Ken Chotiner, Lead Homeland Security Analyst, IHS Jane's DS Forecast; additional reporting by Meabh McMahon - IHS Jane's Airport Review
A US Customs and Border Protection Officer conducts enhanced screening at JFK International Airport. Health screenings to help prevent the spread of Ebola began on 11 October for some arrivals at the New York hub. Source: PA/CBP
Key Points
Brussels wishes to reinforce exit screening at West African airports - it will not demand that all EU airports screen arrivals from Ebola-affected African countries
Screening procedures in the US focus on interviewing arriving passengers from affected countries
Mandatory Ebola screening for passengers arriving from West Africa is not necessary at all EU airports, a Council of Ministers meeting decided on 16 October 2014. Instead, an agreement was reached to reinforce screenings at exit points in affected West African countries.
With the help of the World Health Organisation (WHO), the European Commission (EC) will immediately undertake an audit of exit screening systems in the most affected countries - Guinea, Liberia, and Sierra Leone - "to check their effectiveness and reinforce them as necessary".
Speaking after the meeting, the departing EU health commissioner Tonio Borg said, "There are conflicting reports on whether [temperature] screenings are being effective." He added that the EC would "prepare common protocols and procedures on a passenger questionnaire, common contact tracing forms, and contact tracing procedure", for all ports of entry in EU member countries. However, information given to travellers must be enhanced so "they know what to do and where to go if symptoms arrive".
The problems faced by aviation were underscored on 16 October, when an Air France aircraft was isolated at Madrid-Barajas airport in Spain because a passenger (who had travelled to Paris from Lagos in Nigeria) was reported to have a fever. The passenger was taken by ambulance to a hospital in Madrid, but the rest of the passengers were allowed to disembark as normal, Air France said in a statement.
Some European hub airports have implemented temperature screening and health questionnaires for passengers arriving from Ebola-affected countries. Heathrow in the United Kingdom is one, and France from 18 October applied this method for passengers arriving at Paris Charles de Gaulle from the Guinean capital Conakry. Even non-gateway airports are beginning to screen arrivals from West Africa, with Gatwick the latest to do so on 21 October.
However, the reliability of temperature screening is open to question, since a fever is not in itself a sign of Ebola (and it may take days after travelling for an infected person to show a fever). The ideal technology is a rapid and reliable point-of-care polymerase chain reaction test kit for Ebola which can be deployed at an airport checkpoint - but such a solution has not yet been developed.
US measures
In the United States, meanwhile, Ebola prevention measures are in the spotlight after two healthcare workers contracted the disease. US health officials assured the Congress that they had the wherewithal and sufficient resources to hinder the spread of Ebola - a stance corroborated by President Barack Obama, who stated, "The US is already taking the necessary steps to protect the public by screening passengers as they depart West Africa and again when they enter the US."
Some public figures have been quick to push drastic policies. Texas Governor Rick Perry on 17 October asked president Obama to place individuals who have been in close contact with Ebola patients on the federal no-fly list - in effect, equating them with terrorist suspects. "Air travel is in fact how this disease crosses borders, and it's certainly how it got to Texas in the first place," Perry said.
Screening procedures in the US rely less overtly on fever-screening technology and instead depend more on interviewing passengers who flew directly from or transited through Guinea, Liberia, and Sierra Leone. Any passengers who recently spent time in this epicentre are required to provide a thorough medical history, including experience of any Ebola-like symptoms.
Moreover, potential signs of the disease are observed by trained medical professionals during the interview and passengers' temperatures are recorded with contactless thermometers to identify passengers with a fever. Any such passengers would be transported to local hospitals and placed in isolation.
A number of US cities served by large international airports are implementing this process, including Atlanta, Chicago, New York, Philadelphia, and Washington DC. Other gateway cities in the United States plan on implementing this process in the near future.
In formulating their strategy, US health officials looked at the way the Ebola outbreak has been handled in West Africa. Tighter border controls, good patient tracking, proper medical practices, and luck have largely confined the virus to Guinea, Liberia, and Sierra Leone.
Two success stories of this heightened security protocol include containing and preventing the spread of the outbreak in Senegal and Nigeria.
Senegal is credited with effectiveness in quickly isolating individuals with Ebola-like symptoms and proactively sharing information with the WHO. These tactics have been so successful that the WHO is ready to close its Ebola alert in Senegal if no new cases surface over the next few weeks.
Nigeria suffered 20 documented cases and eight deaths from Ebola in July due to exposure from a single infected Liberian visitor. Health officials used a pre-existing emergency command centre to isolate victims and tracked all Ebola contacts to isolate at-risk individuals from the general population. On 20 October, Nigeria was officially declared to be free of Ebola.
A number of African countries took draconian steps, such as temporary border closures (including flight bans) and mandatory isolation. Airlines, including major African carriers such as Kenyan Airways, halted all flights into the affected countries. In Zimbabwe, all travellers arriving from the affected West African countries must undergo surveillance for 21 days.
In summary, rigorous tracking, early detection, and isolation of patients with Ebola-like symptoms appears to be working. However, protocols will be constantly fine-tuned and adjusted as Ebola and other infectious diseases run their course and new hazards occur, such as healthcare workers becoming infected.
