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U.S. Steps Up Ebola Screening at Airports

U.S. Steps Up Ebola Screening at Airports

By Alexis Simendinger - October 9, 2014

Since the spring, Ebola has killed more than 3,700 people in Africa and counting, and Wednesday it killed the single infected traveler to the United States who slipped past disease detectives in West Africa. The surveillance snagged 77 other passengers and kept them from boarding airplanes. None of those who were detained had Ebola, as it turned out.

The only traveler to date who carried the virus into the United States passed through surveillance nets in two states.

That’s because Thomas Eric Duncan had no fever when he flew to the United States, passing without incident through Dulles International Airport in Virginia on his way to Texas. On travel forms he filled out in Africa, he was not forthcoming about the sickened friends he’d tried to help before leaving Liberia. Eighteen days after arriving in Dallas, Duncan became another Ebola fatality.

Forty-eight people in Dallas remain under medical scrutiny because of close contact they had with the Monrovia native. Their conditions are assessed by health workers daily; they are not yet at the end of Ebola’s 21-day incubation period. 

Those details and others provided by the Centers for Disease Control and Prevention called into question the potential effectiveness of a secondary layer of travel screening in the United States announced Wednesday and slated to begin Saturday at John F. Kennedy International Airport in New York, America’s leading gateway that serves more than 80 airlines.

After passengers clear customs, U.S. officials will check those whose journeys originated in Liberia, Guinea, and Sierra Leone for fever and ask them additional questions about their activities while in West Africa. If their body temperatures are 101.5 degrees Fahrenheit or above -- evidence of fever that could be sparked by causes other than Ebola, such as medication, malaria, and respiratory illness -- they will be detained and referred to health specialists for possible testing.

By next week, the new procedures will take effect at international airports accepting West African travelers in Atlanta, Chicago, Newark, N.J., and outside Washington, D.C. The government estimates that 150 people from the three countries most affected by Ebola arrive in the United States each day, and about 94 percent of fliers from West Africa coming into the country pass through those five airports.

“We don’t have a lot of margin for error,” President Obama warned state and local officials during a conference call from the Oval Office.

The president pointed to Duncan’s tragedy as an exception -- one infected man among thousands of travelers from the affected countries. And yet officials in Dallas have conceded that missteps and misinformation complicated Duncan’s encounter with Texas health care providers and public health watchdogs from the moment he felt ill there.

Wednesday’s high-level White House outreach -- which included information repeated on the phone call by top federal officials -- was intended to impress upon front-line local officeholders and clinicians the urgency of stopping transmission and following Ebola protocols, should another suspected case of infection emerge anywhere in the United States.

CDC Director Thomas Frieden told reporters in a subsequent briefing that “we expect to see people with fever” at airports arriving from West Africa, and he conceded the new precautions will trigger some public confusion and anxiety. Fever caused by malaria, which is transmitted by mosquitoes, “might be a common presentation” among international travelers from Africa, he added, triggering false positives.

American officials, responding to media attention and worries about public and economic overreaction, are working to ward off a rare virus that is harder to contract than the flu, but kills about 60 percent of those it infects.

Frieden sidestepped questions about whether it was the White House that decided to add the new airport precautions in the United States. He did not respond to a question about why the CDC has embraced a layer of entry screening it earlier frowned on, preferring instead to focus resources and effort on intensive exit screening of passengers from key airports in Africa.

The Obama administration continued to oppose a travel ban into the United States from some African nations, believing that pulling up the drawbridge on flights in and out of that continent would only exacerbate the spread of Ebola in the place where supplies and expertise are most needed to stop its transmission. The CDC said the epidemic is worsening in Sierra Leone, and is continuing apace in Liberia, an assessment that underscored the risks posed in countries with fraught governance and overwhelmed health care systems.

“We can’t make the risk zero here. We wish we could,” Frieden said. “We’re stepping up our efforts to protect Americans.”

Alexis Simendinger covers the White House for RealClearPolitics. She can be reached at asimendinger@realclearpolitics.com. Follow her on Twitter @ASimendinger.

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