To slow Ebola spread, new fever screening at 5 US airports

updated 3:20 p.m. In a news conference from Atlanta, CDC director Tom Frieden portrayed the extra screening as a reasonable balance between reassuring the American public and allowing the international travel system to operate normally.

“What we’re doing is putting in additional protection…. As long as Ebola continues to spread in Africa, we can’t make the risk zero here,” he said.

A travel ban, he said, would violate the medical principle: above all do no harm.

But he conceded that the new screening process will yield false positives – people flagged with a fever who don’t actually have Ebola.

“About one of every 500 travelers boarding a flight in West Africa had a fever. Most had malaria,” he said. “That will cause some obvious and understandable concern at the airports.” He noted that malaria is spread by mosquitoes and isn’t contagious.

With only about 150 travelers arriving in the United States each day from the three countries in West Africa where Ebola is a problem, he said, “It’s not an effort that will be particularly disruptive” to the traveling public.

 

Updated at 2:46 p.m. by Sherry Jacobson: Federal authorities released details of Wednesday afternoon of new screening procedures announced at a White House press briefing earlier in the day.

New York’s JFK International Airport will begin the new screening on Saturday. In the 12 months ending July 2014, JFK received nearly half of travelers from the three West African nations. The enhanced entry screening at Washington-Dulles, Newark, Chicago-O’Hare, and Atlanta international airports will be implemented next week.

“We work to continuously increase the safety of Americans,” said CDC Director Tom Frieden, M.D., M.P.H. “We believe these new measures will further protect the health of Americans, understanding that nothing we can do will get us to absolute zero risk until we end the Ebola epidemic in West Africa.”

“CBP personnel will continue to observe all travelers entering the United States for general overt signs of illnesses at all U.S. ports of entry and these expanded screening measures will provide an additional layer of protection to help ensure the risk of Ebola in the United States is minimized,” said Secretary of Homeland Security Jeh Johnson. “CBP, working closely with CDC, will continue to assess the risk of the spread of Ebola into the United States, and take additional measures, as necessary, to protect the American people.”

CDC is sending additional staff to each of the five airports. After passport review:
· Travelers from Guinea, Liberia, and Sierra Leone will be escorted by CBP to an area of the airport set aside for screening.
· Trained CBP staff will observe them for signs of illness, ask them a series of health and exposure questions and provide health information for Ebola and reminders to monitor themselves for symptoms. Trained medical staff will take their temperature with a non-contact thermometer.
· If the travelers have fever, symptoms or the health questionnaire reveals possible Ebola exposure, they will be evaluated by a CDC quarantine station public health officer. The public health officer will again take a temperature reading and make a public health assessment. Travelers, who after this assessment, are determined to require further evaluation or monitoring will be referred to the appropriate public health authority.
· Travelers from these countries who have neither symptoms/fever nor a known history of exposure will receive health information for self-monitoring.

Entry screening is part of a layered process that includes exit screening and standard public health practices such as patient isolation and contact tracing in countries with Ebola outbreaks. Successful containment of the recent Ebola outbreak in Nigeria demonstrates the effectiveness of this approach.

These measures complement the exit screening protocols that have already been implemented in the affected West African countries, and CDC experts have worked closely with local authorities to implement these measures. Since the beginning of August, CDC has been working with airlines, airports, ministries of health, and other partners to provide technical assistance for the development of exit screening and travel restrictions in countries affected by Ebola. This includes:
· Assessing the capacity to conduct exit screening at international airports;
· Assisting countries with procuring supplies needed to conduct exit screening;
· Supporting with development of exit screening protocols;
· Developing tools such as posters, screening forms, and job-aids; and
· Training staff on exit screening protocols and appropriate personal protective equipment (PPE)

Today, all outbound passengers are screened for Ebola symptoms in the affected countries. Such primary exit screening involves travelers responding to a travel health questionnaire, being visually assessed for potential illness, and having their body temperature measured. In the last two months since exit screening began in the three countries, of 36,000 people screened, 77 people were denied boarding a flight because of the health screening process. None of the 77 passengers were diagnosed with Ebola and many were diagnosed as ill with malaria, a disease common in West Africa, transmitted by mosquitoes and not contagious from one person to another.

Exit screening at airports in countries affected by Ebola remains the principal means of keeping travelers from spreading Ebola to other nations. All three of these nations have asked for, and continue to receive, CDC assistance in strengthening exit screening.

Original post at 12:18 p.m.: WASHINGTON—The U.S. government will begin screening passengers arriving at five airports from West African countries affected by the Ebola outbreak, the White House announced this afternoon.

The five airports – John F. Kennedy International in New York, Newark, Chicago O’Hare, Atlanta and Washington Dulles—account for 94 percent of the passengers arriving each day from Liberia, Sierra Leone and Guinea, said White House press secretary Josh Earnest. And there are only about 150 such passengers each day at those airports, making it more feasible to screen people more intensively who come from or recently visited the affected countries.

The Liberian man who died of Ebola today in Dallas, Thomas Eric Duncan, arrived from Brussels at Dulles before flying to Dallas/Fort Worth Internatinoal.

“The vast majority of passengers form those countries would be subject to this additional layer of screening,” Earnest said.

He emphasizing that most effective way to stop the spread of Ebola is to stop people exhibiting Ebola symptoms from flying, and that takes place most effectively in West Africa.

“That will counter and has countered the spread of Ebola,” he said, adding that pre-departure screening is only part of the process. Officials at U.S. airports have already been trying to spot travelers with potential Ebola symptoms.

Screening for fever will be conducted by Customs and Border Patrol, Coast Guard and personnel from the Centers for Disease Control and Prevention, Earnest said. And he said, the screening shouldn’t cause any “significant disruption to the broader traveling public.”

He wasn’t sure if travelers with a fever would be put into quarantine. The Department of Homeland Security will provide more details on the new procedures later today.

Duncan apparently had no fever until a few days after he arrived in Dallas, so it’s unclear whether the extra screening would have prevented him from boarding a flight at Dulles heading for D/FW.

Earnest conceded that there’s no way to screen people who are infected before they show symptoms — which is the point at which they become contagious.

“What we’re trying to do is quickly isolate cases of individuals who are showing symptoms” and therefore could spread the disease. “You can’t get it through the air. It’s not like the flu or catching a cold… What we’re trying to do is safeguard the global transportation infrastructure at the same time we’re protecting the American public.”

 

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