Related articles:
Enhanced medical checks underpin West African anti-Ebola effort
Ebola outbreak highlights limitations of technology
A US Customs and Border Protection Officer conducts enhanced screening at JFK International Airport. Health screenings to help prevent the spread of Ebola began on 11 October for some arrivals at the New York hub. Source: PA/CBP
Key Points
Brussels wishes to reinforce exit screening at West African airports - it will not demand that all EU airports screen arrivals from Ebola-affected African countries
Screening procedures in the US focus on interviewing arriving passengers from affected countries
Mandatory Ebola screening for passengers arriving from West Africa is not necessary at all EU airports, a Council of Ministers meeting decided on 16 October 2014. Instead, an agreement was reached to reinforce screenings at exit points in affected West African countries.
With the help of the World Health Organisation (WHO), the European Commission (EC) will immediately undertake an audit of exit screening systems in the most affected countries - Guinea, Liberia, and Sierra Leone - "to check their effectiveness and reinforce them as necessary".
Speaking after the meeting, the departing EU health commissioner Tonio Borg said, "There are conflicting reports on whether [temperature] screenings are being effective." He added that the EC would "prepare common protocols and procedures on a passenger questionnaire, common contact tracing forms, and contact tracing procedure", for all ports of entry in EU member countries. However, information given to travellers must be enhanced so "they know what to do and where to go if symptoms arrive".
The problems faced by aviation were underscored on 16 October, when an Air France aircraft was isolated at Madrid-Barajas airport in Spain because a passenger (who had travelled to Paris from Lagos in Nigeria) was reported to have a fever. The passenger was taken by ambulance to a hospital in Madrid, but the rest of the passengers were allowed to disembark as normal, Air France said in a statement.
Some European hub airports have implemented temperature screening and health questionnaires for passengers arriving from Ebola-affected countries. Heathrow in the United Kingdom is one, and France from 18 October applied this method for passengers arriving at Paris Charles de Gaulle from the Guinean capital Conakry. Even non-gateway airports are beginning to screen arrivals from West Africa, with Gatwick the latest to do so on 21 October.
However, the reliability of temperature screening is open to question, since a fever is not in itself a sign of Ebola (and it may take days after travelling for an infected person to show a fever). The ideal technology is a rapid and reliable point-of-care polymerase chain reaction test kit for Ebola which can be deployed at an airport checkpoint - but such a solution has not yet been developed.
US measures
In the United States, meanwhile, Ebola prevention measures are in the spotlight after two healthcare workers contracted the disease. US health officials assured the Congress that they had the wherewithal and sufficient resources to hinder the spread of Ebola - a stance corroborated by President Barack Obama, who stated, "The US is already taking the necessary steps to protect the public by screening passengers as they depart West Africa and again when they enter the US."
Some public figures have been quick to push drastic policies. Texas Governor Rick Perry on 17 October asked president Obama to place individuals who have been in close contact with Ebola patients on the federal no-fly list - in effect, equating them with terrorist suspects. "Air travel is in fact how this disease crosses borders, and it's certainly how it got to Texas in the first place," Perry said.
Screening procedures in the US rely less overtly on fever-screening technology and instead depend more on interviewing passengers who flew directly from or transited through Guinea, Liberia, and Sierra Leone. Any passengers who recently spent time in this epicentre are required to provide a thorough medical history, including experience of any Ebola-like symptoms.
Moreover, potential signs of the disease are observed by trained medical professionals during the interview and passengers' temperatures are recorded with contactless thermometers to identify passengers with a fever. Any such passengers would be transported to local hospitals and placed in isolation.
A number of US cities served by large international airports are implementing this process, including Atlanta, Chicago, New York, Philadelphia, and Washington DC. Other gateway cities in the United States plan on implementing this process in the near future.
In formulating their strategy, US health officials looked at the way the Ebola outbreak has been handled in West Africa. Tighter border controls, good patient tracking, proper medical practices, and luck have largely confined the virus to Guinea, Liberia, and Sierra Leone.
Two success stories of this heightened security protocol include containing and preventing the spread of the outbreak in Senegal and Nigeria.
Senegal is credited with effectiveness in quickly isolating individuals with Ebola-like symptoms and proactively sharing information with the WHO. These tactics have been so successful that the WHO is ready to close its Ebola alert in Senegal if no new cases surface over the next few weeks.
Nigeria suffered 20 documented cases and eight deaths from Ebola in July due to exposure from a single infected Liberian visitor. Health officials used a pre-existing emergency command centre to isolate victims and tracked all Ebola contacts to isolate at-risk individuals from the general population. On 20 October, Nigeria was officially declared to be free of Ebola.
A number of African countries took draconian steps, such as temporary border closures (including flight bans) and mandatory isolation. Airlines, including major African carriers such as Kenyan Airways, halted all flights into the affected countries. In Zimbabwe, all travellers arriving from the affected West African countries must undergo surveillance for 21 days.
In summary, rigorous tracking, early detection, and isolation of patients with Ebola-like symptoms appears to be working. However, protocols will be constantly fine-tuned and adjusted as Ebola and other infectious diseases run their course and new hazards occur, such as healthcare workers becoming infected.
Related articles:
Enhanced medical checks underpin West African anti-Ebola effort
Ebola outbreak highlights limitations of technology
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