OCTOBER 11, 2014
As Ebola continues to ravage West Africa and fears grow that the virus will spread around the globe, enhanced screenings began on Saturday at Kennedy Airport in New York.
Travelers coming from three hard-hit African countries are being singled out, having their temperatures taken and questioned about their possible exposure to Ebola. Kennedy was the first of five American airports to introduce Ebola screening protocols, and the new measures were the latest indication of the risk that the disease presented.
Airports in Canada and Europe plan to take similar measures in coming days.
But even as nations try to reassure anxious citizens that they are doing all they can to prevent an outbreak within their borders, public health officials cautioned that the only way to truly eliminate the threat posed by the virus would be to defeat it in West Africa.
“As Ebola continues its slow-motion incursion into developed countries, right now the U.S. and Spain, there is an understandable level of fear growing among people about this terrible virus, even though the chances of seeing anything like the calamity in western Africa is profoundly remote,” said Dr. Irwin Redlener, the director of the National Center for Disaster Preparedness at Columbia University and a special adviser to Mayor Bill de Blasio of New York.
While the screenings might catch a few cases, he said, the focus needs to remain on battling the disease at its source and reacting quickly and effectively to new cases when they appear.
The difficulty and complexity of monitoring people without symptoms but thought to have been at risk of exposure to Ebola was demonstrated on Friday night when the New Jersey Health Department ordered a crew from NBC News that recently returned from Liberia to be quarantined.
The crew included the network’s chief medical correspondent, Dr. Nancy Snyderman, who lives in Princeton, N.J. Dr. Snyderman had been covering the outbreak alongside Ashoka Mukpo, a freelance cameraman who was infected with the virus. Mr. Mukpo is being treated in isolation at a hospital in Omaha.
Citing privacy concerns, the authorities declined to provide information about the other crew members who were ordered to be quarantined.
New Jersey health officials said that upon returning from Liberia, the crew members agreed to isolate themselves from the community and monitor themselves for 21 days, the longest documented period of time it has taken for someone infected with Ebola to develop symptoms. “The NBC crew was ordered to be quarantined after failing to adhere to an agreement they made with health officials,” the department said in a statement without elaborating. “The order will be enforced by the Princeton Health Department in collaboration with the Princeton Police Department. The NBC crew remains symptom-free, so there is no reason for concern of exposure to the community.”
A spokeswoman for NBC News declined to comment on the quarantine, but said she expected the crew would comply with the department’s orders.
The decision to screen travelers entering the United States was announced on Wednesday, the day the first person with a case of Ebola diagnosed in the United States died.
That patient, Thomas E. Duncan, traveled to Dallas from Liberia, and like all airline passengers leaving the West African countries at the center of the epidemic — Liberia, Guinea and Sierra Leone — he was screened for symptoms before being allowed to board his flight.
Over the last two months, 36,000 people have been screened in Africa, and only 77 were kept off flights because of illness. Many of the 77 had malaria, and none were infected with Ebola.
Mr. Duncan did not have a fever or any other symptoms associated with Ebola when he left Liberia. He did not become ill until several days after arriving in Dallas.
Under the new protocols, Customs and Border Protection officers have been directed to single out travelers arriving from the three countries based on their passport information.
If any travelers have a fever or other symptoms, or are revealed to have possible Ebola exposure, they will be evaluated by a Centers for Disease Control and Prevention quarantine officer.
“The public health officer will again take a temperature reading and make a public health assessment,” according to the guidelines released by the agency.
In New York City, officials have designated Bellevue Hospital Center as the destination for any travelers who need to be put into isolation. Since September, the city’s Health Department has had the ability to test blood for Ebola and make a diagnosis within four to six hours.
Travelers who have no fever, symptoms or known history of exposure will receive health information for self-monitoring.
Buntouradu Bamgoura, 54, from Guinea, said she was examined by a health worker after arriving at Kennedy on a flight from Paris on Saturday afternoon. “They did take my temperature,” Ms. Bamgoura said as she left the airport.
She said that the examination was not burdensome and that she was not taken to a separate room. “It took like 15 minutes,” she said, adding that she felt fine and was sent on her way with a list of symptoms to watch for.
Beginning next week, Washington Dulles, Newark Liberty, Chicago O’Hare and Atlanta international airports will employ the same screenings as those put in place at J.F.K. About 150 people enter the United States every day from Liberia, Sierra Leone and Guinea, and nearly all of them come through those five airports.
Since at least the 14th century, when the bubonic plague devastated Europe, posting medical officers at a port of entry has been one of the main tools used to try to halt the spread of disease.
An outbreak of yellow fever in 1878 led the United States Congress to grant the federal government the authority to order a quarantine to prevent its spread.
Those powers were enhanced in 1892 to try to prevent another scourge, cholera.
For several decades, starting in the 1970s, the quarantine program in the United States was neglected until another threat, severe acute respiratory syndrome, or SARS, prompted Congress and the C.D.C. to bolster the program.
Ebola cannot be transmitted through the air, but rather only through bodily fluids; people are contagious only when they are symptomatic. There is no vaccine.
Stopping an outbreak requires isolating infected patients, tracing all contacts and then isolating all of those who begin to show symptoms. That process must be repeated until there are no more new cases.