Prescription for avoiding Ebola airport screening:
ibuprofen
Fri Oct 3, 2014 6:17am BST
By Sharon Begley
NEW YORK (Reuters) - 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, 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."
(Reporting by Sharon Begley; Editing by Michele
Gershberg, Toni Reinhold)
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