U.S. airports are stepping up efforts to halt the spread of Ebola to America, with major transportation hubs beginning to use enhanced screening for travelers arriving from West Africa — a region that has so far seen more than 4,000 deaths from the disease.
JFK Airport in New York is the first of five U.S. airports to implement more robust measures. From Saturday, people from Guinea, Liberia and Sierra Leone — home to most of the outbreak's 4,033 victims — will have their temperatures taken on arrival. Screening will be expanded over the next week to Newark Liberty, Washington Dulles, Chicago O'Hare and Hartsfield-Jackson in Atlanta.
Customs officials say about 150 people travel daily from or through Liberia, Sierra Leone or Guinea to the United States, and nearly 95 percent of them land first at one of those five airports.
There are no direct flights to the U.S. from the three countries, but Homeland Security officials said last week they are able to track passengers back to where their trips began, even if they make several stops. Airlines from Morocco, France and Belgium are still flying in and out of West Africa.
President Barack Obama said Wednesday that the new screening measures are "really just belt and suspenders" to support protections already in place. Border Patrol agents already look for people who are obviously ill, as do flight crews, and passengers departing from West Africa are being screened.
Public health workers at Kennedy Airport will use FDA-approved, no-touch thermometers to take the temperatures of the travelers from the three Ebola-ravaged countries; those who have a fever will be interviewed to determine whether they may have had contact with someone infected with Ebola. There are quarantine areas at each of the five airports that can be used if necessary.
Health officials expect false alarms from travelers who have fever from other illnesses. Ebola isn't contagious until symptoms begin, and it spreads through direct contact with the bodily fluids of patients.
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."
Taking over-the-counter medication during the flight can easily help travelers bring down a fever to evade detection, Gostin said. Passengers could also 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.