriving here. Now that one has, detection and isolation measures will become more and more effective and used by all health care providers. That one case will trigger serious concern and more care will be taken. There will not be any developing pockets of infection here, because care will be taken. Anyone who actually contracts Ebola will be noticed, since the symptoms are so severe, and an epidemic of the disease in the US will be prevented.

Should people be concerned? Sure, if they work in health care or travel frequently where infected, symptomatic passengers might be present. Otherwise, no, people really don't need to be concerned very much. They should, however, get their influenza vaccinations, since that illness is sure to kill thousands of people in the US in 2014. It does every year.

We worry about things that are extremely unlikely and ignore things that are very likely.