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Following the death yesterday of Thomas Eric Duncan, a Liberian man afflicted with the U.S.’s first recorded case of Ebola and sequestered in an isolation ward at a Dallas hospital, the U.S. federal government is launching its first large-scale attempt at screening for Ebola at American airports. The Centers for Disease Control and Prevention (CDC) has announced that it and the Department of Homeland Security’s Customs & Border Protection (CBP) will soon begin a new, more thorough process of entry screening for Ebola at five U.S. airports that receive over 94 percent of travelers from the Ebola-affected West African nations of Guinea, Liberia and Sierra Leone.
New York’s JFK (which alone accommodates 43 percent of these travelers) will begin the new screening this Saturday, October 11, while Washington-Dulles (IAD), Newark (EWR), Chicago-O’Hare (ORD), and Atlanta (ATL) will begin implementing the screening next week.
The new enhanced screening process has the potential to create delays at international entry/customs points. Following passport review, passengers arriving specifically from Guinea, Liberia and Sierra Leone will be escorted by CBP staff members to an isolated area set aside at each airport, where specially-trained medical staff will take each of these travelers’ temperature with a non-contact thermometer that uses an infrared beam, observe them for signs of illness, and ask them a series of health and exposure questions. Those without fever, symptoms, or a known history of exposure will simply receive health information about Ebola and instructions on how to monitor themselves for symptoms.
Similar entry screening has been employed during past health epidemics (e.g., the global outbreak of SARS in 2003), but this effort represents the first time that U.S. travelers’ temperatures will be taken. Prior to this latest announcement from the CDC, its director, Dr. Tom Frieden, has questioned the wisdom of relying on temperature screening; he has warned that this could result in the sequestering of people who simply have fevers rather than Ebola, both in airports and elsewhere.
The CDC and CBP’s present plan of action when screened travelers do display fever or other symptoms, or their health questionnaire reveals possible Ebola exposure, is to refer them to a local CDC public quarantine station, where a public health officer will determine if they can continue to travel, should be taken to a hospital for further evaluation, testing and treatment, or should instead be referred to a local health department for further monitoring and support.
A similar entry screening process has already proved successful at containing the recent Ebola outbreak in Nigeria, and since the beginning of August, airports in Guinea, Liberia and Sierra Leone have been receiving the CDC’s assistance with this same process for exit screening, including assessments of the airports’ capacity to conduct the screening, helping them to get needed medical supplies, and training security and medical staff. Of the 36,000 travelers who’ve so far been screened in these airports, 77 people were denied boarding a flight; none of these 77 passengers were diagnosed with Ebola, and most were diagnosed with malaria, a non-contagious, mosquito-transmitted disease common in West Africa.
Also since August, the CDC has been working with ministries of health in these three West African countries to help define their travel restrictions, developing tools such as posters, screening forms, and job-aids. The CDC has also helped these countries’ airports and health ministries to create protocols for both patient isolation and contact tracing, as the disease-control center feels it’s vital to find and screen any person who may have come into contact with a potential Ebola victim.
In the past few weeks, some American lawmakers have been been pushing for the restriction of all air travel from West Africa to the U.S., but the Obama Administration continues to maintain that this would potentially undermine the global effort to stem the Ebola outbreak by reducing the ability to identify those afflicted with the virus – and their contacts – and provide them with proper medical care. Meanwhile, the UK will decide as soon as today if its major airports will follow suit and adopt a similar entry screening process.
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