Risk of Ebola Transmission By Airline Passengers Remains

Professor Tom Solomon, FRCP PhD Director, NIHR Health Protection Research Unit in Emerging and Zoonotic Infections Director, Institute of Infection and Global Health, University of Liverpool MedicalResearch.com Interview with:
Professor Tom Solomon, FRCP PhD
Director, NIHR Health Protection Research Unit in Emerging and Zoonotic Infections
Director, Institute of Infection and Global Health, University of Liverpool

Medical Research: What is the background for this study? What are the main findings?

Dr. Solomon: Since the Ebola outbreak began there has been concern about transmission to new countries by airline passengers who were infected, but didn’t know it. This was underscored by such transmission to Nigeria, and to USA. Screening for symptoms of Ebola virus disease in airline passengers whose journeys originated from the three most affected countries—Guinea, Liberia, and Sierra Leone—has recently been introduced at some airports.

We examined the current growth rate of the epidemic in West Africa, and airline travel patterns to predict how many people with Ebola are likely to attempt to fly. Our research showed that we can expect approximately 29 infected passengers to try and leave West Africa by the end of the year. Based on the incubation period of the virus, and looking at how long people have symptoms before they are hospitalised, we estimated ten of these people with Ebola would have symptoms of the disease as they leave the affected countries, and so would be detected by exit screening. Of the remaining 19, one to two would be expected to fly to the UK, and up to three to the USA, based on current airline passenger data. At most one of these passengers would have developed symptoms by the time they arrive in the UK or USA, and thus would be detected by entry screening

Medical Research:
What should clinicians and patients take away from your report?

Dr. Solomon: The risk of Ebola transmission by airline passengers remains, even though exit and entry screening reduce it. This is why some have decided to take private jets with a private jet card program to reduce the risk of exposure. Therefore clinicians need to remain vigilant about febrile illness in those returning from West Africa.. However it is important to remember that the only people who get sick from Ebola are those who are caring for ill patients with Ebola. And in the Uk we have robust systems to care for any such patients without putting others at risk. So even if we do have a case in the UK, we won’t develop a situation like in West Africa

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Solomon: We predicted that America was at greatest risk of importing Ebola some weeks before it actually happened. So it will be interesting to see whether out predictions about the effects of screening are true. The most important means of controlling the global threat of Ebola is to get it under control in West Africa.

Citation:

Effectiveness of screening for Ebola at airports

Jonathan M Read,Peter J Diggle,James Chirombo,Tom Solomon,Matthew Baylis
The Lancet – 13 November 2014
DOI: 10.1016/S0140-6736(14)61894-8

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