.
10/3/14, "Prescription for avoiding Ebola airport screening: ibuprofen," Reuters, via Haveeru, Sharon Begley
"People who contract Ebola in West Africa can get through airport
screenings and onto a plane with a lie and a lot of ibuprofen, according
to healthcare experts who believe more must be done to identify
infected travelers.
At the very least, they said, travelers
arriving from Ebola-stricken countries should be screened for fever,
which is currently done on departure from Liberia, Guinea and Sierra
Leone. But such safeguards are not foolproof.
"The
fever-screening instruments run low and aren't that accurate," said
infection control specialist Sean Kaufman, president of Behavioral-Based
Improvement Solutions, a biosafety company based in Atlanta.
"And
people can take ibuprofen to reduce their fever enough to pass
screening, and why wouldn't they? If it will get them on a plane so they
can come to the United States and get effective treatment after they're
exposed to Ebola,
wouldn't you do that to save your life?"
On
Thursday, Liberia said the first Ebola patient to be diagnosed in the
United States had lied on a questionnaire at the Monrovia airport about
his exposure to an Ebola patient. He flew to Brussels and then Dulles
airport outside Washington, D.C., before landing in Dallas on Sept. 20.
The
traveler, Thomas Eric Duncan, had no symptoms when he left Liberia, and
fever scans there had shown a normal body temperature of 97.3 degrees
Fahrenheit, U.S. health officials said. He therefore could not have been
identified through examination as carrying the Ebola virus.
His
arrival and hospitalization in Dallas have underscored how much U.S.
authorities are relying on their counterparts in West African countries
to screen passengers and contain the worst Ebola outbreak on record.
Part of the screening burden rests on connecting airports. For
example, Kaufman flew from Monrovia to Casablanca to London to Atlanta.
He was fever-screened in Monrovia and Casablanca, but not London's
Heathrow, he said,
and not when he arrived in Atlanta.
"At
Heathrow, there were no questions about where I had come from," he said.
"I offered the information to the official in Atlanta, and he said,
'Thank you. Be safe.'"
In August, experts from the U.S. Centers
for Disease Control and Prevention (CDC) began teaching airport workers
in Monrovia and other cities in the Ebola zone to conduct screenings,
CDC medical worker Tai Chen said in an interview.
Ebola cases and
deaths have been reported in Guinea, Liberia, Sierra Leone, Nigeria and
Senegal. The World Health Organization has put the death toll at 3,338
out of 7,178 cases since March.
The CDC also worked with Liberian
authorities to develop the questionnaire that was completed by Duncan:
before travelers enter Roberts International Airport in Monrovia they
are asked if they have had contact with anyone showing symptoms of
Ebola.
There are at least two other screening points before a
passenger is allowed to board a plane, with trained airport personnel
asking about exposure to Ebola in the previous 21 days and any symptoms
including fever, severe headache, bleeding, vomiting, diarrhea, and
abdominal pain.
This process relies on an honor system, (CDC's) Chen said.
Officials
at the CDC and the Department of Homeland Security would not say if
they are considering using hand-held fever detectors on passengers
arriving at U.S. airports. But Homeland Security spokeswoman Marsha
Catron said the agency "will not hesitate to execute additional safety
measures should it become necessary."
CDC Director Dr. Thomas
Frieden cautioned on Thursday that a more restrictive approach to travel
could make the Ebola outbreak harder to contain.
"The approach of isolating a country is going to make it harder to get help into that country," he said.
FEVER DETECTION
Virologist
Heinz Feldmann of the National Institute of Allergy and Infectious
Diseases has studied Ebola for years and helped develop an experimental
Ebola vaccine. He told Science magazine in September that airport
screeners in Monrovia, where he spent three weeks, "Don't really know
how to use the devices."
He said he saw screeners record temperatures of 32 degrees C (90 F), which is so low it "is impossible for a living person."
Feldmann
said in an email that according to his colleagues who have returned
from Liberia in the last few days procedures for taking temperatures and
doing clinical checks have improved.
Since August, major U.S.
airports that receive international flights have displayed signs
alerting passengers to the presence of Ebola in West Africa and telling
them to be on the look out for symptoms, said Customs and Border
Protection (CBP) spokeswoman Jennifer Evanitsky.
On Wednesday,
customs personnel began distributing information prepared by the CDC
describing Ebola symptoms and noting, "You were given this card because
you arrived to the United States from a country with Ebola." It tells
travelers that if they were exposed to Ebola overseas, "call your doctor
even if you do not have symptoms.""
.
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