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
"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
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
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
[to top of second column]
This process relies on an honor system, 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
"The approach of isolating a country is going to make it harder to
get help into that country," he said.
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
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."
(Reporting by Sharon Begley; Editing by Michele Gershberg, Toni
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