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 JFK Airport is the first of five U.S. airports to start enhanced
screening of U.S.-bound travelers from Guinea, Liberia and Sierra
Leone, where most of the outbreak's more than 4,000 deaths have
occurred.
Nearly all of those traveling to the United States from those
countries arrive at JFK, Newark Liberty, Washington Dulles, Chicago
O'Hare and Hartsfield-Jackson Atlanta. The new procedures will begin
at the other four airports next week.
The Centers for Disease Control and Prevention said the airport
screening is just one aspect of an overall strategy to fight the
spread of Ebola.
"Because we want to protect the American public, we are taking a
tiered approach," said CDC spokesman Jason McDonald.
But even before authorities start checking passengers for fevers,
critics questioned whether the screenings would prove effective at
stopping travelers infected with the often fatal Ebola virus from
entering the country.
JFK is the U.S. entry point for nearly half of the roughly 150
travelers who arrive daily from the three West African countries,
and those flights amount to about one-tenth of 1 percent of all
international daily arrivals to the airport, McDonald said.
The Department of Homeland Security's Customs and Border Protection
(CBP) will conduct the screenings under CDC direction, McDonald
said.
Using FDA-approved infrared temperature guns, the CBP staffers will
check for elevated temperatures among passengers whose journeys
began or included a stop in one of the three West African countries.
Screeners will also assess passengers for signs of potential illness
and ask them to answer questions about their health and whether they
may have come into contact with an Ebola patient.
Those with a fever or other symptoms or possible exposure to Ebola
will be referred to the CDC, which will determine next steps. Health
authorities may decide to take a person to a hospital for
evaluation, testing and treatment, or to quarantine or isolate the
patient under federal law, according to the CDC.
"Breaking a federal quarantine order is punishable by fines and
imprisonment," according to the CDC's website.
But U.S. health authorities have never before used fever monitoring
to screen travelers, said Lawrence Gostin, who teaches global health
law at Georgetown Law School, and that monitoring didn't work well
when used in Canada and Asia during the SARS outbreak in 2002.
Fever-monitoring "had virtually no effectiveness," he said. "It is
unlikely to keep us safe."
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Taking over-the-counter medication during the flight can easily help
travelers bring down a fever to evade detection, Gostin said.
Passengers also could lie on questionnaires aimed at determining
whether the traveler has been exposed to the deadly virus, said Dr.
David Mabey, a professor at the London School of Hygiene and
Tropical Medicine. "People may not fill them in very truthfully.
They don't want to be delayed for hours," Mabey said.
Passengers are already screened when they depart from the three West
African countries. In the two months since those screenings began,
only 77 of the 36,000 screened travelers were denied boarding, the
CDC said. Many of them were diagnosed later with malaria, and none
with Ebola.
Thomas Eric Duncan, a Liberian national who died in Dallas this
week, was able to fly to the United States from Liberia because he
didn't have a fever when screened at the airport in the capital,
Monrovia. And he filled out a questionnaire saying he had not been
in contact with anyone infected with Ebola. Liberian officials have
said Duncan lied on the questionnaire and had been in contact with a
pregnant woman who later died.
Both Mabey and Gostin said it was unlikely that a person who passed
the temperature screening at departure time would develop a high
fever during the plane ride to the United States
But Dr. Jeffrey Griffiths, who teaches about infectious disease at
Tufts University School of Medicine, said the U.S. screenings "will
incrementally pick up some people" and are a valuable tool to raise
awareness that early detection and treatment are key to survival.
 "You want to convert yourself to a person who it's caught in early
and increase your chances of making it," Griffiths said.
(Additional reporting and writing by Barbara Goldberg; Editing by
Frank McGurty, Bernard Orr)
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